Unscripted | Episode 11

Finding Joy Amidst Stress: Dr. Joe Sherman’s Insights on Boundaries

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Finding Joy Amidst Stress: Dr. Joe Sherman’s Insights on Boundaries

Unscripted interviews with physicians about common topics that doctors experience

Addisyn Uehling: Welcome to Unscripted. I’m your host, Addisyn Uehling. In this series, we have candid one on one conversations with physicians about common topics that doctors experience. On today’s show, we will be sitting down with doctor Joe Sherman to talk about remembering your joy and the importance of boundaries in the medical field on this episode of Unscripted. Well, thank you so much for joining us today.

Doctor Sherman is a pediatrician and coach and retreat facilitator

Doctor Sherman, can you please start by introducing yourself and sharing a little bit about your career?

Dr. Joe Sherman: Sure. Thanks very much for having me, Addie. I appreciate it. It’s a, pleasure being here. I am living here in Seattle, Washington. I am, ah, pediatrician and physician, coach and retreat facilitator, mostly for healthcare groups and individual physicians, residents, medical students, nurse practitioners, health professionals in general. this is a kind of a second career for me after being a pediatrician for about 35 years or so. And, yeah.

Addisyn Uehling: So how did you choose your specialty?

Dr. Joe Sherman: Wow. Okay. So first was getting to medical school, because that’s something that takes, a lot of effort. I know from my, from my own experience, even though I did it in ancient history, and it’s different than it is right now. when I was growing up, I was the youngest of seven kids, and we came from a fairly middle class, blue collar background. My parents hadn’t gone to college, but I had all these siblings ahead of me that went in all kinds of different careers and different directions, and I wanted to be different from them. So that I think that was probably the biggest motivation. What did they not do, and what were they afraid of doing? And that’s how I was going to prove myself to all those old folks. So everyone was afraid of blood, afraid of doctors, afraid of all that. So that was one major influence. I think the other thing were just a few basic elements. I really enjoyed helping people. I know that that kind of sounds a bit cliche, but even as a little kid, I gained a lot of satisfaction from athletic coaching or tutoring or just helping around the neighborhood and things like that. And I was pretty skilled at math and science and put those kind of things together and came up with a career in medicine, which sounded pretty good to me, and went to college, studied engineering, mostly because my parents wanted to make sure that if I didn’t get a medical school, come up with something and get a job, so that pleased them. But I had no intention of being an engineer, so that’s kind of what brought me to medical school. Pediatrics. I always love kids. I think that’s what got me interested in medicine to begin with, was helping kids. I had one experience with a cousin, a younger cousin, when I was a teenager who had, a condition called viral myocarditis, which is kind of a, terrible, terrible thing that afflicts people who are often normal, healthy people. And this happened to him when he was twelve years old and it was pretty severe. Ended up in heart failure in the hospital. And as a teenager, I was only a few years older than him. I went to visit him in the hospital and just sat with him, watched tv and hung out with him and I watched and observed everybody helping him and what they were doing and that attracted me to that. And, then in medical school, I was constantly looking for role models. Who can I be like? Because there are all these other people that was like, I never want to be like that person. That’s not the kind of person I want to be. And so very often medical students are not only looking for something that interests them, but also people who they see. Oh, I can see myself in that.

Addisyn Uehling: Person, yeah, for sure.

Dr. Joe Sherman: And I happen to run into several pediatricians who I felt were, different from other doctors that I had run into. And one in particular became kind of a mentor to me and she really influenced me more than anything about going into pediatrics. so that’s kind of the long answer of it.

Addisyn Uehling: Yeah. That’s amazing. That’s incredible to have that heart, for pediatrics and for kids and for serving. That’s really cool.

You can kind of mentioned your training experience. How was that for you

You can kind of mentioned your training experience. How was that for you? What did you come away from training with?

Dr. Joe Sherman: Wow. Well, I have to say a couple of events

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Dr. Joe Sherman: that occurred in my life that influenced me, impacted, my choices quite a bit. While I was a senior in college, both of my parents died completely, independent situations. Independent, of one another going through their illnesses and their deaths. As a young person, only 2021 years old, I was exposed to kind of the good, the bad and the ugly of healthcare, encountering doctors and hospitals and things like that with them. This was before I knew anything about medicine. So when I went into medical school, there was this, almost this hyper vigilance of observing people and wanting to be with patients, wanting to be present with patients in a way that my father’s doctor was not with him, but my mother’s doctor was with her. And so as I went through training, I am a reflective person. I journal and I was journaling even during medical school and residency. And so I really paid attention to, what drew me in, what I enjoyed, but also it was a lot of struggle in medical school, it’s not only the long hours of studying first and then work in the hospital, but there’s also the constant questioning of yourself. And this is what was happening to me, I would say from the day I showed up, constantly looking around, comparing myself to other students. Am I as smart as them? Can I do as well as them? so combining this reflective nature that I have, as well as the exposure to all these other brilliant people, because as you go along, it’s kind of like pre med and then college and getting into medical school and then succeeding in medical school, it just becomes less and less people that are, you’re surrounded around more talented people. And so as I went through medical school and residency training in pediatrics, I was really observant and was impacted a lot by positive experiences and very negative experiences. When you’re in pediatrics, I think as a resident, as a pediatric resident, you probably see more kids die than you do in your entire rest of your career in pediatrics, unless you go into a very high risk kind, of specialty. But I would say in general, pediatrics, definitely, I had to deal with, death and dying, not too often as in my adult rotations in medical school, but still I was there.

Dr. Joe Sherman: And I would say the most memorable experiences that I have from my training are when senior doctors, either attendings or residents, took the time to spend with me as an individual, to actually get to know me, to be there with me if one of my patients had died or if something had gone wrong. and I have to tell you, that’s pretty rare. It doesn’t happen enough in medical school, definitely not so much in residency. We have a culture that really likes to focus on what goes wrong in order to improve it, but we don’t have a culture in general that focuses on what goes well. and so that’s something that I really thrived on, during my training and being able to pass that along when I became a senior resident or an attending later on, to be able to really pull people aside and say, I can see this quality in you, and I think it’s, something that you should cultivate and pay attention to.

Addisyn Uehling: Yes, absolutely. Having that, having that good influence and having, being able to be that light to other people is so important and that massive impact that they probably still have. You probably still think of those stories and those times that they helped you and that helps you now in the career. So that hasn’t just trickled down to you, but I’m sure you’ve done that to other people. Right. And it’s just this, like, effect that one person has. And it may not seem like a lot, but it really is, you know, in the long term.

Dr. Joe Sherman: Yes, I would. Yeah, absolutely. I think I can remember, unfortunately, a very few times when an attending physician said something complimentary to me or encouraged me to, pursue a path that I

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Dr. Joe Sherman: was passionate about. and that’s something that I feel like I say is so countercultural, and it’s something that we need a lot more of in medicine.

Addisyn Uehling: Yeah, absolutely. And kind of going back to the. Being a pediatrician. Right. And having those death of kids, that. That has to be so tough. And talking to other physicians, I can’t even imagine that has to be a major struggle. How did you deal with that? in a positive way, because that’s really tough.

Dr. Joe Sherman: I tell you, Addie, I can remember, one of my first rotations as a pediatric resident. I was an intern my first year, and this is back 1985, so it’s a while back. and there was this relatively new disease on the forefront, at the time, it was called AIDS, and it was thought to be caused by what was known then as the HTLV three virus, later to be known as HIV. And we knew very, very little about it in medical school. We had a, 1 hour lecture on this disease. That’s all that was known. That was it. My first patient in the pediatric ICU that I took care of was a child who had, HIV, transmitted from her mom. And like I say, it was very little known about the disease. As an intern, I was the one, and no one knew exactly how it was transmitted. We knew that it was a disease that was seen at first in the homosexual population, in the iv substance abusing population. however, no one really knew. Everyone was scared. We’d mask up like Covid, and we had everything covered, and we didn’t know that it was only through blood or through sexual transmission. So I was taking care of this little child, and she was probably about two years old. Her name was Aisha. And I remember going into this isolation room and all the attendings in residence, senior residents watching me through the glass window because they wouldn’t go in. They were afraid to go in. And I would go in, draw the blood, do the procedures, do all those things, because I was the intern. And then one day I came in and she wasn’t there, and I found out that she had died the night before. Wow. and I was just told, oh, yeah, she died last night. And I remember the first opportunity I had leaving the ICU, going to the hospital chapel at the time, and just sitting there alone, crying and crying. And I just didn’t. I just. I didn’t know how to handle it. I didn’t. I didn’t know. I knew that it was out of my control. And yet, at the same time, to see such a young child die and then the whole situation afterwards, of all the paranoia around HIV and all that the family went through, it was just terrible. And I just had to come back and start working. There was no one that pulled me aside. There was no debrief. There was nobody that talked about it. And, I just was left to deal with it on my own.

Dr. Joe Sherman: And so that was a real shock and a challenge for me from the beginning.

Addisyn Uehling: Yeah.

Dr. Joe Sherman: At the same time, it taught me a lesson. It taught me a lesson about how important it is to, process these experiences and how important it is to, especially the people in the hierarchy of medicine who have the least amount of power. Those are the folks that really are impacted the most because they’re constantly trying to perform and succeed. And, people who are more senior, like me, really need to take the time to have people create the space and the opportunities to process some of the. The joys, challenges and tragedies that occur.

Addisyn Uehling: Absolutely. If you could say a couple sentences to you back then, or to those people who are really in that same position and they’re really struggling with that, what would you have to say?

Dr. Joe Sherman: I would probably say, joe, I know that losing a patient is really, really hard. It’s happened to me, and it’s something that impacts people differently. And I just want you to know that, I’m here to listen, to hear how this is impacting you.

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Dr. Joe Sherman: This is how it’s impacted me.

I’m curious how you’re feeling about losing Aisha

I’m feeling a little scared, a little disappointed, a little guilty. Maybe. Maybe I could have done something differently. I’m curious how you’re feeling and want you to know that, I really appreciate all the hard work that you’ve done and all the loving care that you’ve put into taking care of Aisha. And, I just want you to know that even as you think about this, it might stay with you and hit you at different times. Here’s my phone number. Get in touch with me. Whatever you’d like to do to, kind of talk about this, I’m here.

Addisyn Uehling: Yeah, absolutely. A couple episodes ago, we talked about mentorship and how important it is to have a mentor, especially in. This is a perfect example of that, but also, having those people who also work with you who are higher up and who are above you, the senior residents, any attendings, being able to ask that and to be there for those people. And so even if you’re in residency now, you can still be that light to fellow residents, to anyone. You know, you don’t have to always have that position, but instead just have that compassion toward, what people are going through and really showing them that you hear them and that they are felt and heard, you know?

Dr. Joe Sherman: Absolutely. Yeah.

Addisyn Uehling: Yeah.

Do you feel like boundaries play any role in this kind of boundaries play

Do you feel like boundaries play any role in this kind of boundaries play.

Dr. Joe Sherman: A role in everything? I would say that early in my career, I would say for most of my career, I was not very good at boundaries setting. I went through all of medical school and residency as a single person, so I didn’t have. Often with my coaching clients, I talk about external guardrails and internal guardrails and external guardrails are those things that are obligations and priorities that you have in your life that, you don’t necessarily create, but are created externally. Like, if you’re married, you have kids, if you have obligations, if you have jobs, if you have other things that you have responsibilities and you have to be there, or if you have your own physical limitations that prevent you from being able to spend hours and hours in the hospital or work so hard. These are things that you. I mean, you have no choice, but those are there. And then internal guardrails are those boundaries, those, limitations that you set up for yourself. For example, if someone is in practice and is in outpatient setting, they may set an internal guardrail to say, I will not stay here. I will leave the clinic before 06:00 p.m. or, I will not show up until this time, or I will have all my charts completed within this time. These are things that you set up for yourself. and there can be all kinds of things. When I’m not in the hospital, I will not, you know, looking on the electronic health record at home, or, I won’t do this. There are things that you set up yourself in order to give your brain and your psyche a little space, a little rest, allow your adrenal glands to kind of chill out a little bit, and the cortisol level to decrease so that you, can survive and thrive and enjoy and pay attention to those parts of medicine that are really fulfilling, rewarding, joyful.

Addisyn Uehling: Yeah, absolutely. it kind of boundaries are something that really helps with. To prevent burnout or have healthy work life balance. All of these things go hand in hand. I feel like we were just talking to Doctor Kasim on our last episode about self care and how self care is not selfish, actually, when you take care of yourself, you’re able to better serve those around you. so I think that kind of. That kind of ties into what we’re talking about here. Do you have any ideas or thoughts on that?

Dr. Joe Sherman: I have lots of thoughts and ideas on that. There is no doubt in my own. I can just think about my own experience and I deal with burnout all the time with my clients. And it seems to be. I never even remember the word in residency or I early in practice, I don’t remember that word. However, I do very well remember working with people who always appeared resentful, grouchy, irritable, or people that also that I was working with, who were just kind of mailing it in, going through the motions, not really having their heart in it. and I remember myself being in those situations. And I think it’s

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Dr. Joe Sherman: important to understand that there are times during the course of a day, during the course of a week, where you’re just trying to catch up, you’re just trying to get your work done. And in those moments, you may not be fully present and at your best, and that’s okay. And then there are other times where you really feel. I really feel I’m drawn in. And those are those moments that I pay attention to. There’s a comment that a parent makes something that, perhaps a nonverbal form of communication, that they’re really worried or stressed about something. That’s my signal to put whatever I have down or stop looking at a computer screen and truly pay attention and be present to someone. and that’s what I feel. That’s the benefit of being able to take care of yourself. That’s the benefit of spending that time with restorative activities, those activities which, refill your physical, spiritual, psychological tank, ah, after it’s been depleted through a day or a week of work.

Addisyn Uehling: Yeah, absolutely. Kind of going off of that.

Sherman says how you respond to stress defines your career

How do you feel? Like you found joy in your career, right, with all of this tough stuff happening, with the death of patients with just stress, you know, this is a, very big career, and with that comes big responsibility and stress, and it’s inevitable. But kind of how you respond to that kind of defines how it affects you, you know?

Dr. Joe Sherman: Yeah. I would say at different points in my career, I’ve been better at this than others. I believe that I am, programmed. I have this default mechanism of being a people pleaser and someone that wants to gain, external validation and affirmation for being a good person who does good things. And so that’s kind of how I know myself and the way I function. So I spend quite a bit of time, with meditation, with guided visualization exercises, with self affirmation, trying to understand that, I am inherently a good person and a perfectly imperfect person. And so that’s what’s important for me, is to be able to take the time, understand and acknowledge for myself. When I have been able to influence a patient, a family, a parent in a positive way. Hold on to that, allow it to sink in for myself. Even if I don’t hear, a comment of gratitude or affirmation externally.

Addisyn Uehling: Yes, absolutely. Even like a small note, you know, to someone like, I see you, you’re doing a great job. You know, that is such an impact for those people. And then it trickles down to other people. Cause then they see how much that affected themselves. And now they’re able to share that with other people. You know, I think that’s so important for us to remember.

Dr. Joe Sherman: I’ll tell you one story. I just want to say this because it’s really important as residents and interns. And I think personal stories really help. I spent four years I did with my family. I’m married. I have two kids. They’re, young adults now. But we lived in Bolivia for four years. And at that time they were young kids. And we were there for four years. We were part of volunteer, mission organization. I was working there as a doctor. And we came back and I was trying to fit in and reenter, the medical community here in the us. And I was feeling particularly down because I just wasn’t sure where I fit back in. Previously I had, crossed this bridge between the community health center and the training center and would bring trainees into the community to help train them where their patients and families lived. But I was really feeling down one day. And I came home and, at this time I received a phone call. And on the other line was someone that said, hello, is this doctor Sherman? Doctor Joseph Shermanden. That, the same doctor sherman from the medical College of Virginia, Virginia Commonwealth University. That’s where I trained. And I was at first hesitant. Cause I thought, oh, my trouble. And I was said, yes, that’s who I am. And this woman said, I wanted to call to get your address. You may not remember me, but way back about this time, it was probably 2025 years ago, you were an intern

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Dr. Joe Sherman: in the neonatal intensive care unit taking care of my premature newborn baby. All through my pregnancy, I was addicted to heroin, and I was feeling so guilty about my child being born and addicted and having to withdraw from opioids. And you came in as that young intern into my room and I was crying and you sat with me and you asked what was going on, and I told you what was happening to me, and I was so worried about my baby. And you looked at me and you said, you know, your baby is going to be okay. We’re taking care of him. He’s doing okay. He’s stable. And it’s really important for you to take care of yourself because you’re a good mom. And now you’ve been during this time, you’re in recovery, and, we’ll take care of your baby. And she said, I just wanted to get your address so I could send you a thank you note now and to send you a photo of him now because he’s graduating from college.

Addisyn Uehling: Wow.

Dr. Joe Sherman: and kind of tear up a little bit. But, you know, a couple weeks later, I got this card and this photo of this huge guy graduating in his graduation outfit and that he’s a wrestler and all these other things. And, so you never know. You never know what comment you’re going to make, what influence you’re going to make and the impact that that has on someone that will, you’ll hear again, you know, 20 some years later.

Addisyn Uehling: Yeah. What a small comment or what a small action can produce, it’s truly incredible. That’s super awesome.

Pay attention to who you are early in your career

do you have anything that you want the audience to take away from this episode? If you can just say a couple things, what would they be?

Dr. Joe Sherman: I would say if you are a resident early in your career, this is the time to pay attention to who you are. And when I say who you are, that means before you ever entered medical school, before you ever got interested, what are those qualities about you that are true in whatever setting you’re in? whether it’s in the hospital, outside the hospital, interacting with friends, having fun, what are those things about you that make you unique? What are those things about you that you appreciate about yourself? Pay attention to those things, because what’s going to happen is that you will be told by so many other people the way you should be, the way you should act, what you should be doing with your life, how you should, take care of patients, how you should, behave in front of your colleagues, but hold on to what that is, that is essential of who you are and establish some practice, whether it be journaling, whether it be having, a coach or a friend, a, mentor or whoever, who is going to constantly bring you back to that element of who you are and why you do what you do. Because it’s going to be challenged over and over and over again.

Addisyn Uehling: Yes. Remembering your purpose and not letting your, your career or your success define who you are and what your purpose is. That’s. That’s incredible. That’s such a great reminder for everyone, you know. awesome. Well, thank you so much for joining us today, Doctor Sherman. And it was great to hear all of your past wisdom and your great stories.

Dr. Joe Sherman: Thanks so much for having me, Addie. I appreciate it.

Addisyn Uehling: I’d like to thank doctor Joe Sherman for joining us today. I hope our conversation has shed some light on the importance of good boundaries and finding joy in the middle of stress. Stay tuned for more discussions on important topics in the medical field. And one way to do that is to like and subscribe so you’ll never miss an episode. I’m your host, Addisyn Uehling, and we’ll see you next time on Unscripted close.

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