Merging a Passion for Writing with Healthcare | Jessica Gold MD, MS

Transcript

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Welcome to The Happy Doc, the voice of fulfilled physicians. Sharing life stories from physicians, health professionals and entrepreneurs, so that you can live your happy life.

[00:00:46] Hello everyone, and welcome to another episode of the happy doc. I am excited as always. Today, I have Jessica Gold. She’s an Assistant Professor in the Department of Psychiatry at Washington University School of Medicine in St. Louis, MO. Also, she is a prolific writer, she’s been featured in Time magazine, Newsweek, InStyle, Forbes, Huffington Post.

[00:01:12] Dr. Taylor Brana: I’m excited to get to know you, I’m excited to learn about what you’re working on. So, Jessica, can you say hi to everyone? 

[00:01:18] Dr. Jessi Gold: Sure, you can call me Jessi too, if that’s easier. Cause I tend to go by that. 

[00:01:21] Dr. Taylor Brana: Great. So, Jessi, give us a little bit of background. What got you interested in Psychiatry? 

[00:01:27] Dr. Jessi Gold: When I was in college, I went into college thinking I wanted to be a doctor. My dad’s a Psychiatrist, I’ll put that on the table now. So, I was always interested in science and medicine, was interested in the brain, was interested in why people do the things that they do.

When I was in undergrad, I hated the classes that we had to take. I thought it was really stressful. It was really hard for me to do organic chemistry and general chemistry. And I ended up sort of flocking to anthropology. And in doing so, did a lot more public health, global health, listening to people’s stories, really getting a connection with the human side of medicine as best I could while still being an undergrad.

Ended up getting a master’s in anthro at the same time, took a year off in between college and medical school, did some more public health global health stuff, worked at the World Health Organization (WHO) for this summer and then worked in DC, doing adolescent health policy for the year. Got some exposure to that, which was really cool and really helpful to understanding sort of what physicians can do as advocates while I was applying to medical school.

And then when he went to medical school was like, I’m still interested in humans. I’m still interested in the brain. My dad’s a Psychiatrist, I’m not going to do that. I’m going to be a neurologist. So I went into medical school thinking I would try to do neurology.

Did the neurology interest group, did my summer research after medical school, like first year in neurology, but ended up really taking that project to having a psychiatry flare. So, the person did HIV research in the brain, and I ended up looking at her data with the psychiatry bent. So how the people – the depression data part of it and was like, uh oh, I tend to be again, going towards psychiatry, no matter what my dad says.

And then we did the clinical rotations and I again was pulled more towards psychiatry. I felt like people had – you know, everybody was different, even if they had the same diagnosis, like their reasons for having that diagnosis were really different. Even if, at the core we treated them the same, you know, maybe we gave them all the same antidepressant in the end. The ways that we got to talking about it and the story was more important, and the reasons why they might’ve presented were really different, and I really liked that. I also really liked that people didn’t really fit in this perfect medicine box that were psychiatrists.

I felt like, in a lot of specialties, people were still really being like the characteristic doctor in the way where, you know, you just did these things and that’s what a doctor did. And I had all these other interests in advocacy and writing and I was really trying to figure out how to incorporate that. I felt discouraged to do that in other fields, and didn’t feel like that in psychiatry. I felt like people were like, Oh cool, you want to write? Writing’s fun, do that. Or like, tell me more about writing.

And so, I really felt supported to do that in psychiatry. I felt like people had the time in their careers to do other things, I felt like people actually enjoyed when you did other things. And that really, you know, kind of pushed me towards that over neurology. I also kind of had this feeling like, if I saw a hundred people with a stroke or a hundred people with depression saying like, those are the most common things, what would I rather see? And I was much more drawn to a hundred people with depression. So that’s kinda how I ended up in psychiatry minus really awesome mentors along the road, along the way. 

[00:05:31] Dr. Taylor Brana: Yeah, that’s great. And you know, I’m hearing that, even though you technically thought you wanted to go neurology, I feel that the push away from dad, but you, you always had that sort of gravitation towards the psychiatric part of it. That’s, that’s really what I’m hearing. And then one thing I wanted to go back to that you said, you know, earlier it was, you mentioned all of these sort of opportunities you had early on, before you even started medical school, working with the WHO and doing all this global advocacy.

So, you know, it sounds like you did a lot of really interesting work even before you entered the medical world. I’m just really curious, especially for my younger listeners, but also for me too, because. We’re always trying to build out these opportunities to do something really cool or interesting, or working with, you know, successful groups that are doing something important.

How’d you do that? How’d you get involved in those things? 

[00:06:25] Dr. Jessi Gold: It’s really interesting. So when I was a senior in college, I mean, so I had always kind of thought I wanted to go abroad when I was in college and I just couldn’t get it to work in my schedule. I was like, I couldn’t get the classes done fast enough, I hated premed so much that I couldn’t finish it by not using my summers to do the classes.

So I did a lot of summer school and I just really wasn’t finishing it in the quick time you would have to, to really like take an abroad semester. So it was like, I really need to, I really want to go abroad. I really want to do that. and I’ve always been really drawn on to the work that places like big global organizations doing healthcare work, like the WHO.

So I started doing like a deep dive into how they picked interns and how that worked. It drew me to like other places like the UN and USAID and some places like that. And, they all have formal intern programs, they pick like one person from a stack of thousands. But I had this feeling that they probably did get one person for a stack of thousands, so I sort of, also in addition to doing the formal application program, I scrappily sent my cover letter and resume to any email address I could find, and ended up like, you know, looking through the WHO website. And if I found like, a head of this division, I was like, hi, I’m applying for this. Do you need an intern? Obviously all of them are unpaid and that’s a privilege, you know? I mean, I think. That in and of itself is an unfair privilege, but I was really excited to do it. And I luckily had that privilege to be able to, and, all of those would have been unpaid anyway, which is just ridiculous.

[00:08:04] But, I wrote all of these people and ultimately one of the reproductive health division people was like, sure, I could use an intern and went around the regular program. And I ended up going up there for a bit of time and working with them, which was cool. And, you know, I mean, it teaches you a lot about the bureaucracy of global health, but kind of how all these things working get put together.

But it was also a really fun time just to travel and meet people from other countries and things like that, which was really something I wanted to do as a kind of young out of college person. And the job in DC I got just by applying to jobs. So, I wanted to, it was right around. So I graduated in 2009 from college and it was right around when Obamacare was coming out and there were a lot of, you know, there’s a lot going on around public policy and medicine and health care.

And I was really interested in being in DC around that time, just cause I thought, you know, you’d get to hear so much and learn so much just being around it. And so was trying to just apply for jobs where I’d get to do that. And I ended up working for an adolescent health nonprofit, and got to go to some, you know, meetings on the Hill, talking about adolescents’ role in the Affordable Care Act (ACA). And they were kind of neglected in a lot of ways from the conversation, because they often are, cause they’re not pediatrics and they’re not adults and they’re not geriatrics. And they’re in this in-between group. And so, it was really helpful to get to even just sit in on those conversations, but it was fun.

[00:09:40] Dr. Taylor Brana: Yeah. I mean, it’s amazing. I talk about this on this podcast a lot, I just say label it the positive snowball effect, which is you go out there, you do something ambitious, you put yourself out, there you go towards a passion or a certain interest that you have. And then just through those connections, through those experiences; in your case, the one thing I thought was really interesting too, is, you didn’t just send in that intern application, you said you did the scrappy thing, right? You found like the loophole in the system, you went out of your way to try to do that. And, through that opportunity, then you started to be able to build out those other opportunities. Like you’re saying, to be in Washington, to see those experiences, right. I love that. I love, that’s just a great gem, right off the bat too.

I want to kind of gear us towards a little bit of your writing career because I find that to be very interesting. Again, as physicians we’re taught, and even you said it earlier, which is there’s this linear path, right? Usually we think of this very linear path. And for you, you took that break. You had those experiences. You went into a field that offered you a little bit more breathing room. So how did, how did writing develop, how did you start to do that in your career?

[00:11:04] Dr. Jessi Gold: Yeah. So it’s really interesting. I mean, I think always as a kid I really liked reading and writing, I was like the kid who would do things like enter those weird poetry contests and enter the radio station contest for something. And it was fun for me. Then as I got older, I was still doing English and History classes, but trying to do Science, and then you kind of end up having to prioritize the thing you have to do in college.

And Anthro was a lot of writing, luckily, which led me to still have the balance. but then. You know, I think actually knowing that you’re good at writing in the kind of ways that other people would want to read what you write is not something you know, really. Cause, you know, when you really write for school, you’re writing and they tell you to write on a topic and someone gives you a grade and you know, they’re just telling you you’re a good writer for whatever they’re grading on.

They’re not really telling you you’re a good writer that the popular press would be interested in what you’re writing. So, you know, when I was, on my year off, I started writing these emails to friends and family about what I was experiencing when I was abroad and people would like to comment back and say they were funny.

And so I started blogging a bit when I was in DC about the same stuff, just like, really funny, stupid things that were happening to me, but it was like relaxing. It wasn’t serious. And again, just my friends and family were like, this is funny. Maybe you should do more writing. And then when I went to med school, writing became an outlet for me and a way to really sort of process like the things I didn’t like about medicine, the things I didn’t like about med school and the feelings I was having, that I didn’t feel like I really had the ability to say out loud.

So I started writing and didn’t always share it. I would write kind of in a journal way or I would write and then decide if I wanted to try to start sharing it. I think, you know, probably the biggest thing I started, I know I’m on a third year rotation. I was in a third year rotation and was a med student and called into a case to do cardiac massage on a patient who was already dead. And I didn’t know that. And I didn’t know that until after I had already done the cardiac massage and all this stuff, and it was kind of set up as a learning opportunity. But as a med student, once I found out the person was already dead, and it was just really traumatizing for me, because I don’t function very well that way. I’m a very emotional person.  It wasn’t something I would have thought was fun. It wasn’t something that I would have thought was a good teaching opportunity. The other med student was like, that was cool. Why didn’t I get to do it? And was jealous afterwards.

And it took me a while to process, like what really happened? And I wasn’t sure if I was hazed or that was inappropriate. Like, it just, it was a lot. And I wrote about it and I shared it with my mentor and she was like, you know, you should write this for a journal, or you should write this up, because it’s really something that someone else should see and they should learn from this because this isn’t something people should just do to students.

And so. I ended up – Yale has, I went to Yale for med school – a pretty decent humanities and medicine group. And Dr. Reisman there really helps people who write, and I sent it to her and she helped me edit it. And I ended up submitting it to Annals of Internal Medicine when I was in medical school and it got accepted. And it got a really good, good reception from the Faculty and my Dean. And I was like, Oh, people actually listened to me through this and I can get people’s attention and also, not have to write about research. I can say, like, this happened to me, this was a thing, and this is what you can learn from it. Or this is something you can teach from it. And it doesn’t have to be research all the time, and it doesn’t have to be that and it can still be academic and it can still be appreciated. And I probably almost got better feedback on that than I had from anything I had done all med school. And so, from that started really like, you know, trying to do medical blogs with some of the stuff I had kept to myself.

So turn to KevinMD, cause he was just starting kind of around that time. And I submitted some stuff to there, and submitted some silly stuff to other popular press things, but again it was just kind of like trying to get my foot into writing. Expressing it in a way that other people can see it more.

[00:15:47] Dr. Taylor Brana: Right. I mean, that’s amazing. And it just reminds me of kind of trusting your process, trusting the things that like we talked about before that you enjoy, that you naturally inclined to do. There’s a book, I’m forgetting the name right now, but, one of the things you mentioned earlier was.

People who tend to have a talent or something, they generally are good at, there’s signs of something called naming the gift, which is essentially that people are starting like, Hey, you’re pretty good at this, and other individuals are like coming towards you. And so almost your environment is giving you signals that like, wait a second, people are responding to a skill I’m doing this, works really well for children too, where you start to name like, oh, they’re so good with music. They’re so good with this.

So, I love that. I love that positive effect that you know, that, you know, now you’re, you’re writing and it’s, it’s going to all these great places. The, the article you wrote that you’re referencing before it was that the alligator hands. And, and that won an award, correct?

[00:16:51] Dr. Jessi Gold: Yeah. I got an award in med school for it, for writing it. And then, I think it really inspired me to keep writing for the most part. I’ve really turned away from the academic version of writing and have really figured out that you have a huge platform doing things in this popular press version.

I always tell people who are interested in writing that, you really just want people to read it. So I think when you’re younger, it’s kind of nice to get publications from it, if you can, because they’re publications and you still need publications. Right. And I think. Places like KevinMD or now you guys have like Doximity, MedPage and Medscape.

There’s all these places you guys can write blogs for. And I think blogs are great when you’re first starting out, because they, there are places you can get your stuff out and get them read, you know? And I would never say, you know, it’s almost like when you first write a research paper, it’s great. If you could get it in JAMA, but that doesn’t really happen.

Even for people who are great researchers. They get one or two papers in JAMA, their whole life. Right. So it’s like, I’ve had one piece in the New York times ever. Right. And I’ve had one piece in the Washington post, ever. And I write a lot, and I think people think that it just happens all the time for me.

And it doesn’t, you know, I get pieces rejected all the time, but for me, a lot of writing, in the popular press stuff, has also been really scrappy. To be honest, I use that term a lot about what I do. I mean, I think once I realized I really liked writing, in residency, I did a lot of things like each specialty has trade publications.

So we have like psychiatry has Psych Times and Psych News. And I did a lot of writing through that. I won an essay contest for psych times and then was like, Oh yeah, I am good at writing. Again, like positive reinforcement. And it really inspired me to start writing again, reaching out to people who are writing.

I did an APA leadership fellowship and I sat on the communications council as part of that. And one of the people who was on that was writing for the Huffington Post and he gave me access to the platform, and it let me write a little bit more for there. And I had examples and then because of that, I actually felt more confident to –

I started DMing editors on Twitter and being like, Hey, I have no idea if this is of interest, but I’m a psych resident and I noticed that you sometimes talk about mental health, but it’s never written by a mental health practitioner. And, I don’t know if that’s something you want, but if it is, here’s some of my writing, if there’s something you would want to talk about, or if there’s something I could write, please let me know.

And a couple of people wrote back, but primarily, the former editor of Glamour did. And she connected me to their health editor. And that was really before I had a lot of followers, if you say that now you’ll look at my Twitter, I have 20,000 followers. So you would say, well, of course someone responded.

Because I have a lot of followers and I have a blue check. I had like, 2000 followers and no blue check or anything, you know, she just did that, because she was nice. She’ll tell you that she could see potential in me, and I don’t know what she was talking about, but that was really nice, you know, and she connected me to the health editor and I got some pieces that way.

And the more pieces you get, the more likely other people are gonna read your stuff. And kind of from that, I’ve followed editors around. Like my Glamour editor went to InStyle, and that’s where I got the InStyle writing. And with more confidence about having pieces I have been able to, I DM’d the Self editor, did the same thing and said, Hey, need some mental health pieces? And they were like, Okay! You know, and it’s just been kind of fun that way. but I think it’s just a confidence thing and not really fear of being rejected. I think if I was super scared that all those places were going to ignore me, cause a lot of them do, then I wouldn’t do that. Or if I thought they’d say like, no, I don’t want that, I wouldn’t do it. But I think there’s just sort of a baseline, like the worst that can happen is they ignore me or say no. And the best that can happen is I get a piece.

[00:21:05] Dr. Taylor Brana: Well, and it reminds me of the, you know, the culture of medicine is very, conservative, cautious, and slow.

There’s a lot of fear in medical students. They don’t want to look dumb. They don’t want to ask the dumb questions, but when it comes to, for example, you’re talking about your writing career for a second. You have to do the opposite. You have to be eager. You have to be aggressive. You have to be scrappy.

You have to push yourself towards going and doing the Twitter game, doing the DM game, finding people that are in certain positions, doing that consistently, consistently putting your writing out. And it’s interesting to me, I often talk about this in the podcasting world, but it’s the dichotomy where in one world, you’re being told to little, to humble yourself, make yourself small, make yourself a beginner, constantly looking for knowledge, but, don’t be overly aggressive and all those things. And then in this other world, you do have to push yourself. You do have to move yourself. You do have to look at the opportunities and it’s interesting.

And the one thing I wanted to kind of go back to, before you mentioned psychiatry was the only place you felt like home, where they encouraged you. And I find that very disheartening that surgeons aren’t being taught about other opportunities, family medicine physicians aren’t being taught about these. Pediatricians.

I think it’s opening up more, but, for someone like you, if you were constantly told no, like you wouldn’t have these opportunities possibly. And it’s just terrible that we’re not having that sort of encouragement. If you do have the gift, if you do have an opportunity.

We live in a different world. We live in a world, if you go back 10 years, if you go back 20 years, the accessibility of information is at a completely different level. And we as professionals and people of credibility who have legitimate experience in certain areas that, for example, I mean, we can go off on COVID for instance, but you know, when you actually are in New York City and you’re in a New York City Emergency Department, and you literally see all of these cases, seeing the bilateral pneumonias on the chest X Ray, and you’re seeing these very sick people.

That’s a very different experience that is hard to then inject into society who are chilling on their couches and watching Netflix. And so, there’s a certain level of – technically everyone’s on an equal playing field and social media is a great equalizer. But it is not, it should not be confused as the great equalizer of credibility. And that is something that is hard to kind of talk about. Or, and this is an area that is just so huge, because again, you know, you as a psychiatrist or you as a family physician or someone else as a pediatrician. It just takes really one, one minute, you know, one good video, one excellent written blog, post or piece for maybe a certain set of behaviors or ideas around a topic to change.

And, it’s incredibly powerful and I love what you said about us all needing to encourage that sort of work to be done. This is a new era, and that new era calls for a new set of skills.

And so my next question for you would actually be, I saw that you did writing also with COVID and because it’s so timely. Can you talk about how COVID has really impacted – maybe not just medicine as a whole – but your personal work and what you do in the clinic? 

[00:24:54] Dr. Jessi Gold: Yeah. I mean, a ton actually. So I, clinically, am a college provider usually.

..A complete flip to doing a ton of work around physicians and healthcare providers. So, I have been working with the hospital where I work doing the entire hospital response to how we’re taking care of our own. I would sit in a group of, you know, it’s a mix of psychiatrists, other physicians, HR professionals, other leadership looking at what we need to put in place to support the mental health of our healthcare providers and other frontline workers, what the best things to do in the interim and in the long term are. This has also been kind of, you know, as the issues of racial justice have also been in the forefront, how that incorporates into what we’re doing.

We set up a hotline, we’ve set up more visits. I’ve done a lot of talks and outreach around that, which has been really fun. I’ve also opened up the number of visits that I’ve been personally doing where I see healthcare providers or other people who work for the university. So, I’ve been seeing a lot more people like that. Do entirely telehealth, which was something I never did before, which is a very different thing. I think I’m still getting used to that. And it’s not my favorite thing I’ve ever done in the world, but it’s definitely something that we need to do right now in psychiatry is kind of lucky that it’s an easier thing to transition to for telehealth in comparison to other fields.

There is so much talk about mental health right now, and the mental health of frontline workers in a way that, I don’t think anybody has ever talked to me or wanted this much writing around mental health or wanted this much writing from healthcare providers in first person, ever, since I’ve been in this space.

And I think we have a really big role right now. I think that mental health providers in this space will have a really big role moving forward, because I think we haven’t even scratched the surface of a conversation for mental health. I think we started and then, with new waves, or continued waves, it’s just sort of, you know, goes back to the physical health conversation because it’s the immediate concern. But I think the aftermath is always going to be kind of on us. And there’s a lot, a lot of mental health for the country, but also really for frontline workers that we’re going to be seeing for years to come. And that is going to be something that we need to be advocating for and we need to be keeping in the front of everybody’s mind and really thinking through and making sure the conversations stay in the public.

[00:28:15] Dr. Taylor Brana: Yeah. Absolutely. You bring up some great points about the changing climate and how COVID is affecting us. The telehealth situation in general is such a huge change. I mean, the nice thing, obviously with psychiatry is, a lot of the work, there is a lot of work we can do with telehealth, but what I’m noticing, at least with my work and outpatient, for example, is there’s just so much data and information that you get from in-person, that you do lose and there’s been several instances. I can’t really talk about it because of HIPAA, but like several instances where I’m like, ah, I wish I would have been there, you know? but you’re absolutely right. I mean, It’s really interesting. They’re asking for, I mean, it makes sense with more first person sort of situations, because a lot of people, kind of like we talked about earlier, aren’t in, they’re not in it.

And so they can’t see those experiences and they can’t feel those experiences and they can’t be there to see what’s happening, you know, really on the front lines. So I think you bring up some very valuable information.

So Jessi, for the sake of this great conversation, I’ve asked you many questions, but is there something you, you want listeners to take away today from our conversation in the work that you do?

[00:29:35] Dr. Jessi Gold: I think it’s great that you have a space where people can talk about the positives in medicine. I mean, I think that we do often forget that when we say things that we don’t like about our job, it does affect the people coming up below us. I think that’s going to be something that we need to keep in check for sure right now, because a lot of us are really struggling and a lot of us are really burned out.

And sometimes when we’re burned out or struggling, we say things that we’re just kind of airing, but don’t mean to air and influence others. And it does. I think, you know, something that’s really important to me over time is that we think about how to express vulnerability and express hardships and express good in the same sentence, and in a way that makes the culture better without making the culture worse.

And I think we’re not there yet because they’re not done in the right way. When we don’t express emotions and we don’t express vulnerability along the way, when we finally do it feels like, it’s like everything gets aired in this really hard, such a deep way that it feels like really hard on the person hearing it and catching it and holding it.

And really, vulnerability is leadership, and vulnerability is key to medicine being able to survive in the long run and being able to be a better field. And we’re not there yet. And I’m really hoping, I’m honestly hoping that COVID is a turning point for this because I think it brings up a lot of things where we really need to be vulnerable and talk about emotions openly.

And, to me, I think the balance of it is really important. And so I would encourage people listening that, that’s important in medicine, being able to have emotions is important in medicine. Being able to express joy at the same time as sadness doesn’t mean that you are disregarding the sadness when you feel joy or that something’s not hard because you like it.

You can still like something and it’s hard. You can still be sad about something and feel good sometimes. These things are not something that you can’t feel at the same time, we just don’t talk about that well, and I think that’s really important moving forward in how we really cope with everything that, you know, the changes in medicine and the changes in healthcare and the outcomes of COVID will have on trainees and the people who are dealing with changes to their medical education and changes to the structure of what they’re learning right now.

I think that’s something that they really should keep in mind. And I think that, if they’re interested in writing, and they’re interested in advocacy, they should feel like it’s really important and they should value it and see the value in it because it exists and it’s super, super relevant and super important and needed.

And I, you know, if they don’t feel supported in their own institution, come to social media and we’ll support you there. I’m @drjessigold and you’re absolutely welcome to reach out to me however, and I’ll try to support you if I can. I’ve read people’s writing. I’m happy to help if I can, but I think we need to do better encouraging that in people and if you don’t feel encouraged, I’ll try to help. 

[00:32:56] Dr. Taylor Brana: I love everything that you just said. I mean, vulnerability is definitely an area that is hard, especially for men, I feel, but vulnerability definitely for every individual is something that’s so important. I mean, I love everything you’re doing.

I love the advocacy work, I love the writing. I love the fact that you’re combining these with your own sets of passions. I think when it comes to happiness, that’s one of the reasons I definitely wanted to reach out to you and have you on the show. I also, because of the work that you do and the writing that you do, I’d love to have you on in the future again, to dig into a lot of these, important topics in some more depth.I think you bring up some very important subjects that obviously we haven’t touched on today. But Jessi, thank you so much for your time.

[00:33:40] Dr. Jessi Gold: Yeah, absolutely. I’m happy to come whenever. 

[00:33:44] Dr. Taylor Brana: Awesome. Well, take care and thank you. 

[00:33:47] Dr. Jessi Gold: You got it.

[00:33:47] Dr. Taylor Brana: And that’s the episode for today. I want to thank you so much for listening to the Happy Doc Podcast. Again, this is a podcast that is going to inspire you as a physician, as a health professional, as an individual to be fulfilled in your life, so please look out for the other episodes in The Happy Doc. If you enjoyed today’s episode, please leave a five star review on the podcasting application of your choice. You can also reach out to us by emailing the happydoc1@gmail.com. I’ll see you on the next episode.