Stop resisting the imposter [PODCAST]

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“The problem with feeling like an imposter is thinking there’s something wrong with it.

I know this is different from any way you have thought about it, but humor me. What happens when we are offered an opportunity but we feel like an imposter?

We hide.

We overwork to compensate.

We look around at our colleagues and resent them. Because why do they get to feel so secure? Why aren’t they feeling insecure? They don’t even spend time worrying about it, and that leads to more resentment! They are not working as hard as you, and now they are not stressing about the opportunity like you are.

What is the result of those actions? We spend lots of time in indecision, overwhelm, fear, resentment, and overwork. We might take the opportunity, do well even, but hate the whole process and add it to the bad feelings we already feel about ourselves.

What is behind feeling like an imposter? It’s the thoughts that we tell ourselves. It helps to understand the motivation behind these thoughts.

We were wired to survive.”

Amy Vertrees is a general surgeon and co-founder, The Common Thread Women Surgeon Coaching.

She shares her story and discusses her KevinMD article, “Stop resisting the imposter.”

This episode is sponsored by Tradeoffs, available on your favorite podcast platform.

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Hosted by Kevin Pho, MD, The Podcast by KevinMD shares the stories of the many who intersect with our health care system but are rarely heard from.

Transcript

Kevin Pho: Hi, and welcome to the show, where we share the stories of the many who intersect with our health care system but are rarely heard from. My name is Kevin Pho, founder and editor of KevinMD. Today on the show, we welcome back Amy Vertrees. She is a general surgeon, and she wrote the KevinMD article “Stop resisting the imposter.” Amy, thank you so much for taking time out of your day and coming back on the show.

Amy Vertrees: Thanks, doctor. Really, it’s just a true honor to be on the show. I really appreciate you letting us share our stories, just so we can hear the wide diversity that there is in medicine. I think it’s a fantastic mission.

Kevin Pho: So for those who didn’t listen to our first episode, just briefly share your story and journey to where you are today.

Amy Vertrees: Sure, absolutely. I’m a general surgeon. I actually trained in the Army. I went to USUHS, which is the military medical school; it’s the only one we have. I went to Walter Reed Army Medical for general surgery training. I was there when the first warrior soldier was there, was there for the heights of the wars, went to Afghanistan twice, Iraq myself once. I got out of the military in 2017, and I’ve been a general surgeon at Maury Regional in Columbia, Tennessee, ever since then.

Kevin Pho: So we’re speaking towards the end of September. From a COVID standpoint, where you are and your institution, perhaps tell me what you’re seeing.

Amy Vertrees: It’s utter madness. A year ago, we had a huge peak. There’s just been a lot of, we have a low vaccination rate, and so last year was a little bit challenging, but I think that the community came together a lot. This year is a little bit interesting because now the vaccine is available, we still have low vaccination rates, and our hospital has just been overwhelmed.

We have a 26-bed ICU and a 250-bed hospital, and we have been running in the mid-400s for ICU patients, and in the high 30s of patients doubling up on hospital beds. One reason I was running a little bit late was that I was doing a tracheostomy, really just doing whatever I could to support our ICU colleagues. So assisting with tracheostomies, helping out wherever possible, because we really just have amazing heroes out there.

Kevin Pho: So when it comes to vaccine hesitancy, I hear a lot of stories about people who unfortunately are in the ICU or in the hospital, and they wish they could have gotten the vaccine. Are you seeing some of that regret from some of the patients that you’re seeing in the hospital?

Amy Vertrees: It was so fascinating. This has been such a fascinating experiment with a social construct, because there was one that he did a tracheostomy on, and I called the wife, and she’s like, “You know, he’s so strong, he’s so healthy, we didn’t think this could happen to us. And so we’ve, as a result, just told all of our friends to get vaccinated, because if it could happen to him, it could happen to anyone.”

I think that’s probably the take-home message that a lot of people are taking, looking around. It really hits home when it’s someone that you know, and that you know is healthy, that takes care of themselves, and then it’s just a freak thing how some people just are so affected by it and others are not.

Kevin Pho: All right, let’s transition now into your most recent KevinMD article. It’s titled “Stop resisting the imposter.” Now, for those who didn’t get a chance to read your article, can you just walk my audience through it and share the story of why you decided to write it?

Amy Vertrees: Absolutely. It was interesting. It was based on a Facebook post that I was reading, about someone who was offered a speaking position, who was very well known in their own area, and had mentioned how she was thinking about turning down the speaking gig, because she was like, “Well, who am I to do this?” And then she had talked to a colleague who was also offered, I think it was a panel, and was like, “Well, why is he so secure?” I was like, what an interesting way to approach the problem.

So that’s what we imagine imposter syndrome is, of, “Oh, why would they pick me? I don’t know if I could do this.” And then it was interesting, the attention was projected onto the colleague. So I started thinking about how we approach imposter syndrome. What is the point of all of it, honestly?

Really, what I think in my mind, and this is actually not a new concept, is we have these multiple people in our head. I started thinking, if we think of this imposter as a person in our head that’s just trying to keep us safe, because there is a part of our brain that says, “Don’t do that scary thing. Don’t do that hard thing. It’s so much safer to do these other things.” That’s pretty much what the imposter does: It sits us down and says, “Don’t do this, because you don’t know what you’re doing.”

But I thought, think it through, rather than just try to resist it, say, “Oh, no, they don’t know what they’re talking about. No one else knows what they’re talking about. Of course I’m fine.” What happens is that insecurity is always going to be there. So if you imagine it in a position like a child or someone vulnerable, and you sit them down and say, “What’s really on your mind? Why don’t you tell me what your concerns are, and let’s talk it through.”

What I think that does is, if we resist it, then the first thing we do is we hide. OK, well, we don’t put ourselves out there. We don’t want to confront the possibility that it may be right. But if we sit down and say, “Of course we know what we’re doing. Why don’t we just explore what’s the worst that can happen?” It really goes down a lot to recognizing that we’re worthy. Even if we didn’t do that, even if we didn’t choose to do the speaking gig, we’re fine as we are.

If we sit down with our imposter and say it’s OK to be safe, to try some of these experiments and see what we can do and show what we can do, if we walk in feeling worthy, we’re not going to worry that we need to get worthiness from someone else. In response to looking around at colleagues and seeing how they respond, we only see people’s outer responses anyway. This other panelist who seems so reassured may not be. But either way, if you approach it from worthiness and you approach it from openness and get excited about the possibility, then you’re actually able to interact with other panelists and other experts and really elevate the knowledge in that way, because you’re not so much stuck in your head.

Kevin Pho: So there are a lot of articles on KevinMD about imposter syndrome in medical students, interns, residents, and physicians. You think that physicians are among the most accomplished individuals, right? They’re top of the class, you get into medical school, you do board exams, and being a physician is, of course, an accomplished position. Why do you think so many doctors feel imposter syndrome in light of everything they’ve accomplished in the past?

Amy Vertrees: It’s so interesting, because I think that it’s really embracing the positive aspects of this person that we call the imposter in our head, because what makes us want to do more? If we are feeling like an imposter, it’s basically saying, “I’m not sure we can do it.” If you flip that over and say, “Well, I’m not sure I could do it. Why don’t we just do it anyway?” But that’s a lot of the time what drives us: Let’s see what we’re capable of. If you find yourself at the tip of the spear, and you find yourself at your highest level of accomplishment, of course you’re going to look around and go, “You’re not going to succeed all the time.”

I think that goes into the ultimate definition of success and failure. I’ve explored this a lot on my own and also with other folks, because what is success? Success is achieving a defined goal, which is fascinating when you look at it, because who defines these goals? A lot of times, if we define these goals, what happens if we don’t achieve it? We have to make sure that we’ll be OK if we don’t. And failure is not achieving that goal. So what is the worst that could happen if you don’t achieve the goal? You just restate the goal, you learn something. I think that being able to be open to failure and determining your own success, and by aiming to achieve something higher than you think you can, of course we’re going to fail along the way.

I think the trouble that a lot of people have, especially once they finish medical school and residency, is everything is so linear. In medical school, you just pass a test. It’s very defined, so that goal is defined. You pass a test, you go to residency, you get a certain number of cases, and you’re fine. And as attendings, then you have to really start defining what your goals are. So then you’re the one that’s much more responsible for setting up these goals. If you set them up high, of course you’re going to fail at some of them, because that means that you’re really working at the top level of your accomplishments. And so if you’re not failing, you should really look around and say, “Am I really achieving the amount of success that I could have?”

Kevin Pho: So I know that you’re also a co-founder of a women’s surgeon coaching group. Now, do you have a story of a case study of a physician who is encountering imposter syndrome, and what did you do to help advise that physician?

Amy Vertrees: Oh, everything’s a great example, because really, it’s all just the thoughts we tell ourselves. If you kind of recognize, separate out this idea that “I can’t do it” as a separate part of your brain, and you really look at their motivation, then I take them through and say, “What’s your thought? OK, so you want to be on this panel, and your thought is that I’m not as accomplished as other people. Is that really true? Let’s look at some facts. What have you done in the past? What would make you feel worthy of accomplishing that?” And really ask a lot of questions.

And realizing that when you start challenging that thought, that thought that pops up in your head that’s absolutely urgent, it must be true, then when you challenge that thought, you realize, “Oh, well, that’s actually not even true in the first place.” We were judging our emotions and our actions and our results based on a thought that was never actually true in the first place.

The problem is that we’re built, especially with surgeons, to problem-fix it, problem-fix it, and we don’t really focus a little bit on challenging the thoughts: Is this true? Because we’re so used to believing what we think, and being confident, and realizing that sometimes when you’re achieving something, a little bit of lack of confidence is normal. I think the more that we normalize it and help people question those thoughts in your mind, that’s how we’re going to help people achieve.

Kevin Pho: We’re talking to Amy Vertrees. She’s a general surgeon, and she wrote the KevinMD article “Stop resisting the imposter.” Amy, what kind of advice and take-home messages can you leave with the KevinMD audience?

Amy Vertrees: I think the more that we share these stories, these worries that we have in our head. The one thing that we have at The Common Thread is a free Facebook group for women surgeons, and for residents as well, and we share our normal struggles daily. What has happened, we’ve had this group about a year now, and we find that other members start sharing, and then other people are saying, “I’m glad you shared that. I’m thinking this too.”

So I think really, the more that we normalize the thoughts that we have in our head, the more that we support each other, that’s really the way to do this: supporting ourselves internally, but then also supporting as a community. I think that’s where we’re going to make the big changes.

Kevin Pho: And how can people reach you?

Amy Vertrees: We’re on Facebook at The Common Thread Women’s Surgeons, and we also have a website with the same title. I also have a personal website, amyvertreesmd.com.

Kevin Pho: Amy, thank you so much again for coming back on the show and sharing your time and insight.

Amy Vertrees: Yes, thank you so much. I’m so glad I made it.

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