FHC #64: The hero’s journey in healthcare

American writer Joseph Campbell famously studied and diagramed the hero’s journey in folklore and literature. That journey begins with a call to adventure, prompting the hero’s reluctance—often due to a fear of failure. Along the way, mentors lends guidance and help, but it is ultimately the hero, alone, who must summon the courage to win the day.

In this episode of Fixing Healthcare, hosts Jeremy Corr and Dr. Robert Pearl join ZDoggMD to discuss the hero’s journey in healthcare. In every medical professional’s career, there is a calling, a fear of failure and people along the way who provide support (or pose additional challenges).

Who are healthcare’s heroes these days? What are the dragons that need slaying? How do we overcome our fears of failure in medicine? What journeys lie ahead for the future of American healthcare?

The show concludes with a question posed in our last episode. We asked listeners on social media: “What medical hero or moment in history deserves its own Hollywood adaptation?” The answers may surprise you.

For more, press play or peruse the transcript below.

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Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple Podcasts or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.

 

UNFILTERED TRANSCRIPT

Jeremy Corr:

Welcome to Unfiltered, our newest program in our weekly Fixing Healthcare podcast series. Joining us each month is Dr. Zubin Damania, known to many as ZDoggMD. For 25 minutes, he and Robbie will engage in unscripted and hard-hitting conversation about art, politics, entertainment, and much more. As nationally recognized physicians and healthcare policy experts, they’ll apply the lessons they extract to medical practice. Then I’ll pose a question for the two of them as a patient based on what I’ve heard. Robbie, why don’t you kick it off?

Robert Pearl:

Good morning, Zubin. How are you doing?

Zubin Damania:

Top of the morning, Robbie.

Robert Pearl:

Excellent. I’ve heard from dozens of listeners, who have said they can’t wait to hear us talk about the hero’s journey that you mentioned in our last Unfiltered episode, and I promised that we would explore it today. So let’s dive in. Can you tell listeners a brief summary of Joseph Campbell’s ideas and his model?

Zubin Damania:

Yeah, so Joseph Campbell studied mythology and what he called the monomyth, the single myth that crosses almost every human culture that he studied, is this idea of the hero’s journey. The idea that the hero, all of us, really, starts out in one place, and then there’s a call to adventure, because there’s something not quite right there. There’s a call to adventure, and then there’s a whole series of things that happens. There’s a mentor that comes and takes them, helps them leave the shackles of inertia and fear, go out into the world and fight the dragons and do the trials and suffer the ordeals, all to gain some sort of atonement or knowledge or elixir that then they return with, for the benefit of all people. And this is such an archetype throughout human history, in a spiritual sense, in a actual, absolute sense, and looking at all our pop culture too, the hero’s journey is woven into much of our most popular movies and books and stories and ideas.

Robert Pearl:

As I remember Joseph Campbell’s work, there’s also early in the path, a mentor, a gnome or a dwarf, someone else who gives the hero the encouragement or the ideas or breaks through a thought process that the hero is stuck on, so that the battles with the dragons can begin. How do you see all of this happening inside of medicine? Who are the heroes? What’s the arc? Where should we be looking? What should we be teaching medical students? Tell me how you apply this inside the medical realm.

Zubin Damania:

I think every single person who works in healthcare undertakes the hero’s journey, in some sense. They start out as having not the knowledge and the skills and the ability to do what we do, which is very difficult, and then they embark on this journey. And the mentor can be anybody, anything. Nowadays it can be a podcast that opens people’s eyes, that suddenly expands their circle of understanding or their circle of compassion. What they thought was one way is actually seemed to be not true. It’s actually a bigger way or a more inclusive way. And sometimes the mentor is very specific. For me, it was Tony Hsieh, who was the CEO of Zappos, who snapped me out of my inertia and my fear and said, “It’s clear you want to do these things and change these things. Why don’t you do it?” And helped me quite a bit.

Zubin Damania:

For others, it may be a teacher. It may be a family member. It may be a physician assistant. For me, it was the person who taught me that procedures aren’t something to be afraid of. I was always so afraid of being a klutz and screwing stuff up. And they’re like, no, no, no, no, no, here, here’s how you need to look at this. And so it can be anything. And the idea then ,there’s the personal heroes journey, but there’s also the systems journey. Our system has gone from what I call health 1.0, and then the hero’s journey through 2.0 and the trials and the tribulations and the struggles of our technocracy, the administrative technocracy of 2.0, to the 3.0 return of the hero. So it actually has ramifications throughout medicine, both individually and from a systems stand point.

Robert Pearl:

Are the dragons the diseases, the system or the people?

Zubin Damania:

Sometimes the dragon is us. I really think that the more I introspect on this, the more our dragons are all self-created, because you can say, “Oh, it’s cost and it’s insurance, and it’s corporate medicine and private equity,” and it’s this and this and this. And those are all projections. We haven’t really addressed the internal dragons. The fact that we are very highly conditioned, fear bound creatures, and we get the system that manifests who we are. So maybe the dragon is us. And that’s a difficult journey, but that’s the classic Joseph Campbell spiritual hero’s journey.

Zubin Damania:

The idea of atonement with the father is a part of what he describes in the hero’s journey. And the father can be God. The father can be this idea of oneness and how we feel so separate, and the idea of our own ego, and how do we square that with this sense, this deep intuition, that we’re much more than we think we are. Yeah, it gets spooky and weird, but honestly this is the heart of the matter. And I think the hero’s journey is such a good framework for looking at that for all of us.

Robert Pearl:

So you described your hero’s journey, becoming a doctor, mastering procedures. How about your journey to becoming a transformational leader?

Zubin Damania:

And I’m still uncomfortable even with that term transformational leader, because I still have such an impostor syndrome around this, but I would say that there are all concurrent lines and levels of development in the hero’s journey. So for me, it’s funny, my story, Robbie, it’s weird. It falls classically into this hero’s journey kind of archetype. And I’m not saying I’m a hero or anything. I’m saying it pencils out. Here I am at Stanford for 10 years as a hospitalist and I feel very dissatisfied with how medicine is done.

Zubin Damania:

I feel we don’t prevent disease. We’re reactionary. We’re spending all this money and I feel disconnected from my patients, from myself, from my family. Then comes the mentor, Tony, who is like, “Are you happy doing what you’re doing? Here’s a book you could read,” The Happiness Hypothesis by Jonathan Haidt. My mind is it blown by that. I get very depressed. And then I overcome the fear. I get this offer to go to Las Vegas and then go on the journey there.

Zubin Damania:

And at this point, I have to learn everything about how does healthcare actually work? What does leadership even mean? How do humans even function? How does the mind even work? Because that’s not something we technically learn in medicine. And so the heroes journey for me was battling all this misunderstanding, misconception of how things are, and then battling my own ego, through meditation and that, the spiritual journey, and then doing the work of building a clinic and doing the business stuff and learning operations and fighting that battle, and the mentor helping you, but stepping away quite a bit. And failing, and then feeling what that’s like, the hero setback, but you learn so much from that. And then trying to return with this knowledge, with this show that we do, going, “Okay, now, how can I actualize this in myself and others the best I can while still feeling like a complete impostor?” And so it’s still a journey that continues to unfold.

Robert Pearl:

You’ve mentioned impostor syndrome now twice. One of the books I really enjoyed reading was by Angela Duckworth, the book Grit. And she talks about how perseverance counts twice as much as talent. First, perseverance allows you to build ability, and then it allows you to apply it. And yet so many physicians feel like they’re an impostor, and I believe that it happens because we think that the successful physicians are just brilliant, and we’re not as brilliant as they are. Or they’re articulate. We’re not as articulate as they are. What they don’t see is how much perseverance and hard work goes in there. Anyone who does really well works hard and they hide that often. I think the impostor syndrome is really problematic because it so undermines the confidence and the willingness of people to step forward, and I believe that the whole idea that we are impostors is an illusion. What are your thoughts?

Zubin Damania:

Oh, I think everything we believe is an illusion, honestly, but I think you’re onto something here, Robbie, and I think impostor syndrome has to be reframed internally as, oh, I’m feeling a little uncomfortable with my abilities in this space, for some reason. That’s great. That means I’m pushing the boundaries and that means more diligence or more doing it, more pushing, is probably a good thing. Within parameters. Sometimes doctors feel like they can work their way out of any problem, and that’s also a bit of a misunderstanding.

Zubin Damania:

But absolutely. They don’t realize what your friend Malcolm Gladwell says, it’s these 10,000 hours of diligence. You can have no talent. You can have a bunch of talent, but if you don’t put in the energy, you’re not going to do it. So public speaking’s a great example. You can feel like a complete impostor and you just keep going and doing it, keep doing it, keep pushing. And then it just starts to click and at some point you go on stage and you’re like, wow, what a gift to be able to be here and connect with this audience. And that sense of impostorness is almost like that egoic reflection of me against the world, me separate, dissolves into the absolute oneness of being present with other beings in this mutually reinforcing way. And so yeah, I’m with you, man. I’m with you. That’s a long way of saying, I’m with you.

Robert Pearl:

You say that for some reason we feel uncomfortable. The reason is, everyone feels uncomfortable when they first learn to put a knife into a human being, I guess, unless you’re some type of sociopath, or stick a catheter blindly into a blood vessel and hope it hits the right place, knowing you may penetrate the lung. There are all these things that we do that are designed by nature to be unusual, because no animal can do them. And so we have to gain those skills. So from my perspective, it’s just an inevitability that all of us will have this discomfort. The question I want to pose to you is that, for a hundred people set off on this hero’s journey, how many of them get to the end?

Zubin Damania:

Well, this is the thing. Is there an end to the hero’s journey? It’s almost like if you’re looking for a purpose of life, which I think is a difficult proposition because life doesn’t need a purpose. It’s just beautifully radiant in the present moment. But if you’re looking for a purpose, it is this perpetual hero’s journey of unfoldment. So you may get to the end of one particular aspect of the hero’s journey and then a new journey begins. You’re called again. I can’t tell you how many times it’s been a reawakened, oh, wait, what? No, there’s so much more to do, and so much more to learn. And there’s a different mentor now, and there’s a different set of challenges. And there’s a different elixir of knowledge that you bring back.

Zubin Damania:

And at each stage, one thing Campbell talks about, is there’s the resistance. So the call to adventure, which is when Luke Skywalker is, he’s there on Tatooine. He’s been moisture farming and Ben Kenobi comes to him and he is like, look, dude, your dad was a Jedi. Come with me, let’s fight the Empire. And Luke’s like, no way, man. I still got crops to harvest. My uncle needs me. That resistance to the call is the first challenge. And in medicine, oh my gosh. If you’re going to call the troops to adventure right now to change medicine or to wake up a little from our own conditioning, oh, the resistance is going to be all over the place. There’s a million excuses the mind makes.

Zubin Damania:

So you’ve got to overcome that. And then when you do get the knowledge, there’s a resistance to coming back with it. You want to stay in this transcendent state. You want to go out and just pontificate about it. So, no, no, no, no, no. You have to come back and embody what you’ve learned. And so that means teaching others. It means maybe going and putting it in practice. And there’s a resistance to that. So at each stage, the mentor can help nudge you, or you can nudge yourself, or circumstances nudge you back.

Robert Pearl:

I don’t know about you, but one of the hardest journeys that I believe that doctors are going to have to go down is going to be confronting the end of life and dealing with the realities that death is an inevitability, no matter how long we can prolong it, particularly as our ability to prolong life becomes that much greater. How do you envision this hero’s journey progressing?

Zubin Damania:

And so many of the classic heroes journeys involve a trip to the underworld, to actually address the face of our biggest fear, which is mortality. The fear of loss of control, of helplessness, of all these issues that are so central to the human, we think are so central to the human condition. And of course, in medicine, we’re on the front lines of that. And so if we don’t heed the call to actually address those things, to look at those dragons in our own psyche, then how can we address them for our patients, and what ends up happening is we obfuscate them with our own projections. So, no, no, no, you know what? One more procedure is what your loved one needs, not talking about comfort, not talking about palliative care or whatever it is, or even having the conversation that you know what, life is not infinite. And it’s not a failure to focus on comfort.

Zubin Damania:

Those are crucial things. And then the economic ramifications, the emotional ramifications of the survivors, all those things. When I do talks, I often perform a song that I did a while ago called Ain’t The Way To Die, which is a parody of an Eminem and Rihanna song about end of life. And I do it for people that [inaudible] why would you do it for this audience? Because every single person in the audience has had a loved one or has interacted with someone who’s been in that position where they haven’t had the conversation, they haven’t talked about end of life. There’s all this resistance. And it illustrates that resistance and how we might actually overcome it by making people feel something, like, oh my gosh, it’s always too soon until it’s too late to have the conversation.

Robert Pearl:

I don’t know if you’ve ever watched a particular YouTube video, but I’ve watched it, I don’t know, many dozens of times. And it’s the Susan Boyle Britain Got Talent tryout. Have you ever seen that one?

Zubin Damania:

Oh, it’s amazing.

Robert Pearl:

Yeah, for people who may not know it, it’s been seen by 260 million people. So most of us have seen it at some point. Susan Boyle comes on stage and she’s dressed frumpier than any other contestant. Simon Cowell asks her how old she is and she replies 47. The audience snickers. She can’t remember the word village when Simon ask her to describe where she’s from. And then all contestants, he asks, who do you want to be? And she says, Elaine Paige and the cameras pan to the audience. They’re rolling their eyes with smirks on their face. And they communicated with their body language, she’s a nobody, she’s a failure. The look of pity, it’s everywhere. And then she says, what song will she sing. And she says, “I have a dream, from Les Miserables.” And the music comes on, first three notes that come out of her voice, beautiful.

Robert Pearl:

A golden voice, shocking people. And then she sings the classic line, “I had a dream so different from this hell I’m living.” And the audience is on its feet. The place goes crazy, but it’s just the start of her journey. Simon becomes her mentor, gives her a record contract, new wardrobe, hairstyle, makeup. She confronts her Asperger’s. She goes through a mental breakdown, maybe from coming in second on the show. She goes on to make eight albums, sell 20 million records, nominated for three Grammys. She comes back at her, she continues to entertain. I watch that to tell myself how wrong we are as doctors when we judge patients and the massive mistakes we make when we dismiss people.

Robert Pearl:

Our mental models of healthy and unhealthy are so strong that even when our brain tells us we’re wrong, we struggle to change them. And I bring that up because again, having watched this dozens of times, you would think that I would now be an expert at not doing these things, but I still have this tendency to make these judgements on externalities and to not take people as seriously as I should. I’m not sure that that hero’s journey, as you say, is ever able to be fully completed.

Zubin Damania:

Wow. And that’s beautifully put. And here here’s a couple thoughts I have just hearing you talk about that. And that Susan Boyle thing is amazing. Every single one of our patients is on a hero’s journey, and once we see that, and once we figure that, hey, maybe we’re partially a mentor on this hero’s journey, in a certain way, on a certain aspect of their journey, that changes everything. And maybe we’re on the hero’s journey, and this patient is our mentor and that changes everything. And maybe when you talk about our judgments, Robbie, that is part of the thinking mind. The mind is a judging mind. It’s a comparing mind. It’s a thought generating mind. It’s a secreter of thought and the thoughts aren’t us. They speak in our voice. They use the word I when a voice in our head talks to make us believe that it’s us, but it’s not us.

Zubin Damania:

We’re actually the space those thoughts arrive in, we’re the awareness of that space those thoughts arrive in. So self-forgiveness when we do judge, when do get caught in that, I think is the order of the day, that then allows us to be better. And sometimes a hero’s journey is not this, Susan Boyle was a great dramatic example of that, but maybe it’s just being a little self, little less reactive with your kids, or a little more present. Maybe that’s your hero’s journey, that one arc and that’s enough. It doesn’t have to be so grand, although those grand heroes arcs are what make it so resonant, the Star Wars arc that George Lucas actually used Campbell’s work to design the first star wars series and that’s why it was so good. That’s why the prequels were such trash, and the sequels, weren’t very good, because the monomyth that we all resonate with deeply is right there. But yeah, self forgiveness, really, really powerful.

Robert Pearl:

Speaking about mentors, what’s the best advice you’ve ever received along one of your hero’s journeys?

Zubin Damania:

It was really, it was Tony Hsieh again. And he said, “You’re so afraid of what people think and how you’re going to be received and you’re always making jokes to try to put yourself, distance yourself from any vulnerability and to make yourself feel safe, it seems like, because anytime there’s two people in the room and I’m with you, you’re joking the whole time. And you’re a pretty, actually serious, reasonably thoughtful guy. Why don’t you just be yourself? Why don’t you just be authentic and don’t worry about the fear of what people are going to think and that sort of thing. It’s something that I’ve just noticed.” And of course, initially I was so defensive. I was like, what do you mean I’m making jokes? And then the more I felt into it, the more I realized, oh my God, he’s absolutely right.

Zubin Damania:

So it was such amazing advice because it allows this huge burden of trying to be somebody that you’re not to protect this seeming self from others, when that relaxes, then you’re truly just authentic. And that’s what Susan Boyle did when she sang that song. She’s like, this is me. How scary must that have been for her, seeing the audience rolling their eyes and Simon Cowell who’s notorious for being a butthole, it’s like, oh my gosh, it’ll make you cry just thinking about it.

Robert Pearl:

Absolutely. Someone once said that courage is not the lack of fear, but the ability to move forward, despite the fear. Has your fear disappeared and you’ve just learned to go past it or have you somehow been able to conquer some of your fears?

Zubin Damania:

The fear is always there. And actually on this last silent meditation retreat I was on for eight days, fear was the main theme, it felt like. It was this fear of helplessness, fear of vulnerability, fear of losing control when you realize that your thoughts aren’t you and your identity is very, it’s a construction, that there’s a deep fear. And I think that the trick is letting that fear be there, but acting anyways, like you said, that’s courage. And understanding that fear is just the mind trying to keep you safe, but it’s not often correct.

Zubin Damania:

It’s just like a car alarm that goes off when it was bumped. It doesn’t mean that someone’s breaking into your car. So you can feel it that’s okay. Let it pass through you, but don’t let it rule you. And it’s easy to say, but very hard to do, and you need support. You need people, again, to help and mentor and be there. And a lot of people, unfortunately don’t have those folks. So again, in medicine, I think it’s incumbent on us to try to be that person for our patients whenever we can.

Robert Pearl:

It’s interesting as you talk about it. I’d never put it into this context. When I think about two of the best pieces of advice I’ve ever gotten, I think now, that there were about fear. I wouldn’t have thought that before this conversation. One was from my mom. I was in 11th grade and I was wanting to become a class officer. And I knew that I could run for vice president and win overwhelmingly, but there was a very difficult candidate who wanted to be president. That’s really what I wanted to do. My mother said, “Never aim lower than you really want to go.” And I was able to run for that and win that particular race and enjoy that opportunity that I never would’ve had, had I yielded to that fear.

Robert Pearl:

And then the same thing actually happened when I was had the opportunity to become the CEO. I’m not even quite sure it’s fear. Although, as you know, at the time, Kaiser Permanente was down to two days of cash and had to borrow cash to stay viable. It was not a great job, but it was just not something that I necessarily thought that I wanted. And I went to one of my mentors, a physician, one of my teachers in residency named Lars Vistus. And I told him this story. And he said to me, “Robbie, windows open and close. And when they open, you better jump through them.”

Robert Pearl:

And so in both cases, whatever the resistance exactly was, whether you want to call it fear or you want to call it wisdom. I’m not sure which it might have been. I think that having that opportunity and it goes along with something that I’ve said learned from other people. We tend to regret the things we don’t do, rather than the things that we do do. And certainly, both of those chances that I had turned out, well, maybe that’s why I have such fond thoughts about them. But I think that the idea of taking action when you have that opportunity for something that you think is valuable, is probably a pretty good lesson for all of us going forward, even when we are afraid.

Zubin Damania:

That’s beautifully put. And I think that idea of, we regret the things we didn’t do rather than the things we did, I look back on my own past, and there’s a lot of stuff that, oh, you could have done it differently. Could have done it that way. Honestly, I wouldn’t have done anything differently. It just landed me right in this present moment where there’s so much still to do and it’s all unfolding perfectly and beautifully. So yeah, be fearless as much as you… Fearless meaning, let that fear be, but don’t let it change what you’re doing. I love your mother’s advice and your mentor’s advice. It’s beautiful.

Robert Pearl:

The last program we had, where we talked about the movies, the one that led to the question about the hero’s journey, I received so many individuals sending ideas from movies they would like to see made about medicine, the conversation that we had. There were people talking about Virginia Apgar who in 1952 developed a 10 point scale associated with her name and it saved tens of thousands of lives of children. Galen, living in the second century, who founded the scientific method in medicine that continues as the foundation of research and discovery today.

Robert Pearl:

The Blackwell sisters in the middle of the 19th century became the first women to become physicians in America. And of course, Marie Curie, who developed the theory of radioactivity, won two Nobel prizes, and ultimately died, as you know, from aplastic anemia, from the research that she did with radioactivity. But as I thanked people for their ideas, and I have to say, probably I had 20 different films, all of which would’ve been great. I was struck. No one mentioned anyone from the 21st century or even from the end of the 20th century. Are there no heroes today, or is it that there’s no problems that’s large enough to require heroes or no way to recognize heroism until after people’s careers are over and complete and maybe until they’re dead? What’s going on? Why does there seem to be so few heroes today?

Zubin Damania:

What a great observation. And I think, it’s all those things you said, but I think there’s also this component that mankind is actually evolving into a complexity level where the single hero, the Steve Jobs, for example. That’s a good example of he was maybe a partially 21st century hero to some and villain to others. But this idea that the single human is no longer so essential as this network of humans. So for example, that NASA and the European Space Agency were able to put an incredibly complex scientific instrument where it’s basically human consciousness peering back into the universe, basically the universe looking at itself, in a way that’s so incredibly beautiful and complex, could never have been the work of one person or one hero.

Zubin Damania:

So instead it’s the transcendent work, often, of a group of humans working in concert together over decades with all the resources of government and industry and private sector together. That’s heroism now. And so pointing to one person is so difficult, but pointing to, wow, look what this group of people were able to do, it’s transcendent, I think that’s maybe where we’re shifting and maybe that’s why it’s a little harder. So it’s less of a cynical, where are the heroes and more of a, oh, we’re all heroes, especially when we work together.

Robert Pearl:

You remind me of a conversation that Jeremy had on one of our other Fixing Healthcare shows. We talked at that time that this is the 15th anniversary of the iPhone, the Steve Jobs reference you made. It’s the 10th anniversary of CRISPR, the technology that can be used to alter genes. And it’s the start of the post-Roe Supreme court. Which of these three factors do you think will be most important a decade or two from now?

Zubin Damania:

I really think it’s that iPhone piece because this is where the existential promise and threat comes in because the iPhone has changed a generation of children. It has really exponentially actualized social media, for better or for worse, and I actually worry about it for worse. And it’s given us the universe’s knowledge in the palm of our hand in a way that, the classic saying is Bill Clinton had less access to information than a tribesman in Africa with a smartphone has now. And that is going to continue to transform society and the human mind in a way that CRISPR, okay, we’re hacking our DNA and that kind of thing, that’s cool. That’s going to have ramifications. Post-Roe world means that’s politics and policy and medicine. That’s all important, but man, that smartphone, the change that that’s wreaking on us that we don’t truly understand yet, I think that’s going to have the biggest impact existentially for us.

Robert Pearl:

Amazing answer. Jeremy, your question for us.

Jeremy Corr:

I know so many people, myself included, who’ve had the situation of either a boss that doesn’t believe in them and says, “Hey, you’re never going to make it further than this,” or, “You’re never going to amount to this,” or a parent or some person in their life who doubts them or pushes them down. And I know a lot of people get inspiration from this. Many of the big famous CEOs and successful people in the country have had someone like that in their life who either is, it gives that said person a chip on their shoulder to either work harder or maybe it gives them the understanding that, “Hey, I’m not in the right line of work. Maybe I need to shift what I’m doing or think differently about some things.” Have either of you had some sort of antagonist like that in your life who’s doubted you or told you you couldn’t amount to what you have amounted to, and how did you deal with that, learn from that, grow from that?

Zubin Damania:

Yeah, this is one of those things where you wonder whether these antagonists are actually really meant to be there, and think they are. They’re really essential. And it’s how you respond, it’s a test of the hero’s journey. It’s one of the big trials and tribulations. For me, it’s funny, part of the hero’s journey in the classic Campbell sense, is the father, this atonement with the father, and it can be the literal father. For me, I think it actually is the literal father. So my dad, internist, immigrant physician, private practice, central valley of California. He was always the voice narrating my decisions through life and even though, because I swore I’d never be a doctor because he was one. Then I went into medicine because I felt the call to it. And then his influence was constantly there.

Zubin Damania:

And it was always a, he began coming from India with nothing in his pocket, seeing that you could be homeless and on the street in a second, conditioned him a lot. So it was a lot of fear based decision making and caution and don’t take risk and that sort of thing. And so for me, it was this atonement with, he’s got a point. You should build up a safe base, but at the same time, use that safe base to go out in the world and do what you’re really trying and meant to do and that means taking risks and making yourself uncomfortable and really going out there where the ice is thin. And what’s funny is it comes full journey.

Zubin Damania:

So the hero’s journey comes back and the father in his eighties now recognizes, wow, oh wow, you did something that I wish I had done. You went out and did what you really loved to do and took risk and so on. And he loved doing what he was doing, but again, he had a different upbringing and a different set of circumstances. I was blessed to have his base to launch my own risk taking from. And so for me it was that antagonist was also one of the loved ones in my life, very important person.

Robert Pearl:

I was fortunate, Jeremy, I had a very supportive family, wonderful parents. And along the way, really at every stage, I had mentors who propelled me. I can think back even to elementary school teachers who were so encouraging, to high school, to college, to medical school, residency. So I would say I’ve not had that experience, not to say I didn’t face complex personal situations, but I could overcome them, and I had enough support to be able to overcome them. But I’d say the one time that I would point out, and I’d say it’s maybe the darkest time when I was CEO, was a vicious attack from the press and the state regulators, and the two coming to together in a way to want to be able to be critical. It was very specific to a transplant program.

Robert Pearl:

150 kidney transplant plants had been done. Not a single patient had died. 149 of them were successful, but it came up against the national transplant body that didn’t like the fact that Kaiser Permanente, not a university, was doing transplants with these kinds of results and the reporter came after us for a variety of small things. There was a whistle blower who had been penalized for bringing alcohol to work and fired. And he was the one who fed the information, and there was a state regulator who wanted to have the support and look for… Everything was aligned in the wrong way.

Robert Pearl:

And the problem is that when you are the leader and you’re watching your people get beaten up, it’s like watching your child get struck by bullies on the other side of fence. And no matter how hard you shake it, the barbed wire at the top stops you from getting over the top. And I think at some point, and that’s why I asked the question to ZDogg earlier, to Zubin earlier, we can’t all complete our hero’s journeys. And I actually think that some of the hero’s journey is not being able to find that elixir at the end, because maybe those elixir’s are not really what life is about, but it’s being able to move on and come back despite not having them and the success that we had from a quality perspective, from a growth perspective and the respect of the nation around the quality that was provided and excellence of the physicians, that became the reward in the end.

Robert Pearl:

But the pain of that moment I felt, and I feel bad for anyone, as you say, who has that boss, who has the power and you can’t do anything about it, or the person who stands in your way, when you know that you should be able to get past that door. It’s just incredibly painful. And maybe the hero is being able to get past that and to be able to resume the wonderful life and productive life that you had prior to that. And to recognize that it’s not about you, it’s about them and be able to move on, but it’s certainly not easy. Zubin, another great show. So much fun. Can’t wait for the next time. Thank you for coming today.

Zubin Damania:

Oh, thank you. It’s like therapy for me. It’s beautiful. Thank you.

Jeremy Corr:

We hope you enjoyed this podcast and will tell your friends and colleagues about it. Please follow Fixing Healthcare on Apple podcast, Spotify, your favorite podcast platform. If you liked the show, please rate it five stars and leave a review. If you want more information on it… If you want more information on healthcare topics, you can visit Robbie’s website robertpearlmd.com and visit our website fixinghealthcarepodcast.com. Follow us on LinkedIn, Twitter and Facebook at Fixing HC podcast. Thank you for listening to Fixing Healthcare’s newest series, Unfiltered, with Dr. Robert Pearl, Jeremy Corr, and Dr. Zubin Damania. Have a great day.

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