1 - Balancing Professional Demands and Personal Well-Being

In every operating room, in every ward, in every clinic, and every team meeting, a silent battle brews. Conflict, negotiation, identity. Welcome to the Scalpel and Sword podcast, where I, Dr. Lee Sharma, physician and conflict analyst, Explore the hidden negotiations beyond modern medicine. Let's trade burnout for boundaries and learn the art of healing with precision and power.

Hi everybody. Welcome to Scalpel and Sword, a podcast about conflict resolution in medicine. I am so excited today to have as my guest, Dr. Misha Wallace. Dr. Wallace is absolutely one of the most amazing physicians I've ever met. She did her medical school in New Jersey at Ross Medical School. She did her internship and residency and pulmonary and critical care fellowship at the Medical College of Georgia in Augusta at Augusta Medical Center. She is now in practice in Opelika, Alabama at East Alabama Health. She is the director of pulmonary medicine. She is very active in teaching residents and interns, and in fact, she has been voted their favorite instructor, I think the last 2 years, right?

One for sure. I don't know about the second one for sure.

Okay. And I think that's a testament to how much she has to give to these young physicians. One of the biggest things that we deal with in medicine is being able to set boundaries to respect not only our professional lives, but also to balance the things that we love. And one of the things that Dr. Wallace loves that I think is really cool is she loves fashion, and I'm going to put The link to her socials in the description box. You'll have that in the show notes, but she is on socials as The Style MD.

Yep.

And I encourage you to follow her because she's amazing. So one of my favorite stories about Misha is, I guess it was about 6 months ago, I found a picture of this bag and it's the Ferragamo Mini Hug Bag. Now I will absolutely admit that I do not have the fashion knowledge that Misha does. I cheerfully admit that. But I saw this bag and it was like, I love this bag. And so I showed it to Misha. She's like, oh my gosh, this bag is awesome. But one of the things that I love that she said was, I want to see you with it. It's a beautiful bag, but I need to see you with it. And so over Christmas, I was shopping with my daughter and went to Saks and found the bag. And I told my daughter, it's like, I gotta send the picture to Misha to see what she thinks. And Rachel's like, you just want an enabler. like, no, I don't. I want somebody who's going to honestly tell me how I look with this bag. And I knew you would. I knew you would tell me that. And you did. You looked at the picture and you were like, yes, this bag looks great. And so I own the bag now. How long have you been interested in fashion? When did that become something that you became passionate about?

I think I've always been interested in fashion. Just culturally, I'm from Jamaica. We just really love to express ourselves with our outward garment. I grew up in Brooklyn. One of my first jobs was working at Banana Republic on Fifth Avenue. So I've just always been around fashion and just always found it as a way to express myself.

That is so cool. So were you already in— because you were a nurse before you went to medical school, so you were already very much in that medical world.

Yeah.

So this is something that's been Longstanding for you.

Absolutely. So I actually went to a nursing high school. So I started clinicals when I was 16 years old. So I've been in the hospital for decades at this point because I've been doing training since I was 16 to become a nurse when you graduated high school. And then my first couple of years of college was pursuing an associate degree in nursing applied sciences. And after that, I went to further college for a bachelor's in bio. And then on to medical school. I just wanted to say, like, in high school, while a lot of my classmates got to wear what they want, my last 2 years of high school, I was basically in a nursing uniform. And so on the weekends is when I'd be able to express myself through fashion. And I enjoyed wearing clothes because all week long I had to wear uniforms.

Yeah. Wow.

And I love too, on The Style MD, that you do incorporate your daily medical fashion into that, that you are encouraging all of us. It's like, you don't have to keep this for the weekends, guys. You can definitely express I think that's one of the things I gotta love it when you style your fig scrubs. I get that. It's like, oh, that's so cool. I love, 'cause you're giving inspiration to the rest of us. Um, also, I respect you so much as a content creator because I'm starting to figure out as I'm getting into this podcast world, how much work this is and how much dedication it really does involve to be able to put out good quality content, which you do. How long ago did you start The Style MD? At what point in your career did you jump into that?

So I think officially in 2020. 2020 was a very busy time at work, as you remember, and I would get home and I'd be completely drained, and I found myself watching other creators do things online. And so I found it as an outlet for that maybe 3 hours off that I had on a Saturday or something to like make a video more until officially 2020. Wow.

So this was something that you were using in the pandemic, obviously doing pulmonary critical care. You were really being stretched. Just, I, we talk about trying to go back to what 2020 felt like, and it's kind of a nightmare that we all wanna forget. And yet it changed us so much, but that's really awesome. That became something that was a stress reliever for you to walk outta the hospital and it's like, I'm going to Start creating this content. So obviously schedules change and you're in demand. I mean, you are, you're an excellent clinician. Your patients really respect you. You're respected in the hospital. Was there ever a point that you thought that or felt like that being a content creator, the hospital was starting to infringe upon your efforts to do that? Did you ever feel like you were having to set some boundaries to do that?

No, because this is secondary to what I chose to do for my career. So what I think is my life's calling is medicine. So this is secondary to that. So I never felt like it's impinging upon that. And I, my content creation works around what my first, my primary calling is.

That's awesome. So it's something you feel like you can balance pretty effectively, just knowing where your priorities are.

Absolutely. Absolutely. And I think that's anything in life. You have to figure out what is number one priority and everything else comes after that.

Absolutely. When you're in your professional world, because there are so many demands on you, have you ever felt like you were in a situation where you were being pushed to give more than you wanted to give professionally?

Absolutely. I think in 2020, we all felt that we were working more hours. Than ever before, even more than in residency. For me, I was working more hours and it was absolutely draining physically, emotionally. I started seeing other therapists during 2020 and started to find outlets for just the amount of stress that was happening. So yeah, I feel like there are times in medicine where it demands a lot more than you're willing to give. But it's not always like that.

And That's awesome. You really have, I think, a very clear grasp on your priorities, and I think that leads you to having a really clear set of boundaries. Is that something that you've discovered professionally? Did you have to find your way in doing that yourself, or did you have somebody who modeled that kind of behavior for you? So I think I've always had a really clear sense of boundaries.

I have a lot of people in my life that I look up to, and one of the persons I look up to very much is my Aunt Monica. She was a nurse, and she actually encouraged me to become a nurse. And I've seen her over the years set boundaries in her personal life and in professional life. So if I had to think about it, and I don't think I ever have before, it would be her. I think that the world is teaching us to set boundaries for ourselves as well. So gone are the days where our predecessors were in the hospital for 36 hours, 48 hours. And now our society has made it such that there are rules, duty hours, that set boundaries for us. So I grew up in that generation where the ACGME says you can't work more than 80 hours a week. So it still sounds like a lot, but it wasn't what our predecessors were doing. So The fact that the society is now saying that, yes, you do have to set boundaries for yourself, it makes it a little bit easier than it did for people who trained prior to when we trained.

Absolutely. I love it that you talk about your aunt as being somebody that helped you see how that worked. And I think that's one of those things, especially as female physicians, that's so valuable that some of us didn't have. I agree with you. I had my mom who was a physician who helped me see that. But it's really important that you had a mentor that helped you. And I think that's one of the great things about having resources like podcasts and having this kind of opportunity is hopefully other people can benefit from what your aunt gave you that you are now giving other people in terms of learning how to do that.

Absolutely.

I think one of the other things that I have really respected watching you professionally is that you are very kind, but very firm. At setting those boundaries. And I think it goes back to, and I'm going to reference the Ferragamo bag because it was a cool experience to go through that, but also have your advice on buying it. Ferragamo is going to have to sponsor this episode. I just, I think they're going to have to. They totally should, right? We should both get free bags off talking about Ferragamo on this podcast. That's just only fair. But I think that's something that women, we have a hard time doing is we want to be very giving. We want to be very kind. That's something that's really placed in us in terms of that's what it means to have that kind of feminine energy. And yet sometimes having that kind of presentation or energy, it's not as firm or doesn't come across as being as firm. Do you ever consciously think about having that kind of presentation or is that something that you feel like is just part of you?

I think it's part of me. And I know that's not the answer that everyone wants to hear. I think you can develop it, but I do think it's part of me. I am 5'9. I am pretty muscular. I've always been told that I have a presence. And so just being myself, people feel like they need to give me the respect that I think I deserve and that anyone deserves. There have been times where, for whatever reason, Maybe because I'm a woman, maybe because back then I was younger, that people would try to encroach upon those boundaries. And then I would have to stand for myself and professionally and precisely let them know that we can't go further like this. And, and once again, I go back to my aunt. She really taught me how to do that. She does it with grace, but she sets firm boundaries. And I think I do that.

Pretty well because of her.

I don't think I have to do it as much because my presence makes people realize, okay, maybe I shouldn't.

But I think that's so helpful because there are a lot of us that don't naturally have that. I am 5'1, so I definitely don't naturally have the stature, but the idea of having a presence and developing a presence, I think is huge. And I'm really glad you mentioned that. I think because it is something that I think we can develop. It does take some intention of saying, I'm going to set this boundary. You want me to come in and work this extra 4 or 5 hours. I have this commitment that I'm going to honor, and so I can't do this. And so this is what I'm going to do. I think that is something that we can learn. And one of the things that you referenced, I think having clear sense of priorities, medicine is a priority for you. It's calling for you. And I think we all feel that we're very blessed to be in the profession. The idea that we get to do this.

Absolutely.

Is huge. It's an honor to do it, but that also means we have to preserve ourselves. We have to take care of ourselves to be able to do it. So part of setting the boundary is being able to say, I'm doing this so I can be good at what I do. It's not that we don't love what we do, it's part and parcel of being good at it. And I think the fact that you speak to that is so huge. I love that you are able to do that. So obviously you are respected by your residents. They think a lot of you because of the value they place on your education. Do you ever feel like you have an opportunity or have you had an opportunity to share or talk about boundaries with your students? Is that something that ever comes up in conversation or is that something they get to see you model?

I think more so model. I have an affinity towards female residents, wanting them to stand up and wanting them to be heard. Because I work in critical care, we often run The codes in the hospital. And a lot of times, like an intern resident that happens to be female, they'll walk into a room and automatically cower. They're trying to run a code, but no one hears what they're saying. And so I take those opportunities to say, you are in charge of this code. The patient is depending on you to have eyes over everything that's going on. You need to lead this team. They're looking to you. And for you to lead them effectively, they need to hear you. And so I feel that I teach especially female interns, because they're the ones that tend to cower in those situations, how to stand up and be heard in a room of men and women twice their age who have been working in the hospital for longer than they've been alive. Wow.

That's so powerful that you're absolutely using those opportunities, not just to teach clinical medicine, but also to teach them how to develop that voice. That's so huge. And that's part of the mentor chain, the fact that you are able to do that with them. And I love it that you do feel that affinity towards those female residents, because they need that. So few of them have that opportunity. I think one of the biggest things I will tell medical students that are going off into residency is you have to remember that you are a commodity. You have to remember that as a female in medicine, That you are powerful. People will seek you out to get care because over and by and large, patients feel like female physicians do spend more time with them or a little more empathetic. So they do tend to seek out females more. And so as a result of that, you are a valuable resource in the house of medicine. And I'm really glad that you are showing them how to do that. Do you ever feel like in terms of establishing or like how, as you have done, established those boundaries and been very specific about the things that You express to clinicians, residents. Do you ever feel like you've had a backlash for being female?

Not a systemic backlash, meaning not because of an organization. Individual, yes. You know, and everyone will have that. Someone will like you for whatever reason, because you're old, you're young, you're tall, you're short, you're Black, you're white, you're male, you're female. So I've had that. But not from a systemic standpoint, thankfully, no.

I'm glad to hear that. That's awesome. And I think that's something, as medicine is becoming more overwhelmingly female, we're probably having much less of that, which is awesome.

In the institution where I work, the CEO is female. Lots of the C-suite staff are female. So I think it's, I don't know if that's the same in different environments. This is the only job I've had outside of training. But I think that lends to me feeling very comfortable and feeling like me being a female has not interfered with my work at all.

That's, and that's so powerful. I think that as you get more women in leadership, anytime you get more women in leadership, that perspective is going to shift and you're going to see, I think, more power and more openness to that voice. So I think that's a great recognition. And for a lot of women who may not be in that situation, who may not be lucky enough to have female C-suite, female CEOs, I think that is something That maybe encourage them to encourage more women to get into those roles. I don't think that's something that's traditionally encouraged. The ability to interact with other women in those levels, in those levels of responsibility, I think that also you carry that confidence from that interaction to other interactions as well.

Mm-hmm.

So, even if it's not necessarily female CEOs, female C-suites, you're just gonna carry that confidence everywhere.

Absolutely.

Once you've learned how to do that, I think it does go back to, you talked so beautifully about training residents to have that voice. I think there's a lot of women who will listen to this podcast as like, I'm not sure I know how to do this. I'm not sure I know how to exercise that voice and set that boundary. What would you suggest to them if they were really trying to learn how to do this? Let's say they're out in practice, maybe they're in a very environment where they don't have, feel like they have a lot of power or don't feel like they have a lot of ability to set that boundary. What kind of things would you encourage them to try?

I say, much like anything else, practice makes perfect. I remember as a nurse in the emergency room, watching the residents go by with their textbooks and looking at all the pages that they had highlighted and thinking to myself, this is, this actually happened. How did they read all that? How did that happen? And it was one page at a time, one day at a time. And then now you look at my library and all the books that I've read through medical school, did it. And, you know, it's listening to podcasts like this, it's listening to other women and things that they've done. I have a core group of friends of which you belong, and we get together once a month, twice a month, and talk about things that we find challenging at work and how we've overcome them, or we give each other advice.

Yeah.

And so surrounding yourself with women In those same situations and learning what they did may empower you to do the same thing or something similar. And just practicing setting boundaries in even small spaces, and then it'll get bigger and bigger. Another example I have of this more recently is when I was asked to teach the residents. So when I moved to where we live and work at this hospital, it's a community hospital. I had no intentions of going into academia. I wanted to be in a community hospital, and that's where I was. Now, this residency program was just started about 3 years ago, so about 3 years after I started this job, and they asked me to be a part of the residency program. And at first, I didn't really want to. I never really wanted to do it, but it was vital for me to be a part of this program because at the time I was the only critical care physician practicing at the hospital. And so I had to then decide, am I going to do this? And what boundaries am I going to set so that what I love, the practice of my patients, isn't compromised? And so I came up with a plan and I discussed it with them and I said, these are my boundaries and this is what I can do and this is what I can offer. And I wanted to give my best to those residents as well. And so I made sure that I was giving my best, but I also made sure that I was still protecting my time. And also getting something out of it. And so what I got out of it is I said, now I'm going to have to teach these residents. So I for sure need to be up to date on everything. So it's going to drive me back to my CMEs, going to drive me back to reading more every day, just so I can have the most up to date information to teach these residents. I made it so that I would benefit from it. So I'm going to learn more. I'm going to be able to have more up to date information so I could teach these residents, but also my time was protected so I can get rest. So I wouldn't be overly stressed. There is a psychologist or psychiatrist, or maybe it's a motivational speaker, I'm not sure, who used to be on the Oprah Winfrey Show. Iyanla, I believe her name is. And I'll never forget something she said. She said, you can't pour from an empty cup. And so I needed to allow myself to fill my cup up so that I can give to others. That means reading, that means resting, that means doing things that bring me joy so that I can go out and do what I think I was called to do, which is medicine, and now to teach young physicians.

Oh my gosh. That is so beautiful. So I wanna take a second to unpack this because what you just said and going through this process of this was something that arrived in your professional career that you were not planning to do. You were not planning to be in academia, but here it is. They need you. And even though they need you to effectively train these residents, the way that you looked at this was. I want to, if I do this, I want to give my best in this process.

Absolutely.

And this is why I'm going to set these boundaries. That's gonna be the only way to be fair to them, but to be fair to myself as well. And if I'm going to do this, this is the way that I'm going to do this, that you didn't just say yes or no. 'Cause I think sometimes, first of all, when we as physicians are asked to participate in something, I think sometimes the knee-jerk reaction is yes or no.

It's one of the two.

It's like, no. This is a starting point. And this is all about when we talk about conflict resolution negotiation, so often we look at this as a black and white issue. And instead what it is, is a starting point. It's a starting point to develop something that's going to be sustainable product. The other thing that I loved about what you just said is when people use the word setting boundaries, when that's a phrase that comes up, I think there's sometimes a perception that setting boundaries is selfish. And it's the furthest thing from it. It is what you said. There's no way that you can pour from an empty cup. The reason I'm setting this boundary is because I want to be able to serve, help, do in a capacity that can benefit all of us. But to do that, I have to have it in such a form that I'm still getting fed so that I can feed you.

Absolutely.

The way that you structured that, I think is an object lesson for so many women and so many women in medicine, because We are not necessarily taught or trained to approach it in that fashion. And the fact that you did, number one, probably makes you happier working in this system that you're having to teach the residents. So it actually makes you happier because you're getting to contribute, but you are also, as you said, getting to fill your cup. They benefit from your education, not only medically, but also what you're teaching them in terms of the style MD of what you're doing. I think it becomes the whole package, but it also benefits everybody.

Yeah.

And just that to me, so everybody listening to the podcast, that was the price of admission. What you just heard, that's the thing that we're all going to take with us because I think that's something that we aren't taught and you modeled it so beautifully. So that is wonderful. As you continue on in your career, as you continue on taking such good care of patients and doing these things, Do you see yourself at any point in time shifting maybe those boundaries around? Maybe I'll change these boundaries. Maybe I'll wanna do more of X and less of Y. How do you see that in terms of setting more boundaries? Would you go back and reassess your priorities? Who would you talk to? What would that process look like?

Yeah, I think we all have to do that at various times over our career as our lives change. So I don't have children, but I can imagine for people who have children, their time at work may be different when the kids are in diapers versus when they're in high school versus when they're off to college. And as my life changes with whatever is outside of medicine, I will then have to change my life in medicine to kind of make me that whole person, if that makes sense. And so for now, I don't really see much changing. I love my job. I love what I do. I think my schedule is great. I've created it that way. But if I had to change something, I would go back to the basics. What is most important to me? That's gonna come first and everything else will fall in line after.

And I think that's also just huge. The fact that you use your priorities as a North Star to figure out how you're gonna set those boundaries. Um, and, but that also means, and you illustrate, you talk about it so clearly that we do have to understand what our priorities are. Sometimes we don't always go back and sit down. We think we know what we want. But in terms of actually sitting down and writing, talking, verbalizing this with another person, these are the priorities that I want. These are the things that are important to me. And this is where I wanna direct my time and energy so that I structure a life that feels very complete rather than just, I do one thing and I neglect other things. None of us wanna live that life cuz we all have things that we love to do. I think that's, and I think the idea of that process evolving Professionally, personally, to go back and revisit. Because sometimes if you don't, it's like, you know, what I'm doing now with my life and the boundaries I've set don't work for me anymore. I haven't revisited them in 15 years. I might need to go back and do that again.

Exactly. January 1st is a great time to do that. I do it every year. I know it's cliché, but I really go back and look and see what I've done with my life for the past year and what my goals are for this year. And sometimes they're really small, just small changes that I want to make that I feel would make me more fulfilled. But I do it every year. And you can do it twice a year or 4 times a year, as long as you have a set time that you go back and look at things. Do I like the way things are going? Should I change anything? I think us as physicians have kind of been taught that if you're not doing something, you're lazy. Or this is, I think that's the way we saw it in medical school. If we're not studying, then, you know, what are we doing with our lives? If there's not another goal to reach, what are we doing with our lives? And just realizing that taking time for yourself, taking time to relax, taking time to rejuvenate, if you will, serve only to make our priority, our work, whatever we put in number one, in number one space in our life, that much better. So I can serve that much better if I'm well rested, if I have taken time to take care of myself. If I'm sick and tired and stressed, then I can't do anything right. And so taking the time out and realizing that is not a negative thing. That's a positive thing that I have realized that I need this week to rejuvenate myself, to relax, to get the stressors out of my life so that for the next 3 or 4 months, I can give the best to whatever I want to give it to, whether it be teaching or working in the hospital or creating content, whatever it is that you, that's your priority. You can do that better if you've taken time to rejuvenate.

That's so powerful. I think that's something that not enough women physicians get to hear. I think that's not a message that a lot of women physicians— someone intentionally telling them part of this is taking time to rest. Part of your boundary exists so that you have time to rest and rejuvenate, and you have to do those things. And also not having to validate taking time off, not having to validate, because I think that's another thing, unfortunately, that sometimes happens. Is we feel like we have to justify our relaxation or justify taking time for ourselves. It's like no, this is part and parcel of what we need to be able to do what we have to do. But to have somebody actually give you the permission to say it is okay to sit down and rest, it's okay to actually go get that facial, it's okay to go get that massage. It's one of our other friend group. friends, Ruby, who's also going to be on the podcast at some point. One of her biggest things is she makes me go get my nails done because I didn't want to do that. It's like, it's not something I have time for. I really can't justify doing that.

And she's like, why? Mm-hmm.

You work all the time. This is something you do for yourself. You have to stare at your hands on a keyboard. Why don't you go get your nails done? And I think having someone say that to you, having your colleague, your sister, your dear friend say to you, this is something that's okay to do.

And not only—

We're giving permission to do that.

Not just okay, it's necessary. It's necessary. If we don't do it, we can't do anything else right. If we don't take this time to relax and to do the things that make us happy, everything else is going to suffer. It's like going without sleep. You know what I'm saying? It's okay to go to bed tonight. No, it's necessary. You need to go to sleep. You need to go to sleep so your blood can be reinvigorated. Rejuvenated so that you can do the things that you need to do. And so the rest, it's necessary. Yes.

I love how you say that. I love how you phrase that. That is so powerful. This has been an amazing conversation. I so appreciate you being here. If people wanna follow you on social media, certainly I'll put some in the show notes, but how can they find you? I follow you on TikTok, I follow you on YouTube, and I follow you on Instagram, I believe.

So, and it's all the same handle, it's the_stylemd. So that's Instagram, that's the TikTok, and that's for YouTube.

Awesome. So before I let you go, tell me what your next purchase is going to be.

So I've actually been on a no-spend quarter. And so, okay, this is like I said, something I do every year. So I wanted to just look at my finances, just make sure I'm not— because my other passion is finance, and that's why I don't feel guilty all my purchases. I'm going to Paris for my birthday in a month and a half, and so my purchase will be there. And I think it's going to be a timepiece because I'm not wearing a watch, as you see. And so I think it's time to, to get a watch. I don't know which one it's going to be yet, but it'll be on my YouTube channel and on my Instagram, TikTok, and more.

Awesome. I'm— first of all, I'm excited. Happy early birthday. Paris is amazing. I'm so happy for you. I cannot wait to see what you come back with as a timepiece and Maybe some other stuff as well. So I can't wait to see what you come back with. It's going to be awesome. We will put all of your socials in the show notes. We'll probably also link the Ergamo bag as well. And yes, it's been such a wonderful pleasure to have you on the podcast. I think your ability to set boundaries, your reasons for setting them, and your ability to share that with other women physicians is so beautiful. So thank you so much for being here.

Thank you.

Please come back and be on the podcast again.

Thank you so much.

That'd be awesome.

Thank you. All right.

Every episode is an invitation to speak, to negotiate, to choose. I'm Dr. Lee Sharma. Join the dialogue by subscribing to Scalpel and Sword. Until next time, peaceful warriors, may your choices be sharp and your voice be even sharper. This podcast is a reflection of lived experience and research in conflict resolution. The Scalpel and Sword is not intended as medical or legal guidance. For personal matters, please consult a qualified professional.