Replaceable at Work, Irreplaceable at Home (ft. Jenna Taglienti)

A lot of times we get it backwards. We think we're irreplaceable, you know, at work, and we really aren't.

I was always putting everybody above myself, and I've realized now that I cannot be the doctor or the leader I want to really be unless I take care of myself first. Being on this leave, taking care of myself right now and modeling that that's okay, and be an even better leader when I return, that's more powerful. Welcome to Digital Voices. Digital Voices, where healthcare and life science leaders explore the real work behind transformation. This podcast is about people, leadership, and the conversations that move healthcare forward. Now your host, Ed Marx.

Hey, it's Ed, and welcome to another edition of Digital Voices. I am with Dr. Jenna Taglienti. Jenna, welcome to Digital Voices.

Hi, thank you for having me.

I've been really looking forward to this particular episode because I think it's going to be really helpful to everyone. of our listeners and subscribers. And it's really based on an article that you wrote for JAMA called Time Is Finite. And so, we're going to break into that a little bit. But Jenna, this would not be Digital Voices if I didn't ask you, what are the songs on your playlist? What kind of music do you like to listen to?

I listen to all, probably all sorts, you know, the gamut, and including whatever my kids want to listen to in the car. You know, I've been listening to Ordinary by Alex Warren, and I think one of the lines in it is pretty powerful for me right now. And that is, he mentions like turning the mundane into a masterpiece. And I kind of feel that right now with just really trying to live in each moment. And then, you know, I also have like fun songs. Like Carry On by, by Fine. I think that's just like really uplifting and upbeat and catchy right now for me. And that's, that's sort of where I'm at.

Oh, that's great. And I failed to mention that you're the psychiatry residency training director at Mather Hospital, part of Northwell, and you love to write and you're just a cool person.

Thank you. I don't feel that cool, but But thank you. I appreciate it.

So, we've already sort of gave a hint of what we're going to talk about, and it sort of came out in some of your answers on the playlist, but what's your life message or mantra? What are words that you live by?

Yeah, and it's probably changed a little bit recently because I've been able to put things into perspective, but I think really it's just, you know, living with purpose. Which is easier said than done, but fully being in the moment. And for myself, it's medicine is really important, but you can't give up the pieces of yourself that make you, you.

Yeah, I love that. We're gonna break down into it. So, before we get to your story, tell us a little bit about like who you are, where'd you grow up, You know, what was your life like?

Sure. Yeah. So, I grew up in Oklahoma in a pretty small town there. My mom was a nurse and my dad an engineer. So, I, you know, was kind of around the medical world with my mom would bring home stories from the hospital, of course. And then, my dad was more like analytical and structured, but I think I carry kind of both of those mindsets when I You see the world and how I navigate it. And, you know, when I was younger, my sister was diagnosed with a neurological condition, syringomyelia, and required brain surgery when she was about like 6 years old. So I saw my parents travel all over the country consulting with different neurosurgeons, and they took us a lot. They took me along. It was a huge learning experience, and it had a big impact on how I view the medical world, the respect I have for it, the hierarchy, and how you could challenge the hierarchy. And I saw, you know, my mom in particular as a nurse doing that and advocating, and I think that stayed with me. So that hasn't changed. And then I moved to Buffalo. New York, which was a culture shock, uh, at the age of 13. Um, so I, I lived there for a while, did my medical school training there. Um, and then I met my husband in medical school. He's also a doctor. He's an ER doctor. And we, um, we moved here for residency. So he— we matched at the same hospital, Stony Brook University, and we've lived here ever since. I have 3 kids. Uh, they're amazing. 13, 9 years old, and, uh, 7-year-old. And, uh, and I am a psychiatrist and I run a residency training program.

Yeah, that's so cool. I have to ask you, do you guys watch The Pit?

We do, yes. I, I really like that show. I need to catch up. I have like 2 episodes I have to watch right now.

I know, especially when there's an ED doc involved. But obviously they, they bring in not enough, is what I'm told. They don't bring the psychiatrists in enough into the program. We know a little bit about your background now about why you chose healthcare as a career and why psychiatry. How did that come about?

Yeah, I just, I think that I've always been interested in humans, right? Like that human connection, but on a deeper level. I always wanted to dive deeper. I always felt it was very rewarding. to get to the inner thoughts of somebody and what they're struggling with. And I felt like psychiatry was the field that can— you can connect with somebody on such a deep level. I was drawn to it. I was actually thinking like along the psych lines in undergrad when I took my first Psychology 101 course, and I was like, wow, this is, this is incredible. And I kind of kept with that. When I went to medical school, I sort of thought like, psychiatry would be my place, and that is where I landed.

Yeah, that's super cool. So for those who don't know, what, what's it like to be a residency training director?

It is, it is great. It is one of the most rewarding jobs, really. Like, you can have an impact on future generations of doctors. I don't— I think that is incredible work. And, um, It could be challenging, very, very challenging at the same time. And it's probably, I've heard other people equate it and I have to agree, like I didn't understand what they said at first, but they said this is like middle management, completely middle management, right? You get told what to do and then you gotta execute it and like make it seem like it's your idea or you're part of it, even if you maybe don't agree or, you know. You have to sell it to the people. So I get that now. I was told that years ago and I finally get it. There is no other job I can imagine being happy with. This is what I was meant to do. I love being a program director.

No, that's cool. Yeah. And you get to influence the next generation of psychiatrists and medicine. That's so cool. So cool. Was there a person in your journey that helped you See who you could be?

There is, there's a lot. Uh, I think it takes, I think it takes a village and you as a person have to actually open your mind enough to listen, especially with maybe some really tough feedback at times. But, uh, there is one person in particular who is at our institution and she was one of my main mentors when I first took the job as program director and she was the one that got me through my first really difficult year when I didn't know what I was doing at all. And I, you know, thought that I had to be this person that wasn't really me. I just, I was afraid to make a mistake. And so I think that put up this like force field where people didn't really see me as a person. They didn't know if they could trust me. And it led to some challenging situations, but I was able to learn a lot from it. And she's an incredible mentor, Dr. Zatilla, and she works at Northwell.

I think anyone of substance has had someone help them to get there. So, let's sort of transition into how we got connected, which was through this, the JAMA article. But let me start with this. Was there a pivotal moment in life that fundamentally changed your trajectory?

One that actually changed my trajectory was probably after that first year of being a program director. The learning experience was, I mean, the learning curve was super steep. And what I learned, you know, I had to hear some really hard feedback, but actually open my mind to listen to it and actually grow from it. That changed my trajectory because it changed my entire outlook on the way People lead. What is effective leadership? What does it mean to do this job? Am I any good at it? Should I keep going? All of those questions, like maybe I should just quit. This is like not working out. But no, because I did have fabulous mentors. They saw something in me, and somebody told me this: Just be yourself. Like you're a you're a likable person if they just see you. And see yourself, let people in a little bit more. And that was a huge life lesson. It did change my trajectory. I changed completely the way I was, I was leading.

So, you had another major life moment and that you wrote about in, in this JAMA article, Time Is Finite. So, can you share a little bit about the backstory and then we'll get into some of the, the learnings and the sharing?

Yeah. So, I'm still pretty early in this whole medical journey and the shock and, and all of that. Like, I'm, I'm still in it, but I'll tell you, back in November, it was the day before Thanksgiving. Um, I went to the hospital with the worst pain I've ever had, and I thought it was a kidney stone. Not that I've had 'em before, but I just figured, like everyone says, that's the worst pain in your life. So I keep going. I'm like, work me up for a kidney stone. This typical doctor, like I think of diagnosing myself and, um, and they listened to me. They did work me up for a kidney stone. But it turned out on the, um, CAT scan of the abdomen that they did, it caught my right lower lobe of my lung. And I was lucky about that because that's what showed the tumor there.

Yeah.

And why it was causing such pain was it infected the, like the pleural space there. So that was causing intense pain at the moment. And all I remember, like I, I just was like, I need to get home. I'm hosting Thanksgiving. Just give. Like patch me up, get me something to get through this, and then we'll figure it out later. So I actually did that. I want, and I think they listened and discharged me because I'm a doctor. So like, you know, I have to learn how to be a better patient. But, um, then I had the surgery in January and my doctors were very, very sure that it was not cancer. I was more worried about the surgery and the recovery and, and all of that.

Yeah.

And, um, So it was about 2 weeks later and I was like, I think these results should be in. So I was checking the portal casually and when I opened it, I was, uh, in shock. I just remember like sitting there and I'm like, adenocarcinoma. It says adenocarcinoma. My husband's like, what? Like, that's cancer. What? So I just give him the laptop because I'm in shock.

Yeah.

Information overload. I didn't even wanna know anything else in that moment. I didn't wanna see any other information, so I handed that off to him. to navigate. He's the one who contacted my doctor and got everything explained and helped me, helped me over those next couple of weeks while I was just completely blindsided. And then I was started getting ready to hear a little bit more pieces of information and understand things a bit better after that.

Yeah. And where are you today in that journey?

Yeah, so I just finished 4 rounds of chemo, uh, last week. Was my last round. And, uh, and I'm hoping that we're, we're good. Uh, you know, I think you learn, you live kind of scan to scan a little bit. Um, so I have another scan tomorrow. I have a PET scan scan, uh, tomorrow. So hopefully that's all good.

Sure.

Um, and then I have to do immune infusions for a year. Uh, hope, I'm hoping I'll get back to work in July. I don't know what that exactly is going to look like when I return. So that, that is that balance. It's not falling into the same old, same old when I go back.

Yeah. And, and I don't know what your faith orientation is, but I just wanna call out to my audience that everyone prays for you.

Oh, thank you.

For complete healing. So, so that's cool. So you got this moment of clarity going through this process, and that's really what you wrote about.

So tell us about that process of getting to that clarity and sharing sort of the thesis, you know, I actually had to go back to my original, like, thoughts and, and everything to just even remind myself where it came from in the first place. In that moment, I was really just trying to figure some things out. Like, you know, there's always stuff at work that I bring home and I think it over and think it over and just, you know, second-guess myself and it takes away actually experiencing those small moments with the kids.

Yeah.

But I just thought that, oh, what will this, like answering this quick email? Well, that's not a big deal right now. I'll just do that real quick, get it off my plate. But in reality, I was doing it chronically and it was taking away from really living in it and experiencing those small moments. I just remember sitting in the living room. I was still recovering. I think I had just had my like first round of chemo and I got to see for myself how everybody stepped in, took over my job, did it well, and I'm grateful for that. And they're still doing it really well. I'm very, very happy for my team. But like, I look at my kids and my husband and, and my family and I'm like, well, they wouldn't adapt the next day.

Like if I was gone, it's just, that's just came to me and I just felt like I just Yeah, it's like the meaning of my work, to quote you, meaning of my work's profound, but meaning of presence at home is irreplaceable. Because a lot of times we get it backwards. We think we're irreplaceable, you know, at work, and we really aren't, especially if we're a good leader like yourself. And, but we definitely are irreplaceable at home. So that was a great, A great quote and something that I really took from your writing because everyone is afflicted with what you just described in some way, shape, or form where we try to separate work and life and oftentimes work wins. And so you had this moment of clarity, but it came with a diagnosis. How might someone who's listening who doesn't have a diagnosis, like a big wake-up call, like, like you've had kind of achieve that same clarity? Obviously we hope that they listen and they take to heart what you're sharing and what you've written. Um, but any other words of advice, like how do you make it stick or how without going through the trauma?

I, I know, I know. And I think, I think it can stick. I think it can for people without a diagnosis. I hope it can. You have to just not forget yourself. In the process. It's such a slow, you know, it seeps in and medicine. I mean, it's, yeah, it has, like I said, it has profound meaning, but it, it can seep in over time and take control of your whole being when there's so many other parts of life that make you, you as a human. And it's important to live that. I think people need to put themselves first. Especially doctors and healthcare providers put themselves first. We always are taught patient first, patient first, and and I agree. The patient's got to be like you know first or maybe tied with you, maybe tied with you. I don't know, but I I was always putting everybody above myself—the patients, the the residents, the job—and I realize now that I cannot. be the doctor or the leader I want to really be unless I take care of myself first.

Yeah. I had a colleague, a hospital president, he's now a professor at BYU, who wrote a book that was kind of controversial at the time, but it was called Patients Come Second. And because it was the same premise, you know, you have to take care of yourself and your people, your nurses, your doctors, those sorts of things, and then they will take better care of the patient. So we're actually bettering patient care and taking care of our patients or our residents by taking care of ourselves first. What other pieces of advice might you have for achieving this clarity? Again, you know, you've had this profound situation happen in your life, and some people have and can relate, but for those that can't, like any other sort of tips that you might offer, maybe it's from your psychiatry profession or otherwise, That might help people just connect and, and stay grounded with true purpose?

I've been thinking about it a lot, and I have some thoughts. Um, my, I think that there are some systemic issues in, in healthcare that prevent some of these things that are really needed to have that clarity and have that perspective. I've been thinking about, um, sabbaticals, uh, for doctors. Um, the thing is, I don't think the doctors are going to take it. Um, so it's almost like I was talking to my husband, I'm like, do we do forced sabbaticals? So how does that work? Because I was basically, not that this is a sabbatical, this has been really hard, but I was forced to do this. I was forced to pause and I, that was not a choice I would've made for myself. And I, I think the clarity really came with that and the ability. To finally have a second to to breathe and think and reflect has been really valuable, and I I think all doctors and healthcare providers in general should have that opportunity without it burdening your colleagues though. The way the system's set up now is if you take if you take off, you take a sick day, vacation, you know colleagues are. having to carry your work and their work, and it's like burdening another person. So, you always have that in the back of your head, and you're trying to like do your own health, but you're burdening someone. So, it's like that push and pull is real, and I wish it wasn't quite like that.

Yeah, that's a great idea, these sabbaticals, but with the support for remaining staff, as you mentioned. Another thing I was just thinking about is, sort of forced PTO, right? Because I don't— we're all Type A, like many physicians, just, you know, that's just how the culture and administrators like myself, we're also Type A. We're very driven and we're almost proud of the fact that we didn't take all of our PTO and, you know, because we're such, you know, dedicated professionals, but yet it can lead to some bad outcomes, you know, especially on the home front. And so, if you're forced to take PTO, that's just a practical thing I think that organizations could do and make sure that you take the PTO. And if possible, turn off, and I don't know why it wouldn't be impossible, is turn off your feed of your email. Because we'll go take our forced PTO, but then we'll still be on email trying to run things. I won't go into my story, but I have a similar story, and I would be in the hospital bed doing email because what would happen if I don't?

Yep. Same with me. I was in labor multiple times with 3 kids, and I was texting and emailing from my hospital bed. Yep.

Yeah. Yeah, yeah, yeah. It's crazy. So, there's definitely things. And then, for those who are watching and listening, many of them are in leadership position. We should also sort of take care of the people that we serve with. So, you as a residency director, Uh, has that gonna, is that going to change or impact how you sort of run things or train?

Yeah, I, that's a great question. Um, because I was, you know, I'm obviously reflecting on this a lot and, um, trying to think ahead. Luckily, like, I was always really into wellness and preached wellness, and I encouraged my residents to take off. And we have these things called like wellness days where they get these, you know, a certain number where they could take off and go to their medical appointments. You know, that comes with some challenges because maybe people don't take 'em because they're afraid they're gonna burden their co-residents. So that's another issue. But I think the part that was missing that I'm going to do a much better job is modeling it myself. So I was great with preaching and telling the residents what to do, but I wasn't doing it for myself. And that's part of leadership. You have to model it. Uh, and I think Just being on this leave, taking care of myself right now, and modeling that that's okay, and I'm going to come back and be an even better leader when I return, that's more powerful for residents.

And you're spot on about the modeling, because no matter what policies you might have, people aren't going to follow it if they don't see their leader living it. So, yeah, I would feel guilty if our CEO He never took PTO. And so we didn't want to be that one C-suite member around the table absent in it. It spoke a— it was quiet. It was never said out loud, but man, that's the way we all acted as a result. So that's really good advice. Speaking to the next gen of clinical leaders, so not just your psychiatry residents, but anyone, what would you share in terms of Hey, how you should approach your career?

I think you should approach it with purpose and intention and stay true to yourself, whatever, whatever that may be. There's no right or wrong playbook here. Everybody has to figure out for themselves what, what is meaningful for them, both in life and in medicine. And make sure that they have all of that.

Jenna, has there been any tools or anything that has shaped or formed you in terms of finding that purpose? You know, you talked about being true to self and finding purpose. Is there anything practical you might offer people? Because it feels really good theoretically.

Yeah, no, I mean, it's, yeah, it's vague when I say it like that, but to get into the nitty-gritty, for example, I Still don't call myself a writer. I still, that is something foreign to me. All right. So I just by accident realized I could write during this time. You don't know what talents or what is hiding beneath the surface if you don't have the time to, to think like you have not a spare moment. We get caught up in just the day to day and getting through the day to day. Yeah. What this has showed me is the chance to reflect and think is valuable, and it helped me. It's helping me get through this. That's my coping skill. I learned how to write, but I would say other people probably have other hidden talents like music or you know something else that gives them joy and. Helps them through difficult moments, and it's important not to give that up. I had no idea that I could write until now. This was just something new. Like, just, I'm figuring it out.

No, that's awesome. Hey, let's end on a kind of a fun thing, but it can be practical. Something your parents made you do as a kid where you rolled your eyes, probably like your kids do to you now. But now as an adult, you're like, man, I'm glad my parents made me do that.

There's so many things that, like, you know, in the moment you're just, you do, you roll your eyes and then, but you, years later, you kind of like think you figure it out that that actually made a difference. Um, there, my mom always taught me that if you get, um, like a bad grade or something like in, in school, that you always go up to the teacher and just kind of get, ask them about it or ask them like why or what you could do better or how you can improve. And I just was like horrified, um, doing this as a child. Um, and, uh, but it taught me, it taught me something because the time when I did, the, the teachers, they offered to stay after school or meet me before school for extra help. And it just shows that you can ask for help.

Yeah.

Yeah. I think that's what has been ingrained in me is you can ask for help. And that was taught at an early age.

Yeah, that's a good one. Wow, Jeff, this has been amazing. We talked about a lot of different things. Uh, we talked about some of the music that you mentioned and it's kind of, uh, interesting how it's just all sort of flowed into the common theme of our entire discussion today. But, uh, I think one of them was about mundane, turning the mundane into a masterpiece. And then, just the whole concept in terms of your life message of living with purpose and always be in the moment, obviously heavily informed by what you would share later with your cancer situation. We talked about growing up in Oklahoma and then ultimately Buffalo, where you then went to medical school and you married the love of your life that you met there and have 3 children. And, you chose Psychiatry, obviously, as a specialty to better understand people. And you do watch The Pit with your husband, who's an ED doc. And so that was kind of fun. And then we talked a lot about your JAMA article, Time Is Infinite, and sort of how you came to the conclusions that you did and how important it is to put yourself first. Don't think you're irreplaceable at work. You are replaceable, but you're not replaceable at home. I mean, that's, that's the big thesis. I mean, so it's really important to give your time, your energy, your mindshare to the home. At the same time, you love your work and you're very professional, but the home comes first. And so that was really good. And then we talked about some of the things that you could do definitely by modeling it to others and then talking about incorporating sabbaticals and also taking PTO. So do take your time off when you get it. So different ways of helping others achieve that. And then, you know, taking the time to think, and that's how you find your purpose. Because if you're so busy, you can't find your purpose. But if you take time to think, and you might find new skills out of that, like writing or, yeah, playing an instrument or something like that. So we, and then how you learn from your parents also to ask questions and ask for help. So how important that is. So we talked about a lot of different things today, Jenna. I'm gonna leave the last word to you. What did we miss or anything you wanna double down on?

Sure. I, I think we hit all the high points, um, of about wellness and, and what it means. And, uh, there's still a lot to learn there, and I don't think anybody has all the answers at the moment. Um, but one thing I did wanna say is, uh, about specifically about lung cancer is that We need to figure out a way to screen people who aren't smokers and develop guidelines there. And so we need more research into that area so that people like me could, could possibly get screened and maybe it's caught earlier.

Yeah. Jenna, I appreciate it. Again, as, as we all sign off, we all say a prayer for you and for 100%. Clean Sheet Healing, and thank you for being our guest on Digital Voices.

Thank you. Thank you for listening to Digital Voices. We hope today's conversation sparked ideas, reflection, and connection. Subscribe on YouTube, Apple, and Spotify Podcasts so you don't miss an episode.