Laurie Baedke (00:02.776)
Well, hello, and welcome to another episode of the Growth Edge Leadership Podcast. I am your host, Laurie Baedke and my guest today is Dr. Jillian Bybee. Dr. Bybee is a pediatric intensivist, certified coach, and host of the Humans Leading podcast. She serves as the wellness director for graduate medical education at Corewell Health and Michigan State University College of Medicine.
And is deeply passionate about helping high achieving professionals create more sustainable and fulfilling lives and careers. Jillian is a returning guest and someone I've had the privilege of knowing through our shared interests in leadership, well-being, coaching, and helping others grow. And I am so excited to welcome you back to the show. Jillian, welcome back to the Growth Edge. I'm so excited to chat again today.
Jillian (00:49.692)
Yeah, thank you so much. It's such an honor to be back and I can't wait to have this conversation.
Laurie Baedke (00:55.342)
Well, you know, you speak and teach and write and post so much about resilience and well-being. And you've shared really publicly about recovering from burnout twice and your journey through that in it in medicine. Looking back now, how much of that journey was about changing your circumstances and how much of it was about changing kind of your thinking?
Jillian (01:22.974)
Well, I bet some of the listeners out there would like me to say that it's all about changing your circumstances. But I can promise you that that's not true, which you already know because you coach people and you have these same conversations. So I think the first time I had burnout, I was a pediatric ICU fellow. I also had depression along with that. And so I went to therapy, I got help, and I was so excited to graduate because I was like, bye fellowship.
See you later. All the problems are here in the fellowship program, and I'll go to my next job and everything will be great. And that was true for about two years. And then some of the things that I had brought with me, like my own perfectionism and workaholism, and you know, trying to achieve to get a sense of self worth, I learned I had brought all those things with me. And so it was really through coaching, which is what we'll talk about.
It was through that coaching process that I got to see how those things were impacting what I did. And sure, there we know things in healthcare are related to systems, but we're so quick to blame the systems and to try to take any ownership off ourselves. And I think what I've learned over time is it's both of the things together have to be worked on in order to make an impact.
Laurie Baedke (02:46.135)
makes so much sense. And when you made that one statement when you said you graduated, you were of course referring to graduating your fellowship and starting your career in medicine. But I think it's also real that we can tend to think if we are being coached or if we are in therapy for a season that when we graduate from that, that things will change as well. But that's of course not real either, is it?
Jillian (03:10.98)
No, it's not. You know, as a recovering perfectionist and a high achiever, I would love it if things came with a certificate and I could just check the box like healed, done forever, and move on to the next thing. because there's always somewhere I feel driven to go or something else I feel like I need to be doing in my career. But it turns out, like you're saying, that that is not a place that you arrive at someday. It's this process that you have to relax into and
suddenly you have to accept the fact that probably the things that you are working on now will be the things that you'll be working on forever. It will just be easier for you to notice them and to get out of those unhelpful patterns once you recognize them.
Laurie Baedke (03:55.286)
When you think about both your journey being coached, but then also pursuing coaching certification and being someone who in invests in coaching others, can you think of a specific coaching question or framework that you've been asked or that you reach for in your coaching relationships that really either stops you in your tracks or tends to be the framing that changes things?
Really effectively.
Jillian (04:26.216)
Yeah, one of the coaching questions I got asked that really made me angry, which is a good sign that they're on to something that is deep, was actually by someone who was in my coaching class cohort when I was getting certified. And I was talking about how I was balancing two different leadership positions and also this coaching cohort and a full-time clinical job as a pediatric intensivist. And I was talking about
all these meetings I had on the Monday following our cohort. And I just, you know, was deep in it. So I was explaining like, ugh, I'm resenting these meetings. And talking about how I thought maybe I should either move the meetings or tell the people who are there, you know, I don't have the capacity to come because I need this day off for myself. But of course there was a little voice in my head saying, you couldn't possibly do that because they'll all have these opinions about you. And he asked me the best
Worst question, which is what is the cost to you of not moving the meetings? And I was like, that is so annoying that you've said that. because the cost was clearly my own well being, my own sanity. And I was like, yes, obviously, if I don't take this time for myself, if I don't tell other people what my needs are.
Laurie Baedke (05:37.197)
Mm-hmm.
Jillian (05:52.971)
then I can't possibly have them met. And so I did that. It wasn't a big deal at all. This group of people that I work with are amazing. And a lot of times people want you to be your best self. It's just that we have to own what's going on inside of us and we have to let go of the stories that we manufacture. And so I use that question a lot with my coaching clients now. I had someone the other day who was really focused on.
How her workplace is not listening to her suggestions about the workplace. And I think that can be such a common thing for all of us, whether we work in healthcare or not. And she was going on and on and on and on about that. And so I said, What is this approach of, you know, being fixated on that outcome costing you? And she said, My sanity.
And she's like the fifth person recently who said that sanity has been the cost of the thing that she was fixated on. And so I think when we start to think of things like that, what are these behaviors and patterns and thought processes? What are those doing to us? When we can actually be honest, especially with a coach and say, here's the real answer, it lets it land in a way that we can't hide from it anymore. And I think that's the really valuable part is a being able to
say it, but then also in the coaching relationship to not have that judgment coming back at you. Because we judge ourselves, but as coaches, we don't judge the fact that person is having that experience. We say, good for you, you've had this self-realization. And now you can move forward from a place of agency.
Laurie Baedke (07:33.346)
Man, I I like that a lot. But I really relate to your comment about how those questions that get asked, it's like that mirror that gets held back up to you, can really bristle us and cause the prickles or the hackles to come up within us because there's really no hiding from it. But it's also then effective or functional to help us to realize the impact or consequence that that.
That our actions or our beliefs have.
Jillian (08:07.09)
Yeah, I think often we're going along in our lives, especially as busy people or leaders, just doing, doing, doing. We're humans doing things. And that puts us in this cycle of revved up stress state, no time for myself, no time to stop and think. And everything feels like an emergency. And that's been the thing for me. I work in a place where there are actual emergencies.
At any time of day, an alarm could go off and I could have to run to emergency. But do you know how many times a day that happens? Not that many. Sometimes it never happens in a day. And so our job is really to be able to put ourselves in places where we can have that pause. And I think that's why coaching is so effective, especially for high achieving people and for leaders, because you need someone else to call you out or hold that mirror up for you because you're not going to do it for yourself. You're just like
Keeping the thing moving.
Laurie Baedke (09:05.613)
And you know, you just mentioned high achieving professionals. When you identify as a high achieving professional, you can wrestle with perfectionism tendencies that you alluded to earlier. Many high-achieving professionals suffer from people-pleasing tendencies. And another one that's really common is a proclivity towards self-sufficiency. And I'm curious, Jillian
any of those, but maybe if specifically self-sufficiency, what have you learned about the limits that even the most intelligent and effective and organized high achieving professionals have on figuring everything out on our own?
Jillian (09:50.205)
You know, I relate to all of those. Obviously, I said perfectionism. I definitely have people pleasing baked into the way that I was brought up and also into just, you know, being a woman in this world. But I think the self sufficiency part really was something that started early for me. that was the way my family was. It was like we pull ourselves up by our boot bootstraps and we just keep moving.
I'll give you an example of how that started. I was doing work on my grandparents' farm when I was younger. And you know, I was pruning. They had a Christmas tree part of their farm, and I cut my arm open. And so I put a band aid or I put a rag on it that was dirty, and I was walking back to the house to clean it. And my grandpa passed me on the tractor and he looked down and he said, Where are you going? And I said, You know, I've got an injury. And he goes, pruned the wrong limb.
And then he just kept driving. Like he wasn't interested in me or my injury or wondering how I was. I must have been okay because I was walking myself of my own accord to the house and he knew I would come back and just get back at it. And so that's the way I grew up was like you just get back into it. And I think what I learned with depression and burnout is I could take myself to the hospital. I took care of patients, I showed up every day.
But I wasn't doing it effectively. And then I couldn't make progress on other things. And so that was the first time I had to stop and realize I need somebody else to help me with this pattern. because I can't see it all for myself. So maybe somebody else has some different knowledge. But I think that also is a trap because we often then think, I get it. I can information all of the thing.
I can get all of that. I can achieve it. I can absorb it. and we confuse the fact that like the answers are not outside of us, they're inside, and so we actually have to be able to sit with that. And that's the most uncomfortable thing is you need somebody to sit with you. And often for you when you first start out, that is not you because your inner critic is like going a mile a minute about how weak you are or how flawed you are.
Jillian (12:12.142)
Or how you should just pick yourself up and keep going. And luckily those other people that are out there can be like, No, probably not the best strategy. Or they don't even have to tell you that because they can ask, How well has that strategy gone for you in the past? And you could be like, Well, that's why I'm here with burnout. I has not gone well at all.
Laurie Baedke (12:34.123)
Or I was just in a coaching conversation a couple of days ago and super high achieving, very well-respected female physician leader, and naturally, like so many of us do, wrestling with thoughts about imposter phenomenon, right? And one of the questions I asked her was, what evidence do you have of that? Right? And is there objective evidence? Do others
see or perceive you or do any of the metrics of the outcomes that you've been achieving support this story that you're telling yourself and this narrative about you know something. And I I just think, yeah, when we think about and and I was I was just gonna ask you a question about the the role of reflection and rumination, right? Because you and I both
Jillian (13:25.758)
Mm-hmm.
Laurie Baedke (13:28.351)
One of the things that I adore about you and one of the reasons why I'm so grateful to have you as a friend is that you're a fellow introvert. And as an introvert, what has coaching or your journey taught you about the difference between reflection and rumination or perseveration and their roles in our in our self talk and learning?
Jillian (13:48.361)
I think that's such an important question because as a person who can get stuck in my head and in thoughts and in cycles, I think that's where the ruminating is. So when you find yourself going over and over and over, right, that's the definition of its insanity, doing something over and over again and expecting a different result. When you're in that loop, you don't have any space for anything else. But a lot of us try to make decisions out of that.
rumination path. And so one of the things that's been really helpful for me is I've been meditating for 10 years. And you know, it's funny when people hear about that because they're like, you still have this intense part of your personality. You still, you know, rise to challenge in the ICU. You do all these things. And meditation doesn't make you better at the meditating part of it. It doesn't take you make you a completely calm person with none of the same things that you had before.
It just allows you to see those patterns for what they are. And so there's this meditation teacher I really like, Joseph Goldstein, who when you're going around and around that ruminating path, one of the questions he asks, that's like a coaching question we can ask ourselves is, is this helpful? And I was like, No, almost never is it helpful to be stuck in that pattern of worry and rumination. And so when I feel the frantic energy of it.
That's when I know that it's not something helpful. When I'm thinking, huh, you know, a code happened. How was my behavior? What could I have done better? How could I have communicated more effectively? Did I, you know, recognize everybody's roles? Did I think of everything I needed to in that scenario? That is reflection. And that is the helpful part because I can actually do something about that. If I notice, okay, in this scenario, I didn't do X behavior.
I can do it next time. Or I can ask other people, how do you feel like that went? How was I? What can I do better next time? And I think that's the power of actual reflection is where's a gap? How can I address it with a behavior? Whereas rumination is just frantic stagnation that it's not really helpful for you.
Laurie Baedke (16:08.413)
I like that a lot. And of course, you work in an academic setting. And so you are interacting with trainees and senior faculty, junior faculty. What has coaching taught you that has shaped or reshaped the way that you show up in an educational or an academic environment?
Jillian (16:29.96)
So the first time I had a coach of my own, I was in an executive leadership course. It was a little bit after that period of burnout early in my career. So the second time. And one of the things that had come up on my emotional, social competency inventory was the way that I am with other people. And so fellows and nurse practitioners and nurses were rating a lot of behaviors high like empathy and other things, but sometimes other people.
weren't. And I think what I started to learn was that was because I was showing up as my stressed self with them. And in some ways, we need a place where it can be safe for us to show up like that. But obviously when we are reactive, when we don't have insight into our behaviors, that becomes unproductive. And so with this coach, she had me do the most simple exercise, which is every day for a week while you're on service in the hospital, write down
All of the times you become frustrated. What's happening? Who's there? What time of day? And then the most helpful part that was so annoying was have you addressed your own needs? And of course, like everyone in healthcare, and I can see in your face, no, of course I haven't addressed my own needs because it's always in the afternoon, it's always after I've skipped lunch or rushed into something. And I thought,
I am part of the problem. It's not just the healthcare environment that is set up to make us feel like that. And I don't want to take away from the fact that that is true. Our work environment benefits from the fact that we have been taught to self-sacrifice, to not recognize our own needs. We've been told it's altruistic. And in some cases, like it's an emergency, I don't even notice that I'm hungry because my immediate need is to attend to the patient.
But get getting back to like I said, if you are not having an immediate need of being needed, it's just that chronic address, unaddressed stress that is getting to you. And so that's what a coach helped me with is here's how you can start to notice these things. And that's really the process of embodying myself again. And then that allowed me to come back into the environment and think, if I've been rounding for a long period of time.
Jillian (18:56.25)
Maybe I need a snack. Maybe I need a drink of water. Maybe the other people on my team need these things too. And so sometimes when it's really busy, we don't have time to stop rounding because there's too many patients. There are too many things to do. And so what I like about our group is often we'll be like, Hey, you need to go have a snack or you know, go to the bathroom, get a drink of water, and we take
shifts doing those things because you can't all do it all at once. sometimes there is work to be done, but you can recognize the fact that everybody there is a human being, including you, and everyone deserves that. And not only do you deserve it, it makes your care for the patients and their families better. Because you actually have glucose going to your brain to help you make the decisions.
Laurie Baedke (19:45.262)
That is such a I understand the irritation, but it's it's data collection. And until you take that banal process, undertake that ban banal process of like writing it down, documenting, journaling, and then looking for the through line to say, what's the common thread? What do the data tell me about? okay. Well, if we don't know it, we're gonna continue to repeat the same process or allow the same
infrastructure or system to exist that's getting the exact same result or output. And isn't it it's it's always so frustrating to realize you can have the most intelligent individuals and some of the most effective, air quotes effective systems, but that are producing suboptimal return or causing maladaptive behavioral responses until
We have the fresh eyes or the process to see it and become aware so that change can actually happen.
Jillian (20:49.672)
Yeah, I think that's so true. And then the thing I'm always met with is, well, my system doesn't allow me to do that. Or how do I get permission to do that? Or how no one is going to bestow upon you the permission to do it. It is a benefit or a perceived benefit to systems for you to go and go and go. And clearly, like you're saying, that does not put the patient at the center. It does not put the care at the center. But that is unfortunately the way that healthcare has been set up.
And so it takes those of us who understand the broader context and who understand what a benefit it can be to be like, no, I'm having five minutes. There was a time you know, people ask, How did you get this knowledge and give yourself permission? And honestly, I'm not some enlightened being. It took being pregnant for me to be able to prioritize myself because it wasn't the burnout, it wasn't the depression.
It was the fact that there was another living person whose life I literally had inside of me, to say, I am going to be late to this sedation case because we have worked through lunch and I am going to go eat lunch. It will be fifteen minutes and I will come back. We will start ten minutes late. And everybody I think got from my energy, she's serious. Like, and I think
I just had to let go of the fact that I was going to be perceived as a person who was a human who had needs. Maybe someone would think I was high maintenance, but I just had to stop caring eventually. That my priority was not make everything on the clock work perfectly. It was make my body run, make sure the baby's okay, and then provide better care to that patient afterwards because I had actually eaten.
Laurie Baedke (22:45.857)
No, I there is so much within our structures and systems and and organizations, there is fairly limited autonomy and agency. But yet if we just completely step back and don't take anything, the system will continue to exploit. And I don't say that to insinuate that systems are set up to exploit. And I I I want to be clear because there are amazing leaders and amazing systems. There are some.
Jillian (22:54.333)
Mm-hmm.
Laurie Baedke (23:15.277)
Toxic leaders and toxic systems that exist. And unfortunately, you have to see them for what they are. But by and large, there are good leaders and good systems. But until we take whatever tiny minute amount of agency that we have or need to say, five minutes, need a little sustenance, must have a bio break, right? Have to catch my breath so I can reset my brain to come back effectively.
And I'm curious whether it's that or maybe it's something entirely different. Now that you've been coaching and you've coached many physicians and leaders, Jillian, at this point, what patterns have become impossible for you to not see?
Jillian (23:58.803)
I mean, some of it is unfortunately the blaming in the face of feeling like you don't have any agency. And I think a lot of people mistake agency with being right all the time or always being listened to. I think this is something I see in myself. that person doesn't care about my opinion. It must not be valuable because they don't do exactly what I say. And I think
The more and more I've risen into leadership and also coach with leaders and observe leaders, clearly there are a lot of priorities that you're balancing. There are a lot of things that you're trying to do. And so it can be really hard for you as a leader. And so I have a lot of empathy for them, especially when I go talk to them. And I think that drives some of my frontline colleagues nuts because they would like a place to put blame. And so
I don't think you have to blame yourself, but I think you can also start to take back your power and say, I'm in the driver's seat of my life in these ways. So I can choose to go to the bathroom. I can choose to have a snack. I can choose to bring myself to work in a way that is beneficial to the team. So I think that is what I started doing when I was getting started in this process of my career is
As I was changing myself and as I was doing things, I could then bring myself more effectively into the workplace. And it changes the way that you speak with people. You're no longer attacking them that they should be listening to your answers. You're having in a more effective and collegial conversation where you're saying, here's an opportunity that I'm seeing. Here's a path that we might be able to do that. And here's how it might benefit the system and the people that work inside of it.
Laurie Baedke (25:57.43)
I agree with that wholeheartedly. And I also am just hearing so much evidence of your coaching training because so much of coaching is just about asking really good questions, right? And not making assumptions, but rather just asking people questions to guide them to their own discovery of a solution or an answer they have inside of them, but also just to kind of peel back the layers of the onion. And so often the right or best solutions.
Absolutely exist within us, but maybe there's a preconceived notion, maybe there's a perceived lack of agency that we have, or there's some, you know, narrative that no longer serves us that by someone asking you qu questions can really walk you to something that you know is so self-empowering because you had the answer inside of you. It just took curiosity and and a moment of patience or or active listening.
Jillian (26:55.378)
Yeah. And I think that the other part of that is that coaching can be really helpful when you're learning the skills of deep listening and asking better questions because it also lets you have those conversations more effectively. It's kind of like a little mind trick when sometimes I sit in a meeting and I hear people fixating on X solution or something that doesn't sound like it actually has what we value or our true priority at the center of it. We've gotten off track.
And instead of, you know, declaring that at somebody and saying, You're doing it wrong, that's not in line with our values, why don't you and blaming, you can ask, I'd just like to be clear, how does this serve X goal, whatever it is? And then a lot of times that stops the meeting and it's like a record scratch and everybody stares at each other because they have gone off down a different path. And so I think that's some of the ways that you can
you know, gently disrupt in systems is to refocus on goals because we're very busy and a lot of what the talking that happens is well intentioned, but you end up somewhere different than really where you're trying to go.
Laurie Baedke (28:09.197)
Yeah, I I agree with that. And it makes me curious. You've been leading in formal well-being roles now within your organization for quite some time. What is your opinion or assessment of where healthcare gets well-being right and where do we still tend to misunderstand it?
Jillian (28:32.296)
You know, I am fortunate to work in a place that has really tried to see the fact that healthcare worker well being is system plus individual factors. Because I think a lot of healthcare systems are still in the you as the healthcare worker, whatever type you are, whether you're clinical or not, should be taking control and
you know, there's nothing we can do as in an organization. It's all on you as a person. And so that is a huge fail. That's not what the data show. We know that that does not lead to people feeling like they belong and people leave those toxic environments. So toxic environment equals individual only. I think though there's still people who don't understand that like well-being is a leadership behavior and they don't understand wellness-centered leadership.
And the middle of wellness-centered leadership is caring about people as people. People are first. And the people who also matter are the leaders themselves. So what I often see is leaders telling everybody else that they should be utilizing the well-being resources. You should go to do this. You should go to do this. But they're skipping meals, they're sending emails at crazy hours, which I send because I'm on call sometimes at crazy hours.
But these are people who are not supposed to be awake at this time. But other people feel like they then need to do the do those behaviors, and no one is utilizing the resources. This is especially true in graduate medical education. I have to continually tell program directors no one cares what you have to say about our employee assistance program. If you've never gone to therapy, you've never utilized a help resource, if you can't speak to why it's helpful.
Because just telling people to seek help when they need it does not actually make them do it, especially if they don't feel like you're a safe person or you would support them in doing that. So get to know the resources in your own organization is the thing that I always tell leaders. Because when I go talk to trainees, like I did this morning for our system orientation, I can say, yeah, when I called our employee assistance program, this is what the process looked like. It took five minutes.
Jillian (30:49.798)
And here's why I used it for my work related stress. And it was great because it was free or whatever. it you just have to be modeling those behaviors for yourself. not only for the people, but also for yourself, because you deserve well being as a leader.
Laurie Baedke (30:59.341)
Yes. Yeah.
Laurie Baedke (31:06.487)
Yes, yes, absolutely. And I think just leadership by example is the best leadership. Not only does it make you a consumer of the resources that are available and allows you to make sure that you're assessing for how could it be optimized and refined and improved in an iterative way, but also it tamps down any stigma or barrier that might exist between that trainee or junior faculty member or someone who
who doesn't feel like they have as much formal authority or position to realize, if Dr. Bybee said that she, you know, does X, Y, or Z, it must be okay, I can follow suit.
Jillian (31:47.281)
Exactly. And I think, you know, one of the other things that can be really helpful that my organization is doing and others is having a coaching program. But I wanna caution people that that's not the be all end all either, because as you and I talked about on the last time I was on, people have to be willing to be coached in order for coaching programs to be effective.
Because you don't get anything out of coaching if you don't show up ready to play, ready to admit the fact that you have areas of opportunity for growth. And I think what I see a lot of times is we as high achieving people unfortunately have to come to that reckoning by being brought somehow to our knees. We don't go easily into believing that we need to make change. We have to have whatever that
formative explosion is and then we're like, okay, now I'll really try anything.
Laurie Baedke (32:46.517)
Goodness, agree. Well, our time has gone way too fast, but I have one last question that I want to aim you toward. And that's just, I mean, you've spent years now being coached and coaching others and leading physicians, recovering from burnout, you're raising a family, and and I see a meaningful career. What do you understand today about being human that you wish you'd known earlier?
Jillian (33:12.808)
Think there's so many different ways that I could go. And you know, I'm in the practice of trying not to dump on the former version of myself because I think that's a tendency that I have. but I think understanding that those human imperfections I have, the reason my podcast and blog are named Humans Leading is because we have to embrace those things. And I may have still come to the same point where I needed that reckoning for myself.
to be able to rebuild on the other side of it. But I probably could have been nicer to myself along the way for not beating myself up for needing help or not being able to do all the things that I set my heart out to do because I have learned that I am always going to make more things on my to-do list for myself than I'll ever have time to do. So I could have been nicer about that.
Laurie Baedke (34:07.969)
Well, and I think that there's no better point to land the plane on than that one because I think for every single person listening, and I know it's true for me, the way that I think about myself and the way that I speak to myself is probably the most harsh and unkind narrative that ever I'm around or or or or give to others. And so I think we can all take a lesson from you today to give ourselves more grace.
be kinder to ourselves because that in and of itself is great medicine for ourselves. But it's also, again, because we're setting the example for so many others, if we're giving evidence of that in our homes and in our workplaces, there are other humans who are taking their cues from us. And I know the people that I love the most and I don't want them speaking to themselves as harshly as I occasionally speak to myself. Would you agree?
Jillian (35:01.358)
absolutely. I have the loudest, meanest inner critic and I she has a name, but I feel like she'll be with me forever. But I like her to stay inside now. She's an inside voice. We can just, you know, give her a cup of tea and a biscuit and just set her over there because she's not driving my life anymore. And that is a really freeing thing, not to have to feel like you are driven constantly by the criticism that will still inevitably, as you said, come up.
Laurie Baedke (35:32.973)
Well, Jillian, thank you so much for this amazing conversation. Thank you for the work that you're doing. I will put links in the show notes to where people can follow you on your Substack and on social media. And I just appreciate you deeply. Carry on, my s my friend.
Jillian (35:48.36)
Thanks so much for having me.
