Well, hello, and welcome to another episode of the Growth Edge Leadership Podcast. I am your host, Laurie Baedke and I'm excited to be joined today by a new colleague and friend, Dr. Jessica Bunin Dr. Bunin is a retired Army colonel, critical care physician, psychiatrist, and certified executive coach with more than two decades of military service. She's a graduate of the United States Military Academy at West Point and Tulane University School of Medicine.
And she completed her medical training at Walter Reed Army Medical Center. Over the course of her career, she has directed ICUs, residencies, and fellowships, and served as an assistant dean for faculty development and professor of medicine at the Uniformed Services University of Health Sciences, delivering hundreds of leadership workshops. She deployed to Iraq as a psychiatrist and to Afghanistan as an intensivist, which is just one of the tiny wrinkles.
of interest that I've enjoyed getting to know about Dr. Bunin. She now brings her background in psychiatry, critical care, and coaching to the work of developing healthcare leaders and improving healthcare systems. And her first book, Self-Awareness and Trust Leading Healthcare Teams from the Inside Out, is set to release this Friday as we record today. When you're listening in a few weeks, it will already be on the shelf. And I am so looking forward to chatting about it with you today, Dr. Bunin. Welcome.
Thank you. Such amazing timing for someone who has a book that I have revered for years now to be the week that my book is coming out. It's amazing to be here.
Well, Dr. Bunin, we have so much ground that I'm hoping to cover, and I'm crossing my fingers and toes that we'll get through all of the goodness, but let's maybe start with the story behind the book. You've held some really remarkable roles, as just alluded to in your introduction. What finally convinced you that this was the book that you needed to write?
Yeah. The book began percolating, I would say for me three years ago, without me realizing it honestly until about eight months ago. But three years ago, I was the dean for diversity, equity, and inclusion at the Uniformed Services University. And I was pulled into a student conflict where two of the student groups could not communicate with each other, refused to talk to each other, even in professional settings. It was terrible.
tried to solve it on my own accord and could not. And so took it to a dean staff meeting. And really quickly, everyone in the room said, well, they're not learning how to have good conversations across differences because we're not role modeling how to do that, because we've gotten out of practice.
We've done a lot of virtual education, we've been out of the offices, we haven't had the meaningful conversations and the coffee talks and the lunches and dinners that we used to have. We've fallen out of practice and we're not role modeling it. So that resulted in the creation of a curriculum called Community Building for Civil Discourse. David Acosta at the American Association for Medical Colleges and all of my colleagues in the Healthcare Diversity and Inclusion Certificate program.
helped me create this curriculum. And as I was doing it, I was learning about restorative justice and civil discourse and reading tons and trying to put it all together. And the dominant feeling I had over and over was that this needs to get out.
This isn't a problem at our medical school. This is a problem at all medical schools and everywhere across the US. This is a problem in other industries. This is a problem in households. This is a problem everywhere. And we need the tools out there for people to start working on this if we're gonna recover from the conflicts we're currently in.
Wow. Yes. So it's unfortunate that we're not going to get to talk about the book's content at all. I'm kidding. That's clearly the foundation of the book, but I I just could not agree with you more. It is, it's missing everywhere. And it is so tempting to focus on the tactical or technical things, isn't it? And and just kind of leave those messier gray spaces that you just described alone. And
We do it at our own peril.
Yeah, yeah. Over and over again, we do it at our own peril. Particularly, I think, in healthcare and medicine, we are taught to know our art. We are taught to know the physiology, to know how to do the procedures. And as leaders, we're taught to know how to do a budget and to understand your resources and to use them effectively. But we're not taught about how to have those conversations without someone.
Yes.
Mm-hmm.
taking it personally or landing harshly. And and that's where the problems occur is when we're not having communications with people, like they're the other human who needs to know the full story. And like there are people who have emotions and feelings that are going to stay if we don't take care of.
Yes.
And stepping into the reality that regardless of who we're speaking to, there will be some element of diversity at play. If if we're a gregarious extrovert speaking to a it you know, an introvert, if we are of a different generation from someone else, of course, all of the factors that
All of the different nuances. If we're very tactical and operational and we're talking to someone who's a big idea person, just think about all of the ways that we're diverse. And we step into the tension of I might say something wrong. I might say something that gets misunderstood or misinterpreted. I all of these realities keep us in that quote unquote safe zone of let's just stick to the black and white, right? And then not ever address.
Which just builds so much bloat and bureaucracy and so many barriers between meaningful human interaction and connection.
Yeah, and I I think this has been a huge deficit for all diversity and inclusion conversations, is we have this impression that you have to say things correctly, or you're going to be ostracized, or you're not going to be given another chance, or someone's going to hate you. And it's just not true. If we can go into conversations meaning the best, having positive intentions, having positive beliefs of the other person we're in a conversation with, we can over.
Yes.
Anything, but we can't overcome ignoring a situation. It just causes resentments that grow. And unless we try to have the conversations, we're not gonna get past that. And so I think if we take the time to understand what our intentions are, but understand that our intentions are not how others may experience us or it our impact may affect them.
Yes. Yes.
Yes.
If we can honestly approach that and think about how do I have those conversations where I apologize but don't over apologize, where I change my behavior but but don't make it seem like I'm doing it because of them, but I'm doing it to be better. All of those things I think go into that conversation.
no.
Absolutely. And that really plays through to trust and trust and it's building and it's, you know, its decline and then it's restoration. But you also wrote extensively in your book that leadership fairly that you also wrote extensively in your book that leadership failures are rarely technical. They're almost always relational. What in addition to what you've already described, what convinced you that that's true?
Yeah. Well, there's a couple of things that have happened to me personally in my life that made me believe that. One, in my second year of residency, I had Hodgkin's disease. And I spent a year in and out of the hospital and chemo and surgery and radiation, all the things. And one of my program directors never came to see me, never reached out to see if I was okay, never checked to see when I was coming back. And
Despite any positive effort after I did come back, I couldn't overcome that in myself. I couldn't change the way I felt when I felt disregarded because I wasn't a contributing member of that team at that moment. and so that was a perfect example for me. This guy was great at running his program. He knew his people inside out, he knew what he needed to do, he needed knew the double AAMC requirements and the GME requirements, he could do it all.
But he wasn't taking good care of his people. And it changed how I would go to him for advice in the future, which I didn't. It changed what information I would trust him with. And I and I didn't. And so that small example of what I needed in that relationship was a huge factor for me. The other place where I see this play out over and over and over again is in the context of running meetings, whether that's a one-on-one meeting or a group meeting.
If we go in and take the time to attune to the person across from us or attune to the people in the room and understand the emotional context and know what we're going to talk about and approach it from a relational perspective where no one is surprised by the information that comes out, no one is caught off guard, no one is embarrassed. If we can approach it with thinking about how are the people in this room going to perceive that, we can overcome any technical deficit.
But if it happens the other way around and we jump in and we surprise people or we tell them bad news and we haven't created the groundwork for that, we can't overcome the loss in relationship after the fact. So I think we can overcome the technical deficits. I don't think we can overcome the relational deficits.
And I I just I I think that's such a powerful principle. And I wonder if you have incorporated that into your coaching practice as well. I I know I certainly have, and I can think as recently as two weeks ago. It's a piece of coaching advice that I gave to one of my clients who works in academic medicine. He was preparing to meet with a higher level finance executive a couple of days following our conversation. And he really had never worked with her yet. And he has an impression of her, but he was.
apprehensive about how that conversation was going to go because there were for some some really meaty stakes to be had from you know their conversation in terms of budget and resource allocation. And my encouragement to him was quite simple. It was just really to take a very small moment at the beginning of that conversation where they would be meeting in person for the very first time and just bring curiosity, make a connection. And he reported out
Last week that it went so very well. And the whole posture and demeanor of the meeting was very different from what he read in her as he walked into the meeting room. Her posture, her stance, she was fairly guarded. And he just thawed through genuine connection or curiosity, the ability to kind of establish rapport and camaraderie that removed some of the friction from the rest of their short meeting and will probably.
Help them to gain traction on a meaningful collaboration going forward. But is that something that you also reach for in your coaching practice?
Yeah, there's two things about what you just said that are are really important to me. The first is that exactly what you described was you being his feedback partner. So you could help him before he ever went in that meeting to plan and to practice and to role play and to think about the consequences. And that is something that I advocate for for everyone to have a feedback partner not only for before you go into, but then to meet with afterwards.
marinate the information between the two of you, figure out what to do better next time. So I think that feedback partner, whether it's a coach or whether it's a peer, that's essential. And so I always make sure to ask folks, who's your feedback partner that you're going to work through this with? And if that's me in that context, that's great. But sometimes they need to have someone who understands the context maybe better than I might for their particular situation.
The other thing that I think is key is understanding everyone who's going to be impacted by a decision you make and doing the pre-work before the engagement to make sure that everyone understands the decision that's going to be made, why the decision is going to be made, have their perspectives ahead of time. So again, no one is surprised or harmed in the actual interaction
I couldn't agree more. And so much of that is it's intensive work. It's it's some of that sweat equity that we have to invest as leaders in over-communicating, being thorough and intentional in prepping for, then executing, and then managing after conversations, meetings, decisions, so that you're carefully stewarding the entire process and not putting an over-emphasis on one meeting where
We should be able to check every box, right?
Yeah, hundred percent correct, Laurie hundred percent correct.
Okay, so when I cracked your book open, it opens with a story from the ICU where you recognized that you were too fatigued to put in a chest tube and you asked your nurse and your resident what they thought. It was raw, it was candid, it was vulnerable and courageous, but it probably saved a life. Why do high performers often have the hardest time recognizing when
They're impaired.
Yeah. I'm gonna I'm gonna take this a step further than than just high performers and put it really in high performers and healthcare, because that's what I understand intimately. And I think that this carries over to every other profession, but I don't know the data there. But what I can tell you is that medical school in particular and healthcare professions overall attract service-oriented perfectionists. Right? We attract that.
And then we have data that shows us that four years later, those folks are even more perfectionistic. And often there's been this shift over time from when they came in, they had adaptive perfectionism, meaning they held themselves to high standards. They worked until they achieved those standards. And then they shift to this idea of maladaptive, where now they have to prove themselves to everyone else and they can't make a mistake or it's going to affect.
where they go to residency or their next evaluation or their next step in training, whatever that might be. And so we take folks who, you know, we're perfectionists, but but we're doing a good job maintaining it, and take them to this place where it becomes harmful for them. And I think a lot of that starts
In your academic courses, but really day one, the very first time you round in a healthcare setting, you are told that you need to have the facts and the answers. You're not supposed to be there to have questions and uncertainties. And so it's driven into us over and over again that we have to have the right answer. And you can't show insecurity or uncertainty, or people will think that you're incompetent. And it's just not true.
People really appreciate it when you can say, wow, I don't know the answer to that either. Let's figure it out. Or if you can say, wow, I hadn't thought about it from your perspective. Let's reevaluate it from that perspective. It it adds so much respect to the relationship. And it doesn't take away the idea that you're competent at all.
It just makes it a more collegial relationship instead of it being this hierarchical strategy that can be really challenging.
I just totally agree. And when we lead by example, especially if and when we have any measure of privilege, if you're an attending physician in that circumstance, you hold privilege in the hierarchy over a nurse or a resident, right? And they're looking to you, your demonstration of vulnerability or fallibility, and inviting others to collaborate with you and cover a blind spot.
Or perhaps, you know, say, no, Dr. Bunin we we're worried Like let's bring someone else in, right? those are such vital moments where we can then also create a culture where someone else feels safe to acknowledge in the future when they in fact are feeling a little bit uncertain or perhaps a little bit at risk in a moment and
That measure of privilege is so important. But I also love what you talked about relative to the maladaptive behaviors that perfectionism and we tend to look at that and kind of put it on a pedestal as as as laudable. And there's a lot of value that comes from high standards for excellence. But none of us are robots, right? And none of us get to bat a thousand. What's the cost when leaders never down regulate?
Yeah. Well, I think we have this perception that more hours in the workplace shows your motivation and commitment. And we send the wrong messages to all of our teammates when we do that, when we perpetuate that. And and I'm coming at you as the complete like guilty person in doing this for years and years. It took me a long time to realize how much harm.
I was doing. I wasn't taking all the leave that I could have taken. I was in the office longer hours than many people around me because I felt I had to prove myself and show how committed I was, particularly coming back after illness. I had to show people that I was recommitted to this thing. But
Now we know that if we work too many hours and if we work too hard, we actually work less effectively. So we're losing the cognitive flexibility and the cognitive ability to be able to do a good job. And so we're spending more hours, but we're not getting any additional benefit from those hours. And in that context, also being a really bad role model to the rest of our team that needs to learn this.
And so I I think a really important area for all of us to think about is not how many hours am I spending in the office, but how am I being perceived by those around me? What messages am I sending to my team about when they need to ask for help?
When they need to step away, when they need to take a pause. I think all of those things are really key to helping not only develop your skills better at like how do I do this, but develop the skills of those who are coming up behind you to be better at it for themselves and for their future teams.
I think you're so correct. And one of the things I wonder if if you could talk about for a moment is where does our mindset play into that in terms of what are the the the stories that we tell ourselves that really perhaps are not true? Is there a story that you were telling yourself when you were returning from illness? And was that actually
Yeah.
the way that others saw the scenario and how can we get out of our own way in terms of some of the things that our amazing brains do that actually work against us.
Yeah, it's interesting that you added the second part of that question because the first part took me down one road and the second part took me down another. And the first part is what are the stories that I was telling myself? And the tort the story I was telling myself, the story I was telling myself was that if I wasn't the one working the hardest and the one there the most hours, then no one was gonna think that I could do it, that I could come back. That was the story I was telling myself. And
I would love to say that at that time no one else was thinking that. But in reality, in healthcare and in medical culture, we do still think that. We still think, wow, they need to take some time off. They are weak. Or, wow, I can't believe I have to cover for that guy again because he's sick. Or whatever the case may be, we still have these myths that we perpetuate that.
Mm-hmm. Mm-hmm.
are harmful to the entire culture. And so I do think that these are false beliefs that we hold, but I also think they're false beliefs that are held by the whole system. And we need to start with ourselves so that we can fix the culture.
But it's not just me having that belief. It's everyone around us. And it's it's why the first chapter of my book starts with I put on my fleece jacket to start a week in the ICU and I realize I have a bunch of cough drops in my pocket. Because I was sick as stink.
Last time I was in the ICU, I would have told a resident to go home. I would have told a patient to go home. But here I was with a mask on, doing my job, taking, popping my cough drops consistently to keep from coughing in patients' faces. I should have been home, resting. And I wasn't. And I think that's still what the culture expects. And we need to shift that.
Totally agree. And again, there is so much in the literature that confirms that there is a diminishing return from some of the habits and practices that we uphold. We were trained and then we perpetuate to train future leaders in the same. But in fact, if we are evidence-based leaders, evidence-informed leaders, we should in fact.
direct our attention back to and then hold ourselves accountable to shift the ways that we show up, the ways that we respond and how we interact with others, but then as well, how we lead by example also.
Yeah. And I think some of that is just making a point of just as you said, like making a point of saying, I don't know. Also, we need to make a point of saying, I'm not coming in today because I'm sick. And I want you all to know and understand that and feel comfortable doing that when you're sick. Or I'm gonna go home now because I've been here for 10 hours and I'm not thinking straight.
And it's not okay. So I'm gonna go and I'm gonna call in another doctor to cover for me because that's the safer thing to do for my patients. And I want you all to learn that you can do that too. Because your peers want to help. They want to do the right thing, but you have to be willing to ask for the help.
You know, that really brings me in my mind to a part of your book where you were writing a lot about some of the things we're discussing right now. Medicine really celebrates resilience. but when I was reading your book, I wondered if sometimes we confuse resilience with emotional suppression. What's the difference between the two, Dr. Bunin?
Yeah, in in medicine, I'm not sure there is a difference, unfortunately. I will tell you that I have all sorts of negative reactions to the word resilience. I think, first of all, resilience is a term where we say, well, you have to overcome hardship to develop resilience. And so we use it as an excuse to harm people and to shame people and to hold people to unrealistic standards. And so I would argue, well, maybe we shouldn't really be shooting for resilient anyway.
We should be shooting for healthy or well or joyful or whatever it is that is your standard. But resilience means we're putting people in situations where they have to fight for their life. And if that's the case to make them become more resilient, that doesn't seem worth it to me. And again, this is
an evolution for me. This is not where I was five, ten years ago. But I it really stands true to me now. But I think the emotional suppression is part and parcel to the healthcare profession.
We and not only emotional suppression, but suppression of all signs and signals our body is giving us. So whether it's a we have to pee and we're holding it for 12 hours. Or we we joke in the ICU that often our urine output is significantly lower than our patient's urine output because we just haven't gone to the bathroom all day, or we don't know our hunger signals anymore because we haven't taken a break to eat. And certainly
I have to suppress my emotions if I'm going to see a person, a young person dying in the intensive care unit. How can I appear to be a competent, strong physician if I'm not suppressing my emotions to some degree? So, over and over again, these are skills that we are taught either through the hidden curriculum or sometimes the actual curriculum that we must do to be successful. And so
I don't agree with either. I don't think we should strive for resilience and I don't think we should strive for the emotional or or physical suppression. I think all both of those areas are dangerous.
Agree. And this really kind of connects so beautifully to and so importantly to the topic of self-awareness, which is actually, you know, in the title of your book. And if it is important and appropriate that we would suppress all of our, you know, some of our emotions in professional interactions, because of course there is a job to do. and we can't just be completely weird or, you know, zany all the time. But
Also, if we are completely suppressing ourselves and not attuning to genuinely and authentically who we are and what makes us beautiful and and and genuine in relationships, we completely fall flat with individuals who you know are looking for human resonance. And so talk a little bit about how.
The topic of self-awareness. And having written a couple of books, I know that when it comes to titling a book, it's a very important step. You intentionally chose to put self-awareness in the title. So talk a little bit about that, you know, emotional suppression, the emotional resonance, the importance of tuning into and getting familiar with who we are so that we can in fact show up effectively.
Yeah. It's been a really interesting journey for me. the the jobs that I've held over time have forced me to shift in that direction of self-awareness more and more because I have had jobs where the interpersonal interactions are so important. And not to say that they're not important as a critical care program director, of course they are. But then I became a dean of DEI.
Then I became a dean of community. And in these roles, how I was perceived could make or break our community. And so that made me really take a step back and think about what am I doing to ensure that I know how I'm feeling and how others are experiencing me.
And I realized that like 95% of the physicians out there, I was not doing a good job of self-awareness on a regular basis. If we if physicians go to a course and we say, how important is self-awareness in your leadership skills? They all say it's like nine out of ten importance. But then when we give them an assessment of that, they score very low.
And study after study shows us that how others interpret us is often not how we're experiencing ourselves. So we're not good at the self-awareness, and we do need to keep working on it. But so many of the things that I learned in just the last few years, whether that's about understanding how my diverse identity impacts how others perceive me, how my job title
Yes.
impacts how others perceived me. How the fact that I was a colonel in the army, like we as this was a a huge area of of awakening to me is I was wearing a a higher rank. I think I was a lieutenant colonel at the time. And I expected that all of my learners would just come to me because I was an approachable person. And someone had to say, but you're a lieutenant colonel in the army. Like no one's gonna come to you unless they have to. And it just like was a shock.
To me. I was so unaware of my privilege, of my power, of my longevity in that position, that it was a real big challenge for me to make that shift. And so a key part about self-awareness is this book doesn't ask you to emulate the best leaders around you and do what they do. It asks you to become the best version of you.
By understanding where your strengths are. And should I optimize a strength or work on a weakness? And how do I balance those two things? And how do I understand what my biases are and how they're impacting others? And how do I stay true to my values day in and day out? All of those things we all have to strive for our own individual excellence. It's not about being someone else.
Mm-hmm.
Yes.
Yes. and I just think that in in healthcare specifically, but I know that it exists so substantially outside of of healthcare as well. I think leaders spend years or decades trying to become a better leader before they become or or shift attention to becoming a better observer of themselves. And I just I appreciated so deeply that your book
really encouraged and invited individuals and shared evidence from your own journey of how we can in fact make self-awareness a leadership skill that in fact makes all of the other leadership competencies possible.
Yeah. And I will say that the the stories that came out in this book, they weren't all there. It wasn't obvious to me that these were where the stories were going to lead or or this story should go with this chapter. It was a lot of reflection and self-awareness. So even just in the last six months, I feel like I've grown a lot in self-awareness. And I hope others will too and realize that every one of their stories, whether it was hard,
or whether it was wonderful, all impacted who they are and what they take to the next level.
Goodness. Well, our time is running away from us, but I have three quick rapid fire questions I'd love to kind of run you through in closing. what's one reflection question that every leader should ask themselves with some frequency? Maybe, maybe daily, maybe weekly.
Yeah. One that is super important to me and and we just referred to this a second ago, but am I living by my values today? And how am I or how am I not?
And what's impacting that? Was it that I was tired and so I wasn't living by my values? Was it that something came up in the workplace and I was afraid to bring it up because I was afraid of how others might view me? Like what was it that, or is it complete misalignment with me and someone else as far as our value structure? And how can I stay true to my values and do my job?
And that's a really big one that I think once we start slipping a little bit, we can really drift. And so keeping an eye on am I living by my values every day and not just in saying them out loud by actually doing the things and living them.
Yeah. That's amazing. And that kind of is a perfect bridge to my second question, which was, how do you personally know if and when you've drifted away from self awareness?
Yeah. this is gonna sound really silly.
But when I'm doing well and I'm taking time to reflect and I'm taking time to practice gratitude and I'm in a good place, I sing and whistle around my house all day long. So as soon as I notice that I'm doing the dishes or make cooking and I'm not whistling or singing, I know that something is slipping. And I need to take a step back. And it's such a little thing. But I realized this during COVID. Like I was coming home every day, miserable, wasn't singing, wasn't whistling. I came home at the end of one day.
And I was singing and whistling and my wife's like, wait, what's going on? You're you're doing well today. And I was like, I just spent the afternoon mentoring and I loved it. And so I came home in a different place. So figuring out what are those things that are gonna get us back to where we need to be so that we can be our optimal selves.
Love that. Love that. Okay, last question. What is one leadership habit that you have perhaps changed or rethought because of writing this book?
Yeah. It's it's been huge for me, the value of pauses. And I think of pauses as tactical pauses, meaning I just need to take a breath or I need to have a phrase that's gonna help me get through this moment.
A strategic pause, I need to take a couple days or a week before I make this decision. Or an existential pause, I need to walk away from this job if I'm going to maintain my health. Like all of those things, I have become much more deliberate in thinking about what does any given pause mean today? What do I need to do to optimize my wellness and my well-being and optimize my efficacy for my team?
Which one of these things is gonna help? So I talk a lot about the pauses in the book, and then I think that's the thing that I've taken the most as something that I can use every day.
Dr. Bunin thank you so much for your willingness to come and share about your book. I'm going to include links in the show notes. Is there anywhere in particular that you would love to encourage listeners to come find you? And I'll provide links so that people can become connected with you and follow your work.
Yeah. Well my new website is www.jessbuninmd.com. and there you can find the book, you can find other ways to contact me, you can find podcasts, whatever you would like to see about me, you can pretty much find it all there. So I would encourage people to r to go there.
Fantastic. Thank you again for your time and for your important work. Carry on.
Thank you so much, Laurie.
