DIFFICULT CONVERSATIONS ( The Scripts)

The Podcast Scripts ( for your reading pleasure )

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Learning how to human better with Beth Weissenberger of The Handel Group

Beth Weissenberger (1s):
Your chicken and brat and weather reporter are not on your team, their entire life is about getting in your way.
Their entire life is about you not having what you want. Their job is to mess you up and they are not going
away. They are your board members. They are yours. You should meet them and have fun with them
because they talk constantly.

Announcer (27s):
Welcome to Difficult Conversations: Lessons I Learned as an ICU Physician with Dr. Anthony Orsini. Dr.
Orsini is a practicing physician and the President and CEO of the Orsini Way. As a frequent keynote speaker
and author Dr Orsini has been training healthcare professionals and business leaders how to navigate
through the most difficult dialogues. Each week, you will hear inspiring interviews with experts in their field
who tell their story and provide practical advice on how to effectively communicate. Whether you are a
doctor are faced with giving a patient bad news, a business leader who wants to get the most out of his or
her team members or someone who just wants to learn to communicate better this is the podcast for you.

Dr. Anthony Orsini (1m 13s):
Well, Welcome to another episode of Difficult Conversations Lessons I learned as an ICU Physician. This is
Dr. Anthony Orsini and I’ll be your host. Again, today, today you are in for a special treat. I am very excited to
have, as my guest Beth Weissenberger. Beth is the co-founder and President of the Handel group. The
Handel group is a renowned corporate consulting and life coaching company dedicated to teaching people
how to realize their personal and professional visions. Their straightforward and innovative method has
changed the lives of thousands of private and corporate clients, and has been taught in over 50 educational
programs and institutes of learning, including MIT and Stanford graduate school of business.

Dr. Anthony Orsini (1m 53s):
Beth has developed the Handel group into a multi-platform company, comprised of a corporate, private
coaching ,education sport and product divisions. They Handel Group not only offers live coaching, but a
digital platform interview for a professional athletes, individuals and students. With her 20 years of
experience, coaching thousands of the most senior executives that is not only a masterful coach, but it also
leads corporate seminars in her signature mince no words style on a variety of topics that are fused with
energy, transparency and inspiring personal stories. Beth, thanks for being here today.

Dr. Anthony Orsini (2m 34s):
Really looking forward to this, you and I have met, I guess, about a month ago, we met through Claude
Silver of VaynerMedia and spoke to you for about five minutes. We had instant rapport. I knew this was
going to be an awesome interview. So I immediately booked you and I know you’re busy. So thanks again for
being here. So I really wanted to get into your coaching and your method. I’m just find it so fascinating that
I’ve done my homework, that I want my audience to about it. So let’s just start off slowly by just telling us
about the Handel group, what you do and how it started.

Beth Weissenberger (3m 8s):
For sure. 16 years ago, my youngest sister and I, so there’s four children in the Handel family. We named
the company after my dad he’s our lawyer, but he has been for 16 years and you know, we paid them
nothing, but we gave him the name of the company. So 16 years ago, my youngest sister Lauren and I had
decided we were both coaches and she is a genius who invented our Handel Method and then I’m a builder.
And we said, all right, why don’t we do this? Your genius, let me build you and let’s give it a shot. We gave it
a year. Cause we, at the time, 16 years ago, executive life coaching was not like a thing. The first comment
it was, are you a doctor or are you a therapist?

Beth Weissenberger (3m 48s):
And we’re like, no we’re coaches, but we hit it out of the park. And now 16 years later we’re the largest
executive life-coaching company and we have about 70 people who work for us and we have a ball. So that
is how it started. Lauren is my boss, even though she’s 11 years younger, she really is that genius. She is
the chairman. She’s now working in Handel group inventing two new divisions to new pieces of work and I’m
running the company, but that girl is still my boss.

Dr. Anthony Orsini (4m 19s):
And Lauren wrote a book recently, which I read. It’s an awesome book.

Beth Weissenberger (4m 23s):
So my other sister morning, Marnie Nir is an executive at Handel Group. She is our Chief Content Officer
and our writer. And so she and Lauren wrote the book “Maybe it’s you”.

Dr. Anthony Orsini (4m 33s):
I love that topic. And I read it. It’s an easy read and we will reference it on the show notes. So that’s great.
Now, one of the things I do a lot of coaching, as you know, I do a lot of seminars myself, all in the health
care area, although we are doing some work on business and HR, one of the things that I think really helps
me when I teach physicians is that I speak from experience. And I’ve seen some of your seminars. I’ve seen
you on the internet. You can tell some great stories about yourself, but this is not stuff that you can’t relate to
because when Lauren contacted you, you were at a point in your life also that made you want to change?

Beth Weissenberger (5m 8s):
Yeah, I actually called Lauren, so Lauren remember is 11 years younger. So yeah, I was out of the house
when she was growing up. And so I’m now living in Laguna beach, I’m married to my second husband. So
you can hear yes, jerky genius in business jerky in love the story. It took me to divorces and I live with the
third man who then cheated on me. So it took all of that until I was 59 years old to finally get Love. Both
sisters have to coach me. I’m 61 now in madly in love with the final man, amen. But yes. So I called her
because at the time I was married and I was in a job where I was the head of sales of a management
consulting firm had just had the best year they’d ever had an 18 years.

Beth Weissenberger (5m 52s):
And this is my second year there I was bored out of my mind was not it wasn’t turning me on. I didn’t love
living and sorry those of you who are in California, I didn’t Love Laguna beach. I’m a new Yorker. And max,
our daughter who’s now 19 was about two and I’m like, Oh, Lauren help and I have never called her as like a
coach right? Because you know, I was the coach and in two 20 minute conversations, she literally altered my
life. And that’s when I got, who are you? How much do you charge? My boss charges is 600. And isn’t even
close to who you are charging a hundred dollars? And I was like, Oh, okay. And so I left New York. She had
got me a job that didn’t turn out.

Beth Weissenberger (6m 33s):
I turned her and said, let’s go. And that’s how it started. 16 years ago, August, 2004.

Dr. Anthony Orsini (6m 38s):
And it just gets better and better and better. Let’s get into the Handel method. But one of the things that I
wanted to ask you first is, you know, the premise of this whole podcast is that how we communicate
effectively and with compassion that if we can learn to do that, it will not only help us in medicine and
business, but also in our personal lives. And what I found throughout the years is that it’s the same
communication techniques that I use for telling someone, sadly, that their baby died. It’s the same
communication techniques that can help someone else in business, but also help us in our lives. And so
there’s so much overlap. And one of the great things about doing this podcast is that one week I have
business one week I have health care and you see the overlap is just, people are seeing the same thing,
building trust, building loyalty.

Dr. Anthony Orsini (7m 26s):
I noticed that the Handel group does a lot of different areas. So you do corporate, you do individual, you do
athletes. Is there a common thread that, that works? And is there a special kind of approach that you have to
take with each person?

Beth Weissenberger (7m 40s):
And the Handel Method is the Method no matter what. So Whether, you know, you’re a, Chicken, whether
you’re an NFL player or your a CEO, you’re a brat, whether your, a student or whether your, a mother
staying home with your kids. So our method of Chicken Brat, weather reporter for instance, which I’m sure
we’ll get into or how to have a hard conversation. It’s the same method. Whether I’m teaching a student at,
Stanford or NYU or a Fordham, or you are listening to InnerU student or InnerU love the method is the
method. And as a coach, all of our coaches have to be responsible for. Okay. In fact, we just got off a
recording with Nolan Carol who played for the NFL.

Beth Weissenberger (8m 25s):

His last team was the Dallas Cowboys for eight years. And I coached him and he has built himself. What I
like to call into who he is now and his empire and created himself and took them from hell because they
retired him. But they took on there. But knowing as an NFL player, there’s things you have to know about
that that are different than if I’m speaking with, you know, the CMO of a public company. Right. But I’ll use
the Method, but just frame it for the athlete or the student or the CEO hard conversations are hard
conversations. Whether I’m about to have a hard conversation with my boss or I’m about to have one with
my boyfriend.

Dr. Anthony Orsini (9m 7s):
Yep. And that’s exactly right. And it’s amazing once you learn how to have those hard conversations, it really
doesn’t matter. What do you approach them differently? I find that when I’m coaching physicians and I can
say it because I’m a physician that, you know, sometimes we have egos and a, if you’re coaching CEO’s
they have egos. Now, if you have a different coaching method, you are very no-nonsense, but you still
probably need to approach that differently. I would imagine correct? when you’re doing an athlete or a CEO?

Beth Weissenberger (9m 39s):
There’s the need being accountable for who I’m sitting in front of whether a zoom session or back before the
pandemic with them. Right. So there’s, and there’s industry’s, there are different. So one of our large clients
that we’re on hold with right now, we have a joint venture with live nation. That’s the music industry, the
music industry is different than the insurance industry, right? So there’s industries, there’s humans, there’s,
you know, your age and where you’re at in your, you know, development is a human. So everything has to
be taken into account, but I’m going to still call you a Chicken Brat or weather reporter with you’re in your
way of your own dream. You’re dream at this time. in your life Dr is probably different than if I’m speaking to
obviously a 30 year old and their dreams.

Beth Weissenberger (10m 23s):
But your dream is just as important to you as the 30 year old. And then what’s in your way could be any one
of the 10 things that are in an NFL player’s way.

Dr. Anthony Orsini (10m 34s):
Right. I get it.

Beth Weissenberger (10m 35s):
To teach someone to human better, which is, you know, we call it a burden to human better. Our method is
the same. We just are responsible for who were speaking with.

Dr. Anthony Orsini (10m 45s):
Yeah. And things interlay so well, the audience right now is going, what’s the chicken. And what’s the Brat I
know because I know you, so there we are going to get to that. But before I have one more question, can

you talk about being the author of your life? Because I think that leads into chicken and Brat very nicely.
What do you mean by that? Because I think it’s really impactful.

Beth Weissenberger (11m 2s):
For sure. When you take a look at your life, any area of your life, where you are happy, you are proud and
you’re effective. You can say your being the author, you’re in charge. You have the pen in your hand or the
iPad. Your saying, here’s what I want. Here’s how it’s going to go. And you authored that result. So when
you’re an author, how do you know you’re an author in the area of your body or your health or your marriage
are your children? How, you know, you’re an author, you’re happy, you’re proud. And you’re effective. If you
are not happy with your body, you are not being an author. If you are not happy with where you are in your
career, you are not being an author.

Beth Weissenberger (11m 45s):
So there are areas of your life where you are absolutely being an author. We don’t touch those because
you’re living inside of your dream, what you want, you know, what you want. And you’re out to it. I know
matter what the universe gives you. You are going to figure out a way to stay the author and make it happen.
That we identify. Because then it’s so funny because then I go, all right, Tony, you’re an author here. Why
aren’t you being an author over here? Right. So it’s, it becomes real evident like, OK, you’re in charge here.
And they’re not here. Who is really running the show here. Because author means your running the show.

Dr. Anthony Orsini (12m 21s):
And I think that one of the most difficult conversations we all have is with ourselves. And that’s basically what
you do. You facilitate the conversations that we have with ourselves, correct. That’s really what it’s all about.

Beth Weissenberger (12m 33s):
Who do you have to speak to? You know, Nolan was recording and he was speaking about his NFL coaches
and he’s like, they always say, get out of your, Way get out of your way. He said, for years, I was like, I am
out of my way. What are they talking about? But when he started to get coached by me, he got that what
was in his way was himself in his own head.

Dr. Anthony Orsini (12m 53s):
And that’s where we lean into the chicken and the Brat. So tell us about that. What I really liked about
learning about what you do with the Handel method is that you simplify things so much, that you’re exactly
right. You get out of your own way. I did it myself. I did the Chicken and the Brat myself. And it makes you
think Clearly, it really does. Tell us more about the chicken and the Brat.

Beth Weissenberger (13m 14s):
Let me give a little context and then I’ll back into it. So the question becomes what’s the source of results.
And most people will answer that the source of any result that you have in your life or don’t have is because

you’re either taking the actions or you’re not, you’re taking the right actions, your being effective with your
actions, it’s all action based. So if you say, OK, what’s the source of results. You’re going to go, Oh, I made
an action and people really do think it’s action. But if you’re dealing with an area where let’s just say in
COVID you gain 15 pounds, right. With as many people have, you know, you’re sitting at home today and
you’ve gained the 15, you will then say, so if I go alright stop it stop eating those french fries, stop snacking
all day he’ll be like, yeah, yeah, that’s right.

Beth Weissenberger (14m 0s):
That’s right. That will not stop you for eating just because you know, to stop. So actions are not the source of
results. The source of all your results is your inner dialog, your thoughts are, and you might have just said to
yourself what inner dialog. Yeah. That voice that just said that, that your inner dialog and Dr. David Hawkins
years ago, did a study of human beings inner dialog. And what he discovered is that 80% of a human being’s
inner dialogue is negative, not surprising at all. So 80% of your thoughts are negative, which gives you your
actions and gives you your results. And then wait, one more statistic.

Beth Weissenberger (14m 43s):
95% of the 80%. That’s negative is the same crap you thought the day before. That, when I was looking in
the mirror, I’m like, Oh my God, I’m falling down. Do you think that I have a different thought tomorrow, look
in the mirror tomorrow, it’s falling. Right? So it’s the same, Crap 80% negative. So what we do at Handel is
you having that information will do nothing. So now we break it down to, all right, let me introduce you to the
80% negative that talks to you constantly. And we broke it down to three Inner Dialogues, three Voices. One
is the Chicken voice and the Chicken voice. And we’ll hear yours in a moment. Your chicken voice is the
avoidant.

Beth Weissenberger (15m 25s):
Like you avoid anything hard, confrontational. You don’t want to hurt their feelings. You were a nice guy. Oh
my God, do you want to put it off? That’s the harder phone call. I didn’t want to deal with them for 20
minutes. I don’t have the time to listen to their products. So you would avoid. And so a Chicken might say to
you, Ooh, I should talk to Tony. Today about that thing that happened, you know, it’s his podcast today. He’s
really busy. He doesn’t have time for me. You know, Fridays are usually good because it’s the weekend and
he’ll be happy. So I’ll wait till Friday to tell him. And you’ll think that’s the greatest business strategy. And then
I’ll laugh at you and go no no , you’re a Chicken. So Tony, why don’t you tell them your chicken that you had
done that?

Dr. Anthony Orsini (16m 3s):
Yeah, I was afraid of you were going to ask me, this is so I know I wasn’t going to get out of this. I think you
can even heard you ask Gary Vaynerchuk, what his cavity was. I think that my chicken is an inability to step
back, to move forward to where I want to be. I think that’s probably the best way that I could answer it. That I
have so many projects going on, that what I really need to do is stop doing them all at, or some of them. I

don’t want to see I’m being in a physician at 90%. But other things that I wanted to do with my life. I’m doing
it at 80% because I don’t want to step back. And I think that’s my Chicken.

Beth Weissenberger (16m 39s):
So your Chicken is avoiding taking certain actions on things that your higher self that keeps telling you to do.

Dr. Anthony Orsini (16m 45s):
Yeah, my Chicken is to, to not step back,

Beth Weissenberger (16m 47s):
Step back from what what’s the Chicken say.

Dr. Anthony Orsini (16m 49s):
So I have so many different projects, right? I’m a full-time Physician, but eventually I want to teach more. I
love teaching and in doing my workshops and doing my communication and doing these learning modules, I
would need to step back from being a physician a little bit, but that would hurt me because I like doing that.
But also financially, that would hurt me temporarily too. So I think that’s my chicken it’s, you know, time to, as
they say, poop or get off the pot sometimes, you know, in Brooklyn words.

Beth Weissenberger (17m 15s):
So yeah, you are being Chicken about, Oh, no, the money. Oh, this rather than create something that could
actually make you money doing something else you loved to do. Yes. Be a chicken. All right. So that’s one
voice, everyone. The other voice that makes up the 80% is the brat, the brat and the defiant voice. It’s like
my 19 year old daughter. And I know that those of you who have teens, for sure, you know, the Brat voice,
but the funny part is Is Oh, you’re a Brat too. So the brat, the defiant voice goes like that, but I don’t want to.
You can’t make me. You’re not the boss of me. Leave me alone, drop dead and get away from me go away.
So the brat is like the one in the morning where you’re supposed to get up. You have the alarm set. You had
said to your wife the night before honey, I’m going to get up and meditate.

Beth Weissenberger (17m 57s):
So when my eyes are closed, no I’m meditating for 20 minutes. You wake up the next morning to go meditate
in your voice goes, Nah go back to sleep. And you like to go, thank you, God, like God just talked too. And
you go back to sleep. That would be the Brat just ran in your life. So do you have a Brat one Tony to tell
people?

Dr. Anthony Orsini (18m 17s):
I think my Brat one is that I am so busy at work and doing so many different projects that I keep saying to
myself, you know, you’re having trouble sleeping, you know, you’re not exercising and you quit golf. Totally
because you took on too much. And then I go, well, but I really can’t help that because I got all this to do and

some day. So I think that would be my Brat.

Beth Weissenberger (18m 39s):
Yeah. You’ve got your Brat and a bit of weather reporter in there, which I am going to explain. So it’s so far
everyone, you got your Chicken, so you want to identify your chicken. So and then if you identify your
chicken, it’s really your higher self that just identified your lower self. That’s a good thing because the
moment your higher self met, your lower self, we can now do something about it rather than you walk around
in life thinking that your chicken is real. So the last one, so we got the chicken, we’ve got the Brat and the
third one is the subtlest of the three, but just as deadly, it’s called the weather reporter. So what’s a weather
reporter. So I’m sitting in New York city. Let me look up the weather. It is sunny and 70 degrees.

Beth Weissenberger (19m 20s):
There’s nothing I can do about that. Those are the facts, sunny. Yup. 70 degrees. So now when you are
being a weather reporter in your life, you swear, the excuse, the reason and justification as to how come you
can’t do something is as real as it, 70 degrees and sunny. So you might say to me, Beth I don’t have time to
do what I want. I don’t have time to work out. I don’t have time to meditate. And you think I don’t have time is
as real, as 70 degrees and sunny, like it’s not malleable. It’s a fact. So the reporting is all of the excuses,
justifications, and reasons you use to not be accountable for something.

Dr. Anthony Orsini (20m 3s):
I love that.

Beth Weissenberger (20m 3s):
you blame it on the reasons like you’re a victim. And you could hear the difference between the author
whose in charge. And then the weather reporter, who is like, Oh, I know I don’t have time COVID. You know,
I can’t have any fun in my life until COVID is over it. That’s a weather reporter. So then the question
becomes, all right, so you’ve now identified them. So we then don’t leave people in their Chicken Brat or
weather reporter. So with your Chicken Tony about like all, I have so many things in so many projects at all
of that, right? You need three things, everyone, before I give you the three things, let me say this, your
chicken, brat, and weather reporter are not on your team, their entire life is about getting in your way.

Beth Weissenberger (20m 44s):
Their entire life is about you not having, what you want their job is to mess you up. And they are not going
away. They are your board members. They are yours. You should meet them and have fun with them
because they talk constantly. You know, one of mine is when I have to do something scary. It reminds me
that I had ADHD and I had to take fifth grade again. So it says something like Beth Don’t forget, you were an
idiot. Beth, don’t forget you’re stupid Beth don’t forget, right? It will say that. Got it. Like in the middle of
wherever, I’m like really thank you. Yeah. So you have to be able to hear it so you can tell it to shush up,
right and back off.

Beth Weissenberger (21m 25s):
It’s not you, it’s not God. It is not you, not you. That has nothing to do with your higher self, but your higher
self must hear it. So we are now clear the Chicken, Brat weather reporter are not on your team. So then the
question becomes, how do you move from being the Chicken ,Brat, weather reporter to being an author,
because remember wherever you are an author, your happy, proud, and affective, wherever you’re a chicken
brat, weather reporter, you’re not living true to your dreams and what you want in life. So there’s three things
you need. And its like, Tony says, this is simple. This is not hard. There’s three things. You do these three
things and you will alter every chicken, brat and weather reporter.

Beth Weissenberger (22m 7s):
So the three things you need is I’ll say it and then explain them. You need a specific, measurable promise.
You need a consequence and you need someone to hold you to account. So let’s start backwards to the
person to hold you to account has to be someone who doesn’t take your crap. So like if you don’t keep the
promise and you go, honey, come on. Like with my love of my life, Steve, right? If I break a promise and I’m
like, honey, and he was like, eh it’s okay. That is not who I ever have hold me to account for my promise. All I
do is just text me my sister, my new promise or consequence and that’s the end because I’m not messing
with her. So you need someone who doesn’t do the double or nothing.

Beth Weissenberger (22m 50s):
Crap. Okay. All right. So then specific measurable promise. Why is it must be measurable is because you’re
Brat we’ll find loopholes. I’ll share one with you. So I had another NFL player whose came up with his
promise and his consequence was, he says Beth I love my wine. If you take my wine away from me, that will
kill me. And I’m like, perfect. So we made the promise and if you broke it there’d be no wine. All right. Well, if
he gets in his next session with me and he’s giggling and he, you know, I know him and I’m like, what are
you giggling about? He goes, you didn’t tell me I couldn’t have vodka. Well, you didn’t tell me you liked the
vodka.

Beth Weissenberger (23m 32s):
So you will find a loophole. So it’s got to, your promises has gotta be specific and measurable. Can not just
be, I will work out because you’ll sit at your desk and lift your arms 10 times ago. I worked out right. So
specific measurable. Okay. So like with Toni, you would need a specific measurable promise with regards to,
you know, when are you starting a project, right? You would need that. All right. So then now the most
important part. So you got the promise, you got someone holding you to count is the consequence. The
consequence is the way in which you manipulate the chicken, brat and weather reporter from not running the
show because they need a manipulation because there are good.

Beth Weissenberger (24m 14s):
And they’ve been running in your life for some of you for 40 years. Right? So it needs something. So as a

consequence is going to feel like a punishment, but it’s, you’re the one that’s inventing, right? So you’re the
judge. You are the criminal, you are inventing your own. So it’s got to be something that if you don’t keep the
promise, you have to pay, that would so annoy the crap out of you, that it forces you to keep the promise.
Cause over your dead body are you paying for that? So I’ll give you an example and I’ll give you some of
mine. So one example, I have a client who at the time was 61 years old, billionaire owned a company, very
successful, except the one area.

Beth Weissenberger (24m 54s):
There were a few, but one of the areas that sucked in his life is he never worked out and his doctors were
furious with him. Like you’re going to die. Like he was overweight, his heart wasn’t good. Now watch, he had
three homes. He had gyms in each home and he had a trainer in each home. He would just pay them to do
nothing. All right, well you got the brat you hear are the brat right? and so his promise, which worked was for
every workout he did not do. And all he had to do is three a week. With the specific measurable three a week
for any one he missed he had to pay Trump $10,000. and this for a year to go when and Trump was first
running, right?

Beth Weissenberger (25m 37s):
Ask me how that man’s health is fabulous. Great, lost the weight he works out. He never had to pay Trump
the $10,000. Now that’s obviously being a billionaire. So then what do you do inside if not right. So money.
$10 bills out your car window, throwing them to the street, not to the homeless, not to make you feel better
drop it. That would be annoying. You know, anyone of your vices like my sister or one of my sisters loves her
TV shows. And so if she breaks a promise, whatever current TV show she’s in, she loses the next episode
and never gets to watch it. Right? Take your liquor away, take your weed away.

Beth Weissenberger (26m 17s):
You’re coming up with something, your golf or anything that would annoy you. That’s what you got to do. And
then you have to have someone to hold you to count. And I promise you, if you do that today, you will alter
your life in that area done.

Dr. Anthony Orsini (26m 28s):
love that. Now you got to find somebody in your life is willing to be tough. I got a beautiful, very sweet wife.
She’s not going to be my,

Beth Weissenberger (26m 36s):
You pick out one of your nurses who would like to talk with you. You pick another doctor who would enjoy the
giddiness of taking your money, right? Like try to find someone who will do it.

Dr. Anthony Orsini (26m 46s):
It sounds like a college roommate. Who’s very quick to tell me I’m flawed in every way. So that’s, that’s what

guys do to each other. So that sounds great. Yes. So that’s fantastic. But you know, for that person who’s
listening right now, there is going, Oh my God, this speaks to me. Beth then I need to do this right away. This
is where the inner U comes to. Like, how do they say I need help? Beth

Beth Weissenberger (27m 11s):
Yeah. So one of the things that we have, so about two years ago, when we were in, remember I’m the
president of the corporate division. So we go into corporations and we’re expensive. So, you know, you get
the top, let’s call it like the 50 people, right? Who are going to get the one-on-one coaching, get the
workshop’s, you know, at the top C-suite. So then the question became, what are you doing for my other 300
people in my other 500 people? How come, you know, I don’t want to spend that kind of money on them.
And so that’s when we went, we should have an online coaching program. We could do that. We could
charge, we could give it out in bulk. And so that’s where we invented. We have innerU student where
students do that.

Beth Weissenberger (27m 52s):
We have innerU Love to handle your love life. We have IinnerU Life for your whole life. And we have innerU
Career that’s for inside of us. We sell them in bulk, inside a corporation’s or individual. My sister does the
principal. Chicken, Brat weather reporter has someone giving an example. Whether one of our clients. And
one of our coaches gives you the homework gives you answers to questions, the most common questions.
And you’ve got 12 modules. That’ll take you about six months, which is a coaching program to do it on your
own in your home. You get one free coaching session that you get one private coaching call that comes with
it. And then you have access to any one of our masterclasses.

Beth Weissenberger (28m 35s):
And you have that. It’s a lifetime subscription.

Dr. Anthony Orsini (28m 38s):
Yeah. So it’s really bringing in that corporate service that you give to the individual who said, I need help.
And I don’t have that much money. And it can’t be that bad because you are, you’re offering it to the
students.

Beth Weissenberger (28m 49s):
Fordham just dropped it to I think a hundred students. Yes. So colleges are now going to start doing that. It
just makes the difference right for you too. What I mean? Hi, we’re in the middle of COVID and you’re
working from home. When this is to take care of you. And if you do, there’s two ways to do it because it’s a
beast. You can just listen to it. Don’t do any of the homework, just listen to it. And it will change your life. If
you do the homework, which is a beast, because it’s about 30 minutes of listening and then it could be, you
know, an hour and a half of homework plus, right? If you do the homework, you’re life will be radically
different in six months, like altered, life altered those of you listening.

Beth Weissenberger (29m 29s):
We have a coupon so you can get innerU career? That’s usually $650. You can get it for half off use Difficult
Conversations. If you go on to our website, you’ll see innerU Career put in Difficult Conversations get it for
half off.

Dr. Anthony Orsini (29m 44s):
Fantastic. See if it does pay to listen to this podcast. So that’s amazing that you were able to do this Your I
can tell you. I know, I see your face in the audience. Doesn’t see your face. You loved this stuff. You breathe
it. This is, this is fun for you. And people say that about me. I just know I heard you interview. I think you ask
Gary Vaynerchuk what his cavity was. And he said I wanted it to avoid conflict. I think that was what his was.
And then I thought to myself boy, and how different people are ’cause I would say that was one of my strong
points because that’s what I teach. I teach her to go through conflict resolution. And so everybody’s different,
but everybody, there was no one in the world. It, it doesn’t have a chicken and a brat.

Beth Weissenberger (30m 24s):
Well, I’m more bratty than I am chicken. Some people are more chicken than they are Brat so you’ll find out
where you land in it. But we all have what sucks about us, right? We all have our dark side. We all have our
bad traits. We all have what doesn’t work about us. And one of my favorite things that I have people do is to
ask two questions to your spouses and partners too, your children. And I did this with my daughter when
max was six and a half years old, the two questions are what sucks about me. And when I do that, how does
it make you feel? So I’ll never forget. You know, I know what sucks about me when Arman and I got divorced
and we have a lovely divorce.

Beth Weissenberger (31m 7s):
We’re dear friends. This is my daughter’s daddy. I knew when he left, he was the fun one. I was, I am not fun
back then. So this is now a year. I know this is why we got divorced. So this is like 8 plus years ago, almost
10 years ago. And Max was nine years old and I sit with her and I’m like, Maxi, is mommy any fun? I knew
the answer. He was like, mommy, you are not fun. And she laughed. And I laughed. Now, if that’s all the
conversation was that would have done nothing about it was, I then said, Maxi, how does that make you feel
when mommy is not any fun?

Beth Weissenberger (31m 49s):
And she burst out hysterical, crying. So, and when she could breathe again, she said that you never want to
play with me. That struck my heart, like a sword through my heart. And that was the end. I made a promise
and a consequence. I kept the promise. I didn’t ever have to pay the consequences. And I altered my
fun-ness for my daughter because I was not going down, having her think that I didn’t want to play with her.

Dr. Anthony Orsini (32m 15s):

And that’s a great example, right?

Beth Weissenberger (32m 17s):
So it, it, it behooves all of us are the people that work for you or your loved ones, your children, your spouse.
I know you’re not gonna want to, but go ask them, listen, we have three more months left in the year. I want
to be a better leader, a better mother, a better wife, a better girlfriend, whatever it is. And I want to know from
you, what sucks about me and you’re not in trouble. I won’t defend. I won’t answer you. Write it down. What
sucked. And when you tell me what sucks, tell me how it makes you feel that I do that. That’s the most
important thing is how it makes them feel. Because they make stuff up. You have no idea. And then after
they tell you to make a promise and a consequences, cut it out, right?

Beth Weissenberger (32m 58s):
’cause you’re not proud of that behavior. You don’t want to be that human. You think I really want to be mean
to the love of my life. I know, Oh my God. But from time to time, I had that bad trait. I got hurt. I’ll go like that.
And then in a matter of five minutes or less, it’s like, Oh my God, I was just all, let’s not, you know, like fix it
because that’s not who I want to be. That’s not who any of us want to be, but we all have our bad traits. And
so we teach you how to human better.

Dr. Anthony Orsini (33m 28s):
Fantastic. And you know, this podcast is about learning how to navigate through those difficult conversations
in your life. And you certainly inspired us to be better people. That’s my first promise to the audience. And
boy, we learned how to navigate those difficult conversations with ourselves and with each other. And I think
one of the most important thing is ourselves. We need to have more of those conversations and stop
avoiding them. So I must say I was worried that you would be asking me, I didn’t expect to be revealing stuff
about myself. So now my audience knows about my chicken and a hopefully a we’ll see what happens is
about that. I think that was really very informative. I’ve loved this episode. And I think that Handel Group is
doing amazing things that are just getting bigger and bigger and bigger.

Dr. Anthony Orsini (34m 9s):
And I’m just so happy to get to know you. And so honored that you were on this podcast. Thank you so
much.

Beth Weissenberger (34m 16s):
Absolutely. And everyone just go on to our website. If you don’t want to buy anything, just get the newsletter.
We ou, blogs are hysterical because we just keep telling on ourselves, write to make it easier for you to own
your dark side.

Dr. Anthony Orsini (34m 28s):
Yeah. So that’s the Handel group.com, right?

Beth Weissenberger (34m 29s):
Well, Group H a N D E L. It’s our maiden name. Handel group.com. Go enjoy it. There’s some fun stuff on
there. I’m and we would love to have you join our newsletter.

Dr. Anthony Orsini (34m 41s):
That’s fantastic. And so contact Beth. We’ll put this all in the show notes. If you enjoyed this podcast, please
go ahead and hit subscribe. It’s available on every platform. And if you want to reach me it’s
drorsini@theorsiniway.com that’s Dr Orsini at the Orsini Way.com. Then we’ll put that all in the show notes.
So thanks again so much. I really appreciate it.

Beth Weissenberger (35m 4s):
Thank you everybody for listening.

Announcer (35m 5s):
If you enjoyed this podcast, please hit the subscribe button and leave a comment and review. To contact Dr.
Orsini and his team, or to suggest guests for a future podcast, visit us@theorsiniway.com.

James Orsini (1s):
Delegation really comes from something that you should be doing, that you bestow on somebody else to get
done for you. And facilitation is really looking at a much broader landscape and taking the time to really
understand what it is that people do well. And then how connecting the dots between two folks whose paths
normally wouldn’t cross and how they bring value when united together on a particular project.

Announcer (27s):
Welcome to Difficult Conversations: Lessons I Learned as an ICU Physician with Dr. Anthony Orsini. Dr
Orsini is a practicing physician and the President and CEO of the Orsini Way. As a frequent keynote speaker
and author, Dr. Orsini has been training healthcare professionals and business leaders, how to navigate
through the most difficult dialogues. Each week, you will hear inspiring interviews with experts in their field
who tell their story and provide practical advice on how to effectively communicate.

Announcer (1m 3s):
Whether you are a doctor faced with giving a patient bad news, a business leader who wants to get the most
out of his or her team members, or someone who just wants to learn to communicate better this is the
podcast for you.

Dr. Anthony Orsini (1m 12s):
Welcome to another episode of Difficult Conversations Lessons I learned as an ICU Physician. This is Dr.
Anthony Orsini I’ll be your host today and every Tuesday moving forward. Today I’m especially excited
because I have my cousin as a guest James Orsini. James Is the President of The Sasha Group, which is a
VaynerX Company. Working alongside Gary Vaynerchuk it’s CEO in a serial entrepreneur, james leads The
Sasha Group to help small businesses reach explosive growth, potential.

Dr. Anthony Orsini (1m 43s):
The Sasha group provides educational consulting and marketing services for companies from 1 million to
200 million in revenue, James previously held key high level positions, four VaynerMedia, including Chief
Operating Officer and Chief Integration Officer. Before coming to VaynerMedia, James held prior positions
as chief executive officer and member of the board of directors of site to Mobile. He has more than 35 years
of experience and operations experience across a broad range of marketing and communication disciplines.
James was the executive vice president and director of finance and operations for Saatchi and Saatchi in
New York, where he worked closely with the CEO to provide strategic and day to day direction for all
financial and operational functions.

Dr. Anthony Orsini (2m 21s):
His impressive resume continues prior to joining Saatchi and Saatchi, James held the key leadership
positions that they had brand North America, KPMG and Goldman Sachs. James graduated, Magna c*m
laude from Seton Hall University in New Jersey with a bachelor of science in business administration. He
received at universities, presidential academic scholarship is still served the university today. He is a

licensed New York state certified public accountant. On a personal level, James is a board member of
renovation house in New Jersey, New York a residential substance abuse rehabilitation program.

Dr. Anthony Orsini (2m 53s):
He served as a member of the board of regions for Seton hall university, but perhaps his best
accomplishment was winning that third and fourth grade little league championship with his cousin. Yours
truly wouldn’t you agree that’s your highest accomplishment of life?

James Orsini (3m 8s):
Absolutely. I take every occasion to mention it to where they allow me to do so,

Dr. Anthony Orsini (3m 13s):
You know, I think you and I were the two worst player’s on the team. You played center field, I was a second
base man, but somehow I think both of us or the championship went three for three.

James Orsini (3m 23s):
Yeah. Yeah. And I gave birth to an athlete. So I make it All level off now

Dr. Anthony Orsini (3m 28s):
That’s right after you’re a stellar career in third grade, you’re son went off to play college baseball. It must’ve
been Joanne’s genes, I guess,

James Orsini (3m 35s):
Absolutely Joann who we met when she tripped and I picked her up. So we do not have any kind of finesse
when it comes to sports.

Dr. Anthony Orsini (3m 44s):
All kidding aside, your career has been an incredible story of one success after another. And I really enjoyed
watching your accomplishments pile up. As I read your bio in the position that you’ve had I thought anybody
would be it happy just to have one of those positions, but each career defining step that you made, you just
took on more and more and had more and more success. I think that’s incredible. I just want to say, I’ve
personally enjoyed watching your career just give better and better. .

James Orsini (4m 11s):
It was unplanned, but the, but it unfolded really in a, in a nice way.

Dr. Anthony Orsini (4m 16s):
So the topic of this podcast that has always difficult conversations and particularly we are going to talk about
Difficult Conversations in Leadership, you’ve held so many positions in leadership, but before we get into

that, I just want the audience to know that James Orsini that I know. So tell us about James Orsini. How
would you describe yourself? What drives you and what is your leadership philosophy?

James Orsini (4m 37s):
Well, I’m a family man. I love every aspect of my family and look to spending as much time as I can with
them. I actually see business as my hobby, which most people find strange and unusual. So it wouldn’t be
crazy for me to be on a vacation, still reading the wall street journal where a, a, a business book and hand.
So that’s why it, my passion has actually become my profession. And I don’t feel like I really work. I just
show up and do what it is that I like to do.

James Orsini (5m 7s):
So, you know, my leadership style is one a servant leadership. You know, I actually serve out of this to get
the best out of them. I am a facilitator rather than the delegator. So a that means you gotta do to really take
the time to understand what it is that people do well, and then how your needs plug into their talents. You
know,

Dr. Anthony Orsini (5m 26s):
It’s interesting. You bring that up. I read a piece that you actually wrote, I think in 2017, right? Don’t Delegate,
Facilitate, So just expand upon that. Could you just mentioned that a little bit? What did you mean by that?

James Orsini (5m 37s):
Yeah. You know, delegation really comes from something that you should be doing that you bestow on
somebody else to get done for you. And facilitation is really looking at a much broader landscape and taking
the time to really understand what it is that people do well. And then how connecting the dots between two
folks whose paths normally wouldn’t cross and how they bring value when united together on a particular
project. I kinda see things from 30,000 feet.

James Orsini (6m 6s):
So things look small to me, but as a result of that, if you think about it, right, when you’re up in an airplane
and you see these little puddles that you realize there’s, somebody’s swimming pool, but you were at 30,000
feet. So they don’t look grand in any way, shape or form. And that’s the way I see problems. I just don’t see
them big. I have a different vantage point and I help people navigate through them.

Dr. Anthony Orsini (6m 27s):
That’s great. So you had some great positions and then tell us the story, because you know, you can get
through an interview without somebody asking you about GaryV right? So he’s just bigger than life. And you
work with him, and I have a couple of questions about Gary V how did you end up at VaynerMedia? If you
could tell us the story and then tell is how the soccer group started it and why you started that.

James Orsini (6m 47s):
So it wasn’t interesting that I went to Seton Hall, University basketball game. I was invited by another board
member at the time, and he brought his son and his son brought a friend and their friend was AJ Vaynerchuk
Gary’s younger brother. At that time, I was Chief Operating, Officer it Saatchi and Saatchi. And, you know,
we’ve got to talking and I just invited him down to Saatchi to see what it was like when he gets big. And it
took me up in the offer, but most importantly, he knew enough to stay in touch with me and use me as a
mentor, you know, oftentimes ask, have you ever done this?

James Orsini (7m 19s):
You know, somebody who does that, how would you handle this? So we kind of stay in touch over the years.
And I left Saatchi. I went out to become the CEO of Sito Mobile and then I stood, there are three and a half
years. I had a three year employment contract. I spent three and a half years, and now I was leaving to
come back into big advertising. So I just called AJ to just say, Hey, man, I’m going to see you again. You
know, I’m going to be back in big advertising. And he’s like, you know, did you ever meet my brother Gary.?

James Orsini (7m 50s):
And I said no, and he said, you ever hear of him? And I said, no not really. And he’s like, all right, well, do a
quick Google search. He’s not going to be harder to find. I spent some time with him that long, maybe 15
minutes, I got a call back from AJ and said, Listen he likes you, he want’s to have dinner with you. You know,
don’t take that too lightly. His times is pretty valuable and we had dinner and he said that James, I want to
create a $500 million independent integrated international communications company. Can you help me do it?
And I said, yeah, I actually think I can. So he was like, all right, well, don’t take one of those other jobs.

James Orsini (8m 21s):
You’ve already had that step on a cloud and do this with me. And I did. And, you know, he has certainly been
successful Before since, and it continues to be, I like to think I had played a small role and help a piece of his
vision come to life.

Dr. Anthony Orsini (8m 37s):
And that’s an important point. You mentioned in one of your interviews, the Gary asked you one simple
question. So what is it that you do tell us about that?

James Orsini (8m 45s):
He said, could you describe what you do in one sentence? And I said, yeah, I take dreams and visions and
put them into action plans. And he was like, you’re hired. So I got a lot of dreams. So it does good.

Dr. Anthony Orsini (8m 55s):
Well everybody needs someone to see the big picture and then somebody who facilitates. So I think that is
certainly you, it sounds like its a perfect match.

James Orsini (9m 3s):
Yeah, yeah. Has been, we’ve got an absolute blast and I’ve had several positions and is running the VaynerX
world and the newest of them right now.

Dr. Anthony Orsini (9m 10s):
So lets start moving towards difficult conversations and I asked Claude Silver the chief heart officer at
VaynerMedia the same question I’m gonna ask you. Of all the years you have been in leadership and all the
types of conversations that you’ve had with board members, CEOs, workers, employees, what do you think
is the most difficult conversation that you have had and that you continue to have to have that you really
thought that you needed to master?

James Orsini (9m 36s):
Well, its so many people unfortunately define who they are by their work it’s said definition, but it is factual
and removing someone’s work while not removing their soul has always been a difficult situation for me. And
as you read from that bio, I have had a lot of senior roles with those senior roles come, a senior
responsibilities, many of which was unfortunate in all different times, right?

James Orsini (10m 7s):
Or removing people who are simply out a position and I’ve had to do that around the world. I’ve done that
with bodyguards. I’ve done that with translators. I’ve done that in different cultures and it’s always difficult
when you’re removing the people who was used to removing to people. So I’m talking about CEOs,
founders, businesses that I bought and then remove leaders really, really difficult situations. And you know,
we need to do it because you know, the needs of the many outweigh the needs a few and what you are
trying to accomplish.

Dr. Anthony Orsini (10m 41s):
Any advice that you have to the young executive out there who needs to remove somebody’s or separate.
We had Dr. Larry Barton on a few weeks ago, Dr. Barton is the world’s leading expert on workplace violence.
He has a brand new book that talks about the way you separate someone from employment can really
predict whether they’re gonna come back and shoot the place up. Or, you know, I mean, those are rare
instances, but they do happen. So what advice do you have that for that manager whose got to remove
somebody’s that you could help him do it in the kindest most compassionate manner?

James Orsini (11m 14s):
Well, one, it shouldn’t be a surprise. So make sure you’re taking the time to properly communicate, to
evaluate over a period of time to, you know, having an ongoing dialogue. I believe Claude calls it “radical
candor”, you know? So by the time you get to that closed door office, nobody should be sitting on the other
end of that desk, thinking that it was a surprise. To, you know, be as fair and reasonable as you possibly can.

This is not the time. You know, at that moment to try and save an extra week, salary are pay or whenever,
you know, try and be as fair as you possibly can within the policies of your company and as reasonable as
you can in a, you know, not making it a choking situation.

James Orsini (11m 56s):
You know, as a global CFO, I was the guy that used to have to remove global CEOs. The CEO didn’t do it,
he put me on a plane and say, you know, you’ve go to Mexico city or your going to Tokyo, you know? So that
was always hard and difficult. They kind of knew when I was flying in this sort of grim reaper type of analogy,
I’ve removed people who was companies’ I bought, we then absorbed a company and there was no need for
the founder anymore. That was difficult. But you know, I’ve done it in such a way, in one particular example
where I called years later in a different company.

James Orsini (12m 30s):
And I said, listen, I know I’m not the voice you want to hear on the other end of the phone, but I had the right
opportunity for you now I’m in a different place and I know what it is that you do well. And if you’re willing to
trust me, come and join me here in this new role. You know, I made lifelong friends that way. Obviously when
you do something like that in the Sito Mobile situation, I was brought on as the CEO, the founder was moved
to a chairman role. We worked for a couple of years together and then the board told me, listen, you have to
remove him.

James Orsini (13m 4s):
It was his, yeah. It was really, really, really difficult. Two grown men crying on each side on the phone, you
know, their thinking about it. It, it was his baby birthed that company. Now, if he was removed from it. So that
is a really hard,

Dr. Anthony Orsini (13m 17s):
Yeah. You know, it’s interesting that your first thing you said was they should already know it’s coming and
I’ve been training doctor’s as you know how to break bad news, how to give tragic news. You have cancer,
your baby is passing away. Your child’s gonna have neurological deficits. And what I teach and I use this
acronym called program PROGRAM and the G is for gradual and its the number one rule of breaking bad
news in healthcare and business. There’s so many parallels. That’s why I’m having you on also that there’s
so many parallels that when someone hears the bad news, that their husband just died in the emergency
room, et cetera, I always tell the doctors, they have family members should already know what’s coming.

Dr. Anthony Orsini (13m 56s):
So you want to plead your case first. And this is what happened. There is a heart attack was worse than we
thought it was by the time he got to the emergency room in his heart was a very low, his blood pressure was
low. We had to give him an adrenaline, etc, etc, etc. And this is neuroscience based just allows people to
brace themselves for that news. That’s coming in your case, you’re talking about over a period of time where

your giving them feedback, et cetera. But it’s interesting that the parallels, that was a first thing that you said
and that’s number one rule in medicine too.

James Orsini (14m 26s):
Yeah, no surprises. I mean, but at a time some of this difficult and hard conversation is coming. It’s horrific
when it’s cold water in the face, you know, it’s never easy, but it’s a little more acceptable. When this is the
third time you’re talking about this particular topic and this is going to be the last time.

Dr. Anthony Orsini (14m 44s):
In a small way. They appreciate that you took the time that you gave them the chance and that you did in a
compassionate manner. And so that whether you’re a separating someone from a appointment or you are
doing it in medicine, it’s really, really the same thing. There’s so many parallels. And as you know, I’m a big
student of communication. Well, I know you very well, but knowing each other, since, since we were
children, I know you have a very even temperament. And in medicine I had a mentor when I was very young
training, I think he was doing a neonatology fellowship and he told me this thing, he said, the higher you are
up on the ladder or the softer you speak.

Dr. Anthony Orsini (15m 21s):
And that was probably the best advice that I ever got. And I routinely get thrown into situations where there’s
a child or a baby who has no heart rate and the team whose very, very good and their very well trained. They
are trying to resuscitate. Then they called me and I can get in there. And although they are very good,
there’s panic in the air or there’s and I’ve seen Physician to start barking. You see it on TV, right. They
started barking orders, right. That doesn’t happen. Not real. And I learned very early on from this mentor that
when everybody is screaming and yelling and get this and grab the oxygen and do that, And I walk in and I
just say, okay, what are we have here?

Dr. Anthony Orsini (15m 58s):
That’s what’s going on. The level of tension in the room goes down. So you mentioned how you’re even
temperament helps. Can you expand upon that? Just again, to join another parallel?

James Orsini (16m 6s):
You know, that’s been both a blessing and a curse for me because for some high strung people, it was like,
Listen, James, you’re not sensing the urgency that I’m trying to relay to you. And I said, I am sensing the
urgency, but if we’re all running around, like our hair is on fire, you know, nobody’s gonna have to see
through it and understand how important it is. Right. I’ve wrote a great book called the six fundamentals of
success by Stuart Levine, who is the ex CEO of Dale Carnegie. Now, if you know anything about Dale
Carnegie in business, it’s they train CEOs and it was about knowing what’s on your bosses dashboard.

James Orsini (16m 41s):

Some meaning like know what’s important to your boss and make sure that’s important to you. You know, for
a lot of what it was that I did with Gary in the earlier years, I was more like a decoder ring to him because
you know, the people that were around him were he used to Gary barks and out in an order and they run
100 miles an hour. Sometimes they smashed into a wall. And I was like, Listen I heard what he said, I think
this is what he means. You can go in a direction like this. Where do you know what let’s put some, we didn’t
necessarily call it process. We called it is scalable organization because when you are in hyper growth
mode, like most of his companies are, you know, process by nature sounds lethargic and slow.

James Orsini (17m 21s):
So we were just trying to organize enough to be able to scale. And a lot of times it gets tense in those rooms.
He’s just such a passionate individual that it comes out with a sense of urgency. And I just have a way of
seeing the dots in the room and understanding how they connect and come together. So I’m a much better
and a crisis situation. And I am a, it’s so funny. Because anytime I get very emotional in happy situations,
you want me as your pallbearers, but you know, because I’m gonna be no problem, but like they give a toast
at your wedding.

James Orsini (17m 55s):
I’m crying. So, You know, that’s a familial. And in fact, I just interviewed, I have a niece she’s gonna be on in
a couple of weeks, probably before this even airs. She was a premature baby survive that then, when she
was 16 years old, she got lymphoma, went through chemotherapy. She survived that. And now she’s a
pediatric oncology nurse and she takes care of kids with cancer. So I’m so proud of her. And I thought she
was going to be perfect. So I had her on, she was really a great interview.

James Orsini (18m 25s):
And during the interview or the introduction to my niece’s interview, I said in that introduction that please
forgive me because I think it’s familial that I might cry outt of pride and your gonna hear my voice quiver.

Dr. Anthony Orsini (18m 43s):
And my father is the same way. I think your father was the same way. Sadness, stone cold. But when their
kids graduating high school, they’re bawling their eyes out.

James Orsini (18m 54s):
Yeah, absolutely. Absolutely. That’s it. That’s the way it is.

Dr. Anthony Orsini (18m 58s):
So I don’t know if this is an Orsini thing anything or an Italian thing or what, but we were all the same and
let’s move on. So you, once said, were talking about More Difficult Conversations and sometimes you have
to have difficult conversations with clients, in the Sasha Group and I want you to tell us a little bit about that.
You’re really into mentoring and consulting and people are coming to you to help, but you once said a big

idea is not a business Hope is not a strategy and expand upon that. And I would think that sometimes you
have to have those difficult conversations with clients, with the Sasha group were people that come to you.

James Orsini (19m 28s):
Yeah. And that’s all, it was interesting when Gary pivoted and said, Hey you ready to start something new?
And I said, yeah, would you have a mind? He said, well, come on the cover of entrepreneur magazine, I got
14 million followers and we built a company to service Fortune 500, I don’t have a company for the smaller
and medium sized businesses. So he said, I want to start a new company. I want to name it after my dad for
legacy purposes his Dad was from Belarus, a Russian immigrant, who came to the United States worked his
way up. Bought his own liquor store? I, you know, the story there are, Gary helped out with that to help to
grow or whatever.

James Orsini (19m 59s):
It was 3 million in sales to 60 million in sales. So servicing the small businesses and is why we kind of
positioned ourself more like a consultancy on the front end in an advertising agency on the back end, you
know, fortune 500 has a brand manager’s from Wharton MBAs and, you know, understanding the real side
of marketing. And the folks that I serve are founders and owners and entrepreneurs, you know, who has a
passion for something and saw an opportunity could have been as a family owned business that they are
now taking to another level.

James Orsini (20m 30s):
You know, it could have been something that they saw on the marketplace and saw a way to pivot and they
be learned something new and they need guidance, not only marketing guidance, but business guidance,
but I was fortunate at this week to be included in a campaign, the magazine’s 40 over 40, it celebrates
wisdom and experience. Really, if you think about it, there’s no substitute for that. And in this space, I
happen to have that.

James Orsini (20m 60s):
So there are, are difficult conversations there. Like I know you’re birthed in this business in you and you
loved it, but the pivot the has to be here, or I know this guy has been along side of you for umpteen years,
but he’s not doing you any favors in the role that he’s in. And he’s simply not a chief operating officer or is it
not financially savvy? So there are difficult conversations with people who, you know, are passionate about
what is that they birth in a business, but don’t necessarily have a plan, but I spent a lot of time giving them
outlines to a business plan.

James Orsini (21m 35s):
Here’s how your idea becomes a business. Now remember the four pillars that Gary gave me, I wanted to be
integrated international independent communications company. Those four pillars, help guide the decisions
that we were making. They did two things. One, they enabled us to hit the gas and directions that aligned

with that. But more importantly, they enabled me to push back and challenge him.

James Orsini (22m 5s):
When, it didn’t align. Why are we doing this? I don’t understand how this fits. Remember the pillars that you
gave me. You know what I mean? So and Gary, by his own admission, says that he’s a moldable dictator,
right? So their buddies, a moldable, a dictator, meaning that you can have a conversation with him. And you
know, he’s going to make the ultimate decision as he should, but you can reason with him to understand why
things should be the way they are.

Dr. Anthony Orsini (22m 30s):
So you have to approach that conversation with at CEO because as you said, it’s his, baby, its her baby.
Then you need to tell them I have to train a bunch of physicians sometimes who are referred to me from their
hospitals saying that this guy’s is a great surgeon. He’s the great obstetrician. We were getting so many
complaints about his bedside manner. His, we call them H cap scores. Our patient satisfaction scores are
really low and it’s my job to coach them. Sometimes I put them through improvisational role playing with
actors.

Dr. Anthony Orsini (23m 1s):
I’m getting someone already. Who’s got an attitude like he or she does not want to be there. They’ve been
sent by daddy down there to get trained. And I can say, Because, I’m a physician. I mean, doctors have egos
and that I’m sure CEO’s have egos. And I’ve learned through my coaching that you do have to spend a lot of
time stroking that ego. And as they say, lead the horse to water in, when I teach conflict resolution, you kind
of steer them until they go, you know what James I think we should do this way. And that’s exactly what you
wanted them to do with it.

Dr. Anthony Orsini (23m 33s):
Is that a problem with CEO’s too? Stroking the egos a little bit?

James Orsini (23m 36s):
Well, I, you know what, the interesting thing, when I was going to Sito Mobile to become a CEO, you know, I
had never been a CEO. I was never been in a publicly traded company. And at the time I didn’t know
anything about technology and a, I resigned from Saatchi and the then global CEO, Kevin Roberts said to
me, so your going to be the CEO of a small, publicly traded company. He said three things. He says one
lonely job. He said two-hard job because when it gets to your desk, as this stuff that nobody else can figure
out.

James Orsini (24m 7s):
And he says three, where is it trading now? And I said, it’s trading on the bulletin board and were going to
bring it up to the NASDAQ. And he said, you are going to be asked to compromise your morals and integrity

on a daily basis. You know? And I shook his hand, it sounds like a Hallmark card. And six months later I went
back and I said, wow, those words were so deafening because it is exactly what I was feeling. So the
interesting part is in any room, there are so few people who even, you know, I’m sure as publicly traded
companies CEO is I’m honored to have held that title.

James Orsini (24m 40s):
I know what I don’t want to be ever again. And its a publicly traded CEO but once you have the badge, you
have the bage. So while Gary has 900 people in VaynerX, I don’t know anybody other than me, who’s been
in a publicly traded company CEO. So there are decisions he makes that you no, in the earlier times when I
was able to send him a text and so I know how to difficult, that is how you handled it eloquently I’ve been in
that situation. Well done.

James Orsini (25m 11s):
And that’s what happened with some of the CEOs, nobody want’s to come in and you know, and then they
were like, James, what do you know? What, what do you know about retail furniture? What do you know
about insurance? What do you know about law firms? And I said, absolutely nothing. I said, but I will never
know as much as you know about your practice, but you’ll never know as much as I know about the people
who are purchasing your services. Now that’s where the two of us come together. So that’s what I have. And
I don’t profess to know what it is that you have, but what you have becomes better when you mix it with what
I have,

Dr. Anthony Orsini (25m 45s):
It’s all about credibility. I have the same issue when I’m coaching physicians or when I’m doing workshops
and big hospitals about improving patient experience. We do exercises about how you sit down. When you
speak to a patient, how to be a genuine person, et cetera. Many of the other companies that do what I do,
they are taught by masters in education. Maybe they are taught by a nurse and as a physician, I know this to
be true. So even when I started my workshops, they are sitting in the back with their arms crossed, going. I
don’t really want to be here, but once I say to them, listen, I work in the world’s largest neonatal intensive
care unit.

Dr. Anthony Orsini (26m 22s):
We’ve adopted these practices. Our patient experience scores have gone up and I still go home at four or
five o’clock then all of a sudden, everybody sits up a little bit straighter. So when you were alluding to is it’s
all about the credibility. And I think that’s really important, but you still have to be careful with egos, right?

James Orsini (26m 38s):
That’s right. You, you definitely have to play with egos and it can get to your head. Just you read in bio. You
know, I was kind of cringing and looking around and I couldn’t even look at you reading it. I mean, if not done
properly, it will go to your head. You know? And now we had a 40 over 40 accolades somewhere in the

bottom of that, my wife does a good job of helping ground me. You know, they say Einstein’s wife thought he
was an idiot. Right,

Dr. Anthony Orsini (27m 6s):
Exactly. Right. I know you. well, your very grounded, your genuine people wouldn’t even know you do what
you do. Because you just loved to laugh. You enjoy life. And so I think that really goes a long way. Tomorrow,
“I’m going to be interviewing Stephen Covey, the speed of trust author. And he talks about building trust and
building loyalty, the best bosses I’ve ever had in my life. I walked through a fire for them. And that if you said
something poorly about them, I’d be very angry at you. No matter what. And some bosses I’m not happy
with.

James Orsini (27m 37s):
Yeah. That’s really, really important. You know, when I left the Sito Mobile I read a book called “Consigliere
ruling from the Shadows” and it was about being a great number two. When I read that book, I’m like, Listen,
that’s who I am. I don’t need to be the guy on the stage. I don’t need to be the number one. God, I think I
would of been a better CEO if I had a number two, like me behind me, I know most people have a number
two who is trying to shoot them to be number one. And that’s kinda, you know, what the realities of the
business world are.

James Orsini (28m 9s):
But I think that’s kinda where even when the, and this is, this is a funny one, Gary was like, alright, so you’re
going to be the CEO of the Sasha Group. I said, nah I think I would like to be the president. And they said,
you should be the CEO it’s, you know, you should be the CEO of VaynerMedia. You should be a CEO of The
Sasha group. And he’s like, wow. I never really had somebody get back a title. No, but it was like, that’s
kinda what was, I knew what was going to be doing. I didn’t really need any bigger title than the one that I
had to do, what it is that I knew I can do. And there’s a lot of trust there you know, there’s a lot of trust there.

James Orsini (28m 40s):
The thing as his father, his name on it, you know, he doesn’t want to screw it up in any way, shape or form.
He was involved in the vision. And then I sat the strategy for how to execute the vision.

Dr. Anthony Orsini (28m 49s):
And the trust has to go also downwards. So there are so many managers and leaders in bosses that I’ve had
where, I know the way that the way they stay up top, they believe in a way to stay up top is to keep
everybody down. And the best bosses I’ve had were ones that, you know, would hire Anthony Orsini and
then say, when I have another accomplishment, I’m going to take the credit because I hired him and there’s a
big difference. And as the audience knows my daughter Summer, she also works for VaynerMedia.

Dr. Anthony Orsini (29m 21s):

We had the episode with Claude on that atmosphere that Gary has started in that you are able to do that
people wanna work there. Right? I mean, how do you build that trust and loyalty for, with the people that
work for you?

James Orsini (29m 34s):
The interesting part about the Sasha group, is that we over index on senior people. So when I came to the
Sasha, I mean, I took me six VPs and SVPs is over to recognize people that I took over at each one of them
were running a portfolio of a business bigger than the Sasha Group. And I had a half a dozen and most were
like, Hey, how are you going to make any money? I, you know, all of these people making all of this, you
know, big salaries and, but I knew what it was that we were trying to build. And you know, the people that we
were servicing wanted to hear from senior people on the other end, a, a, a consultancy by it’s nature, you
know, Gary gave me the, the, the creative Liberty.

James Orsini (30m 12s):
They take the cream of what I saw at KPMG , Goldman Sachs, interbrand or Saatchi and pull kinda those
things together to form what it was that the Sasha group is and does for its clients, I’m big believer in a
succession planning. And you should have that or not feel threatened by it. You know, if I were to hit by a
bus and you know, one of those leaders is going to run this company. That’s important and you have to be
really comfortable in your own ability to do that.

Dr. Anthony Orsini (30m 41s):
That’s exactly right. The bosses that are worried about keeping people down are often insecure and worrying
about it, but I know you, and I think the reason why people stay loyal to you and you build so much trust, is
that even at work, I know this from my daughter, you’re just a genuine person, your James right? I mean,
everybody knows you, if you have to tell everybody you’re the boss, then you probably not doing a good job,
right? How do you build that loyalty with your employees?

James Orsini (31m 7s):
I tell people that I lead mostly because people choose to follow not because I get on the desk and say, Hey,
I’m the CEO or I’m the COO, and you need to listen to me. So that happens. I’m in touch with every boss I’ve
ever had. Listen to that statement. I am in touch with Every boss. I had ever had, and I left, although you
went through a line of Company. So obviously I resigned, left a lot on all of them, but it, my cell phone, I can
call even the first guy who hired me out of college, Larry Jansen from KPMG, you know, because I left on
great terms.

James Orsini (31m 44s):
And that is a lot of the advice I would give to people, even when there were resigning or looking to resign, I
would like, you know, I understand that the notice is two weeks, as Gary says, and I’ve really hung on to this
doing the right thing is always the right thing.

Dr. Anthony Orsini (31m 58s):
That’s what I tell my kids all the time, right? Is that right or wrong? As always, while you, you can rationalize
away from it,

James Orsini (32m 3s):
You know? And I can tell them from experience. I understand they want you over there. They will never want
you more than the first day that they want you. So just so you know that I’ll tell them that, you know,
everybody wants you today. There’s always the need today. And you need to tell him that you are going to
start there next month. The good news is you’re coming. The bad news is, is it’s the next month. And if they
want you that bad, they’re going to accept that. And I’ve done that time and time and time again, when I left
into a brand to go to Saatchi and I gave three months notice, and, you know, I left Saatchi to go to Sito
Mobile I gave three months notice, you know, three months was a long time, know your kind of leaving and
walking out the door, but it was the right thing.

James Orsini (32m 43s):
And they said, James why are you doing this? I said, because you would want me to do it to you. If it was
different, you would want the same thing. You know, I also think that giving them people or helping people,
and this is why get along so well, I think with Gary because he genuinely loves to help people as do I even
doing it, even when there’s nothing in it for you seemingly at that moment, there’s no quid pro quo, right? It’s
I happen to be in a position to help. And therefore I am, you know, now, is there an expectation if I were to
call you fourd months from now, you should be taking my call.

James Orsini (33m 18s):
Absolutely. But we don’t do it with that notion of a favor bank per se.

Dr. Anthony Orsini (33m 23s):
That’s a great answer. Or two more questions. Because I know you gotta go. So one of the questions that I
teach, communication skills, especially a conflict resolution, et cetera, we talk about active listening and I
saw quote that you wrote that somewhere. Listen more than you speak. Just expand on that. Just briefly.

James Orsini (33m 41s):
When I went to VaynerMedia as the oldest guy in the building, I think at the time, the average age was 26. I
didn’t really know anything about social media. Gary gave me great advice. He was like, I want you to just
kinda breathe. I don’t need you in every room or making a decision or telling us how to do it. I want you to
breathe my company is just take a few months and taken all in. I would learn a lot. You know what I mean?
That’s the other thing, like its just not too old to learn. Do you have this wisdom and experience?

James Orsini (34m 11s):

Yes, but I certainly became relevant in my kids’ lives because they’re all the sudden I was telling them what’s
coming up next on Snapchat. You know what you know, there is times to learn. So I do listen more than I
speak just so I could, you know, help connect those dots that we talked about earlier. I just wanted to see
how it comes together. And then I’d like to think that my input is a thoughful.

Dr. Anthony Orsini (34m 37s):
Speaking of they have 26 year old average age or the millennial and generation Z this leads, me to my last
question. And I asked Claude the same question. So there are a little different than we are. The millennials
generation Z is our kids are both. And most of those are little, in my opinion, in a little bit more impatient than
we are. Some of them may be more used to texting. Then they are speaking in communication. At least
when I’m training young physicians, I find that their communication skills or not what they should be.

Dr. Anthony Orsini (35m 9s):
I ask Claude this question. What advice do you have to the young person who really wants to do more for
the company who wants to speak to their manager or somewhat higher up and say, Hey, I’d like to do more. I
would like to move up, but not necessarily a raise, but you know, I want to advance a little bit. What advice
can you give them about that conversation? How should that go?

James Orsini (35m 30s):
Two things. One, I want to reverse it and the speak to the people who are getting those requests and
recognize my observations. I dispell alot of notions about millennials. Okay. I did not see them as lazy and
self centered. I mean they’re smart, they’re inquisitive, they’re collaborative, they’re hungry. So why not
harness that difference from our generation, right? Or rather, rather than stifle it. So one embracing the
differences and you know, not to get off on a tangent, but certainly we as a country or not doing that really
well.

James Orsini (36m 6s):
Like if you’re not like me that’s a really bad, bad, bad problem. Right? So embracing the differences two we
encourage an open door policy, you know, I probably spent more time with people putting in 15 minutes on
my calendar simply to try and figure out what it was that a chief integration officer did or what does chief
operating officer was there to do? Do you, you know, and in most other company’s those senior levels are
kept in a corner office. You don’t get access to them.

James Orsini (36m 37s):
Okay. You just, you just don’t, you don’t even go to The when I was at Saatchi, most people didn’t come to
the 17th where I sat next to the chief executive officer and chief creative officer or chief strategy officer and
me, and we had this glass off areas and you didn’t come there, you know, unless you’re summoned to be
there. Not here at VaynerMedia they had like scheduled 15 minutes. So like, I am just, you have to introduce
myself, find out what is it you do James you know, what do you do here to do so gathering that information is

important.

James Orsini (37m 8s):
Recognizing I asked them to do an SSP matrix, strength, skills, and passions. Okay. So it’s a reflective mirror
where you could look at yourself and you’re going to tell me honestly, with your strengths, skills and passions
are, and then I will tell you where that fits in our company as opposed to okay. James yeah, I think I’m ready
to be a creative today. And I said, aren’t you going to be in the strategy department? And they said, yeah,
yeah, I’m ready to try being a creative.

James Orsini (37m 39s):
I said, well usually you’re either born creative or you know you went to Miami school design or something.
You don’t just kind of flip a switch and say today’s today I become creative, right? This is where using your
strengths, skills and passions. If you are strength, skills and passions, don’t align with a creative director. I
don’t see a lot of hope for you finding your way there. So the NSSP matrix has really opened the eyes to
many of these younger people that say, Hey, you know what?

James Orsini (38m 9s):
I am passionate about that. And now, now I can find my way there because I have a skill in it. And I’m getting
stronger in that.

Dr. Anthony Orsini (38m 18s):
Let’s go with that. So now you are a young millennial. You want to talk to your boss, you look at your
strengths, your skills, your passion. If you think you’re in line and now you need to get up enough energy to
go into your boss. And you say, how do you think that conversation should go as the boss? If you said, well,
if he or did it really well

James Orsini (38m 37s):
In the SSP matrix, I just kind of lead them from themselves. I then help them position the conversation,
right? So there’s another form of advice. If your one of these millennials don’t go, you know, boldly in where I
would know, man has gone before, find yourself a mentor to help you are going to flesh this out. Now your
going to be like Listen I did my strength, skills and passions. I think I could align nicely with that position over
there. That’s open. And can you help me maybe even role play that you look your whole profession right now
is on role playing, right?

James Orsini (39m 12s):
So you know the importance of that and how much you could learn from that, would you mind role playing or
if I know, I know you’re not the one that I’m supposed to ask when I’m gonna run this by you and this way,
can you Q and a, this with me, I do this with my wife to, you know, hen she’s a looking to do something at
work, let her do a little role play and being honest, you know what? I don’t see it. I don’t see you. haven’t

made us strong enough compelling case for why this should be.

Dr. Anthony Orsini (39m 37s):
Great. That’s great advice that a young person, so James was, this was a lot of fun. And I want to thank you
so much for taking time out of your crazy crazy schedule, but it’s always fun talking to you. Can’t wait for this
to air because, you know, I promise my audience two things, every single episode in that’s to inspire, which
you certainly did because your career is inspiring. And you gave a lot of advice about communicating both as
a boss and as a young millennial who was trying to go to increase their career.

Dr. Anthony Orsini (40m 7s):
And I just want to say thank you. I think my audiences in a real treat when this airs, so thank you so much.

James Orsini (40m 13s):
It was great being on. I hope that they do find some value with it. You know, they can follow me or find a lot
of what we talked about. I wrote about in medium, whether it’s to delegation stuff or how to work with
millennials, it’s all on James Orsini in media, and James Orsinion LinkedIn and Instagram. And I am
@Jimmy the pencil on Twitter. Yeah. I wanted to ask you about the Jimmie the pencil thing. That’s it. We
have a story for another day or you actually do remember me with the pencil thin Clark Gable mustache.
When I combine with the fact that I started in accounting in the pencil.

Dr. Anthony Orsini (41m 12s):
Fantastic. All right. Great. Well, thank you so much. If you enjoyed this podcast, please go ahead and hit.
Subscribe to podcast is now available on Apple, Spotify, Amazon now, and Google podcast. If you like to get
in touch with me or find out more about the Orsini Way I can go through the Orsini way.com and you can
reach me through that. James thank you again. It was an absolute pleasure and I will see you hopefully
soon.

James Orsini (-):
Hopefully a Florida.

Dr. Anthony Orsini (41m 14s):
Yes, that would be great.

Announcer (41m 17s):
If you enjoyed this podcast, please hit the subscribe button and leave a comment and to contact Dr Orsini
and his team, or to suggest guests for a future podcast visit Orsini way.com. <inaudible>.

“Discovering the best in others with Diane Rogers” With Dr. Anthony Orsini

Diane Rogers (2s):
When we see that we are doing and being what we wanted to in the first place. And that is to make a
difference in other peoples lives than that will help to fuel and nourish our heart’s in what it is that we do each
and everyday. So if you want to work 24 plus hours a day making a difference and you can be well in doing
so then let’s create the environment that supports that for you

Announcer (32s):
Welcome to Difficult Conversations Lessons I Learned as an ICU Physician With Dr. Anthony Orsini. Dr
Orsini is a practicing physician and the President and CEO of the Orsini Way. As a frequent keynote speaker
and author Dr Orsini has been training healthcare professionals and business leaders, how to navigate
through the most difficult dialogues. Each week, you will hear inspiring interviews with experts in their field
who tell their stories and provide practical advice on how to effectively communicate. Whether you are a
doctor faced with giving a patient bad news or a business leader who wants to get the most out of his or her
team members, or someone who just wants to learn to communicate better,This is the podcast for you.

0 (1m 18s):
Well,

Dr. Anthony Orsini (1m 18s):
Welcome to another episode of Difficult Conversations Lessons I learned as an ICU Physician. This is Dr.
Anthony Orsini and I will be your host today. Before we started the episodes today, I wanted to go ahead and
thank my audience because, you know, I started this podcast a few months ago and I was hoping that one
person would at least listen, but the audience has been amazing. My subscribers are going up every week
and it’s getting more and more popular. And I want to say, thank you now, I’d like to take credit for that, but
actually the credit goes to all my amazing guests and I’ve had some great guests and we have some more
guests that are lined up and today is no exception. So today we are lucky enough to have Diane Rogers.

Dr. Anthony Orsini (1m 59s):
Diane Rogers has a diverse background that a big heart, both of which power, a simple and focused
mission. And that is to inspire individuals and organization to harness the strengths and magnificence of
people. She is the Founder and President of Contagious Change LLC Diane is best known for her Breakthru
programs for health care organizations, where she has long been a trusted coach. Sought after for her ability
to inspire strength based leadership behaviors among medical professionals who want to optimize
performance, experience and engagement, I guess the best word to describe Diane’s approach to leading
and inspiring others is the word collaborative in everything she does.

Dr. Anthony Orsini (2m 39s):
She endeavors to leave her stakeholders feeling like their best selves. Diane is frequently called upon by
leadership teams across the various industries, including health care technology, finance, and professional
services to do the important work of developing and coaching leaders, improving quality and performance,

implementing organizational change and transforming workplace cultures. DIane holds a PCC level
certification from the international coaching Federation, as well as several certificates in positive psychology.
She is a dynamic energetic speaker, as you will see, who offers keynotes in presentations of all kinds, and
she is an author and her first book, Leading, hArtfully the art of leading through your heart to discover the
best in Others is scheduled to be out in publication on October 21st.

Dr. Anthony Orsini (3m 28s):
And depending on when this airs may already be out. And I’m sure Diane will tell you how to get that at the
end, but we are very, very happy to have Diane. Then I think that if this is gonna be an incredible episode,
I’m really looking forward to it. And thank you. Diane for agreeing to come on. I know you’re so busy.

Diane Rogers (3m 43s):
Well, Tony, I am absolutely thrilled to be here. I can’t even tell you. I remember when we first met at the Beryl
conference and it was like, you and I were magnets together. There was an energy and a passion that we
both shared around how to best create the most exceptional human experience. And also I hear your
passion come out in the Podcast. I’ve listened to, I think all of ’em at this point, right? And hearing Larry and
Nicole and Claude. And what I loved so much about the podcast is Tony you have such a way of just making
them real and inviting for people.

Diane Rogers (4m 27s):
I think that your mission is to inspire and have somebody take something away each time, an honest to God,
every time I listened to one of your podcast, I am inspired and taking away something new. So I’ve really
enjoyed them.

Dr. Anthony Orsini (4m 43s):
Fantastic. I make that promise every week, and I know I’m going to keep it this week, cause I know all about
you. And I know my audience is gonna get both promises fulfilled. So thank you so much.

Diane Rogers (4m 52s):
Your welcome. Thanks for letting me be here today.

Dr. Anthony Orsini (4m 55s):
And so, yeah, so we met at The Beryl Institute I think it was three or four years ago. We are going to talk
about The Beryl Institute later on and you and I had just met and the audience will find out by the end of this
podcast about your dynamic personality. You’re a very Contagious. I think that’s a great title for your
company. Contagious change because you have a Contagious personality. And I showed up at The Beryl
Institute first time ever, didn’t know what to expect. I loved it. I’ve been teaching patient experience for four or
five years. You and I met it. I think a physician break out. And as you say, it was just instant rapport.
Although I have a feeling you don’t really have much of a problem getting rapport with everybody. So, but it

was great. And we’ve kept in touch.

Dr. Anthony Orsini (5m 36s):
You become friends with Liz, our director of operations. So it’s really just great to have you here, I know
about you and I know your background and I know you you’ve had some great thoughts, but I think I would
like the audience that first get to know who Diane Rodgers is. And a little bit of your background. I have a
whole bunch of questions ready to go, but I really want you to tell your story that I can tell everybody about
yourself and how you got to this moment at this time.

Diane Rogers (6m 1s):
It is a really great question because it requires it oddly enough, each time I’m asked that to actually reflect on
that journey because it kind of shifts and changes, but I have a very diverse background. I started out years
ago in nuclear power as an engineer, and then moved into aerospace. And I worked for what is now Boeing
on the Apache helicopter. That’s cool. While it is called, let me tell ya. It is the coolest they’re playing in the
whole wide world. Right? And I was good at what I did and I had various leadership positions, but for a very
long time, I was searching for purpose.

Diane Rogers (6m 44s):
I wanted a gazillion kids and that just didn’t work out. And so there was like this hole in what I was doing and
how I could find meaningfulness in it in one day, John Rogers and I John Rogers and my husband were
playing golf. Then we came upon this house were a friend of ours, had just up and left his house to go
beyond the senior tour. And I turned to John Rogers that I asked them, I said, how does somebody just
leave their house and go play golf? And John Rogers looked at me, he’s a very smart man. And he looked at
me and he said, you know, I suppose that if that’s what your dream is, that’s what you would do.

Diane Rogers (7m 27s):
And that struck me. And I turned to Jon and I said, what would my dream be? And he said, your dream
would be to help people. And that quick moment was very inspiring for me because I had really never
thought about it. And honest to God, the next day I went back to work. I was working in semiconductors at
the time I went to work and I called a colleague who worked for our local hospital system here, which is now
called banner health. And I called up our colleague and he said, you need to talk to this woman. And I talked
to her, she worked in performance improvement at banner health and a long story short.

Diane Rogers (8m 12s):
I ended up working for banner health for many years, working with them to help improve and reduce their
liability claims. And Tony, it was there that I found purpose. It was that I could connect back to what was real
and healthcare professionals were real and they were doing amazing, magnificent things. And they did these
very scientific and incredible clinically profound things. But at the same time, they were just showing up and
taking care of people.

Diane Rogers (8m 52s):
And what I realized all across the many years is that if I could help others to see the magnificence they had,
simply in being who they are, what an amazing purpose I might have. And so that’s really kind of where it all
started is really around how is it that I can be my best self in an endeavor to help others discovered the best
in themselves.

Dr. Anthony Orsini (9m 19s):
That’s a great story. And so you’re made this change and now you spend most of your time coaching
physicians, correct?

Diane Rogers (9m 27s):
Yes. I work with physicians holding up the mirror if you will, to their magnificence, but in a way that brings
clarity and specificity to what it is that they’re doing and who it is that they’re being. And most importantly, the
impact that they make in doing that. And I also work with organizations to kind of create a culture where
we’re actually leveraging the best in others.

Dr. Anthony Orsini (9m 53s):
And that is going to dovetail into a question later. I’m gonna ask you about something in your book, on a
character, in your book, as a person called Bob, and then we’ll talk about Bob. But in the meantime, we’ll get
to the book. One of the things you and I had talked about, I wanted to ask you, so my audience, a lot of them
are physicians. A lot of them are in Healthcare. I also have a lot of business. People physician’s are tough
people, and I can get away with saying that because I’m one and Dike Drummond was on our Podcast
previously, he does physician burnout and he talks about how physicians are a perfectionists and physician’s
are told from a very early on, you need to work harder. And if you’re working 24 hours a day, then you should
be able to work 24 hours a day in one minute, and you should never complain.

Dr. Anthony Orsini (10m 40s):
And it makes them a little bit hard around the edges. But when I give lectures and I do a lot of lecturing, as
you know, to physicians and to health care professionals about how does it remind themselves of how they
are, why they went into medicine for the first place, and that leads into a good patient experience. And I’m in
a room and I read body language. You, as you know, I loved that kind of stuck when you see the physician
sitting in the room, not all of them, but some of them, and you see them in their arms are folded. And they
are like, I can’t believe I have to be here. Many of the classes that I’m forced to take from a hospital and from
the administration are given by nonmedical people that are not physicians. And I’ll be honest with you. Many
times, a lot of physicians come out of they’re going, Oh my God, what does she know.

Dr. Anthony Orsini (11m 25s):
She doesn’t know what it’s like that to see 30 patients in a day. She doesn’t know what it’s like, got

administration on my back. She doesn’t know what it’s like to be forced to work more and more for less and
less money. And to spend all of my off time doing paperwork. And on the electronic medical record. I have an
advantage because I can say, Hey, I’m one of you and I have a little bit of an in. And so I get some credibility
with them. You’ve been very successful as a lay person, being able to coach physicians and get through that.
And I think part of its your personality is so I kind of know the answer to this, but you have a certain
technique that allows the physicians to put the, the wall down and say, Hey, I know she’s not a physician, but
I’m gonna learn something from her.

Dr. Anthony Orsini (12m 11s):
So how do you approach that?

Diane Rogers (12m 13s):
So, I love how you captured kinda of the environment that we do step into right? The one thing that you keep
on saying Tony was, she doesn’t know what it’s like. Right. And that’s exactly true. And I don’t pretend to. So
how do I connect with a physician or really anyone else in the coaching relationship is first is to appreciate
that I am not the expert in their lives. The second thing is to believe, and as coaches, we are trained to do
this as well, but to believe that each individual holds within themselves their own ability to do and be their
best.

Diane Rogers (13m 2s):
And so, you know, I thought about this a lot actually. And the word that kept coming up in my head was this
notion of collegiality, right? That part of how you can stand up in front of a bunch of physicians as a physician
is the relationship that you’ve established and collegiality is grounded in trust, right? So they know that you’re
not going to stand up there and really throw them under the bus if you will. But, and I know you, but to come
forward in an empathic way, understanding them, right in an endeavor to partner with them together, right?
And so foundational to how you relate to them is trust. And if I can appreciate it.

Diane Rogers (13m 42s):
So when I enter into a relationship with some physicians, with some people they do have their arms crossed,
there are like, why am I here? Right? So the most important thing for me is a couple of things. One is to
know I’m not the expert, two, I always create an intention. I created an intention before our conversation
today, what experience do I want to create? And I think that’s really important. What intention do I want to
make in an, an endeavor to have an experience that is meaningful, productive, and positive.

Diane Rogers (14m 23s):
So I try and to actually think about this. So if I go into a physician relationship and I want them to change
their behavior so that they have a better patient experience and that I’m going to be auditing them to ensure
that they do what I think is best for them to create the patient experience, that will never work. But if I enter
into the relationship and I ask you Tony, I know that you went into medicine for a reason. Tell me about that

and tell me what it is that you want to create with your patient interactions. And I value that. And I trust that
that is a way in your interview with Claude Claude talks about what she does as hold the space and see you
as a coach.

Diane Rogers (15m 9s):
What we are doing is we’re creating the space for you to discover again and again and again, what is grand
about you and where your strengths lie? And then I also have the trust that I’m this’ll sound really weird, but
that I’m also really good at what I do, because if I come in, not confident, just like when you see a patient
and you have to tell them something, you talked about this, I forget with Nicole bout how you have to go in
with confidence, right? Even if you’re going to share bad news, you have to bring confidence, right? So I
have to be confident and trust that I know how to bring out the best in each individual.

Diane Rogers (15m 55s):
Because if, if I go in going, Oh my God, they’re going to hate me. I don’t know what to do. I’ll just crumble. So
the whole idea of how I show up as my best self to leverage the best in others becomes really important in
our ability to create trust and build a relationship where that is therapeutic and pathic and where you see the
magnificence in who you are each and every moment.

Dr. Anthony Orsini (16m 24s):
And I think that’s beautifully said, Diane thank you. And I think as, whether you’re a physician are a business
leader and you’re being coached. I think that’s the key. You are able to get trust because you’re saying I’m
not coming from you at a different angle, and I’m not going to tell you what to do. And I think you talk about
that in your book, when you were a leader that you realize that telling people what to do is not the best way
to get the best out of them. As Claude Silver said, you want to bring the best out of each person. And I think
those are the words that you use. Also, what it’s really important that we put people in positions, but I do
some lecturers for business leaders, the different between a basic manager and a real leader is bringing out
the best in everybody.

Dr. Anthony Orsini (17m 7s):
Right? And so your bringing the best out of the physician and the example I’ll use at my workshop is I will
say, listen, if I take Peyton Manning or Tom Brady two phenomenal hall of fame quarterbacks, then I put
them at linebacker are going to be lousy football players. You’re not putting them in a position to succeed.
And so what you just said, there was beautiful because that was the answer. It that’s how you break down
the arms folding and Oh, she’s not telling me what to do. She is bringing out the best of me. And I think that’s
beautifully said, so thank you for that. Let’s get to your book. I’ve read it. It’s not out yet. Or you were nice
enough to give me an advanced copy. So I looked through it. I really enjoyed it.

Dr. Anthony Orsini (17m 47s):
I love it. One of the great things about doing podcasts is that I get the read so many books and years was

really incredible in your book. You give us story of yourself, how you were a leader. You are a perfectionist.
You are really, if you thought you were a great and you thought you knew everything. And then you had this
aha moment of which your boss, you are giving a presentation that said he’s going to give you some
constructive criticism. You saw all the bad things you saw in your boss, you saw it in yourself. And that was
really your AHA moment that changed your life. Right? Tell us about that.

Diane Rogers (18m 24s):
Well, first off, Tony, thank you for reading my book. Great, great. I mean that, so sincerely when I set it to you
and you wrote me back and you said, you know, I’ll make sure to read it. I was like running downstairs, going
to John Rogers, Dr. Orsini is goiead my book. I was so excited. Right. So I really do appreciate that. You
took the time to read it. My defining moment. Yeah. That mirror that was held up in front of me. Do you
describe it quite well? I had prepared and prepared for a presentation thinking that I had mastered it. And,
you know, I had spent my whole life growing up in the leadership world, really trying to be perfect and trying
to be the best.

Diane Rogers (19m 10s):
So then boy, when do you do that? At least for me, lots of things. Just get in the way of being able to create
meaningful relationships. Right. And I had a boss who was very much, although it took me years to realize
very much about driving perfection and everything I did. There was always something wrong. And I
remember the presentation that you’re talking about specifically, because at the end of that, not only did he
tell me, well, here’s the things that you missed. I got very defensive and he then went on to tell me how now,
it was time for us to have a teachable moment.

Diane Rogers (19m 57s):
And I felt so demoralized and so invisible and that I didn’t matter at all. And I realized that that moment, Tony,
that my way of being in my leadership approach, I was doing all of that to all of the people that work for me,
even though what I thought we were doing was hitting the mark on our organizational objectives, write that I
was driving this team of people to be there best. The reality is, is that I was driving them to be my best and
the organizational best. And I think that we grow up in leadership.

Diane Rogers (20m 39s):
You asked this question, I forget who I think it might’ve been to Claude as well, but you know, how is it that
we undo? Or how is it that we got, where are right now in terms of how we lead? And I think that, you know,
we continue to do what has been successful. So if we’re climbing the ladder because of our
micromanagement techniques, because of our command and control philosophies, right? And we continue to
get promoted in that way and acknowledge in the way we are going to continue those behaviors. So you
really have to, you know, I mean, my defining moment was a horrible for me to look at in the mirror, but I will
tell you that in seeing that and really coming and choosing to shift everything about the way I did it, Today,
I’m a better leader today.

Diane Rogers (21m 38s):
I can help others be a better leader. What we achieve in terms of potential is far beyond that when I ever
imagined is possible, because when I’m in charge of, we can only be as good as what I think. Right? And so
when, when we can leverage the best in others and we’ve heard this, this is not new science. This has been
the mantra forever. But until we want to step into a space where we are choosing to discover reflect act
differently, be differently. All of this takes work. I tell my clients all the time, the burden of change lies in
leader’s burden of change doesn’t lie in our employees’ at all.

Diane Rogers (22m 22s):
It lies in how we choose to show up in order for them to show up, to be their best.

Dr. Anthony Orsini (22m 29s):
You wrote in your book, you shifted from it’s all about me, too. It’s all about them. And that’s a concept that
Claude Silver so eloquently spoke about. And that’s what leadership is all about. Now this all ties in to the
patient experience because, and you’re work with being a physician because in many ways we have the
audience might be going, OK, we’re going off topic here. But in many ways, the physician is the leader. And
there is no way around that can be walks into a room. The pressure’s on my shoulders, I’m in a code
situation. Everybody is looking towards me. It’s part of a team. And when you look at the best physicians and
they get the best patient experience scores, I learned a long time ago, stop looking at the people who were
failing, and start looking at the people who are succeeding.

Dr. Anthony Orsini (23m 18s):
You learn so much more than say, why does that? Dr get 95% from all of this patient. And if you sit back and
watch, you will see that the true leader, the very effective physician is one that has relationships. That’s the
word that I use all the time. That can form a relationship. He or she walks into the room. Every nurse lights
up, every therapist, lights up, he walks into a patient’s room he introduces themselves. She introduces
themselves. I use an acronym called program in my book. The G is for genuine, they’re are a genuine
person. They spend a few minutes and they’re being leaders, but what they’re doing is when they enter the
room, everyone is better.

Dr. Anthony Orsini (23m 59s):
Yeah everyone is a better version of themselves, as opposed to just kind of being grumpy or just going
through the motions. So this all ties into a patient’s experience. And that’s what you and I really care about,
right? Because we are trying to make a horrible situation. And I don’t care if you’re in the hospital for an
appendectomy or you’re in a hospital for cancer. Of course I’m not equating them, but it’s a horrible situation.
As I say, my book, nobody says, you know, I would like to go to the hospital today. Wouldn’t that be fun?
Nobody wants to be there, so you talk about how you can bring the doctors or the leaders to be the best of
themselves. And one of the things you talk about in your book is being in an understanding that you are

good at what you do, because whether you’re in business or your nurse or your doctor, you are kind of
always just told what to do.

Dr. Anthony Orsini (24m 51s):
One of the people that you speak about that you’ve coached was a guy named Bob. You speak so highly
about him. Not going to take it away from you. I want you to tell the story about Bob was great, except for
one problem. What was Bob is a problem?

Diane Rogers (25m 4s):
Bob is great. Bob is a fine fine human being. And I have known Bob for her 25 years and Bob approached
the Patient Experience when I first met him very intellectually. He had read every book. He knew every
communication technique. He was very good at telling his team of docs, you know, use this technique.
Although we sit down and he, by the book, man, he could do it. But what Bob didn’t connect to initially was
the impact of how he showed up. I remember he and I had this huge argument. One night I was standing
outside of a restaurant.

Diane Rogers (25m 46s):
I literally had to get up from the table. We were talking on the phone. I said, Bob in fact, he is how I kind of
started coaching positions. I said, fine, I’m gonna come. We’re going to do this together. And I’m going to
help you to see how incredible you are. Don’t get me wrong. Bob knew. He was a good doc and Bob new
that he was good at communication, but taking this deeper level. And we went into see this one woman who
was her kid’s had sent her to the ER, he’s an ED doc. He had sent her to the ED for some chest pain, and,
Oh my God. The way in which he immediately connects, just as you described.

Diane Rogers (26m 27s):
And as I imagine you would as well, Tony, you walk into the room and you see the person and you
understand that they’re, there, and they’re scared. And Bob had this most incredible way of reassuring the
patient instantly. And he was very clear in explanations and could go through all of the things that he did so
wonderfully. I still can see it in my head. And I was kind of standing off into the corner. And I just watch the
relationship as you describe. And also Your G Tony, his genuineness coming out. And at the end of the
interaction, I asked the woman and I don’t do this today because I’m not a part of the interaction at all.

Diane Rogers (27m 15s):
But at the time I had asked the woman, I said, Bob, do you mind if I ask her a question? And I asked her a
question. I said, if you could describe the interaction that you had with Bob, how would you describe it? You
know. Was it good? Or was it just OK, or would you not even bring your dog here? All right. And she looks at
me and she said, well, I wouldn’t give him a good, and I think Bob was startled by that. And I had said, well,
please tell me more. And she said, I would give this man an excellent, because I could tell that he truly cared
about me.

Diane Rogers (27m 59s):
And I even still I’m can be right in that moment. You know, doc’s are kind of funny sometimes, right? So he
wasn’t going to say anything to me, you know, but as we both kind of walked out of the room, I could see in
his head, in his eyes and in his heart that he got it, he knew exactly what I was talking about is, you know,
my phrase, Tony is turn your observer on and notice the impact that you make. Because when you can see
the impact that you make, I call those change a world moments. When you can see your own capacity to
change a world that going to reconnect you to the, what is meaningful.

Diane Rogers (28m 41s):
And that is part of how we are being Well. In other words, that’s part of our strategy toward wellbeing. And its
also how we are going to reduce burnout is that when we see that we are doing and being what we wanted
to in the first place, and that is to make a difference in other people’s lives than that will help to fuel and
nourish our heart’s in what it does that we do each and everyday. So if you want to work 24 plus hours a day,
making a difference and you can be well in doing so then let’s create the environment that supports that for
you .

Dr. Anthony Orsini (29m 21s):
And the audience can’t seek because this is audio only, but, but Diane can see that I have been nodding my
head up and down. Yes. And it all ties together. So I’m gonna say to the audience out there, if you’re a nurse
or a doctor, or even if you’re in business tomorrow, that when Covid is over and go back into the office, go in
to the hospital, sit there and watch people. There are some people and I know, you know, already who they
are, there are some people that walk in and the room becomes a better place. Immediately. The nurses light
up the therapist light up. You, as you said, Bob made the patient feel excellent. It improved the patient
experience.

Dr. Anthony Orsini (30m 2s):
We know beyond a doubt that when the patient experiences better, it improves clinical outcomes,
malpractice, losses, everything is better and burn out goes down, it’s all about enjoying what you’re do and
not getting caught up in the weeds. That’s exactly right. And so next time you go to work, sit there and watch
someone whose good at that. Coaching is great. And if you need coaching, Diane is the person to call, call
her right now. But to get to the point where even know that you’re need coaching, ask yourself, wow. I mean
there were people and I grew up, I did a rotation with a doctor in my goodness when he walked into that
hospital, every single person was happy to see him.

Dr. Anthony Orsini (30m 42s):
And you know why? Because he was happy to be there. He enjoyed what he did. It showed. He was a family
doctor that actually I’ve mentioned this one of the other podcasts. He practiced 50 years. He delivered me,
and then I did a rotation with him. But I was in his office. It was the Italian section of Newark New Jersey

where I grew up and I was doing my family practice rotation. I would say at least no exaggeration Diane,
eight out of 10 patients who came in, brought him food. They loved him so much that they felt weird, not
bringing him a gift. And so I was lucky enough to have that role model.

Dr. Anthony Orsini (31m 26s):
And I think understanding your importance and as you bring out the best in people, when you bring out the
best in people, it brings up the best in everybody else. And yeah, Helen Reiss was on our podcast also that
she wrote the book of the Empathy Effect. Yeah. And one of her things taking care of yourself first, be happy
first and it’s contagious what a great title of your company. Contagious change. Because that’s what you’re
all about. Your very contagious.

Diane Rogers (31m 52s):
Okay. Well thanks. And you know, Tony, just add to that. Right when you walk in and you see those people
creating that environment, right. Then just the, I invite you just to say to yourself, I want some of that. And
then to take the next step to, create an intention or ask yourself, I wonder what it would look like. If I walked
in to that room where everyone was thrilled to see me, what would I have to do? What strengths within me,
what intrinsically about me would I want to bring forward? And what is it that I wanted to look for to notice to
where, I can say, OM G and a half their thrilled to see me because then each and every day you will be
motivated, inspired to do it again and again and again.

Diane Rogers (32m 46s):
Right? So everyone has the capacity to be that way. And the other thing that you were saying, like the doc
that you were talking about, right? Imagine that I’m just ever so curious, what would be like for him to know
that Today, you’re still talking about the impact that he made years ago. Right? And so the invitation is also
there to say, as you’re entering into the room, consider that 10 years from now 15 years from now, people
will still be talking about how you made them feel. In my book, I use Access your superpower to make
people feel un-invisible And so what is it that you want to do to make people un-invisible and then notice how
you are happier.

Diane Rogers (33m 40s):
You are more joyful and you appreciate your own capacity to make a difference.

Dr. Anthony Orsini (33m 46s):
Now there’s people listening right now and Because this is, I hear this all the time. Well, in fact, when I first
gave one of my first workshops, it was in my own hospital and my own boss said to me, are you sure you
want to give this workshop because not everyone can be you. And there’s a common misconception that
some people either have an outgoing personality or they have an ingoing personality. I’m gonna share with
my audience. And I’m going to share with you that you’re probably going to say no way, but the truth is I am
very shy by nature. I worked at it. I know it doesn’t look that way, but I was very shy by nature my whole life.

But I learned that I watched and you make everyone better.

Dr. Anthony Orsini (34m 27s):
And so you don’t have to be a natural extrovert and you don’t have to be the life of the party, but you can
learn communication techniques like smiling with your eyes, looking in people’s eyes, being genuine, sharing
something about yourself, all of those things, you can be that person. And if everybody was like that, what a
great work environment and how much that would improve the patient experience. You know, every doctor
that I train, you know, This statistically, you will have between 200 and 250,000 patient interactions in their
lifetime. So what an impact to train one doctor, how many patients you are helping.

Dr. Anthony Orsini (35m 7s):
And that’s an amazing thing before we close. And then, because I don’t wanna take much more of your time
at want people to hear more about the Beryl Institute and your work. There how you got involved with that.
Just what its all about because what you’re talking patient experience, The Beryl Institute is the go to place
and it’s all about patient experience. So I’ll just tell me a little bit how you got involved with that and a little bit
about The Patient Experience

Diane Rogers (35m 32s):
Absolutely. So The Beryl Institute is and I’m just gonna read the who we are, right? It is a global community
of practice committed to elevating the human experience in health care. And I loved this notion of human
experience. It has 20,000 members in 36 countries. So that notion of global in every state and the
membership varies in roles across health care, right? So it’s not just physicians or nurses in the patient
experience experts, but anyone interested in elevating the human experience. Right? So what I love about
The Beryl Institute is the community Tony, you and I are connecting because of that community.

Diane Rogers (36m 20s):
It’s not an organization of experts that are telling 30,000 people what they need to be doing. Everything
developed within the Beryl comes from the community itself. So it is extremely inclusive for me. I can’
actually remember the year that I first connected with them. It was either 2011, 2012 kind of timeframe. I
walked into that room, walked into the key note speaker room. And I don’t use this word very often, but I
have found my tribe, these where people who are passionately connected to the purpose of making a
difference in the lives of others in the field of health care.

Diane Rogers (37m 3s):
I work with them as a faculty member, we have 15 domains of knowledge around the things that are
important in being a patient experience professional. And while I’m the facilitator of their virtual classes as a
faculty member, I’m telling you, I learned from these experts in the community of patient experience all the
time, they are welcoming and they are open. And I would be remiss in not mentioning Jason Wolf, who is the
president of The Beryl Institute, who is one of the most incredible visionaries.

Diane Rogers (37m 47s):
He is very focused on data and information and brings that forward. He shares everything that The Beryl
Institute uncovers and just guides us in what I think he would call a movement toward creating Experience
excellence by enabling others to create a human experience that is exceptional.

Dr. Anthony Orsini (38m 15s):
I’ve met him one time. He’s an amazing guy. If your listening, Jason, I have emailed you a few times and try
to get you out of the podcasts. Diane time you see ’em tell ’em what a great experience it was. But yeah,
The, Beryl Institute is wonderful because it’s inspiring because you have so many people who are dedicated
to making the patient experience better. I think this Podcast was an amazing episode because I kept
promise Diane. I think people out there are inspired to be the best themselves. If I can be the best me that I
can help other people, whether I’m the doctor, a nurse in business, we have given some really good tips
about how to lighten up a room. So I think everybody learns some really great communication techniques.

Dr. Anthony Orsini (38m 56s):
Your book might be out by the time this episode airs. I’m not sure of the date, but it is certainly gonna be
available on Amazon. Is that correct? Yes. So please everybody, if you need Diane, what’s the best way to
contact you Diane

Diane Rogers (39m 9s):
You can just get me a diane@contagiouschange.com

Dr. Anthony Orsini (39m 13s):
And the book is called Leading hArtfully the art of leading through your heart to discover the best in others.
And that should be out any day now. So Diane thank you so much. You’ve been an excellent host and
another podcast that I’m gonna get credit for, but I had nothing to do with me. It’s just all about you . So
thank you so much.

Diane Rogers (39m 33s):
Oh, Tony. It was my absolute pleasure as it, you know, it is disappointing that people can’t see the video
because I’m smiling so much, Tony, you’re a gracious host. You have the ability to make people laugh.
There’s a fluidness in all of this. My intention, I will tell you was to create a conversation with you that people
would listen to and go, Oh my God, they must be the best buds. There are just dancing in the moment. And I
think Tony, that we did that wonderfully together. So thank you for the invitation. Right?

Dr. Anthony Orsini (40m 9s):
And thank you for the kind words. If you liked this podcast, please go ahead and hit subscribe. If you haven’t
already, please go ahead and download this podcast and all the other previous episodes, you can find it on

Apple and Spotify and Google podcast. If you want to find out more information about the Orsini way, you
can go to www.theorsiniway.com. Then you can contact me through that website. Thanks again, Dianne.
This has been amazing and I can’t wait for your book to come out and to find out how many people bought it.
I’m sure it’s going to be a big best seller. So thanks so much. Thank you.

Announcer (40m 46s):
If you enjoyed this podcast, please hit the subscribe button and leave a comment and review. To contact Dr.
Orsini and his team, or to suggest guests for a future podcast, visit us at The Orsini Way.Com.

3 (40m 56s):
<inaudible>.

James Orsini (1s):
Delegation really comes from something that you should be doing, that you bestow on somebody else to get
done for you. And facilitation is really looking at a much broader landscape and taking the time to really
understand what it is that people do well. And then how connecting the dots between two folks whose paths
normally wouldn’t cross and how they bring value when united together on a particular project.

Announcer (27s):
Welcome to Difficult Conversations: Lessons I Learned as an ICU Physician with Dr. Anthony Orsini. Dr
Orsini is a practicing physician and the President and CEO of the Orsini Way. As a frequent keynote speaker
and author, Dr. Orsini has been training healthcare professionals and business leaders, how to navigate
through the most difficult dialogues. Each week, you will hear inspiring interviews with experts in their field
who tell their story and provide practical advice on how to effectively communicate.

Announcer (1m 3s):
Whether you are a doctor faced with giving a patient bad news, a business leader who wants to get the most
out of his or her team members, or someone who just wants to learn to communicate better this is the
podcast for you.

Dr. Anthony Orsini (1m 12s):
Welcome to another episode of Difficult Conversations Lessons I learned as an ICU Physician. This is Dr.
Anthony Orsini I’ll be your host today and every Tuesday moving forward. Today I’m especially excited
because I have my cousin as a guest James Orsini. James Is the President of The Sasha Group, which is a
VaynerX Company. Working alongside Gary Vaynerchuk it’s CEO in a serial entrepreneur, james leads The
Sasha Group to help small businesses reach explosive growth, potential.

Dr. Anthony Orsini (1m 43s):
The Sasha group provides educational consulting and marketing services for companies from 1 million to
200 million in revenue, James previously held key high level positions, four VaynerMedia, including Chief
Operating Officer and Chief Integration Officer. Before coming to VaynerMedia, James held prior positions
as chief executive officer and member of the board of directors of site to Mobile. He has more than 35 years
of experience and operations experience across a broad range of marketing and communication disciplines.
James was the executive vice president and director of finance and operations for Saatchi and Saatchi in
New York, where he worked closely with the CEO to provide strategic and day to day direction for all
financial and operational functions.

Dr. Anthony Orsini (2m 21s):
His impressive resume continues prior to joining Saatchi and Saatchi, James held the key leadership
positions that they had brand North America, KPMG and Goldman Sachs. James graduated, Magna c*m
laude from Seton Hall University in New Jersey with a bachelor of science in business administration. He
received at universities, presidential academic scholarship is still served the university today. He is a

licensed New York state certified public accountant. On a personal level, James is a board member of
renovation house in New Jersey, New York a residential substance abuse rehabilitation program.

Dr. Anthony Orsini (2m 53s):
He served as a member of the board of regions for Seton hall university, but perhaps his best
accomplishment was winning that third and fourth grade little league championship with his cousin. Yours
truly wouldn’t you agree that’s your highest accomplishment of life?

James Orsini (3m 8s):
Absolutely. I take every occasion to mention it to where they allow me to do so,

Dr. Anthony Orsini (3m 13s):
You know, I think you and I were the two worst player’s on the team. You played center field, I was a second
base man, but somehow I think both of us or the championship went three for three.

James Orsini (3m 23s):
Yeah. Yeah. And I gave birth to an athlete. So I make it All level off now

Dr. Anthony Orsini (3m 28s):
That’s right after you’re a stellar career in third grade, you’re son went off to play college baseball. It must’ve
been Joanne’s genes, I guess,

James Orsini (3m 35s):
Absolutely Joann who we met when she tripped and I picked her up. So we do not have any kind of finesse
when it comes to sports.

Dr. Anthony Orsini (3m 44s):
All kidding aside, your career has been an incredible story of one success after another. And I really enjoyed
watching your accomplishments pile up. As I read your bio in the position that you’ve had I thought anybody
would be it happy just to have one of those positions, but each career defining step that you made, you just
took on more and more and had more and more success. I think that’s incredible. I just want to say, I’ve
personally enjoyed watching your career just give better and better. .

James Orsini (4m 11s):
It was unplanned, but the, but it unfolded really in a, in a nice way.

Dr. Anthony Orsini (4m 16s):
So the topic of this podcast that has always difficult conversations and particularly we are going to talk about
Difficult Conversations in Leadership, you’ve held so many positions in leadership, but before we get into

that, I just want the audience to know that James Orsini that I know. So tell us about James Orsini. How
would you describe yourself? What drives you and what is your leadership philosophy?

James Orsini (4m 37s):
Well, I’m a family man. I love every aspect of my family and look to spending as much time as I can with
them. I actually see business as my hobby, which most people find strange and unusual. So it wouldn’t be
crazy for me to be on a vacation, still reading the wall street journal where a, a, a business book and hand.
So that’s why it, my passion has actually become my profession. And I don’t feel like I really work. I just
show up and do what it is that I like to do.

James Orsini (5m 7s):
So, you know, my leadership style is one a servant leadership. You know, I actually serve out of this to get
the best out of them. I am a facilitator rather than the delegator. So a that means you gotta do to really take
the time to understand what it is that people do well, and then how your needs plug into their talents. You
know,

Dr. Anthony Orsini (5m 26s):
It’s interesting. You bring that up. I read a piece that you actually wrote, I think in 2017, right? Don’t Delegate,
Facilitate, So just expand upon that. Could you just mentioned that a little bit? What did you mean by that?

James Orsini (5m 37s):
Yeah. You know, delegation really comes from something that you should be doing that you bestow on
somebody else to get done for you. And facilitation is really looking at a much broader landscape and taking
the time to really understand what it is that people do well. And then how connecting the dots between two
folks whose paths normally wouldn’t cross and how they bring value when united together on a particular
project. I kinda see things from 30,000 feet.

James Orsini (6m 6s):
So things look small to me, but as a result of that, if you think about it, right, when you’re up in an airplane
and you see these little puddles that you realize there’s, somebody’s swimming pool, but you were at 30,000
feet. So they don’t look grand in any way, shape or form. And that’s the way I see problems. I just don’t see
them big. I have a different vantage point and I help people navigate through them.

Dr. Anthony Orsini (6m 27s):
That’s great. So you had some great positions and then tell us the story, because you know, you can get
through an interview without somebody asking you about GaryV right? So he’s just bigger than life. And you
work with him, and I have a couple of questions about Gary V how did you end up at VaynerMedia? If you
could tell us the story and then tell is how the soccer group started it and why you started that.

James Orsini (6m 47s):
So it wasn’t interesting that I went to Seton Hall, University basketball game. I was invited by another board
member at the time, and he brought his son and his son brought a friend and their friend was AJ Vaynerchuk
Gary’s younger brother. At that time, I was Chief Operating, Officer it Saatchi and Saatchi. And, you know,
we’ve got to talking and I just invited him down to Saatchi to see what it was like when he gets big. And it
took me up in the offer, but most importantly, he knew enough to stay in touch with me and use me as a
mentor, you know, oftentimes ask, have you ever done this?

James Orsini (7m 19s):
You know, somebody who does that, how would you handle this? So we kind of stay in touch over the years.
And I left Saatchi. I went out to become the CEO of Sito Mobile and then I stood, there are three and a half
years. I had a three year employment contract. I spent three and a half years, and now I was leaving to
come back into big advertising. So I just called AJ to just say, Hey, man, I’m going to see you again. You
know, I’m going to be back in big advertising. And he’s like, you know, did you ever meet my brother Gary.?

James Orsini (7m 50s):
And I said no, and he said, you ever hear of him? And I said, no not really. And he’s like, all right, well, do a
quick Google search. He’s not going to be harder to find. I spent some time with him that long, maybe 15
minutes, I got a call back from AJ and said, Listen he likes you, he want’s to have dinner with you. You know,
don’t take that too lightly. His times is pretty valuable and we had dinner and he said that James, I want to
create a $500 million independent integrated international communications company. Can you help me do it?
And I said, yeah, I actually think I can. So he was like, all right, well, don’t take one of those other jobs.

James Orsini (8m 21s):
You’ve already had that step on a cloud and do this with me. And I did. And, you know, he has certainly been
successful Before since, and it continues to be, I like to think I had played a small role and help a piece of his
vision come to life.

Dr. Anthony Orsini (8m 37s):
And that’s an important point. You mentioned in one of your interviews, the Gary asked you one simple
question. So what is it that you do tell us about that?

James Orsini (8m 45s):
He said, could you describe what you do in one sentence? And I said, yeah, I take dreams and visions and
put them into action plans. And he was like, you’re hired. So I got a lot of dreams. So it does good.

Dr. Anthony Orsini (8m 55s):
Well everybody needs someone to see the big picture and then somebody who facilitates. So I think that is
certainly you, it sounds like its a perfect match.

James Orsini (9m 3s):
Yeah, yeah. Has been, we’ve got an absolute blast and I’ve had several positions and is running the VaynerX
world and the newest of them right now.

Dr. Anthony Orsini (9m 10s):
So lets start moving towards difficult conversations and I asked Claude Silver the chief heart officer at
VaynerMedia the same question I’m gonna ask you. Of all the years you have been in leadership and all the
types of conversations that you’ve had with board members, CEOs, workers, employees, what do you think
is the most difficult conversation that you have had and that you continue to have to have that you really
thought that you needed to master?

James Orsini (9m 36s):
Well, its so many people unfortunately define who they are by their work it’s said definition, but it is factual
and removing someone’s work while not removing their soul has always been a difficult situation for me. And
as you read from that bio, I have had a lot of senior roles with those senior roles come, a senior
responsibilities, many of which was unfortunate in all different times, right?

James Orsini (10m 7s):
Or removing people who are simply out a position and I’ve had to do that around the world. I’ve done that
with bodyguards. I’ve done that with translators. I’ve done that in different cultures and it’s always difficult
when you’re removing the people who was used to removing to people. So I’m talking about CEOs,
founders, businesses that I bought and then remove leaders really, really difficult situations. And you know,
we need to do it because you know, the needs of the many outweigh the needs a few and what you are
trying to accomplish.

Dr. Anthony Orsini (10m 41s):
Any advice that you have to the young executive out there who needs to remove somebody’s or separate.
We had Dr. Larry Barton on a few weeks ago, Dr. Barton is the world’s leading expert on workplace violence.
He has a brand new book that talks about the way you separate someone from employment can really
predict whether they’re gonna come back and shoot the place up. Or, you know, I mean, those are rare
instances, but they do happen. So what advice do you have that for that manager whose got to remove
somebody’s that you could help him do it in the kindest most compassionate manner?

James Orsini (11m 14s):
Well, one, it shouldn’t be a surprise. So make sure you’re taking the time to properly communicate, to
evaluate over a period of time to, you know, having an ongoing dialogue. I believe Claude calls it “radical
candor”, you know? So by the time you get to that closed door office, nobody should be sitting on the other
end of that desk, thinking that it was a surprise. To, you know, be as fair and reasonable as you possibly can.

This is not the time. You know, at that moment to try and save an extra week, salary are pay or whenever,
you know, try and be as fair as you possibly can within the policies of your company and as reasonable as
you can in a, you know, not making it a choking situation.

James Orsini (11m 56s):
You know, as a global CFO, I was the guy that used to have to remove global CEOs. The CEO didn’t do it,
he put me on a plane and say, you know, you’ve go to Mexico city or your going to Tokyo, you know? So that
was always hard and difficult. They kind of knew when I was flying in this sort of grim reaper type of analogy,
I’ve removed people who was companies’ I bought, we then absorbed a company and there was no need for
the founder anymore. That was difficult. But you know, I’ve done it in such a way, in one particular example
where I called years later in a different company.

James Orsini (12m 30s):
And I said, listen, I know I’m not the voice you want to hear on the other end of the phone, but I had the right
opportunity for you now I’m in a different place and I know what it is that you do well. And if you’re willing to
trust me, come and join me here in this new role. You know, I made lifelong friends that way. Obviously when
you do something like that in the Sito Mobile situation, I was brought on as the CEO, the founder was moved
to a chairman role. We worked for a couple of years together and then the board told me, listen, you have to
remove him.

James Orsini (13m 4s):
It was his, yeah. It was really, really, really difficult. Two grown men crying on each side on the phone, you
know, their thinking about it. It, it was his baby birthed that company. Now, if he was removed from it. So that
is a really hard,

Dr. Anthony Orsini (13m 17s):
Yeah. You know, it’s interesting that your first thing you said was they should already know it’s coming and
I’ve been training doctor’s as you know how to break bad news, how to give tragic news. You have cancer,
your baby is passing away. Your child’s gonna have neurological deficits. And what I teach and I use this
acronym called program PROGRAM and the G is for gradual and its the number one rule of breaking bad
news in healthcare and business. There’s so many parallels. That’s why I’m having you on also that there’s
so many parallels that when someone hears the bad news, that their husband just died in the emergency
room, et cetera, I always tell the doctors, they have family members should already know what’s coming.

Dr. Anthony Orsini (13m 56s):
So you want to plead your case first. And this is what happened. There is a heart attack was worse than we
thought it was by the time he got to the emergency room in his heart was a very low, his blood pressure was
low. We had to give him an adrenaline, etc, etc, etc. And this is neuroscience based just allows people to
brace themselves for that news. That’s coming in your case, you’re talking about over a period of time where

your giving them feedback, et cetera. But it’s interesting that the parallels, that was a first thing that you said
and that’s number one rule in medicine too.

James Orsini (14m 26s):
Yeah, no surprises. I mean, but at a time some of this difficult and hard conversation is coming. It’s horrific
when it’s cold water in the face, you know, it’s never easy, but it’s a little more acceptable. When this is the
third time you’re talking about this particular topic and this is going to be the last time.

Dr. Anthony Orsini (14m 44s):
In a small way. They appreciate that you took the time that you gave them the chance and that you did in a
compassionate manner. And so that whether you’re a separating someone from a appointment or you are
doing it in medicine, it’s really, really the same thing. There’s so many parallels. And as you know, I’m a big
student of communication. Well, I know you very well, but knowing each other, since, since we were
children, I know you have a very even temperament. And in medicine I had a mentor when I was very young
training, I think he was doing a neonatology fellowship and he told me this thing, he said, the higher you are
up on the ladder or the softer you speak.

Dr. Anthony Orsini (15m 21s):
And that was probably the best advice that I ever got. And I routinely get thrown into situations where there’s
a child or a baby who has no heart rate and the team whose very, very good and their very well trained. They
are trying to resuscitate. Then they called me and I can get in there. And although they are very good,
there’s panic in the air or there’s and I’ve seen Physician to start barking. You see it on TV, right. They
started barking orders, right. That doesn’t happen. Not real. And I learned very early on from this mentor that
when everybody is screaming and yelling and get this and grab the oxygen and do that, And I walk in and I
just say, okay, what are we have here?

Dr. Anthony Orsini (15m 58s):
That’s what’s going on. The level of tension in the room goes down. So you mentioned how you’re even
temperament helps. Can you expand upon that? Just again, to join another parallel?

James Orsini (16m 6s):
You know, that’s been both a blessing and a curse for me because for some high strung people, it was like,
Listen, James, you’re not sensing the urgency that I’m trying to relay to you. And I said, I am sensing the
urgency, but if we’re all running around, like our hair is on fire, you know, nobody’s gonna have to see
through it and understand how important it is. Right. I’ve wrote a great book called the six fundamentals of
success by Stuart Levine, who is the ex CEO of Dale Carnegie. Now, if you know anything about Dale
Carnegie in business, it’s they train CEOs and it was about knowing what’s on your bosses dashboard.

James Orsini (16m 41s):

Some meaning like know what’s important to your boss and make sure that’s important to you. You know, for
a lot of what it was that I did with Gary in the earlier years, I was more like a decoder ring to him because
you know, the people that were around him were he used to Gary barks and out in an order and they run
100 miles an hour. Sometimes they smashed into a wall. And I was like, Listen I heard what he said, I think
this is what he means. You can go in a direction like this. Where do you know what let’s put some, we didn’t
necessarily call it process. We called it is scalable organization because when you are in hyper growth
mode, like most of his companies are, you know, process by nature sounds lethargic and slow.

James Orsini (17m 21s):
So we were just trying to organize enough to be able to scale. And a lot of times it gets tense in those rooms.
He’s just such a passionate individual that it comes out with a sense of urgency. And I just have a way of
seeing the dots in the room and understanding how they connect and come together. So I’m a much better
and a crisis situation. And I am a, it’s so funny. Because anytime I get very emotional in happy situations,
you want me as your pallbearers, but you know, because I’m gonna be no problem, but like they give a toast
at your wedding.

James Orsini (17m 55s):
I’m crying. So, You know, that’s a familial. And in fact, I just interviewed, I have a niece she’s gonna be on in
a couple of weeks, probably before this even airs. She was a premature baby survive that then, when she
was 16 years old, she got lymphoma, went through chemotherapy. She survived that. And now she’s a
pediatric oncology nurse and she takes care of kids with cancer. So I’m so proud of her. And I thought she
was going to be perfect. So I had her on, she was really a great interview.

James Orsini (18m 25s):
And during the interview or the introduction to my niece’s interview, I said in that introduction that please
forgive me because I think it’s familial that I might cry outt of pride and your gonna hear my voice quiver.

Dr. Anthony Orsini (18m 43s):
And my father is the same way. I think your father was the same way. Sadness, stone cold. But when their
kids graduating high school, they’re bawling their eyes out.

James Orsini (18m 54s):
Yeah, absolutely. Absolutely. That’s it. That’s the way it is.

Dr. Anthony Orsini (18m 58s):
So I don’t know if this is an Orsini thing anything or an Italian thing or what, but we were all the same and
let’s move on. So you, once said, were talking about More Difficult Conversations and sometimes you have
to have difficult conversations with clients, in the Sasha Group and I want you to tell us a little bit about that.
You’re really into mentoring and consulting and people are coming to you to help, but you once said a big

idea is not a business Hope is not a strategy and expand upon that. And I would think that sometimes you
have to have those difficult conversations with clients, with the Sasha group were people that come to you.

James Orsini (19m 28s):
Yeah. And that’s all, it was interesting when Gary pivoted and said, Hey you ready to start something new?
And I said, yeah, would you have a mind? He said, well, come on the cover of entrepreneur magazine, I got
14 million followers and we built a company to service Fortune 500, I don’t have a company for the smaller
and medium sized businesses. So he said, I want to start a new company. I want to name it after my dad for
legacy purposes his Dad was from Belarus, a Russian immigrant, who came to the United States worked his
way up. Bought his own liquor store? I, you know, the story there are, Gary helped out with that to help to
grow or whatever.

James Orsini (19m 59s):
It was 3 million in sales to 60 million in sales. So servicing the small businesses and is why we kind of
positioned ourself more like a consultancy on the front end in an advertising agency on the back end, you
know, fortune 500 has a brand manager’s from Wharton MBAs and, you know, understanding the real side
of marketing. And the folks that I serve are founders and owners and entrepreneurs, you know, who has a
passion for something and saw an opportunity could have been as a family owned business that they are
now taking to another level.

James Orsini (20m 30s):
You know, it could have been something that they saw on the marketplace and saw a way to pivot and they
be learned something new and they need guidance, not only marketing guidance, but business guidance,
but I was fortunate at this week to be included in a campaign, the magazine’s 40 over 40, it celebrates
wisdom and experience. Really, if you think about it, there’s no substitute for that. And in this space, I
happen to have that.

James Orsini (20m 60s):
So there are, are difficult conversations there. Like I know you’re birthed in this business in you and you
loved it, but the pivot the has to be here, or I know this guy has been along side of you for umpteen years,
but he’s not doing you any favors in the role that he’s in. And he’s simply not a chief operating officer or is it
not financially savvy? So there are difficult conversations with people who, you know, are passionate about
what is that they birth in a business, but don’t necessarily have a plan, but I spent a lot of time giving them
outlines to a business plan.

James Orsini (21m 35s):
Here’s how your idea becomes a business. Now remember the four pillars that Gary gave me, I wanted to be
integrated international independent communications company. Those four pillars, help guide the decisions
that we were making. They did two things. One, they enabled us to hit the gas and directions that aligned

with that. But more importantly, they enabled me to push back and challenge him.

James Orsini (22m 5s):
When, it didn’t align. Why are we doing this? I don’t understand how this fits. Remember the pillars that you
gave me. You know what I mean? So and Gary, by his own admission, says that he’s a moldable dictator,
right? So their buddies, a moldable, a dictator, meaning that you can have a conversation with him. And you
know, he’s going to make the ultimate decision as he should, but you can reason with him to understand why
things should be the way they are.

Dr. Anthony Orsini (22m 30s):
So you have to approach that conversation with at CEO because as you said, it’s his, baby, its her baby.
Then you need to tell them I have to train a bunch of physicians sometimes who are referred to me from their
hospitals saying that this guy’s is a great surgeon. He’s the great obstetrician. We were getting so many
complaints about his bedside manner. His, we call them H cap scores. Our patient satisfaction scores are
really low and it’s my job to coach them. Sometimes I put them through improvisational role playing with
actors.

Dr. Anthony Orsini (23m 1s):
I’m getting someone already. Who’s got an attitude like he or she does not want to be there. They’ve been
sent by daddy down there to get trained. And I can say, Because, I’m a physician. I mean, doctors have egos
and that I’m sure CEO’s have egos. And I’ve learned through my coaching that you do have to spend a lot of
time stroking that ego. And as they say, lead the horse to water in, when I teach conflict resolution, you kind
of steer them until they go, you know what James I think we should do this way. And that’s exactly what you
wanted them to do with it.

Dr. Anthony Orsini (23m 33s):
Is that a problem with CEO’s too? Stroking the egos a little bit?

James Orsini (23m 36s):
Well, I, you know what, the interesting thing, when I was going to Sito Mobile to become a CEO, you know, I
had never been a CEO. I was never been in a publicly traded company. And at the time I didn’t know
anything about technology and a, I resigned from Saatchi and the then global CEO, Kevin Roberts said to
me, so your going to be the CEO of a small, publicly traded company. He said three things. He says one
lonely job. He said two-hard job because when it gets to your desk, as this stuff that nobody else can figure
out.

James Orsini (24m 7s):
And he says three, where is it trading now? And I said, it’s trading on the bulletin board and were going to
bring it up to the NASDAQ. And he said, you are going to be asked to compromise your morals and integrity

on a daily basis. You know? And I shook his hand, it sounds like a Hallmark card. And six months later I went
back and I said, wow, those words were so deafening because it is exactly what I was feeling. So the
interesting part is in any room, there are so few people who even, you know, I’m sure as publicly traded
companies CEO is I’m honored to have held that title.

James Orsini (24m 40s):
I know what I don’t want to be ever again. And its a publicly traded CEO but once you have the badge, you
have the bage. So while Gary has 900 people in VaynerX, I don’t know anybody other than me, who’s been
in a publicly traded company CEO. So there are decisions he makes that you no, in the earlier times when I
was able to send him a text and so I know how to difficult, that is how you handled it eloquently I’ve been in
that situation. Well done.

James Orsini (25m 11s):
And that’s what happened with some of the CEOs, nobody want’s to come in and you know, and then they
were like, James, what do you know? What, what do you know about retail furniture? What do you know
about insurance? What do you know about law firms? And I said, absolutely nothing. I said, but I will never
know as much as you know about your practice, but you’ll never know as much as I know about the people
who are purchasing your services. Now that’s where the two of us come together. So that’s what I have. And
I don’t profess to know what it is that you have, but what you have becomes better when you mix it with what
I have,

Dr. Anthony Orsini (25m 45s):
It’s all about credibility. I have the same issue when I’m coaching physicians or when I’m doing workshops
and big hospitals about improving patient experience. We do exercises about how you sit down. When you
speak to a patient, how to be a genuine person, et cetera. Many of the other companies that do what I do,
they are taught by masters in education. Maybe they are taught by a nurse and as a physician, I know this to
be true. So even when I started my workshops, they are sitting in the back with their arms crossed, going. I
don’t really want to be here, but once I say to them, listen, I work in the world’s largest neonatal intensive
care unit.

Dr. Anthony Orsini (26m 22s):
We’ve adopted these practices. Our patient experience scores have gone up and I still go home at four or
five o’clock then all of a sudden, everybody sits up a little bit straighter. So when you were alluding to is it’s
all about the credibility. And I think that’s really important, but you still have to be careful with egos, right?

James Orsini (26m 38s):
That’s right. You, you definitely have to play with egos and it can get to your head. Just you read in bio. You
know, I was kind of cringing and looking around and I couldn’t even look at you reading it. I mean, if not done
properly, it will go to your head. You know? And now we had a 40 over 40 accolades somewhere in the

bottom of that, my wife does a good job of helping ground me. You know, they say Einstein’s wife thought he
was an idiot. Right,

Dr. Anthony Orsini (27m 6s):
Exactly. Right. I know you. well, your very grounded, your genuine people wouldn’t even know you do what
you do. Because you just loved to laugh. You enjoy life. And so I think that really goes a long way. Tomorrow,
“I’m going to be interviewing Stephen Covey, the speed of trust author. And he talks about building trust and
building loyalty, the best bosses I’ve ever had in my life. I walked through a fire for them. And that if you said
something poorly about them, I’d be very angry at you. No matter what. And some bosses I’m not happy
with.

James Orsini (27m 37s):
Yeah. That’s really, really important. You know, when I left the Sito Mobile I read a book called “Consigliere
ruling from the Shadows” and it was about being a great number two. When I read that book, I’m like, Listen,
that’s who I am. I don’t need to be the guy on the stage. I don’t need to be the number one. God, I think I
would of been a better CEO if I had a number two, like me behind me, I know most people have a number
two who is trying to shoot them to be number one. And that’s kinda, you know, what the realities of the
business world are.

James Orsini (28m 9s):
But I think that’s kinda where even when the, and this is, this is a funny one, Gary was like, alright, so you’re
going to be the CEO of the Sasha Group. I said, nah I think I would like to be the president. And they said,
you should be the CEO it’s, you know, you should be the CEO of VaynerMedia. You should be a CEO of The
Sasha group. And he’s like, wow. I never really had somebody get back a title. No, but it was like, that’s
kinda what was, I knew what was going to be doing. I didn’t really need any bigger title than the one that I
had to do, what it is that I knew I can do. And there’s a lot of trust there you know, there’s a lot of trust there.

James Orsini (28m 40s):
The thing as his father, his name on it, you know, he doesn’t want to screw it up in any way, shape or form.
He was involved in the vision. And then I sat the strategy for how to execute the vision.

Dr. Anthony Orsini (28m 49s):
And the trust has to go also downwards. So there are so many managers and leaders in bosses that I’ve had
where, I know the way that the way they stay up top, they believe in a way to stay up top is to keep
everybody down. And the best bosses I’ve had were ones that, you know, would hire Anthony Orsini and
then say, when I have another accomplishment, I’m going to take the credit because I hired him and there’s a
big difference. And as the audience knows my daughter Summer, she also works for VaynerMedia.

Dr. Anthony Orsini (29m 21s):

We had the episode with Claude on that atmosphere that Gary has started in that you are able to do that
people wanna work there. Right? I mean, how do you build that trust and loyalty for, with the people that
work for you?

James Orsini (29m 34s):
The interesting part about the Sasha group, is that we over index on senior people. So when I came to the
Sasha, I mean, I took me six VPs and SVPs is over to recognize people that I took over at each one of them
were running a portfolio of a business bigger than the Sasha Group. And I had a half a dozen and most were
like, Hey, how are you going to make any money? I, you know, all of these people making all of this, you
know, big salaries and, but I knew what it was that we were trying to build. And you know, the people that we
were servicing wanted to hear from senior people on the other end, a, a, a consultancy by it’s nature, you
know, Gary gave me the, the, the creative Liberty.

James Orsini (30m 12s):
They take the cream of what I saw at KPMG , Goldman Sachs, interbrand or Saatchi and pull kinda those
things together to form what it was that the Sasha group is and does for its clients, I’m big believer in a
succession planning. And you should have that or not feel threatened by it. You know, if I were to hit by a
bus and you know, one of those leaders is going to run this company. That’s important and you have to be
really comfortable in your own ability to do that.

Dr. Anthony Orsini (30m 41s):
That’s exactly right. The bosses that are worried about keeping people down are often insecure and worrying
about it, but I know you, and I think the reason why people stay loyal to you and you build so much trust, is
that even at work, I know this from my daughter, you’re just a genuine person, your James right? I mean,
everybody knows you, if you have to tell everybody you’re the boss, then you probably not doing a good job,
right? How do you build that loyalty with your employees?

James Orsini (31m 7s):
I tell people that I lead mostly because people choose to follow not because I get on the desk and say, Hey,
I’m the CEO or I’m the COO, and you need to listen to me. So that happens. I’m in touch with every boss I’ve
ever had. Listen to that statement. I am in touch with Every boss. I had ever had, and I left, although you
went through a line of Company. So obviously I resigned, left a lot on all of them, but it, my cell phone, I can
call even the first guy who hired me out of college, Larry Jansen from KPMG, you know, because I left on
great terms.

James Orsini (31m 44s):
And that is a lot of the advice I would give to people, even when there were resigning or looking to resign, I
would like, you know, I understand that the notice is two weeks, as Gary says, and I’ve really hung on to this
doing the right thing is always the right thing.

Dr. Anthony Orsini (31m 58s):
That’s what I tell my kids all the time, right? Is that right or wrong? As always, while you, you can rationalize
away from it,

James Orsini (32m 3s):
You know? And I can tell them from experience. I understand they want you over there. They will never want
you more than the first day that they want you. So just so you know that I’ll tell them that, you know,
everybody wants you today. There’s always the need today. And you need to tell him that you are going to
start there next month. The good news is you’re coming. The bad news is, is it’s the next month. And if they
want you that bad, they’re going to accept that. And I’ve done that time and time and time again, when I left
into a brand to go to Saatchi and I gave three months notice, and, you know, I left Saatchi to go to Sito
Mobile I gave three months notice, you know, three months was a long time, know your kind of leaving and
walking out the door, but it was the right thing.

James Orsini (32m 43s):
And they said, James why are you doing this? I said, because you would want me to do it to you. If it was
different, you would want the same thing. You know, I also think that giving them people or helping people,
and this is why get along so well, I think with Gary because he genuinely loves to help people as do I even
doing it, even when there’s nothing in it for you seemingly at that moment, there’s no quid pro quo, right? It’s
I happen to be in a position to help. And therefore I am, you know, now, is there an expectation if I were to
call you fourd months from now, you should be taking my call.

James Orsini (33m 18s):
Absolutely. But we don’t do it with that notion of a favor bank per se.

Dr. Anthony Orsini (33m 23s):
That’s a great answer. Or two more questions. Because I know you gotta go. So one of the questions that I
teach, communication skills, especially a conflict resolution, et cetera, we talk about active listening and I
saw quote that you wrote that somewhere. Listen more than you speak. Just expand on that. Just briefly.

James Orsini (33m 41s):
When I went to VaynerMedia as the oldest guy in the building, I think at the time, the average age was 26. I
didn’t really know anything about social media. Gary gave me great advice. He was like, I want you to just
kinda breathe. I don’t need you in every room or making a decision or telling us how to do it. I want you to
breathe my company is just take a few months and taken all in. I would learn a lot. You know what I mean?
That’s the other thing, like its just not too old to learn. Do you have this wisdom and experience?

James Orsini (34m 11s):

Yes, but I certainly became relevant in my kids’ lives because they’re all the sudden I was telling them what’s
coming up next on Snapchat. You know what you know, there is times to learn. So I do listen more than I
speak just so I could, you know, help connect those dots that we talked about earlier. I just wanted to see
how it comes together. And then I’d like to think that my input is a thoughful.

Dr. Anthony Orsini (34m 37s):
Speaking of they have 26 year old average age or the millennial and generation Z this leads, me to my last
question. And I asked Claude the same question. So there are a little different than we are. The millennials
generation Z is our kids are both. And most of those are little, in my opinion, in a little bit more impatient than
we are. Some of them may be more used to texting. Then they are speaking in communication. At least
when I’m training young physicians, I find that their communication skills or not what they should be.

Dr. Anthony Orsini (35m 9s):
I ask Claude this question. What advice do you have to the young person who really wants to do more for
the company who wants to speak to their manager or somewhat higher up and say, Hey, I’d like to do more. I
would like to move up, but not necessarily a raise, but you know, I want to advance a little bit. What advice
can you give them about that conversation? How should that go?

James Orsini (35m 30s):
Two things. One, I want to reverse it and the speak to the people who are getting those requests and
recognize my observations. I dispell alot of notions about millennials. Okay. I did not see them as lazy and
self centered. I mean they’re smart, they’re inquisitive, they’re collaborative, they’re hungry. So why not
harness that difference from our generation, right? Or rather, rather than stifle it. So one embracing the
differences and you know, not to get off on a tangent, but certainly we as a country or not doing that really
well.

James Orsini (36m 6s):
Like if you’re not like me that’s a really bad, bad, bad problem. Right? So embracing the differences two we
encourage an open door policy, you know, I probably spent more time with people putting in 15 minutes on
my calendar simply to try and figure out what it was that a chief integration officer did or what does chief
operating officer was there to do? Do you, you know, and in most other company’s those senior levels are
kept in a corner office. You don’t get access to them.

James Orsini (36m 37s):
Okay. You just, you just don’t, you don’t even go to The when I was at Saatchi, most people didn’t come to
the 17th where I sat next to the chief executive officer and chief creative officer or chief strategy officer and
me, and we had this glass off areas and you didn’t come there, you know, unless you’re summoned to be
there. Not here at VaynerMedia they had like scheduled 15 minutes. So like, I am just, you have to introduce
myself, find out what is it you do James you know, what do you do here to do so gathering that information is

important.

James Orsini (37m 8s):
Recognizing I asked them to do an SSP matrix, strength, skills, and passions. Okay. So it’s a reflective mirror
where you could look at yourself and you’re going to tell me honestly, with your strengths, skills and passions
are, and then I will tell you where that fits in our company as opposed to okay. James yeah, I think I’m ready
to be a creative today. And I said, aren’t you going to be in the strategy department? And they said, yeah,
yeah, I’m ready to try being a creative.

James Orsini (37m 39s):
I said, well usually you’re either born creative or you know you went to Miami school design or something.
You don’t just kind of flip a switch and say today’s today I become creative, right? This is where using your
strengths, skills and passions. If you are strength, skills and passions, don’t align with a creative director. I
don’t see a lot of hope for you finding your way there. So the NSSP matrix has really opened the eyes to
many of these younger people that say, Hey, you know what?

James Orsini (38m 9s):
I am passionate about that. And now, now I can find my way there because I have a skill in it. And I’m getting
stronger in that.

Dr. Anthony Orsini (38m 18s):
Let’s go with that. So now you are a young millennial. You want to talk to your boss, you look at your
strengths, your skills, your passion. If you think you’re in line and now you need to get up enough energy to
go into your boss. And you say, how do you think that conversation should go as the boss? If you said, well,
if he or did it really well

James Orsini (38m 37s):
In the SSP matrix, I just kind of lead them from themselves. I then help them position the conversation,
right? So there’s another form of advice. If your one of these millennials don’t go, you know, boldly in where I
would know, man has gone before, find yourself a mentor to help you are going to flesh this out. Now your
going to be like Listen I did my strength, skills and passions. I think I could align nicely with that position over
there. That’s open. And can you help me maybe even role play that you look your whole profession right now
is on role playing, right?

James Orsini (39m 12s):
So you know the importance of that and how much you could learn from that, would you mind role playing or
if I know, I know you’re not the one that I’m supposed to ask when I’m gonna run this by you and this way,
can you Q and a, this with me, I do this with my wife to, you know, hen she’s a looking to do something at
work, let her do a little role play and being honest, you know what? I don’t see it. I don’t see you. haven’t

made us strong enough compelling case for why this should be.

Dr. Anthony Orsini (39m 37s):
Great. That’s great advice that a young person, so James was, this was a lot of fun. And I want to thank you
so much for taking time out of your crazy crazy schedule, but it’s always fun talking to you. Can’t wait for this
to air because, you know, I promise my audience two things, every single episode in that’s to inspire, which
you certainly did because your career is inspiring. And you gave a lot of advice about communicating both as
a boss and as a young millennial who was trying to go to increase their career.

Dr. Anthony Orsini (40m 7s):
And I just want to say thank you. I think my audiences in a real treat when this airs, so thank you so much.

James Orsini (40m 13s):
It was great being on. I hope that they do find some value with it. You know, they can follow me or find a lot
of what we talked about. I wrote about in medium, whether it’s to delegation stuff or how to work with
millennials, it’s all on James Orsini in media, and James Orsinion LinkedIn and Instagram. And I am
@Jimmy the pencil on Twitter. Yeah. I wanted to ask you about the Jimmie the pencil thing. That’s it. We
have a story for another day or you actually do remember me with the pencil thin Clark Gable mustache.
When I combine with the fact that I started in accounting in the pencil.

Dr. Anthony Orsini (41m 12s):
Fantastic. All right. Great. Well, thank you so much. If you enjoyed this podcast, please go ahead and hit.
Subscribe to podcast is now available on Apple, Spotify, Amazon now, and Google podcast. If you like to get
in touch with me or find out more about the Orsini Way I can go through the Orsini way.com and you can
reach me through that. James thank you again. It was an absolute pleasure and I will see you hopefully
soon.

James Orsini (-):
Hopefully a Florida.

Dr. Anthony Orsini (41m 14s):
Yes, that would be great.

Announcer (41m 17s):
If you enjoyed this podcast, please hit the subscribe button and leave a comment and to contact Dr Orsini
and his team, or to suggest guests for a future podcast visit Orsini way.com. <inaudible>.

Read the transcript of Dr. Orsini’s podcast with Dr. David Shulkin

Dr. David Shulkin (1s):
Well, I think this single most difficult conversations that I had were when I had to speak to family members,
wives, mothers, and fathers of Veterans that either sacrificed their life or had taken their own lives through
suicide and sitting down with people that clearly are not only deeply missing their loved one’s, but continuing
to replay in their own mind if they could have done anything differently.

Dr. David Shulkin (38s):
And knowing that this was the many ways of failure of a system that I had responsibility for. Clearly were the
most difficult conversations that I ever had.

Announcer (50s):
Welcome to Difficult Conversations Lessons I learned as an ICU Physician with Dr. Anthony Orsini. Dr Orsini
is a practicing physician and the president and CEO of the Orsini Way. As a frequent keynote speaker and
author, Dr. Orsini has been training healthcare professionals and business leaders, how to navigate through
the most difficult dialogues. Each week, you will hear inspiring interviews with experts in their field who tell
their story and provide practical advice on how to effectively communicate.

Announcer (1m 22s):
Whether you are a doctor or faced with giving a patient bad news or a business leader who wants to get the
most out of his or her team members’ or someone who just wants to learn to communicate better. This is the
podcast for you.

Dr. Anthony Orsini (1m 34s):
Well, welcome to another episode of Difficult Conversations: Lessons I learned as an ICU Physician. This is
Dr. Anthony Orsini and I will be your host today and every Tuesday moving forward. I know I say we have an
extra special guests every single week, but this time it is really incredible. Today I am so honored to have
with us the Honorable Dr. David J Shulkin. The honorable Dr. David Shulkin was the night Secretary of the
us department of veterans affairs.

Dr. Anthony Orsini (2m 4s):
Nominated by President Trump to serve his cabinet, Secretary Shulkin was confirmed by the US Senate by a
vote of 100 to zero. He was the only Trump’s cabinet member to receive a unanimous confirmation. Prior to
serving as secretary of the VA , Dr. Shulkin served as the under secretary of health under President Obama,
for which he was also confirmed unanimously by the U S Senate. As Secretary Dr. Shulkin represented the
21 million American veterans and was responsible for the nation is the largest integrated health care system
with over 1200 sites of care, serving over 9 million veterans.

Dr. Anthony Orsini (2m 37s):
The VA is also the nation’s largest provider of graduate medical education and major contributor of medical
research. It provides Veterans with disability payments, education through the GI bill, home loans, and even

runs a national cemetery system. Prior to coming to VA, Secretary Shulkin was a widely respected health
care executives having served as chief executives of leading hospitals and health systems, including Beth
Israel in New York city and Morristown medical center in Northern New Jersey.

Dr. Anthony Orsini (3m 7s):
And that’s where I first met him. Secretary Shulkin has also held numerous physician leadership roles,
including the Chief Medical Officer at the University of Pennsylvania health system. The hospital at the
university of Pennsylvania, Temple University hospital and the medical college of Pennsylvania hospital.
Secretary Shulkin has held academic positions, including the chairman of medicine and vice Dean at Drexel
University school of medicine. Dr. Shulkin received his medical degree from the Medical College of
Pennsylvania, his internship at Yale University School of Medicine and a residency and fellowship in general
medicine at the University of Pittsburgh Presbyterian medical center.

Dr. Anthony Orsini (3m 45s):
He is board certified in internal medicine received and advanced training in outcomes, research and
economics as a Robert Wood Johnson foundation, clinical scholar at the University of Pennsylvania. Over
his career, his secretary Shulkin has been named as one of the top 100 physician leaders of hospitals and
health systems by Becker’s hospital review. And one of the 50 most influential physician executives in the
Country by Modern Healthcare and Modern Physician. He has also previously been named 100 most
influential people in American Healthcare by Modern Healthcare.

Dr. Anthony Orsini (4m 44s):
Dr. Shulkin is currently the CEO of Shulkin Solutions a company that provides solutions for a rapidly moving
health care system. And his recently published book which were going to spend a lot of time talking about. Is
titled: It shouldn’t be this heart to serve your country our Broken Government and the Plight of Veterans and
it’s an amazing book and I highly recommend it. Well ,Welcome Dr. Shulkin and I’m just so honored to have
you here.

Dr. David Shulkin (4m 44s):
I’m glad to be with you.

Dr. Anthony Orsini (4m 45s):
So I’ve been a huge fan and we have a few things in common first, I’m a graduate of Philadelphia college of
osteopathic medicine and you graduated medical college of Philadelphia, which is really write down the road.
And then it reading your bio,, You’ve spent some time at Pennsylvania hospital, university of Pennsylvania,
Drexel temple MCP. And then I also did my residency and fellowship at Thomas Jefferson, which I think you
have some ties to also is that correct?

Dr. David Shulkin (5m 29s):

Yes, that’s correct.

Dr. Anthony Orsini (5m 23s):
So after starting my career at NYU, I went to Morristown medical center in 2001 and stayed there til 2014.
And I believe you were there from 2010 to 2015, is that correct?

Dr. David Shulkin (5m 28s):
Yes, that’s correct.

Dr. Anthony Orsini (5m 25s):
And we met once or twice. I’m sure you don’t remember, but I do.And because I’m a real student of
communication, the day that I met you and I knew you were the president of the hospital, I immediately felt
that the word I thought about you was really genuine. You were very down to earth. You were extremely
friendly. You were very engaging. I don’t know if you remember, but we talked very briefly about the breaking
bad news program that I was bringing to the residents there. And I really just wanted to say, I really
appreciate it, but I, there was a down to earth kind of genuine likability to you and I that’s what really stands
out.

Dr. Anthony Orsini (6m 3s):
So it was really, really very happy. I thought, well, Dr. Shulkin is not going to come on my podcast, but you
know, let me give it a try. He probably doesn’t remember me, but I want to say, thank you because I reached
out to you, you got back to me in less than an hour and said sure. And I was like, wow, that’s amazing site
again. Don’t want to say thank you.

Dr. David Shulkin (6m 22s):
I’m glad to do it.

Dr. Anthony Orsini (6m 23s):
I’ve got a lot of questions and I’ll try to honor your time. But my first question is you’ve done a lot of medicine.
You finish your training, you were a practicing internist. Then even when you’re at the VA are, you still kept
seeing patients. And we all go into different avenues in medicine. Some people go into private practice,
some people who go into academics, other people go in to leadership. What made you take that path from
the very beginning? Because you took that fellowship and economics right away. So was there something
that you do you always want us to do that led you into the leadership role?

Dr. David Shulkin (6m 57s):
No. I think that I gave them what I advise people who’ve come and ask me for a career advice is I just
followed my instincts and followed my curiosity and allowed myself to explore areas that seemed both
interesting and meaningful to me. And I can’t say that there was a clear path when I did it. Today physicians

or being involved in management or executive positions is certainly increasingly common.

Dr. David Shulkin (7m 28s):
But ,when I finished my training, that was a very unheard of career path. Physician’s just, didn’t go into
management positions and my fellowship directors at the university of Pennsylvania, a very academic
program. I remember sat me down and said, listen, I hope the types of the things that you are working on in
publishing on the real world applications of economics to the practice of medicine and this new area of
understanding cost and quality in health care.

Dr. David Shulkin (8m 2s):
I hope you enjoy it. Because you should consider it a hobby, not a professional path. The only real
professional path that you should be pursuing is publications, research and academics. I remember
acknowledging that ut saying they may be right, but it really doesn’t matter to me. What I’m interested in
doing is in applying my knowledge into the real world environment, I just followed my instincts and that led to
some very, very interesting opportunities for me.

Dr. Anthony Orsini (8m 35s):
And so you go down to a leadership role in your career is well documented, and we spoke about it and the
bio I’m gonna get right over two. Maybe, perhaps what’s gonna be the most difficult question for you to
answer it. Maybe not. So you’re a physician, your health care leader, former us secretary of the VA, that title
of this podcast is Difficult Conversations and in those three positions you’ve must have had a lot of Difficult
Conversations. What do you think is the most difficult conversation that you have had to have in any of those
roles?

Dr. Anthony Orsini (9m 5s):
And can you give anybody some advice about how to, is your approach to the same as you’re approach
different and how did they do different in each different role that you played?

Dr. David Shulkin (9m 14s):
Well, I think the single most difficult conversations that I had were when I had to speak to family members,
wives, mothers, and fathers, of Veterans that either sacrificed their life or had taken their own lives through
suicide. And sitting down with people that clearly are not only deeply missing their loved one’s, but
continuing to replay in their own mind if they could have done anything differently.

Dr. David Shulkin (9m 50s):
And knowing that this was in many ways of failure of a system that I had responsibility for. Clearly were the
most difficult conversations that I ever had to have.

Dr. Anthony Orsini (10m 2s):

I can’t even imagine how difficult that is the premise of the whole podcast. And what I do is really that, you
know, as a neonatologist, having to tell someone that their baby died. And I talk about it in my book about a
conversation that I witnessed between a physician telling someone that their son had died and how badly
that went. And I always say that the most difficult conversation I have is telling somebody that your baby is
going to die or have continued developmental delay or a problem with that. And so there’s a lot of
misconceptions on how to approach that.

Dr. Anthony Orsini (10m 36s):
And in medicine, I think we continue to train young physicians incorrectly. One of the things that they are
being told over and over again, this is about information. It’s about provide as much information as possible
to the patient. And although that’s important, I think the most important thing is to obtain that relationship and
show them that you care and that your with them. And I guess that’s very similar to speaking to a family of a
Veteran who’s passed away or any advice you can give?

Dr. David Shulkin (11m 4s):
Well, I think that most importantly, it’s to create an environment where people that are suffering and have
something to say can be heard, and it’s not about providing information or educating somebody about what
really happened. It’s letting them explain to you what their experiences is and that it’s very powerful. The
second thing I would say is, is that where there is a fault in the process, whether it was when I was running
private hospitals and I had to sit with families and explain that something happened in the hospital, a medical
error happened that led to the harm or death have a family member or whether it was as I was describing
before in the VA where the system let the veteran down.

Dr. David Shulkin (11m 59s):
I think saying that your sorry, and acknowledging that more could be done. And that part of the purpose of
the conversation is to figure out how this could never happen again, what we can do to prevent it. That’s very
important. And I will tell you, I think these are very, very personal discussions. These are representing
institutions. These are people sitting down and talking about things. And so some of the families that I
described before that had lost sons Wives of veterans who were severely injured, even though I no longer
am the secretary of the VA, I maintain those relationships today.

Dr. David Shulkin (12m 45s):
They let me know about their life events. They let me know how things are going. We continue to
communicate because once you make that human connection, it’s much more than just about a particular
institutional issue.

Dr. Anthony Orsini (13m 1s):
So you are a problem solver, that’s one thing that comes through through your book, through your career
that, you know, it’s clear from learning about your career, that you love a challenge you loved to problem

solve, and they have all these questions ready to ask, but I’m going off the questions a little bit, because I
really wanna know. So we have a problem in medical education training right now is that we’re not spending
enough time training, medical students, training residents. And there are so many senior physicians who are
just not good at communicating. And I individually trained in role-playing over 5,000 doctors.

Dr. Anthony Orsini (13m 33s):
So far, both senior and young doctors, who are residents, what should we do? This is a problem. We have a
problem with communication. And I’m going to ask you about patient experience later, cause really what I
want to get into with you, but how can we fix that at the medical school level, at the residency level and get
rid of all these misconceptions? You know, I can’t tell you how many young doctors told me that when I
asked them, how do you give bad news? Have you learned anything from this? And the, he said, yeah, well
that was a resident. I was told by a senior physician that giving bad news is, is like a bandaid or you just rip it
off and get outta there.

Dr. Anthony Orsini (14m 8s):
So this is a problem. As a problem solver, how do you think we can fix this?

Dr. David Shulkin (14m 12s):
Well, I think it should come as no surprise that this continues to be a problem because we continue to select
physicians to enter medical school in the same way. And that’s based upon test taking and academic
performance. And there is no real serious consideration given to the attributes of what everyone hopes for,
from their doctor, which is humanity and the ability to experience empathy and to display that and to be able
to communicate effectively.

Dr. David Shulkin (14m 45s):
So if we continue to continue to select based on test taking abilities, we’re going to continue to have
deficiencies in these types of people that are, are coming, are doctors in the future, but that it’s not just who
you select. It’s also the whole system of reinforcement while you were a medical students and a resident.
We reward on academic skills and in the case of residency often on the technical skills.

Dr. David Shulkin (15m 16s):
But unless somebody really crosses the line ethically or behaviorally, there really are no positive or negative
rewards for these types of attributes that you’re talking about, about the ability to connect with people and
communicate effectively.

Dr. Anthony Orsini (15m 34s):
What I have found is that there is a real desire of physicians and nurses to want to learn, to communicate
that they are generally compassionate people, but that at a higher level, it’s still not being placed and really
at the top of their concerns. In fact, when I came up with the breaking bad news program while I was at

NYU, it took me almost 10 years to convince someone, to let me start teaching the residents with his
improvisational roleplaying. And since then I’ve been doing it for 10 years. But I also think that we as a group
and I think that the patient experience thing has helped me a little more, but we really have to bring more to
the forefront communications.

Dr. Anthony Orsini (16m 13s):
When I round with residents, sometimes I’ll ask them, did you call the mother? And they’ll say yes, I called
the mom and gave her an update. And then I’ll say to them, what’d you say, and you see their faces on
rounds. Like what do you mean? What did I say? Like, you know, I want to know word for word what you
said, what’d you talk about how long we are on the phone and by the end of the rotation, they start to get it
that it’s not about just the word you say, but it’s, it’s how you say it. And I think as a healthcare system, we
need to bring communication. I’m hoping that in the small way of this podcast and the work I do with the
Orsini Way is kind of helping with that, but I think they generally appreciate it.

Dr. Anthony Orsini (16m 48s):
So I can talk about this all day, but let’s move on because I really wanna talk about your book. I read it. It’s
phenomenal. I’m sure that it’s selling a lot of books and really want to talk about it. The first thing about your
book that was impressive to me was really the dedication. As soon as I read the dedication I I think that said
it all right. And you dedicated the book to the veterans and their families decide, this is why you went into
Washington in the first place. And I really felt that that was just a true statement.

Dr. Anthony Orsini (17m 19s):
And really if you go back, there were people that thought you were crazy to go into Government right.

Dr. David Shulkin (17m 24s):
All right. A lot of people,

Dr. Anthony Orsini (17m 27s):
As far as you found, it’s not for the faint of heart, but you had a calling. I understand you’re in the book. You
talk about your father or you grew up an army base in your father was a psychiatrist’s in the army base. How
much do you think your father influenced you becoming a physician and then towards eventually wanted to
serve the VA?

Dr. David Shulkin (17m 46s):
Well, my dad was a psychiatrist and is probably smart enough to know that If he overtly you’re directly tried
to influenced me to do something I might of done the opposite not unlike many people and their adolescent’s
making the decisions about what they might want to do. So I never felt any direct pressure or direction or
influence from either of my parents’ in terms of what I wanted to do. They gave me the space to figure out
what I wanted to do. And you know, I appreciate that.

Dr. David Shulkin (18m 17s):
I don’t think I had any particular commitment or, or a desire to help give back to our veterans. Then I would
hope or any other American. I think that the regular people that I talked to really do appreciate the sacrifice
that these men and women give for our country. It’s the volunteer army. As, we all know with less than 1% of
people in this country serving. And they really do the work for the rest of us to allow us to lead the types of
lives that we are able to leave.

Dr. David Shulkin (18m 51s):
And so when I was called and asked if I could help, I was the CEO of a hospital, I said, how can I say no? I
believe that if I can help and give back. There was no doubt that I was going to do that.

Dr. Anthony Orsini (19m 6s):
And so you leave Morristown medical center where I was, you go head to serve for the VA has on their
Secretary. I think you’re first day was February 15th, 2017. And you’ll get there on your very first day. And at
the time the VA was going through difficult times. It was a, it talks about wait times and, and they were
receiving, as you say, in your book, the wrong kind of headlines. Can you tell us about on that first day, what
you realized you had up in front of you?

Dr. David Shulkin (19m 33s):
Yeah, we’re actually talking about 2015 when I arrived. I was first contacted by the white house in 2014, in
2014 was what was called the wait time crisis, where Congress has exposed the fact that the VA had
hundreds and thousands of Veterans waiting for care and not able to get access. Some of them being
alleged of have been harmed or, or even died waiting for care. And that was a national story.

Dr. David Shulkin (20m 3s):
And I remember sitting there as a citizen reading about it, seeing it on TV in saying, this is really horrible. If
there’s any group of the Americans that deserve better, that deserve, you know, the best that this country
can offer in terms of Healthcare it’s our veterans and this shouldn’t be happening. And I remember probably
saying what so many people say when they see headlines, they say, boy, I wish I could do something, but
not thinking that you rarely ever will have that chance. And then shortly afterwards, the white house called
me and I knew this was my chance.

Dr. David Shulkin (20m 35s):
And so that’s, that’s when I raised my hand to say that I would help. It took about 10 months to get through
the vetting process. The head of the VA healthcare called the under Secretary needs to be Senate
confirmed. The president is not going to announce a nominee unless they are absolutely sure that this is a
candidate that could get Senate confirmed. And so it was a very extensive vetting process. So I arrived at
the VA after my conformation in July of 2015 or about 11 months after the wait time crisis was first exposed

and the place I thought was in dramatic need of a plan to fix the wait time issues.

Dr. David Shulkin (21m 25s):
And that’s immediately what I began to do. That was my focus to make sure that no veterans were waiting
for care or who had an urgent medical problem.

Dr. Anthony Orsini (21m 34s):
Do you fix it relatively quickly to talk about in your books, a stand down order? Or can you tell us more about
how you went about fixing that? Because it, it happened pretty quickly. I think anyway,

Dr. David Shulkin (21m 44s):
Important thing for me was to get a system in place that could prioritize which Veterans needed to be seen at
what time. Previously to my arrival, the VA treated all appointments at the same. So you could have a urgent
medical appointment or you could have a routine medical appointment and they would stay in the same
place in line. And so I immediately changed that so that we can identify those patients who has urgent
medical needs.

Dr. David Shulkin (22m 14s):
Once we did that, I called for what I named a national stand down order, where we stop what we’re doing
across the entire country in the VA system. This is now, you know, several hundred thousand employees
working in the VA. And I just said, we will do nothing, but see those patients with urgent medical problems
there were 57,000 veterans waiting for an urgent medical problem, more than 30 days. And those 57,000
became the focus of the VA until we saw those patients.

Dr. David Shulkin (22m 49s):
Several days later, that list of 57,000 was down to less than 1000. We contacted all those patients. We had
seen them all and once I knew that we had taken care of the backlog of patients with urgent medical
problems. I knew that the only way to prevent that from ever building up again and repeating that terrible
problem would be to put in place same day appointments across the VA. So if you had an urgent medical
problem, you would know if you arrived at a VA, you will be seen that day they’re would be no wait times.

Dr. David Shulkin (23m 26s):
And by December, 2016, as President Obama was thinking about his last month in office, I was able to say
that we had put in place same day appointments at every VA medical center across the country. And to
ensure that that would remain in place on that we’d be accountable for that I published or our wait times
publicly. And to this day, you can see the VA wait times on the public websites to see whether we’re honoring
that commitment.

Dr. Anthony Orsini (24m 0s):

That’s fantastic. And yes, and that ties into my patient experience. The question that I’m waiting to as in the
meantime, my next question is the difference. There were very few people, if any, or I don’t know if he were
the only one who really worked in the Obama administration and the Trump administration. It really wasn’t a
very common correct?

Dr. David Shulkin (24m 17s):
No, it was not. I was the only one in the Trump cabinet that would come from the Obama administration.

Dr. Anthony Orsini (24m 23s):
I thought in your book, you say I’m not an Obama guy. I’m not a Trump guy. I’m here for the veterans, but it
was a very different way that both the administration’s when about things, can you tell us the differences and
how you were able to switch over to navigate through the, two different environments?

Dr. David Shulkin (24m 37s):
Well, I like to think that I didn’t switch. I like to think that I had a game plan. I felt like I had found a formula for
how to begin to address the problems in the VA that had been there for decades that had spanned
administrations, Republican and Democrat. And that I was implementing a plan that not only, I believe I
made sense for veterans, but it was showing that it worked and whether it was a democratic president or a
republican president, that was the plan that was going to stick with.

Dr. David Shulkin (25m 13s):
And what I did much, you know, in line with my academic roots I had published those plans I wrote and their
new England journal, what my plan was to fix access I talked and gave talks, whether it’s the national press
club or on television or an academic journals about what I was going to do and how I was gonna fix it. And I
stayed true to that plan. Now you work in the context of the environment and who your bosses in this case,
the President, and there were some things that were more difficult to get done in the Obama administration
than they were in the Trump administration.

Dr. David Shulkin (25m 53s):
And there were some things that were more difficult in the Trump administration than the Obama
administration, so that you would continually try to adjust. But the most important thing was not to deviate
from your principles and not to yield to political pressures, because I believe much like when I ran at a
hospital in the private sector, like Morristown medical center, I was there representing the patients. And this
is how I view things as a doctor first.

Dr. David Shulkin (26m 25s):
And you know, doctor’s is, you know, you and I both took the Hippocratic oath. We will do no harm. I was not
willing to yield to political arguments or pressure and had the end result be that something happened, the
Veterans, that I didn’t think was the right thing. And that ultimately led to me no longer being able to operate

in the Trump administration was a difference in political views about what the right thing to do for a Veterans
were. But I will say that during my time as Secretary in the Trump administration, we’ve got a lot done, the
ability of President Trump to allow me the freedom, to do things, to get stuff done and not be bogged down in
the traditional ways of doing things, allowed me to get huge improvements done in the VA.

Dr. David Shulkin (27m 20s):
We got 11 major bills, all with bipartisan support. There is no other agency in the government under the
Trump administration that had that type of bipartisan support that was able to get so much done through
Congress and the white house. So there were some positive things to it as well until of course there came a
time that it was no longer positive for me. And I knew that the right thing to do would be to stick to my
principles and ultimately, President Trump decided to make a change.

Dr. Anthony Orsini (27m 53s):
What about President Obama and President Trump went about things, as you said, very differently. One was
much more methodical. The other one shot from the hip and maybe made some mistakes somewhere in the
middle might be a perfect way of doing it. But you were able to that not adopt where you were able to
succeed, really to get things done in both the administration’s, which is really a testament to you. And in your
book I was chuckling when you were describing you’re first meeting with President Trump were President
elect Trump, and you describe it in such detail.

Dr. Anthony Orsini (28m 23s):
And now that we’ve gotten to know president Trump on TV, it, you can certainly see exactly the way he just
moved around him and went so fast. And I thought that was just a funny, a funny story that you left there,
you had mentioned something about you being the new secretary, but when you left and you didn’t even
know that he was going so fast, you didn’t even really know if that’s what he said, is that correct?

Dr. David Shulkin (28m 44s):
Yeah. President Trump likes to keep you sort of on edge and keep you guessing, you know, that’s part of the
way that he does things. What I think is interesting is what I write about my book, what I experienced myself
at the time, very, very few people had insights into the way that President Trump operated. But if you take a
look at the experience that I had, that I’ve described in the book, not only from that initial meeting, but all the
way through all of my contacts with the president, til the very end where he tweeted me out of office, this
experience has now been repeated time and time and time again by other people who have come forth and
told her stories about their experience from working in the Trump administration.

Dr. David Shulkin (29m 32s):
So in some ways I think that the detail in which I had described things is so clearly now understood by many,
many people who have heard about these experiences. Now, many times over.

Dr. Anthony Orsini (29m 46s):
Absolutely. I want to switch over and talk about patient experience, reading about you and knowing you’re a
little bit people have called you, the champion of patient experience, patient experience, the experience of
the VA. Those are all things that we’re very, very important with you. And I believe when you were under
secretary, you and Secretary McDonald started Patient Experience Program at the VA. And by the way, I was
at a meeting, a conference last year at the Beryl Institute for a patient experience and patient experience
department for the VA gave a presentation.

Dr. Anthony Orsini (30m 20s):
And that the amazing things that they were doing was nothing short of remarkable. And I was so impressed
with what their doing, but patient experience is really very important. And the one thing that you did was we
decided that you were going to publish or make public, the patient experience scores for the VA. And that’s
something that I feel very strongly about. My it’s all the Delivery program that I give to many hospitals
concentrates just on communication skills. We’ve been able to improve patient experience scores
dramatically just by teaching doctors and nurses, how to communicate.

Dr. Anthony Orsini (30m 53s):
But I know that I know in a lot of hospitals, there’s a lot of pushback to make public the patient experience
scores specifically by the physicians. And in fact, one hospital that I know they started doing it. And within
three months the physicians shut it down. How strongly do you feel that that’s important and tells us how you
were able to start that patient experience? Program I was so impressed.

Dr. David Shulkin (31m 16s):
Yeah. Well, first of all, the reason why in every position I’ve held, whether it’s been the CEO of the hospital or
Secretary, or Under Secretary at the VA in that I’ve always put down my white coat and my stethoscope and
go out and taken care of patients myself is not because I think that I’m God’s gift to medicine or that there
aren’t other doctors that could do as good or better job than me, but it really is because I’ve always felt that
that’s what the job was.

Dr. David Shulkin (31m 48s):
If you are the leader of an organization, if you really have to understand the impact of your decisions and the
type of organization they were running. And the only way I knew how to do that, its to see how your
customers are experiencing are brought up. And so when I would be secretary of the VA and I would go see
patients, I get to see, how does the electronic health record work? How does it work to order medications or
labs? What are your coworkers attitudes like? What is the ability to get help when you need a consult?

Dr. David Shulkin (32m 20s):
What’s the Patient telling you about the experience. And so that fundamentally kept me grounded in
understanding what my job is a leader was and what the patient experience was in terms of trying to put in

place the large program at the VA. A lot of that rycredit belongs toG Secretary McDonald was the CEO have
a large consumer product company before and becoming secretary. He had been CEO of Proctor and
Gamble for much of his career.

Dr. David Shulkin (32m 51s):
And so he came at it from a very consumer oriented point of view. I came at it from a very Dr Patient point of
view. That was a nice combination for us to be able to drive in improvement and the experience. And I would
just say for those that are in medicine, that resists That, you know, I think as doctors, we all understand that
physician’s perspective that many physicians believe its more important to do the right thing medically and to
focus on the science, not necessarily on whether a patient likes you, but for those who don’t really
understand why it’s so important to be consumer focused in to understand the patient experience, I would
say, this is the reason why so many people medicine now complained that they’ve lost control of their
profession because this ultimately needs to be Healthcare needs to be a consumer driven system.

Dr. David Shulkin (33m 55s):
It needs to be a system that represents those things that matter most to patients. That’s what is this about?
And if you don’t understand the patient experience and you’re not willing to be transparent about it, you’re
never really going to participate in it. You are going to be continually sidelined off to be a technician. And a
ultimately this is why so many physicians are feeling burned out and looking to leave medicine because they
no longer feel that there are in control of the fields that they thought that they would be when they entered.

Dr. David Shulkin (34m 30s):
Right.

Dr. Anthony Orsini (34m 31s):
Awesome. I’m so happy. You said that because when I give my workshops, I tell physicians that when you
are able to form that relationship with the Patient, which is what patient experiences all about. And there was
a study at a university of Florida that showed you could form a relationship if you do it correctly with in 56
seconds with someone, by being a genuine person by sitting down. But then when you’re able to form
relationships and you really make that connection with each and every one of your patients, you go home a
lot happier at the end of the day, I think, and you feel less like a factory worker and more like you’ve made a
difference, even if you practice good medicine.

Dr. Anthony Orsini (35m 4s):
And I saved a couple of lives that day, or cured a couple of babies, go home, knowing I really bonded with
that family. And, and it does decrease physician burnout. And in fact, next week I interviewed doctor Dike
Drummond, who’s an expert on the physician burnout when we talk about this, but I don’t think physicians or
hospital administrators understand how important it is to the well being of the patient, but also the wellbeing
of the doctor or the nurse and the patient experience as tied to better outcomes, right? Better, better patient

compliance.

Dr. Anthony Orsini (35m 34s):
And it seems, although a lot of hospital administrators are saying it’s number one, it’s a difficult thing to crack
would you agree?

Dr. David Shulkin (35m 41s):
He would agree. And I, know, at least for me, when I was a resident, I injured my back in a water skiing
incident where I needed surgery at my own hospital, that I was training at it and I got to experience the
patient experience personally and see wha it was like to deal with a surgeon who was technically very good
and had the worst bedside manner I could imagine. He would check on me, do his postdoc rounds from the
doorway.

Dr. David Shulkin (36m 13s):
He just didn’t even want to step into the room because of, probably in his mind he would commit him two a
longer conversation or, or having to answer any questions or to interact. And so, you know, having that
experience and looking at things through the eyes of a patient, I think changes you and changes your
perspective about being a doctor.

Dr. Anthony Orsini (36m 36s):
I agree it gets better for everyone. So I know you have a hard stop coming up soon. We only have a few
minutes left. I want to get a, just a comment about Telemedicine real quickly during COVID crisis, because
I’m all about the patient experience and making that connection. You brought telemedicine to the VA where
you at least, made it more common and that helped a lot. Telemedicine is great. It’s convenient. It’s difficult
too, to form that human interaction with Telemedicine. In fact, we are doing some training programs now for
some hospitals to help them with their communication skills so that they can bond a little bit through
telemedicine.

Dr. Anthony Orsini (37m 10s):
Do you think that telemedicine is here at this level to stay, or do you think that if we keep doing more and
more Telemedicine we’re gonna miss that, that relationship?

Dr. David Shulkin (37m 16s):
Well I think there’s a couple answers to the question. I think, you know, if you’re looking at the number of
telemedicine visits across the country and you were looking at it from a numbers point of view, I think that we
will see a decline in the number of telehealth visits from the high point where people just weren’t able to go
into the doctor’s office or weren’t able to you going to a hospital to get care, but it’s clearly gonna stay way
above were.

Dr. David Shulkin (37m 53s):
It was pretty COVID. I think the changes in reimbursement, the changes in regulations, the changes in the
patient experience, people would never accessed or tried to telehealth. I think fundamentally will change the
way that people will utilize tele-health forever. And so were gonna see a much higher level than pre COVID,
but maybe not as high as what we’re seeing right now.

Dr. Anthony Orsini (38m 20s):
Do you think that’ll be a good thing?

Dr. David Shulkin (38m 21s):
Well, I think telehealth is an excellent thing that what we need to, and we did this at the VA utilize telehealth
appropriately. It can provide care in the home and it can provide access to people that frankly have had the
challenge in getting transportation. We can provide easier access for the doctor’s. In some cases can be
more therapeutic, like in telebehavioral health. They think it’s easier in some cases for patients to express
themselves over a video, then if they were having to sit in front of the person.

Dr. David Shulkin (38m 58s):
But what I was gonna say is I think when I say that were gonna come down to a certain level and stabilize
that’s with what we think about as telemedicine Today I don’t think we’re going to think we’re at a very early
stage we’re tele medicine for most people means a tele visit a video visit across a phone. And I think that
this has just the very early stage of where we’re going in virtual care. We have to now transition from just
using a video, to have a talk with the doctor and a patient to one that really adds much more significant
value.

Dr. David Shulkin (39m 39s):
So it no longer is just an episodic care, but it’s more continuous care. One where we can use tools like
artificial intelligence to improve the way that we make decisions. One that provides the doctor and the patient
more information that they can share together, actually sharing the chart together, discussing and showing
pictures together so that you can actually improve the communication and a patient experience. And so I
think we’re just at the very early stages of how technology has been impact our ability to talk in the future.

Dr. David Shulkin (40m 16s):
But I’m very optimistic that remote monitoring and advances in the way that we use this technology are going
to dramatically improve the doctor patient experience.

Dr. Anthony Orsini (40m 28s):
I think we can do the help those people have difficulty getting through the doctors is certainly will be a good
thing. One final question, Dr. Shulkin you’ve had so many accomplishments in your life through the private or
public sector career wise. What are you most proud of? You think?

Dr. David Shulkin (40m 43s):
I think that there is no doubt that my answer to that are the people that I had a chance to impact their career.
And one of the things that’s always been important to me as been in being able to be a mentor and then
training future leaders in the Country because when you do a job and you get something done, you feel
proud about that. But when you influence somebody life who, who goes on and creates their own impact on
the world, that’s a force multiplier.

Dr. David Shulkin (41m 19s):
And so I’m most proud of those people that I had an influence on their life who are now on doing great things
and leading organizations of their own. And to me, that’s going to be a lasting impact.

Dr. Anthony Orsini (41m 31s):
It can really relate to that, when I do my training of other physicians and I teach a young physician how to
communicate and how to build relationships, I know that that Physician is likely going to have about 200,000
patient interactions in their life. And if I can have a small part and how they treat their patients, it just makes
my life meaningful and it gets me excited and it makes me want to do even more. So I think that’s a fantastic
answer. My mother always used to tell me, Dr. Shulkin always leave the place better than you found it in one
thing that comes clear of in reading your bio and knowing you and reading your book is that you certainly do
that.

Dr. Anthony Orsini (42m 10s):
I want to thank you on behalf of everyone on behalf of the Veterans for all of the work that you’ve done, you
truly make every place better than you found it. And so thank you so much for that .

Dr. David Shulkin (42m 21s):
Great. Thank you.

Dr. Anthony Orsini (42m 22s):
If somebody wants to get in touch with you, you just do it through Shulkin solutions?

Dr. David Shulkin (42m 26s):
I would love for people to follow me on twitter @davidshulkin and I do have a professional website
shulkinsolutions .com.

Dr. Anthony Orsini (42m 26s):
Fantastic. Thank you so much. And I will share the links with you also on our notes. If you enjoy this
podcast, please subscribe and we are available on Apple, Spotify in other formats or a Google podcast. If
you need to find more about the Orsini Way please contact me at www.theorsiniway.com Dr so could I know

you had to go, thank you so much. I am very honored to have you on this podcast and I hope we can speak
again soon.

Dr. David Shulkin (42m 59s):
Great, thanks. Take care. Thank you.

Announcer (43m 2s):
If you enjoyed this podcast, please hit the subscribe button and leave a comment and review to contact Dr
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Read the transcript of Dr. Orsini’s podcast with Lauren Heaslip

Lauren Heaslip (2s):
My advice to a teenager who would just got the news to keep on living your life, keep on being a teenager,
keep on doing what you like to do. Tell your doctor what is important to you, what you want, what milestones
do you want to be there for, what you don’t want to miss. Now, unfortunately, some things you are going to
have to be in the hospital for and you are gonna have to miss something. But having that conversation with
your doctor of “Hey this is really important for me”.

Lauren Heaslip (32s):
Because when, as a patient, if you get to do what you enjoy and you get that spark, of I got to go to my
favorite movie this weekend? Or I got to go to my prom. There are going to do better in treatment because
they were happy. You are getting to live your life too. You are not so down inside. And I truly believe that like
a positive outlook in a positive attitude is what is going to get you through that and get you through it.

Lauren Heaslip (1m 4s):
You know, well. So keep on living life. My advice for doctors and healthcare practitioners that anyone that is
there giving bad news is just to try and put yourself in that family’s position. Try to just remember what you
are telling, but remember that you are dealing with the human and that human side of it and how you would
want someone to tell you, or your loved one.

Announcer (1m 34s):
Welcome to Difficult Conversations Lessons I Learned as an ICU Physician with Dr. Anthony Orsini. Dr
Orsini is a practicing physician and the president and CEO of the Orsini way. As a frequent keynote speaker
and author, Dr. Orsini has been training healthcare professionals and business leaders. How to navigate
through the most difficult dialogues. Each week, you will hear inspiring interviews with experts in their field
who tell their story and provide practical advice on how to effectively communicate.

Announcer (2m 7s):
Whether you are a doctor, faced with giving a patient bad news, a business leader who wants to get the
most out of his or her team members or someone who just wants to learn to communicate better, this is the
podcast for you..

Dr. Orsini (2m 17s):
Well, welcome to another episode of Difficult Conversations Lessons I Learned as an ICU Physician this is
Dr. Anthony Orsini and I’ll be your host today. Well every week. I’m thankful to have the honor of interviewing
one amazing guest after another. We have had physicians, HR executives, life coaches, and patient
experience experts, and every time I do an interview, I leave feeling inspired. And I learned just so much.
This week is extra special because my guest is extra special to me.

Dr. Orsini (2m 49s):
And that’s not only because she’s an incredible young person with an incredible story, but also because she

just happens to be my niece. Now, a bit of a warning to my audience, as of, you know, especially people who
know me, well, I tend to wear my heart on my sleeve. I’m not sure if it’s that Italian gene, my father and
grandfather tended to get emotional, especially during happy times. So it was sort of a public service
announcement. The level of pride that I feel four, my niece Lauren is through the roof and her ability to
triumph over life challenges better than people twice her age is beyond incredible.

Dr. Orsini (3m 25s):
So if my voice quivers it a little bit, please, excuse me. Lauren Heaslip was born prematurely at 31 weeks on
March 21st, 1996. She is the fourth and youngest daughter and my brother in law, Tom Heaslip and
sister-in-law Catherine Heaslip. That very first day of spring of 1996, started. Off in a New Jersey is a very
uneventful, but that would not last long after being confined to bed, rest in the hospital for Placenta Accreta a
condition that occurs when the Placenta attaches through the uterus and into other organs, Katherine and
began to hemorrhage profusely a STAT cesarean section would be required in order to save the life of both
mother and baby.

Dr. Orsini (4m 9s):
A few minutes later, Lauren Pender Heaslip was born at three pounds, 11 ounces, and 31 weeks gestation
at a small community hospital, not designed to care for a very sick and premature infants. As Lauren was
placed on a ventilator and transported to a level three neonatal intensive care unit, her mother, Katherine,
and also remained critical, due to massive blood loss. Catherine clinging to life on a ventilator at one hospital
while Lauren was transferred on a ventilator two another one, but by the grace of God, both mother and
daughters survived and Lauren survived and is doing well.

Dr. Orsini (4m 46s):
Lauren spent nearly six weeks in the neonatal intensive care unit before being discharged. She continued to
do well and excelled at everything that she did. Then on new year’s Eve in 2012, after receiving an x-ray for
a painful neck that showed her cervical vertebrae extremely unstable, she was rushed to Children’s hospital
of Philadelphia for emergency surgery to reconstruct her neck. One cough or sudden movement, Lauren
could have been paralyzed for life. Two weeks later on January 16th, she was diagnosed with non Hodgkin’s
lymphoma.

Dr. Orsini (5m 23s):
And once again, Lauren now a thriving and accomplished 16 year old, would be forced to face and other
medical challenge. As is Lauren and her family, her diagnosis and second medical challenge did not define
her as she continued to live her life with as much normalcy as possible. And Thankfully after 19 rounds of
chemotherapy and all of those side effects associated with the treatment Lauren was cancer-free and
remains cured until this day. As is Lauren she rebounded it even more strongly and went on to graduate
Duquesne university with a bachelor of science and health science in December of 2017.

Dr. Orsini (6m 1s):
She then continued her studies and received her nursing degree at the very competitive school of nursing of
Duke University and graduated in May of 2019. Lauren is currently working as a registered nurse at
Children’s hospital of Cincinnati where she works in a pediatric hematology, oncology ward, treating children
with cancer. What an amazing story.

Dr. Orsini (6m 30s):
Welcome kiddo, its just a great to have you. So excited to have a special person. I just read your bio. So
you’re going to be surprised when you hear it. I didn’t want you to hear it because if I read it in front of you, I
might cry. Cause I’m so proud of you. So I want to read it now, but how are you doing things are go

Lauren Heaslip (6m 47s):
Things are good. Thanks for having me here. I’m honored to be here.

Dr. Orsini (6m 50s):
How’s your job going?

Lauren Heaslip (6m 52s):
It is great. I love it so much. It’s crazy to believe that I’m there now. And every day I still get shocked at
where I work and what I get to do. And I just love it so much.

Dr. Orsini (7m 6s):
And we’re going to talk about the specifics of your job and why I think that you have so much to offer later
on. But first I just, you know, we talked about your challenges in life during the intro and your too little to
remember when you are a premature baby. So you don’t remember anything about that. I do know your story
and I mentioned it in the bio. Let’s go to the point where you were 16 years old and just kind of hanging out
and thriving and playing sports.

Dr. Orsini (7m 37s):
And you were having some neck pain right right?

Lauren Heaslip (7m 40s):
Yeah, I was playing sports. I was normal, healthy. Everything was fine until the neck pain started. And at first
no one really thought anything of it. I didn’t really think anything of it when back and forth with our athletic
trainer and everything seemed fine. I was healthy just having some pain, but it was playing sports. So I, that
can be expected at times. And it just progressively got worse and worse and worse over the course of two,
three months and still was playing sports, all of that.

Lauren Heaslip (8m 18s):

And all the doctors I went to physical therapist, the athletic trainer went to my primary. Everything was
checking out completely fine. And I still looked healthy. All blood counts, all that, everything looked
completely normal. So it was all just chalked up to maybe a sports injury or something, until it wasn’t.

Dr. Orsini (8m 40s):
So all of a sudden you get your x-ray and I know you went through a couple hospitals where you ended up at
Children’s hospital of Philadelphia and you had to have emergency surgery. And I think your parents always,
even though you were 16 years old, but they never really hit anything from me. Right. So tell about the
conversation that you remember when they told you that you had to go into emergency surgery.

Lauren Heaslip (9m 2s):
Well, that all kinds of started with them not hiding anything from me as well. Before I got to CHOP, I was at
another hospital in Philly and I was alone in the room. I was stuck, but on my back because of my broken
neck and one was letting the move and one of the doctors took my parents out into the hall and talked to just
my parents out in the hall. And I couldn’t hear much that they were saying, but I heard the word tumor and I
don’t remember too much else after that.

Lauren Heaslip (9m 36s):
But after that I told my parents, I said anything that they have to say, I want to hear it. I want you guys to talk
about it in the room because it’s happening to me. And I want to know, I don’t want it to be hidden from me,
anything like that. I kind of put that out there and I was like, I wanna know. And I don’t want you guys to talk
about it in the hall. I want to be told in front of me because I don’t even know if at that hospital, they really
said anything to me after that they sent me to CHOP.

Lauren Heaslip (10m 8s):
And to be honest, we don’t really remember much about being told, having to go into surgery or any of that. I
was admitted, I believe straight to the ICU at CHOP to go through halo traction and to prepare for the
surgery. It took, I think at least a day to prepare for surgery.

Dr. Orsini (10m 27s):
So your parents came in and told you, that was difficult conversation number one. Your parents were the
ones that told you that about the tumor that it might be cancer or was it the doctor?

Lauren Heaslip (10m 37s):
That’s the part I don’t remember all too much. By that point I had the MRI done outside of Philly and had
about probably at least a two hour ambulance ride all the way to Philly. I was stuck flat on my back. They
weren’t letting me eat. I was miserable. I was in pain. I was uncomfortable. So a lot of that time between
finding out that my neck was broken and waking up from surgery, I don’t really remember much.

Lauren Heaslip (11m 8s):
Especially once I got admitted to the ICU, they had all kinds of painkillers and everything to make me
comfortable through halo traction, because that’s a painful experience. So a lot of that time, so I really don’t
remember much of like who have exactly told me. I remember hearing the doctor in the hallways, they had
tumors. And I think that point and you know, where I was just laying there, I wasn’t fully processing a lot. And
I remember thinking that, you know, to me and in my 16 year old head tumor meets cancer.

Lauren Heaslip (11m 41s):
But part of me was thinking like, well, that can’t be right. Like I, I can’t have tumors. Like I don’t have cancer.
And that’s really, my aunt had come in and was just telling me like everything was going to be okay.
Everything’s going to be okay. And that’s really everything I remember from before surgery.

Dr. Orsini (12m 1s):
Then two weeks later in January, that’s when they told you that you had non Hodgkin’s lymphoma, Correct?

Lauren Heaslip (12m 8s):
Yes. Then that conversation, I remember like it was yesterday.

Dr. Orsini (12m 12s):
So that’s what this whole podcast is about. So tell me about that conversation and comment in the eyes of a
16 year old.We had a doctor Michel Neier on this podcast. she’s pediatric oncologist. And she, and I
specifically asked her about how you speak to teenagers about cancer. And she had so much insight, but I
want to hear it from you. So tell me everything you remember about that conversation and what helped you
and what you think might of gone better.

Lauren Heaslip (12m 41s):
So going into the whole thing, I had come back because they had a biopsied and what was on my liver. And
before that, I was kind of thinking, you know, I was back to the point of, I think I’m okay. Like they fixed my
neck, something’s wrong, but they had ruled out so many things. And the doctors have been calling by
house and my parents every single night to let them know here’s what we’ve tested, here’s what we’ve ruled
out. Here’s what we’re going to be looking at next. And they just weren’t finding the answers. So that’s when
they called me in for the biopsy and I had to stay after.

Lauren Heaslip (13m 15s):
And it was the day after the biopsy and it was late in the evening. My dinner had just arrived. I was really
excited. I got some fajitas, the food at CHOP. It was very good. And my doctor walked into the room and it
was just the general oncologist. So he didn’t continue to be my doctor throughout the rest of the year. And I
knew immediately that they knew something and that it wasn’t the best news because it was his day off. And
he had come back in.

Lauren Heaslip (13m 47s):
So I knew, and I remember thinking like he’s in normal people, clothes, like I knew what was his day off too?
I was like, can you just came in to tell us something? So that kind of sugared me right away. I know that you
guys know something and it can’t be great. And he told us that the biopsy had come back, that it was non
Hodgkin’s lymphoma and he let us sit there for a minute. And he said, I’m going to give you guys a few
minutes to process. And then I’m going to come back and sure enough, I, you know, my dad and I sat there
and I cried a little bit and then was like, you know, in my 16 year old head again, I don’t think I fully
processed it right there.

Lauren Heaslip (14m 31s):
In that time. I started eating my dinner again, because that was really hungry. And sure enough, probably not
even five minutes later that doctor came back with who becomes my primary oncologist, Dr. Susan,
Reingold. And she is an incredible person. I look up to her so much. So she comes in and she asks me, she
goes, Hey, Lauren I, she, she introduces herself and asks me what I was just told, which I think it was one of
the greatest things she ever could have done because if she didn’t make me say it out loud, right there, then
I may never have.

Lauren Heaslip (15m 12s):
That was what truly made it real. And I had to say that again. He said, I have cancer. And I started crying
again. And immediately she just put my nerves and my fear at ease. She said, no, no, no, this is a good
thing. We know what it is. We know how to treat it. We have your entire treatment plan laid out already. And
if plan A doesn’t work, we have plan B and if plan B, it doesn’t work. We have plan C, and just immediately
putting that in and putting it in the perspective of we have a plan and we know what are going to do put me
at ease is as well.

Lauren Heaslip (15m 51s):
And saying like, okay, yeah, this, you know, it may not be good news, but we can treat it. Now we have the
answer. And that was the big thing that’s happening. The answer,

Dr. Orsini (16m 3s):
It sounds like from what you were saying, he felt this immediate bond with her in a partnership. And you
know, in my book we talk about it. So there’s a couple of things that, from the story that makes me feel good
because, you know, I teach the stuff through. We teach breaking bad news. I teach communication and have
written a book about it, but it makes me feel really great when I have patients who kind of validate what I’m
teaching, because fortunately I’ve not had cancer, but I worked with parents who have lost, loved ones who,
who have lost babies, et cetera.

Dr. Orsini (16m 34s):

And what she did there are to you was she reviewed and she made sure that you knew what was going on
before she moved forward. And I don’t know how long was that conversation. It doesn’t sound like it was
very long, but you formed that instant bond with her.

Lauren Heaslip (16m 48s):
Yeah, absolutely. I don’t think, I don’t remember exactly how long it was, but it definitely wasn’t an hour long
conversation. It was probably only 10, 15 minutes, you know, to introduce herself. You know, she is the
leukemia lymphoma attending doctor at chop. I’m going to introduce herself to say that she’s going to be the
oncologist and kind of let her know that we have that plan. And then moving forward in days after that, we
had much, much longer meetings and all that.

Dr. Orsini (17m 16s):
And CHOP has an incredible place. And when I teach breaking bad news and communication, there’s three
goals that we want to meet when we first give bad news. And one is, we want the patient to feel that
compassion that we have for them. And that is genuine. It’s not fake. And correct she passed that first one?
Or two, we want too, for the physicians that nurses out there that we want the patient to feel that we are the
expert in the room that I got your back.

Dr. Orsini (17m 47s):
And I always say, the patients should feel that they could figuratively put their arms around your shoulder
and you will lead them to the next step. Clearly she did that. Correct? Absolutely. And then third is, she is not
going to leave you. So a great example of a difficult conversation that went well from an amazing physician.
And I think that it says a lot about your frame of mind. I know you and your family, obviously you guys are
related to me. I know you guys are a very positive. How does the first conversation go with your parents after
that?

Lauren Heaslip (18m 17s):
My dad, so my dad was one that was there. My mom just as unfortunately was one of the one nights that
she went home, but my dad was the one staying with me that night. And he has said, you know, looking
back on it that you had to play off my strengths and that I had to fully admit this now, was in a state of denial,
I think for a lot of the year. And just kind of like pushing through you do what you have to do and you’ll get
through it.

Lauren Heaslip (18m 50s):
But also that whole risk of mortality in all of that, I don’t think really hit me as a 16 year old. And that may be,
he understood more. So being older and looking at his child now hearing that diagnosis, I can only imagine
what it was like for him hearing that, but him seeing that I was okay with it and that I was okay, that they
played off that. And I don’t think my parents and I ever had like full on conversation, but we all just kind of
went into the like, okay, like we are going to do this.

Lauren Heaslip (19m 23s):
Here’s what Dr. Reingold says that we got to do. And here’s what we are going to do. And she is, this may
be jumping ahead a little bit. But one of the main reasons we really love her so much is because she started
everything with Your life does not stop and you’re life can not stop because of this. And you have to keep on
being a teenager. You need to keep on living life, keep on doing the things that you love to do, and that’s,
what’s going to get you through.

Lauren Heaslip (19m 54s):
And so that’s what we did. You know, I was lucky enough to be outpatient for all of it, but I got to keep on
going to school throughout everything. I got to keep on a somewhat playing sports. I was still on my sports
teams, but couldn’t really play, but was still in my sports teams by my family was able to go on the yearly
vacation that we always went on my prom, my driver’s test, my birthday, like all kinds of things. I thought that
fell while I was undergoing cancer treatment, she would make sure that I was feeling good for.

Lauren Heaslip (20m 30s):
I remember having to ask her my birthday and my driver’s test fell on a Friday and I got all of my treatment’s
on Fridays. So I remember asking her, it was like, well, doctor, I’m going to go. I’m supposed to take my
driver’s test, but I have chemo that day. Is there any way that we can do it a different day in? She was like
100%. Absolutely. You’re going to take your driver’s test. You’re going to pass, are going to get your license.
And she led me switch it to that following Monday.

Lauren Heaslip (21m 0s):
And it wasn’t, wouldn’t normally be her clinic day that she was there. She would be on the inpatient side are
some other side, but she would make sure I was able to get my treatment that day and come meet me, have
our doctors appointment that day, do all of that, which really, I think set the tone for everything and let us to
get through it as well as we were able to.

Dr. Orsini (21m 24s):
And much is written about the advantages, have a positive attitude when you’re faced with any adversity and
you and your family, you certainly have that. It sounds like Dr. Reingold helped you to do that. And you did
well, your cancer free, but it wasn’t easy. And I don’t want people out there to think that it was easy. You did
have all the side effects of chemotherapy and I’m sure you were sick more than you would let people know,
but you pushed through, you went to your prom. Tell me about that.

Lauren Heaslip (21m 53s):
I think the prom wasn’t as bad because I was already going to school bald, but going into school bald was
the big thing. One night, I, that was like the biggest thing I was dreading. You know, I knew it was going to
lose my hair. I really didn’t want too, but one night it just got way too annoying to deal with and it falling out.

So I woke my parents up and said, it needs to go, I need it gone. It needs to go. Two days later, it was
Superbowl Sunday.

Lauren Heaslip (22m 23s):
We call it the crew in my sisters came home from college. Some of my cousins came over and my uncle
shaved my head. And that following Monday, going into the school, that was the day that I was scared to do,
because I was like, well, everyone in school knows that I’m sick, but I didn’t really look that sick, but now I
have no hair. And I tried the wig on, we had a wig, I tried it on and I think it spent all of five seconds on my
head and I immediately took it off and said, that’s not me.

Lauren Heaslip (22m 55s):
I can’t do it. That’s not my hair. It just didn’t feel right. So going to school that Monday was tough, but it, my
two best friends walked into school and my mom or dad drove us to school that day. They walked in with me
and I actually had a whole crew of people waiting for me in school, celebrating with me and just so excited
for me and showing all of that support. So it was weird at prom to, you know, not have that problem hairstyle
and do all of that. But I felt like at that point, that almost felt more normal because I had been doing it
already.

Lauren Heaslip (23m 31s):
So

Dr. Orsini (23m 31s):
That’s fantastic. So you graduate high school and you decided to go to Duquesne, or when you went to
Duquesne university, you were not sure that you were going to be a nurse yet, or you’re still weren’t sure.

Lauren Heaslip (23m 42s):
I still wasn’t sure at that point, I knew, I always knew I wanted to go into healthcare and nursing. I always
admired nurses, especially after the ones that I had, but still going into a hospital. It made me nauseous, just
walking in the smell is a of it. I had been in a hospital way too much in the last year before that. And, and
then there was some fear of I couldn’t do nursing. It, it was to hard, you know, my last year and a half of high
school, we’re really not.

Lauren Heaslip (24m 16s):
I wasn’t fully there in my head. I was going through cancer treatment or I was sick before that. So I went in
as an occupational therapy major, still have so much respect for occupational therapists. I love that career.
But two years into college, it was after my sophomore year, I was studying in for one of my occupational
therapy classes. And it was like, you know, this isn’t really what I want to be doing. It’s the nursing side of it,
but I really want to be doing that is what I felt more drawn to.

Lauren Heaslip (24m 49s):
And I was terrified to tell my parents and to make that switch of switching by a major that’s a huge thing to
do, but it was truly nursing that I felt drawn to and that I have a passion for.

Dr. Orsini (25m 3s):
So and so typical of you, you don’t go to any nursing school, you go to Duke. And one of the highlights in my
last decade was visiting you at Duke and getting to go see a basketball game. There are people who know
me know that I’m a huge Duke fan. So thank you for picking that place. I probably would have never gotten
to get to see a basketball game. So you go to Duke and you do really, really well. And the conversation that
you had with yourself about, okay, what kind of nursing I want to do? Was it natural that I’m going to do
pediatric oncology, or was that a difficult decision for you?

Lauren Heaslip (25m 34s):
It was a really difficult decision. It did not come easily. I had endless conversations with friends of mine,
professors, mentors I had from clinical instructors and people from the hospital. It was something that was
always on my mind. I had a nurse from when I was inpatient in the hospital. I believe it was like right after my
diagnosis. Cause it was when I was going to preparing for my first chemo treatment, all of that.

Lauren Heaslip (26m 5s):
And she was my nurse for three days in a row. And on her last day, she tells me, she goes, Lauren, you are
going to be alright, you’re going to get through this. I was there one time to, and she had pulled up her scrub
pant leg and she had a prosthetic leg. She never had to tell me her whole story. She never really had to say
much else. And at that time I don’t think I like, you know, fully realized what that did for me. But looking back,
I was like, well, that is also who showed me and who I had in the back of my head to see that there a life
after this.

Lauren Heaslip (26m 45s):
Going like through that and going through the years, sometimes it feels like, how can you ever be normal
again? Or what is my life going to look like after I’m done with this? And I think I always had her in the back
of my head. I was like, well, no one is going to know afterwards, but when life is going to be normal, I’m
going to be fine. So I always thought it when I was making my decision, I was thinking I’ve heard two. And
I’m like, you know, she knew what it felt like from you to be there in the hospital. And she knew what it’s like
to get chemo, all that kind of stuff.

Lauren Heaslip (27m 17s):
So that definitely contributed to my decision and how that impact that I could hopefully one day have on my
patients and families. I had some other fears though, of just, you know, the same smells that I experienced
in accessing ports. And I know what that pain is like and giving chemo, you know, what would it be to close
to home? Because yo still face some nightmares and stuff of people coming in with the same symptoms that

you had and some symptoms that maybe, you know, I feel a twinge in my back and it scares me of do I have
it tumor again?

Lauren Heaslip (27m 53s):
And I know in my head that I am not going to relapse, I’ve passed my five year Mark. You know, my doctor’s
are not concerned about me relapsing, but I have those fears of is it going to be to close to home, to treating
kids that could be, you know, basically me laying in that bed. But after a lot of conversations with family
members and mentors from school and friends, I felt that I could handle it mentally and being in there and
that I could have a lot to offer to these kids and families.

Dr. Orsini (28m 29s):
Again, you take the hard road, you didn’t take the easy road. So you make the difficult decision. You want it
to stay at Duke, but there was no opening. And once again, you don’t take the easy route. You just pick up
and go to a city that you’ve never been to before or a city that you don’t know anyone. Right? And you are at
Cincinnati children’s hospital, one of the best children’s hospitals in the country, actually. So a big shout out
to them. So first year at CHOP, but amazing children’s hospitals as a patient. And now you go to Cincinnati
children’s hospital and your working with Pediatric Hematology kids and Oncology.

Dr. Orsini (29m 1s):
And so now you’re treating cancer. And some of the cancer that you’re treating his might be the same cancer
that you’ve had. As you said, you were worried about doing that and how you would feel with that. I work
with a lot of parents that have lost children and when we teach doctor’s on what to say and I work with it, a
lot of physicians who try not to get emotional and don’t know how to answer questions about what they
would do in this particular situation. And I often tell him, tell them that if you’ve gone through a similar
situation and nothing is the same, nothing’s exactly the same.

Dr. Orsini (29m 36s):
There’s no two cases that are same, but if you lost your mother from a particular type of disease, and now
you’re treating a patient that talking to a family that has the mother with the same diseases, you can say, you
know, I’ve been through that. I have little babies, we’ll have seizure disorders. And for those people don’t
know I had a seizure disorder when I was a child that was on. I don’t even know if you know that Lauren do
you know that they do from your book? Oh, from the book. Okay. So I was on a seizure medications until I
was 12 years old.

Dr. Orsini (30m 6s):
When I say to a mother, I had seizures too, when you look at me and they said, well, what he’s doing well,
he’s fine. And it makes them feel a little better. It doesn’t mean that every baby with seizures is going to do
well in, it certainly doesn’t mean that every cancer patient is going to go do well. But how do you use your
experience as a cancer patient to help your patients and how do you decide whether to reveal that or not

reveal it at all? Or is it a special relationship that you just feel it

Lauren Heaslip (30m 34s):
A little bit of that, just like that feeling that I know it’s a really hard decision whether to disclose to a family
that or not. And I really try not to, because it’s not about me, it’s about them. And I don’t want to ever
disclose that and make them think that I’m trying to make it about me because it’s not, it’s completely about
them. It’s also difficult because on the inpatient side, we see a lot of our kids, especially being at Cincinnati
children’s, and this would be a similar case with all top hospitals and programs.

Lauren Heaslip (31m 11s):
We see a lot of multiple relapses, second, third, fourth opinions, people who travel hundreds and thousands
of miles to come be treated with us, that a lot of times outcomes are not going to be favorable for the child.
But then we also do have our freebie, ALL kids that are going to get better and do have favorable outcomes.
But it’s difficult in that situation because you don’t want to give too much hope to, a family whose kid, you
know, as a practitioner that is not going to do well, or is likely to not going to do well.

Lauren Heaslip (31m 55s):
But a lot of times with you, the kids that do have a favorable outcomes, or just in times where families need
that hope and need to see that they’re is going to be another side of it, that they are going to be okay, they’re
going to do what they need to do. A lot of families, I have seen that, they kind of question chemo, and they
see chemo as, is it, and how can I get this poison two, my kid, but it’s their only option.

Lauren Heaslip (32m 28s):
And it’s OK. It is kind of a poison, but it kills what it needs to kill and it does the job. So that’s kind of another
side that I can kind of like tell them and say, look, you know, like, well, I’ve been through it. Like I’ve gotten it
and I’m okay. What is, and isn’t the best way to see chemo as a it’s a treatment. And its one of the only
options that they have. I try, like I said, not to disclose it all that much just because it’s not about me, but I
feel like that I can use my experience as a guiding point of how I was treated or how I would want to be
treated if I were in that position and just being there for a family and sitting there to listen with them or to hold
a hand, whether it’s the patient’s hand in the kids hands or the parent’s hand as a pediatric nurse, as much
as I’m a nurse to the little kiddos that are lyin in the bed, but it also to the parent.

Lauren Heaslip (33m 25s):
So a lot of the time and having those conversations with them and sitting there and listening to them and
they have so many more fears then the kid does because a lot of times the kid doesn’t really realize it fully
what’s going on.

Dr. Orsini (33m 38s):
Oh my God. That was an amazing answer. And so if you weren’t paying attention, cause you were doing

something else and you’re listening to this podcast rewind and listen to that answer again because it was so
great. And I think that the take home, we promised the audience are two things to be inspired. We’ve already
had that and to learn. And I think that the learning point from what you’ve just said was you have to read
your audience, right? You have to know what the situation is. And you may have a patient who has a very
favorable diagnosis of cancer that is very favorable and that is not handling it well is super depressed.

Dr. Orsini (34m 15s):
Everybody has different personalities. That would say you bring your personality wherever you go. So they
may be too depressed and you need to make them feel a little better. And that may be a point where you say
I had it too. And I did okay. Someone who doesn’t wanna take chemo, like you said, I took it, I got through it.
You know, kind of encouraged them to do that. Same thing with me when I have a, baby’s having seizures
with severe brain injury, I’m certainly not going to, that’s not an appropriate time for me to say, Hey, I had
seizures too, because it’s just not the same thing.

Dr. Orsini (34m 45s):
So part of the pro G R a M acronym that I use in the book, there’s a plan and you have a plan and then while
you’re in the room, you’re constantly seeing, you know, how’s the patient reacting to you. And so there’s
people that are just extreme worriers and they get so depressed even though you know, that it’s, they are
going to do well. And so that’s a gift that you can give them. And this situation that I wouldn’t be able to give
them, you know what it’s like to take chemo. Even if you don’t tell them that you had chemo, you know what
it’s like?

Dr. Orsini (35m 17s):
And so the difference between empathy and compassion is imagination and that’s who you go from,
empathy to compassion means to feel pain. And you can’t do that with your patient, unless you have an
imagination, but you don’t need to imagine what it’s like to have chemo. Right? You know what it’s like
chemo. So I think the world has a better place because Lauren Heaslip went into the pediatric hematology
oncology. And I do believe that. And I think the easy is not always the best way.

Dr. Orsini (35m 49s):
And I think the easy way for you would be to just like, I’ve never going to think about this again. I’m going to
do something else, but that’s not in your DNA. And I’m just so proud of you. Any advice that you want to give
any person out there who is having a difficult conversation with their doctor? Give me one last advice to a
teenager who is just told by their doctor or their mother that they have cancer. What would, what advice
would you give them? Not an easy question.

Lauren Heaslip (36m 15s):
No, it’s not my advice to a teenager who just got the news to keep on living your life. Keep on being a
teenager, keep on doing what you like to do. Tell your doctor what is important to you. What milestones do

you want to be there for what you don’t want to miss? Now, unfortunately, some things here are going to
have to be in the hospital for, and you’re going to have to miss some things. But having that conversation
with your doctor of, Hey, this is really important for me because when, as a patient, if you get to do what you
enjoy and you get that spark, of I got to go to my favorite movie this weekend?

Lauren Heaslip (36m 58s):
Or I got to go to my prom. We are going to do better in treatment because your happy. You are getting to live
your life too. You are not so down in sad. And I truly believe that like a positive outlook in a positive attitude is
what is going to get you through that and get you through it. You know, Well so keep on living in life. My
advice for doctors and healthcare practitioner, that any one that is ther giving bad news is just to try and put
yourself in that family’s position.

Lauren Heaslip (37m 34s):
Try to just remember what you’re telling. Remember that they are a human. A lot of times, I think in practice,
it’s easy to just have your list of tasks and want to check them off and just do what you need to do and then
get out and move on to the next one. But remember that your dealing with a human and look at that human
side of it and how you would want someone to tell you or your loved one. What you’re about to do the news,
whether it’s bad news that someone has cancer or even just something that may be an inconvenience to
them of, Oh, you have to get this medicine now or you have to be in the hospital for another day.

Lauren Heaslip (38m 16s):
It was just always remember that there are a human and trying to look to that side of it too.

Dr. Orsini (38m 22s):
There is no way that I can end any better. Then with that, that’s just an amazing and buy the way everyone,
if you didn’t do the calculations does young ladies only 24 years old. And you’ve just learned more from her
about living life and communicating and helping people when they need us the most. And so I couldn’t be
more proud of you. Lauren thank you so much for coming on this. I can’t wait to see you again. Next time we
have a family reunion, but I could not be more proud of you. So thank you again.

Lauren Heaslip (38m 50s):
Thank you for having me

Dr. Orsini (38m 53s):
If you liked this podcast, please go ahead and hit subscribe and download all of the past episodes. If you
want to learn more about the Orsini Way you can reach me @TheOrsiniWay.com. Just hit the contact list.
We have a new podcast episode dropping every Tuesday and I hope to see you again next week. So thank
you everybody. And thank you again. Lauren

Announcer (39m 11s):
If you enjoyed this podcast. Please hit the subscribe button and leave a comment and review. To contact Dr
Orsini and his team, or to suggest guests for a future podcast visit us at TheOrsiniWay.com.

Read the transcript of Dr. Orsini’s podcast with Forbes writer Kathy Caprino

Kathy Caprino (3s):
What they found is if you make a value statement, it works better. So for instance, you might say in that
situation, I really value honesty and transparency. So I have to share, I don’t agree with the direction the
team is going. And just saying that value statement allows it to be heard.
Announcer (25s):
Welcome to difficult conversations lessons I learned as an ICU physician with dr. Anthony Orsini. Dr. Orsini
is a practicing physician and president and CEO of the Orsini way as a frequent keynote speaker and author.
Dr. Orsini has been training healthcare professionals and business leaders, how to navigate through the
most difficult dialogues each week. You will hear inspiring interviews with experts in their field who tell their
story and provide practical advice on how to effectively communicate whether you are a doctor faced with
giving a patient bad news, a business leader who wants to get the most out of his or her team members or
someone who just wants to learn to communicate better.
Dr.Anthony Orsini (1m 7s):
This is the podcast for you. Well, hi everyone. This is Dr. Anthony Orsini, and welcome to another episode of
difficult conversations lessons I learned as an ICU physician. You know, when I started this podcast, I made
a promise to myself and a promise to you that each and every episode will not only be informative, but
inspiring as well. And I’ve been very fortunate to have some great guests to my admire and I respect. And
today is no exception. We are very lucky tonight to have Kathy Caprino with us.
Dr.Anthony Orsini (1m 37s):
Kathy is an internationally recognized career and leadership coach, a writer, a speaker, and educator
dedicated to the advancement of women in business. A former corporate vice president, Kathy is now a
trained marriage and family therapist and a seasoned executive coach. She’s a senior Forbes contributor
and the author of two amazing books. Her most recent book titled the most powerful use seven bravery
boosting paths to career bliss was just released on July 28th and is now available on Amazon and other
outlets.
Dr.Anthony Orsini (2m 8s):
Kathy’s core mission is to support a finding brave global movement that inspires and empowers women to
close their power gaps, create more impact and make the difference they long to in the world. Kathy is the
founder and president of Kathy Caprino LLC, a premier career coach and executive consulting firm offering
career and leadership development programs and resources for professional women or finding brave
podcasts is in the top 100 on Apple, Kathy as a former TEDx speaker. And by the way, I checked it out.
Dr.Anthony Orsini (2m 38s):
It was great. She’s a frequent keynote speaker and top national media source on women’s issues, careers
and leadership. Well, that’s quite a resume. I think I’m going to have to take a break a second to catch my
breath. Wow. A lot of words. Well welcome. But I must say it’s quite an honor to have you on this very
recently launched podcast, a big fan of yours. And I think the last I checked your head 130 episodes, maybe
even more
Kathy Caprino (3m 5s):
I have, and I can’t thank you enough for having me. I’m so honored and grateful. Tony, thank you.
Dr.Anthony Orsini (3m 12s):
Well, that’s really impressive. And I know it’s a lot of work now from personal experience, so it’s more
working people understand, I think, but it’s certainly, I recommend your podcast, everyone. It’s really great.
So I have so many questions for you, and I want to talk about your latest book, but in full disclosure, we’re
recording this in early July. So the book is actually not out yet, but I’ve already, pre-ordered mine on Amazon
and I can’t wait for it to come, but you and I first got to know each other, I guess it was about six months ago
when you were doing a Forbes piece on the keys to navigating tough conversations with employees.
Dr.Anthony Orsini (3m 48s):
And I remember calling you afterwards just to follow up and you were so easy to speak to. We had a great
time. We shared stories with each other. I think I looked up at the clock. It was 45 minutes later and we built
instant rapport. It was, it was just great. So when I decided to do this podcast, I said, you know what? I
wonder if Kathy will do it. So you were the, one of the first people that I thought about it.
Kathy Caprino (4m 14s):
That’s so kind. Thank you we did have a great chat. I think it could have gone on for hours.
Dr.Anthony Orsini (4m 19s):
Yeah, it was so easy. It really was.
Kathy Caprino (4m 23s):
But I think we’d see things similarly in terms of how we talk to people, how we connect, right.
Dr.Anthony Orsini (4m 29s):
And it’s all about communication. And that’s why I started this podcast because I’m just fascinated by the
way people communicate. It’s just amazing or people can’t communicate. I’m also fascinated about that also.
So before we talk about your book and get into all the questions, cause I have so many questions for you,
you know, I know your story because we shared it that day on the phone and many people do. But for those
people that don’t, could you just spend a few minutes to tell us about your personal journey and how you got
to be where you are right now?
Kathy Caprino (4m 59s):
Hmm. Thank you. I’d love to quick story. Long story short, I had an 18 year corporate career marketing
publishing membership services. And on the outside it was successful on the inside. It was not. And I had
bumps all along the way, rough profit experiences. But when I hit 40, they, they became crises truly. So I
faced sexual harassment, gender discrimination, toxic colleagues and narcissistic bosses. And who knew
what narcissism was.
Kathy Caprino (5m 30s):
I didn’t until I became a therapist. And I’m like, Oh, that’s what happened. Narcissism zero work, life balance.
I was chronically ill for every three months or four months. I get an infection of the trachea as a physician. I
know, you know what that is, but no one could help me. They’re like here take antibiotics. It was such a
mess, Tony and not in the fabric of my young kids’ lives, but honestly, more painful than all of was waking up
and thinking, is this the work I’m going to be doing this?
Kathy Caprino (6m 3s):
This, it was meaningless to me except for the paycheck, which was big. So I knew I had to make a change.
And I tried, I saw therapist. I saw career counsel. I couldn’t do it because at 41, with two kids in a big house,
what are you going to do? Number one, most people don’t even know what they would do if they could, if
they won the lottery, I couldn’t figure it out. So what happens when we don’t move forward on our own, the
universe stepped in one month after moving to this bigger home in a more affluent area was nine 11.
Kathy Caprino (6m 33s):
And one month later I was laid off and this is one thing we were talking about. It was so brutal to me, how it
was done and it wasn’t even, you know, it wasn’t abusive. It’s just, when you think you’re a valuable person
in an organization and you are kicked to the curb and when the conversation leaves you feeling less than in
confused, it’s devastating. So I will make this brief, but it was a breakthrough moment for me. I said, I’ve had
enough. I’ve had enough of not feeling in control, not feeling valued, not feeling I could be myself.
Kathy Caprino (7m 9s):
And I became a marriage and family therapist, which was life changing in and of itself. This is how I’ve
learned so much about empathy and communication and how you really match with someone and help
them. And you can’t help someone if you’re judging them and looking down on them. Right. But then I have
to say, I found coaching career coaching and especially for women. And I’ve been doing that for 15 years
and it is the most rewarding thing in the world. But this book is a combination of what I’ve seen. That is an
epidemic of powerlessness, Tony, it for women.
Kathy Caprino (7m 43s):
So there are seven damaging power gaps that I’m seeing every day. And I did a survey just to check that it
wasn’t just my self selecting pool in 98% of the women surveyed are having at least one of these gaps and
over 75% have three or more. And when you have these gaps, you can’t thrive at the highest level. So that’s
my story in three minutes.
Dr.Anthony Orsini (8m 7s):
Well, it’s amazing story. And I know you can go on and on forever and I can talk, I can talk to you forever. So
it’s, it’s great. So you talked about the life changing moment. How that conversation, you speak about toxic
bosses in your first book, and you talk about the way that you were let go. How did that conversation go?
And now that you’re a coach, how do you think the conversation could have gone better? Because part of
this podcast, even though I’m a physician, I’ve trained some HR professionals and we have dr.
Dr.Anthony Orsini (8m 38s):
Larry Barton coming on in a few weeks, who is a crisis management expert. And we talk about how to let
people go with compassion. How do you think that conversation could have gone better? If it could.
Kathy Caprino (8m 50s):
I would like to talk about that, but can I talk about the context to anyone who’s listening as a manager and
leader has to understand this, and if you haven’t been through it, you can’t really understand it. But after nine
11 happened, we heard that a lot of people would be laid off. So, and they tried to do it quickly, but I think it
was a good three weeks that closed doors, everyone thinking, was it, is it me? Is it me? Is it me? Is it me?
And when you are in that scenario, it’s so scary. Especially if you have big financial responsibilities, right? So
first of all, you’re scared to death and you’re thinking, could it be me?
Kathy Caprino (9m 23s):
It can’t be me. And so I just want to say this one thing, why this was also hard. I make friends with
everybody. That’s just my Greek Italian nature. As you can see everybody and the office manager who got
all of our equipment and I was a vice president, then he was a good friend of mine. And the day we were
going to hear who it was, who got laid off, he couldn’t look at me. I could just cry. So the very first
devastating thing is don’t make people wait like this. Don’t do something different where we’re not all
wondering, am I going to be dumped?
Kathy Caprino (9m 56s):
When he ignored me? I was sick to my stomach. So I knew they were going to tell everybody the next day.
And what I heard was you were going to get walked out. You were going to have 30 minutes to get
everything, get stripped of your card, key in your computer and Lee and be walked out like a criminal. Okay.
People do not do it like that. Okay. So how did I learn this? Another vice president who was a great friend of
mine. He said, he knew he wasn’t one of them.
Kathy Caprino (10m 28s):
This was the night before. And I said, can you go find out if I am? And he came back and he was this burly, I
love him, loved him, burly Megan’s man. He actually sat down talk about difficult conversations. And he had
a tear in his eye, this man who I never saw a vulnerable moment for two years. And he said, it is you. And
you know, you’re full of these emotions. You want to throw up you a, how can it be there’s rage? And so I
said, would you go back and ask the boss? Would he do it now so that I can leave with some dignity and
have some time?
Kathy Caprino (11m 2s):
And the boss said yes. So I went in to talk to him and this is why it’s so painful. And anyone who’s had, I’m
not saying this guy was a narcissist, but anyone who has had emotional manipulation in their life is going to
know what I mean. I said, why, why me? Because I had had great promotions, a huge promotion, big raise.
Why would you be laying me off? And he said, I did some speaking around.
Kathy Caprino (11m 33s):
And I talked to two people who work with you. And they said, you’re difficult to work with. And what’s really
difficult is, you know, when you’re being gaslighted, you know, that’s a term in narcissism of all the people I
work with, you chose the two people that I don’t like and who don’t like me. So BS, you are just covering your
yep. And when you’re being gaslighted in that way, it’s so I just shake even thinking about it. Don’t be asking
me. So, number one, in a difficult conversation, don’t lie to cover your tush.
Kathy Caprino (12m 9s):
That’s how we had felt now, am I right? I don’t know. I, you know, we have been in touch and I didn’t want to
go there. It’s painful. But the second thing he said that I will never forget. And I learned never to do. He said,
you know, I think the world of you, and this is harder for me than it is for you. No it isn’t. And when Tony, we
were talking about this, don’t ever say something like that to someone who you are giving terrible news to,
and you know why that’s so bad. I was just thinking about this earlier.
Kathy Caprino (12m 39s):
I learned this as a therapist, frankly. I think we should all have therapeutic training. Everything you share with
someone should not be for your benefit. It should be for their benefit. If, I mean, not in a friendship, of
course, you’re going to be honest and open, but when you’re delivering that kind of bad news, it should not
be about him and his feeling. How dare you and how not empathetic. I just bought a huge house because
this company told me to do it. The president told me to buy the biggest house I could buy.
Kathy Caprino (13m 9s):
So you’ve just stripped away a lot of my future. And you’re saying you feel worse about it than I do. It’s so
angering Tony. So I know you have both books about this. You have years of training by the, what do you
think about what I’m saying here?
Dr.Anthony Orsini (13m 27s):
You’re right on. And I’ve been training doctors and nurses, how to have difficult conversations. I started out
by training doctors, how to give bad news. And there are certain words or phrases. And I was thinking about
this when you were speaking that are just no nos. And you don’t say them. Sometimes people say words
that are phrases, that they don’t mean what they’re really saying. And maybe they’re just nervous and maybe
would take that back now. I don’t know, but there’s certain phrases.
Dr.Anthony Orsini (13m 58s):
When you tell someone they have cancer and they start to cry and the doctor says, I understand the patient
turns around and says, why you have cancer too? How could you possibly understand in my field as a
position, as a neonatologist, a mother loses her baby, her baby dies. And you hear doctors and nurses. And
they don’t mean anything by Kathy, but they’re saying I understand. And I go, no don’t ever say that you can
switch the words around and say, cause I know this is what you mean.
Dr.Anthony Orsini (14m 28s):
Just say, I can’t imagine what you’re going through right now. It’s comforting. And, and you know, physicians,
when I teach physicians and even business leaders, they hear these phrases and they go, Oh, I like that. I’m
going to use that one. You know? But there’s certain things that you say, my mother-in-law just a quick story.
My mother-in-law who recently passed away when she was this little old Italian woman who was very quiet,
believe it or not Italian women, it’s quiet. Right? So you’re Italian. Oftentimes I can tell you, but she was very
quiet and she never really spoke a bad word about anyone.
Dr.Anthony Orsini (15m 2s):
But when she had her third child, it was the third day. And those days you stayed in the hospital for like a
week when you had a baby. And on the third day, the nurse didn’t bring the baby to her. And she said,
where’s my baby. And the nurses said, well, the doctor will call you about half hour later. The doctor calls. He
doesn’t come in on the phone because on the phone. And he says, and she tells a story. And he says, you
know, your baby died last night. And he says, I’m sorry.
Dr.Anthony Orsini (15m 32s):
And he says, you know, these things happen, which was the first thing. And the next thing was, you’re
young. You could have other children. So when my mother in law told that story, this kind little gentle woman
still refers to him 60 years later as the a-hole who told her that, you know, and if you heard her curse, it’s
actually funny when you hear this woman Paris, because there’s certain things and words that you can just
change and you can learn. And for you, it was, you know, this hurts me more than you.
Dr.Anthony Orsini (16m 5s):
That’ll never leave your mind. Right? So
Kathy Caprino (16m 8s):
What a story I want to riff on that for a second. Could I, because you’ve said something really important
when people share, if they’re kind decent people, I don’t mean narcissists and fools, but if they’re kind
they’re, what’s coming out of their mouth is their way of making you the, they think they’re making you feel
better. I want to tell you, I was talking to my son, my 22 year old son about this one yesterday. Here it is. And
I really want people to understand this. My 96 year old mom has just recovered from COVID.
Kathy Caprino (16m 40s):
Wow, God bless God bless what a warrior spirit. But you know, there’s other issues about, you know, that
come about in terms of an older person that doesn’t move for four months in her room. You know, there’s
other issues. But this is what people have said to me twice. In two times in my life, my dad was 93. When he
died of cancer, that spread everywhere and dementia. It was hellacious to watch this man, thank you.
Kathy Caprino (17m 9s):
Fade, who is so brilliant and wonderful. And here’s what people said, Tony, I can’t tell you many people said,
well, you know, he lived a great long life. I can’t tell you how angering that is. And I was telling my son about
my mom, that people have said, I said, mom has COVID. And they’re like, well, how old is she? Yeah. Wow.
And I say 96. And they’re like, well, you know, she’s lived a good long life. I want to tell people don’t ever say
that because the reality is yes, 93 and 96.
Kathy Caprino (17m 43s):
It’s a long life. But that, isn’t what I’m talking about right now. I’m talking about having lost dad or I’m talking
about the idea that I could lose my mother without seeing her. I don’t care how old she is. And my son and I
were talking that well, mom, so many people have lost their parents at much younger ages. If you’ve lost
your father at 60, when he was 60 or your mother 80 to them, 93, 96 is amazing. But see again, Tony, it’s
about them. Yes. So he said, gosh, mom, I think I probably would have said that.
Kathy Caprino (18m 16s):
Trying to make someone feel better. And I said, well, here’s what I want to teach. You need to communicate
in a way that you validate what the person is feeling, not what you’re feeling. And we don’t need statistics.
Like the doctor going, look, this stuff happens and you’re young. We don’t need data. Would you agree with
that? Is that
Dr.Anthony Orsini (18m 37s):
I think we say things sometimes out of being nervous because no one likes to have these difficult
conversations. No one really knows what to say. When you tell them that your 96 year old mother has
COVID. And, but what I teach communication is think about here’s what I want to say to you. It’s not about
you. And sometimes we say things because we feel like we have to say something, you know, in the words
of Rabbi Kushner, who was the man who wrote when bad things happen to good people, when you don’t
know what to say, say you’re sorry, and then shut up.
Dr.Anthony Orsini (19m 8s):
And I think that’s great advice. And I quote him all the time. There’s so many phrases that really hurt. So I
think that’s fantastic. And that’s great. One other thing,
Kathy Caprino (19m 20s):
I have a friend who had cancer and she told me that she’s never felt so alone because she would walk in the
grocery store and her friends when they’d see her, they would go the other way. And it’s because they didn’t
know what to say. And she knew that, but it made her feel so alone. So here’s something I say, just like
Rabbi K ushner saying, you know, say, I’m sorry. And shut up. Sometimes that doesn’t feel like enough. Like
if we say, Oh, I’m so sorry, Tony, what I always say when I don’t know what to say is how are you holding up?
Kathy Caprino (19m 51s):
Perfect. So you tell me how you’re doing. And then, you know, most often they share because a lot of people
don’t ask them how they’re really doing. So that can be another one you can have in your toolbox. Yeah.
Dr.Anthony Orsini (20m 5s):
That’s referred to when people ignore you, someone referred to that as the bushes effect, he said he had
just found out his son had cancer. And every time he came home, his neighbors would jump in the bushes
because they didn’t know what to say. And they were trying to hide from him. So it’s common. So very
interesting stuff. But I want to move on to a couple other things, because I know you’re busy. You talk about
in your first book, breakdown and breakthrough giving you say that hating, what you do is giving yourself up.
It’s giving the power to someone else.
Dr.Anthony Orsini (20m 37s):
During my communication workshops, I talk about physician burnout, professional burnout, and there is a
clear epidemic of physician burnout right now. It’s about 60 positions are the highest rate of suicide of any
profession right now. And that’s correct. Yeah. It’s been like that for a couple of years now. And I kind of say
it differently than you say it. Like what happens in medicine right now is that physicians used to have control
of how they practice medicine, their hours.
Dr.Anthony Orsini (21m 7s):
They were entrepreneurs. If you would, they had their own practices. Medicine right now is very task
oriented. You’re pushed to be efficient. And what happens is, and I always quote, when people act contrary
to their beliefs and core values, burnout increases, and you were telling your story about how you just hate it,
what you were doing. And I think there’s a real good parallel. There’s a lot of parallels between what I do and
what you do. There’s a real good parallel because what happens to physicians is they realize I went into this
to heal.
Dr.Anthony Orsini (21m 39s):
I went into this to form relationships and I want to comfort. And what am I doing? I’m being forced to see 25
patients in two hours. And so what happens is we go home as physicians and we don’t understand what’s
going on, but we’ve done a good job, but we feel empty. We go home because gee, I did really good. Maybe
I saved a couple lives. Maybe I really helped people, but in the end, why do I feel so empty? And it’s that
emptiness is because I wanted to bond with my patient a little more. And so we were actually teaching
doctors and nurses to spend that extra minute.
Dr.Anthony Orsini (22m 14s):
And it, and it is literally an extra minute to feel more fulfilled about their job. And so I want to know what your
comment is about that. Oh wow.
Kathy Caprino (22m 24s):
Wow. I feel so much for the, the health care community right now.
Dr.Anthony Orsini (22m 28s):
It’s really everyone who has not fulfilled. It’s it’s what happened to you, right?
Kathy Caprino (22m 34s):
That’s interesting. I haven’t ever heard this before. I think why so many I’m right there with you that when
your values aren’t aligning with how you’re being made to work, what I see with career professionals is they
feel either like an imposter that I don’t really know enough or what you’re asking me to do. I don’t know how
to do well enough. Number two, I thought I liked this work, but this company is so toxic and the outcomes
that I’m being made to deliver, I don’t care about.
Kathy Caprino (23m 7s):
So there’s a misalignment or a disconnection. It’s not exactly what you’re talking about, that I can’t make
relationships, but from a lot of people, like for me in a number of years, I can’t be who I am, who I really am.
Like, I’m a loving, caring person and I’m gentle and I’m compassionate. And I remember in one of these jobs
that wasn’t appreciated that wasn’t what we wanted in that role. That’s not what they wanted. And I talk
about six dominant action styles that I’ve seen people take or follow in terms of pursuing goals and achieving
those goals.
Kathy Caprino (23m 41s):
Striver seeker, pacer, researcher, challenger, advocator. So for instance, if you’re an advocate of, you’re like
a striver, you get things done. You’ll climb any mountain, but you have to be doing work. That’s advocating
for something bigger than yourself. If you can’t do that, if you’re one of these styles and that style isn’t
allowed, I’m a seeker. You know, I just want to learn and I don’t want to just all get it done. And it’s all about
the goals. If you can’t pursue those styles in your work, you’re going to be miserable, but you’re not going to
know why.
Kathy Caprino (24m 14s):
So it’s interesting. I think in the physician world, it sounds like people understand, clearly I’m being treated
like a robot that I got to come in and do it and leave. I think for corporate professionals is a myriad of things
that are going wrong, that don’t fit with their soul.
Dr.Anthony Orsini (24m 29s):
Yes, I agree. Yep. Yeah. That makes a lot of sense. You talk about in your book also, and I want to get to
your new book, but standing up for yourself and how especially women don’t do that or not good at it. And
you give a variety of reasons. How do you coach that, Kathy? How do you coach to stand up for yourself?
And I’m a big person on body language. So, you know, 70% of language is nonverbal. And when I train
people on communication, I tell them, you can use all the right words, right? You can tell them exactly what
to say, but if they’re saying it in their nonverbal language is meek or scared, it doesn’t matter because 70% of
it is nonverbal.
Dr.Anthony Orsini (25m 6s):
And that’s the message you’re going to give, regardless of whether I give you a script or not. How do you
coach that to your, to your students?
Kathy Caprino (25m 13s):
So two things of the seven gaps that the most powerful you book talks about. One is commute. Number two
is communicating from fear, not strength, which women 70% have said they suffer with. And number five is
acquiescing, instead of saying stop to mistreatment. So I want to talk about women for a minute. There’s a
lot of research. I’m not making this up a lot of data about how, when girls hit about 12 or 13, they go
underground. Their voice goes underground. They were on par with boys before that, in terms of thinking
they were leaders interested in STEM topics, you know, all of it, but at 13 it changes.
Kathy Caprino (25m 52s):
So what I ask women to look at and you know, I teach a course and I see them 30 people on my zoom call
once a week, you can see everything, right. You can hear it. You can see them looking down. You can see
how afraid they are, but the communicating from fear not strength. The first thing I ask women to look at is
where are you weakening your message. And I don’t, I don’t necessarily train about eye contact. I get to the
core of where you communicating generally from fear. So where are you over apologizing?
Kathy Caprino (26m 23s):
Tons of research that women say, you know, I’m sorry, exponentially more than men. And it’s true. Really?
I’m sorry about everything. They weakened their message. For instance, when they’re about to say
something in a meeting, you know, I’m not sure this is right, but you know, if you are saying that you’re
broadcasting, don’t listen to me, right? Or you allow people often men to cut you off. So for instance, I’ll train,
listen, if you’re continually cut off, here’s what you say. Oh, thanks Fred. That’s an interesting point.
Kathy Caprino (26m 53s):
I would like to finish. I wasn’t done with my point very calmly, but there’s also this amazing thing I learned
when I interviewed these guys, the behavioral science guys, Joseph granny, and David Maxfield. When they
showed a video of a woman saying a forceful thing and another video to another audience of a man saying
the same forceful thing, I’d own agree with the direction the team is going. Her perceived competence
dropped exponentially and her perceived dollar value dropped exponentially compared to the guy saying this
exact same thing.
Kathy Caprino (27m 26s):
So what they studied and here’s the end of the story here is, are there statements you can make before?
You’re about to make a forceful statement that isn’t going to go over well, that is going to mitigate the
backlash. So I teach this a lot. What they found is if you make a value statement, it works better. So for
instance, you might say in that situation, I really value honesty and transparency. So I have to share, I don’t
agree with the direction the team is going. And just saying that value statement allows it to be heard better
rather than people feeling slapped down because everybody wants their ideas to be accepted where all
week, well, I don’t know if that’s a hundred percent true.
Kathy Caprino (28m 9s):
We’re all vulnerable. We all want validation. So when you say, I don’t agree, you’re going to get a rise out of
people. So there are ways you can say things that will mitigate the backlash, but we must say the difficult
things. We must.
Dr.Anthony Orsini (28m 24s):
I’m a big person on tone and body language. I don’t know if you’re familiar with Amy Cuddy. She’s a
Kathy Caprino (28m 31s):
Amy cutting the power stance. Right?
Dr.Anthony Orsini (28m 34s):
Awesome. Right. Yes. She’s done studies to prove that if you just stand in front of a mirror before you have
that conversation, you’re actually will be more confident that she measured cortisol levels and testosterone
levels. And that she’s brilliant. I love and I love, but it’s really the nonverbal and the tone of your voice.
There’s a great study out of a sociologist. I think her name is Nina <inaudible>. She did a study trying to
predict which doctors would have malpractice lawsuits. And so she took 36 surgeons.
Dr.Anthony Orsini (29m 4s):
About half of the surgeons had been sued multiple times. The other half had never been sued for
malpractice. And she put little cameras in the patient’s rooms and she videotaped and audiotaped the
surgeon going in for a routine visit just by dr. Sini. Then she took those, those interactions. She put it in a
machine that analyze just tone, not the words, just the tone and the machine predicted which doctors were
sued multiple times in which doctors weren’t just by their tone, the tone, harsh cars, condescending, harsh.
Dr.Anthony Orsini (29m 38s):
She had a whole bunch of things. And then she did something really cool. She just the videotape to people
with no audio. And they were able to pick the ones that were sued. So these people were blowing it, both
roles. So I teach that the positions, because when you’re having a serious conversation and you’re having a
difficult conversation with someone, you don’t want a doctor who looks me, you don’t want a doctor who
looks confused. You don’t want a doctor that says maybe, you know, I always tell physicians, the word think
should never come into your language. Take that out.
Dr.Anthony Orsini (30m 8s):
You shouldn’t say, I think you have cancer because the response is going to be,
Kathy Caprino (30m 14s):
How about no?
Dr.Anthony Orsini (30m 15s):
Why don’t you know, why don’t you find someone who knows that’s going to be the answer, right? But you
can change that one word. And you can say, I’m very concerned. I looked at the, or Jessica’s right. And I’m
very concerned that you have cancer. It means the same thing. It means I’m not a hundred percent sure.
Kathy Caprino (30m 29s):
Ask a question, Tony, I got to ask where I was going with. What you were saying was that I bet you, these
people are narcissists because narcissists has zero ability to sit in other people’s shoes. So they’re saying it
in ways that are so off putting, but I don’t think that’s what you mean. Do you, you’re talking about doubt
insecurity is that it is that what was coming out that made these people,
Dr.Anthony Orsini (30m 57s):
Oh, you’re going back to the lawsuit. What made people get sued as people generally don’t Sue for
malpractice because of bad outcomes. They Sue for malpractice because they’re angry because they feel
that they didn’t have that relationship.
Kathy Caprino (31m 9s):
These people are narcissists. We need to go back on that study and overlay narcissistic tendencies.
Dr.Anthony Orsini (31m 16s):
It could be. In fact, the study is in the famous book, blink. He refers to that study and how insurance
companies, instead of setting malpractice rates, by your record of how many times you’ve been sued,
insurance companies are moving towards just analyzing doctor patient relationships to set the malpractice
rate. Because if you have that tone, if you have that empathy in your voice, you’re less likely to get sued. So
it’s fascinating. Do we have time, Tony? Can I talk about this to you? We have as much time as you want
Kathy Caprino (31m 45s):
Three hours. So sometimes, and it happens less and less with me now, but every once in a while, I will have
a coaching client who does something that’s inappropriate for me. So for instance, someone said that I came
late to a meeting too, and I was late eight minutes and I had said, I would give her eight minutes. And she
said she was so rattled that she wanted a complete redo. I’m not going to go into that for a minute, but I am
going to go into the answer was no, that is not going to happen.
Kathy Caprino (32m 21s):
And there was, and I’ll give you another example. There was one guy we were talking about, you know, how
to change careers. And he wasn’t taking the advice, the coaching, he wasn’t taking the steps. And all of a
sudden in a Mo in one morning, I get a lambasting email. You’re not helping me at all. He lost it. And I do
think know, he told me he suffers from bipolar. I think this was a bipolar moment. So I want to say that in all
of these times that, and I’ve grown in this. When someone attacks me or asks for something that I feel you’re
not going to get it.
Kathy Caprino (32m 54s):
And I think the guy might’ve even said, I want a refund. There are no refunds for working with me. And I
make that very clear. Why? Because you can see 500 videos of me in podcasts and you can check out my
approach, right? It’s the approach works. But I wrote to him, I got upset, but I wrote to him and said, I hear in
your voice, how angry you are. I hear it. I don’t think I said, I understand. I hear it. And this is what I would
like to share. And then I was very clear and very calm that this is not how I see what has gone down in our
coaching.
Kathy Caprino (33m 31s):
And here’s what I see has happened. And number three, if I ever get an email from you like this, again, we
will be done in there. As you know, there are no refunds, but I’m here. If you would like to have a
conversation, I would love to talk on the phone. This was before zoom at Benanna was calm. I was not
judgmental and cruel, but I laid it on the line here. I will not get another one of these emails. And he, two
hours later wrote, I am so embarrassed. I was having a very bad morning and I was so overwhelmed.
Kathy Caprino (34m 4s):
And I, I see now. And I think I said, I would like you to read this again, your email from a really calm place.
And tell me what you would do. If I sent this to you and he said, I’m mortified. So why am I saying I’m the
best communicator in the world? No. However, I’ve had to hone it a lot in working with people that want
things that aren’t appropriate to give them. But I think the keys are stay compassionate, stay understanding,
but be very clear what you will and will not accept.
Kathy Caprino (34m 42s):
And you don’t have to. Somebody once said, and I say it all the time. You can say anything. When you say it
with love in your heart, I would say a lot of people go love. I don’t have love at work. Come on now. I think
you can say anything when you say it with compassion in your work.
Dr.Anthony Orsini (34m 56s):
And there’s a difference between we use the word, empathy and compassion interchangeably, but there’s a
difference. It’s a difference. Empathy is understanding someone’s pain, right? But compassion in Latin
compassion means with pain. It means feeling someone’s pain. And before you’re going in to have that
difficult conversation, it would really help. If you just take a minute to pretend or feel like you’re the other
person, like, what’s it coming? Like, what’s it from their point of view and with emails and reference to what
you just said, people don’t do that. Cause they just rattle off an email. They hit send.
Dr.Anthony Orsini (35m 26s):
And they, in the old days, when I was younger, you wrote a letter nasty letter. And by the time you mailed it,
the next morning you ripped it up. But people don’t do that. What emails they hit send, and then they regret
it. So put in the other person’s shoes, I think is great advice for someone who’s having those difficult
conversations.
Kathy Caprino (35m 43s):
And isn’t there also another, there’s a lot of research on didn’t. They do it in the, whatever, what, in the fifties
of this, they recruited a team of people to turn a dial and sensibly. The person that you couldn’t see was
feeling a shock and you know, an electric shock. And you know, the instructors had turned it up and you’d
hear it was an actor, but they didn’t know that you’d hear the person’s screaming and the instructor, no, turn
it to 10. And they’re screaming. What they found is when you’re not seeing the person, you are going to
follow instructions even to the detriment or even to the death of another person.
Kathy Caprino (36m 21s):
So, and other pieces, get on a zoom call with them, Dar fire off an email, look them in the eye.
Dr.Anthony Orsini (36m 29s):
There’s the body language again, the nonverbal cues. It’s so important. The energy of the person. Exactly,
exactly. So, well, before we finished, I want you to tell me, by the time this airs, I’m already going to have
read it, but I haven’t read it yet. So tell me what I should expect when I read this book. And how’s it different
from your first book?
Kathy Caprino (36m 48s):
Thank you for asking. So the most powerful you is about, and it comes from the 10 years of research on
what a, here’s, how it happened. I was looking at why is it? So I’ve worked with thousands of women right
around the world. I sat back and said, I don’t get it. How is it possible that all of these women at every first of
all country level socioeconomic level education level fueled, how are they coming with the same problems
over and over and over again?
Kathy Caprino (37m 20s):
And here’s the question I wanted to answer. Number one, what is missing in their lives and work that they’re
coming to me for help with. And number two, what is coaching with me, giving them? And the answer was
bravery and power. That’s what is missing. And when I ask women, tell me about power. A lot of women who
said, I don’t want power. And I say, why not? And they say, because it’s abused. So that is the biggest lesson
that I wanted to share that you can’t have what you want in this life without internal and external power, but
I’m not talking about power over.
Kathy Caprino (37m 56s):
I’m talking about power to power to create power, to impact, power, to change. So, and bravery in my view is
the ability to recognize what isn’t working and take accountability for what you can change. Power is the
ability to change it. So this book is the seven damaging power gaps. And what I love about it, you know, all
of us who are in thought leadership are doing podcasts. It’s fun to hear yourself talk for a while, but it’s much
more fun to hear other people’s messages and strategies and, and research.
Kathy Caprino (38m 29s):
I find. So the book talks about not only my coaching strategies, but it’s every chapter is a real life client or
course member who, how she suffered having the gap and how she overcame it and what she did. And it
talks to 30 plus of the nation’s top experts in things like Susan Cain, introversion, Terry, real, what it is to live
in a patriarchal society and what that does to both men and women and Judy Robinett about how we need to
network in the right room and network up and Ivan Meisner about networking.
Kathy Caprino (39m 1s):
So it’s really powerful. And I’m so proud of it. I have to say it’s a culmination of 10 years. And I think every
woman on the planet should read it. And I think men who men have these gaps, do we, they just process
them a little differently. But I think also if you lead and manage, you need to read it because you need to
understand, speaking of empathy, you need to understand the internal lives of the women you’re leading and
what they’re going through in certainly male dominated organizations in careers, but even in the patriarchal
world we live in.
Dr.Anthony Orsini (39m 34s):
Yeah. You know, you just heard about something else too. The difference between a manager and a leader,
and wow, I’m trying to really get the message out. Cause I’ve had some toxic bosses as you call them. And
I’ve had bosses that I would walk through fire for. And the difference is how they communicated with me,
how they made me feel, how they valued me. They didn’t try to push me down to make themselves look
better. They tried to lift me up to make themselves look better. You know, I always say, if the person you
hired it comes great.
Dr.Anthony Orsini (40m 8s):
You can still say, Hey, I was smart enough to hire her. You can still take the credit. You don’t have to push
them down. And so it’s really important that we, we learned communication in business and how those
conversations go. So I’m so excited to read your book. I can’t wait for it to come. This has been great. If you
want any more information, you can contact Kathy Kathy caprino.com and her podcast finding brave is
available on Apple. It’s been a pleasure. And while you did not disappoint, this was a great interview.
Dr.Anthony Orsini (40m 40s):
Thank you again. If you liked this podcast, please go ahead and hit the subscribe button. If you want to find
out more about what we do and how we teach communication, you can contact me@yourseniorway.com.
Hopefully you’ll listen again every week. And I’m excited. And thank you again, Kathy.
Kathy Caprino (40m 55s):
Thank you so much. And thank you for the work you’re doing in the world. Tony. It’s so meaningful.
Dr.Anthony Orsini (41m 1s):
Thank you. That means a lot.
Announcer (41m 4s):
If you enjoyed this podcast, please hit the subscribe button and leave a comment and review to contact

Read the transcript of Dr. Orsini’s podcast with Author and patient experience leader Marcus Engel

Marcus Engel (3s):
It was just the bare bones type of information. That was all I could really take. But what was even more
important was that as she held my hand, Jennifer just kept repeating the two lowest compassionate words
that I feel any human being can say to another. And those words are here. She held my hand and she just
kept saying over and over Marcus I’m here.
Announcer (26s):
Welcome to difficult conversations lessons I learned as an ICU physician with Dr. Anthony Orsini. Dr. Orsini
is a practicing physician and president and CEO of the Orsini wet as a frequent keynote speaker and author.
Dr. Orsini has been training healthcare professionals and business leaders. How to navigate through the
most difficult dialogue each week, you will hear inspiring interviews with experts in their field who tell their
story and provide practical advice on how to effectively communicate whether you are a doctor faced with
giving a patient bad news, a business leader who wants to get the most out of his or her team members or
someone who just wants to learn to communicate better t his is the podcast for you.
Dr. Anthony Orsini (1m 10s):
Well, welcome everyone. This is Dr. Anthony Orsini, Welcome to difficult conversations. Lessons I learned
as an ICU physician today is a very special day because I get interviewed one of the most amazing people
that I’ve ever met. His story is one of tragedy, triumph, and success. And I promise you, by the end of this
podcast, you will truly be inspired. But just as importantly, whether you’re a healthcare professional or a
patient, you’ll have a whole new perspective on what healthcare should be all about.
Dr. Anthony Orsini (1m 42s):
And what patient experience really is through my years of teaching communication techniques to healthcare
professionals, I of course, had heard about Marcus, this story and the great work he was doing. So when a
mutual friend told me, I think about three years ago that she knew Marcus, I immediately jumped at the
chance to meet him. We talked on the phone for awhile and I was honored, but Mark has accepted my
invitation to attend one of my patient experience workshops right here in Orlando. And I got to say, I was a
little nervous speaking in front of someone with Marcus, his reputation, but let’s talk more about Marcus as a
professional speaker and author Marcus angle is considered an expert in communicating the patient’s
perspective and inspiring healthcare professionals towards excellence.
Dr. Anthony Orsini (2m 24s):
Marcus speaks from personal experience like few others can, after being blinded and suffering catastrophic
injuries at the hands of a drunk driver, he endured years of hospitalizations, rehab and recovery blending,
personal narratives with evidence based research. Marcus helps put an unforgettable name and face to the
patient experience movement. Martin’s holds a BS in sociology from Missouri state university and a master’s
in narrative medicine from Columbia university. He is currently an adjunct faculty member at the university of
Notre Dame.
Dr. Anthony Orsini (2m 55s):
Marcus has authored four amazing books, which are being used by scores of nursing schools, med
students, and allied health care programs to teach strategies for excellent patient care. He’s also a certified
patient experience professional through the Beryl Institute and certified speaking professional through the
national speakers association and in 2017, the Philadelphia college of osteopathic medicine, awarded
markers and honorary doctorate for his contributions in the field of healthcare Marcus lives in Orlando, right
near me with his wife and his seeing eye dog Elliot.
Dr. Anthony Orsini (3m 29s):
Well welcome Marcus. Thank you so much for coming on.
Marcus Engel (3m 32s):
Thanks for having me, Dr. Orsini and thanks for all of the incredible work that you’re doing in the realms of
patient experience too. Thank you. I didn’t know that you received an honorary doctorate from the
Philadelphia college of osteopathic medicine. I don’t know if you’re aware. That’s my Alma mater. Excellent,
wonderful. Yeah. This was actually the branch that is in Georgia, but still part of the same college. Yeah.
Dr. Anthony Orsini (3m 53s):
You know, as I got into the communication world and training doctors on communicating and patient
experience, I started to really think about my time at PCOM because PCOM, even back then when it wasn’t
the most popular thing, really pushed compassion to medicine. I mean, osteopathic medicine does that as
you know, but I didn’t realize when I was learning it, but I think it really shaped who I am now today, and it’s a
very special place. So when I saw that, when I was doing my research and I saw that, I thought, wow, what a
coincidence?
Dr. Anthony Orsini (4m 24s):
That that’s really great. So if you don’t mind, I think, you know, I know so much about your story and so
many people do. I really would like to start off with you just telling everyone out there, your amazing story of
tragedy and triumph. And then afterwards, I’d like to, you know, this is about difficult conversations and no
one’s had more than you and your book is so insightful of how those conversations can affect you both in a
positive, negative way. So if you don’t mind, you just tell your story. I think it’s an amazing story. And I want
everyone to hear it.
Marcus Engel (4m 55s):
I’ll give you the cliff notes version. And currently I’m 45 years old. I grew up in st. Louis, Missouri actually
grew up in Ferguson, Missouri for the first 10 years of life. And then what I, my parents moved to the rural
farm land of Missouri, where I really consider my hometown to be high Hill Missouri, nice little wide spot in
the road with a population of less than 200 now. And I grew up a typical red blooded American Midwest kid. I
was in all the high school activities, played football national honor society.
Marcus Engel (5m 30s):
And I decided that I wanted a big college experience in contrast the small town that I grown up in went to
Missouri state university and six weeks into my freshman year of college. I came home for the weekend. It
was my first weekend home from college. And on Saturday night, I drove into st. Louis to meet up with three
friends who were also all 17 and 18 years old. We ended up going to a st Louis blues hockey game.
Marcus Engel (6m 2s):
That night had a great time at the game. And on our way home from that game, our car was struck
broadside by another car. This is at an intersection in South st. Louis. There were four people in the car that
I was riding in. I was riding shotgun, front passenger seat, and the car that struck us hit directly where I was
sitting. So there was just a piece of thin Toyota metal between 50, 60 miles an hour.
Marcus Engel (6m 32s):
And my self not only did that crash, crushed every bone in my face, I’ll afford three fracture, but also caused
permanent and total sight loss and both arms. I can remember laying in the street. I can remember, you
know, just the most enormous pain. I think any person could experience having all the bones in my face
crushed. And I remember laying in the street and not being able to see, but I, I just thought it was because I
had been knocked for a loop.
Marcus Engel (7m 6s):
I didn’t realize that that was permanent blindness. Luckily that crash site was only maybe two or three miles
away from a level one trauma center at Barnes Jewish hospital, Washington university’s med school. And
they pulled me into the emergency room that night. And that started my journey to recovery, which as you
stated was extensive, it was long, it was detailed. It was painful, not only the physical recovery and literally
hundreds of hours of surgery, but then also the adaptations to a totally new way of being a totally new life
without sight.
Dr. Anthony Orsini (7m 49s):
That’s quite a story and your books, and we’ll talk about them later on, but your books really detail your
journey. And it’s really amazing. You have some practical, really advice that we’ll get into later on. I also saw
a while back something that happened to you. So your accident was in 1993, correct? Correct. Yeah. So
there’s something that happened to you in 2013 with meeting someone. And I wonder if you would share that
story because that’s also amazing story.
Marcus Engel (8m 20s):
Sure. So as you can probably imagine that night that they rolled me into the emergency department, my life
was hanging by a thread. I had been cracked in the street by paramedics. That’s how extensive the facial
damage was. And you know, they pull me into the emergency room. I remember just little bits and pieces
about that. First night. I remember pain. I remember darkness. I remember terror, but what I remember the
most was the fact that there was a female who held my hand the whole night in the emergency room.
Marcus Engel (8m 56s):
And she would just, every time she could tell I was conscious, she would say, Marcus, my name is Jennifer.
You were in a car accident, you’re in the hospital. And it was just the bare bones type of information. That
was all I could really take. But what was even more important was that as she held my hand, Jennifer just
kept repeating the two most compassionate words that I feel any human being can say to another. And
those words are I’m here.
Marcus Engel (9m 27s):
She held my hand and she just kept saying over and over Marcus, I’m here, I’m here. And I have been going
around the country for the last gosh, at least 15 closer to 20 years talking about the experience that brief
encounter with Jennifer and I, gosh, I’ve written books. One of my books is called I’m here, compassionate
communication and patient care. But the truth of the matter is after that night in the emergency room, I never
knew anything of Jennifer.
Marcus Engel (9m 58s):
Again, I’ve never known her last name. I’ve never known her title or her physician in the emergency room.
Even my close friends and family had to ask the question, you know, was Jennifer even real? And there’s
every chance I could have hallucinated her that. So in 2013, I just graduated from Columbia’s narrative
medicine master’s program. I was continuing to speak around the country and I got the invitation from the
very hospital that saved my life Barnes Jewish hospital in st.
Marcus Engel (10m 33s):
Louis. And while I was there keynoting for their patient experience efforts, I had my mind absolutely blown
when I got done giving a keynote speech and the director of the patient experience department came up to
the front and she said, Marcus, we’ve got a surprise for you. We found Jennifer. And first time in two
decades, I finally got to hold her hands again.
Marcus Engel (11m 3s):
I finally got to say, thank you. And I finally got to learn the other bits and pieces that I didn’t remember. And I
learned that at the time Jennifer held my hand. She was just 20 years old, just year and a half older than me.
And she was a patient care tech in the emergency room. And today I’m just honored that I can call her. My
friend and Jennifer has gone from being a patient care tech at 20 years old in st.
Marcus Engel (11m 33s):
Louis till just a year or two ago, she accepted her first job as a chief nursing officer of a 500 bed hospital in
Nashville, Tennessee. Fantastic. Wow. It’s amazing. The lies that have been laid out over the years. So
that’s a great starting point. I’m here. And when I Talk about difficult conversations and I’ll talk about my book
in a second, but we talk about difficult conversations. I was listening to an old video of dr.
Marcus Engel (12m 4s):
Rabbi Cushner. I’m sure you might know. He is the person who wrote what bad things happen to good
people. And his story is that he had a child who had a disease called progeria, and he’d found that his child
was going to die very young. And he talks about something called the bushes effect, which means he said
his neighbors didn’t know what to say. So when he drove home, after he had had the bad news, his
neighbors would jump in the bushes because they didn’t know what to say to him. And his answer to just
say, you’re sorry. And then shut up is what he said.
Marcus Engel (12m 35s):
But a lot of people don’t know what to say. And this young woman who was only 20 years old, had to have a
very difficult conversation. And all she said was I’m here. And that changed how you felt. And so the point is
conversation doesn’t have to be long. It doesn’t have to be complicated, just has to be done with
compassion.
Dr. Anthony Orsini (12m 58s):
And I’m guessing that you felt that compassionate in her voice
Marcus Engel (13m 1s):
When she said that, certainly, certainly. And holding a hand. I know that we’re in COVID times right now, the
idea of shaking hands, much less holding hands is a little not acceptable, but boy, just holding a person’s
hand during such a tragic time of their life. It communicates as much as words can. And I always say that
that I’m here. Those are the two most compassionate words that any human being can say to another
because it can’t change anything, but it means that I am willing and able to sit with you in your suffering and
just be present.
Marcus Engel (13m 42s):
Just give you the gift and the magic of simple human presence.
Dr. Anthony Orsini (13m 48s):
Exactly. And exactly what you said is just saying that I’m here and being there. And when I train physicians
and nurses on how to provide a better patient experience, how to be more compassionate, I tell them, start
by sitting down and show them that I’m not in a rush. And you’re the most important person there. I want to
share something with you personally, if you don’t mind, I saw you, I think two years ago at the Berlin Institute,
you probably don’t remember, but I mentioned to you, Marcus, I’ve been writing this book for three years.
Dr. Anthony Orsini (14m 24s):
I have both of your books, but I’m really afraid to read them because I don’t, I don’t want to accidentally have
any of those things in my mind. And so my teaching and communication to physicians and compassion pain
from years of research and I interviewed probably almost a hundred patients about death and dying and their
experience, et cetera. And so took me few years to write the book. The book came out in March, it was
published. It’s called it’s in the delivery, improving healthcare, starting with a single conversation.
Dr. Anthony Orsini (14m 55s):
And you were at my workshop that the book is based on and I’m giving it from a physician’s point of view, not
from a patient’s point of view. Although I got it from patients, I read your book for the first time a few weeks
ago, the one I read to them, the other end of the stethoscope and I’m here, and my wife came into the room
and I gotta be honest with you. I was choked up crying and she said, what what’s going on?
Dr. Anthony Orsini (15m 28s):
And a lot of what you said in that book is what I teach. And I actually got choked up because it validated
what I was teaching. And I wanted to just share that with you, that I felt, thank God I’m teaching it the right
way because Mark has lived it. And I just want you to know how much that meant to me. I was really moved.
I’m like, thank God I got it. Right. I’ve been teaching the right stuff.
Marcus Engel (15m 55s):
You’re sharing that. And thank you for reading my stuff too. I always try to come at this from the angle of
what we’re talking about with communication. It’s not rocket science, but it does take being vulnerable and
intentional in your communication. And Jennifer was very much that way to me that first night. And as you
bred, I had many other caregivers who I don’t want to say that they would humble themselves, but to a
certain extent they would, because they would move into a place of vulnerability with me to let me express
what I needed to express and then not to take it personally.
Marcus Engel (16m 36s):
I’m not a clinician, but I feel like a lot of times with clinicians, we have to come back to the idea that this
individual is hurting, right. There are patient and sometimes hurting people, hurt people. And I very much
hurt many of my physicians mentally and emotionally. And you know, the day that the ophthalmologist told
me that I would never see again, I wanted to hurt them physically. And that was a difficult conversation. And
maybe that’s a, that’s a good jumping off point for us.
Dr. Anthony Orsini (17m 8s):
Yeah. I try to tell physicians when I speak about that, what the terms that the phrase I use is it’s not about
you, if that, and you spoke about it in your book, if that patient needs to yell at you now, as you know, I’m a
neonatologist, so my patients don’t speak, but the parents do. And it’s the same thing. And if a parent needs
to yell at you and scream at you, and that’s the way that they can get through this, take that on, on your
shoulders and think of it as a gift. There’s no reason to take it personally, or your concept of one, a couple of
the other things that you were just discussing is how people humble themselves or the people that you were
close to.
Dr. Anthony Orsini (17m 44s):
I call that being genuine. Don’t be just the doctor. Be Dr. Orsini who likes the New York Yankees and is also
treats me like a person and sitting down. I want to talk about the person in your life named Barb that you
speak about, because I think she epitomized to me from the book being genuine and being a person. Can
you speak a little bit about her?
Marcus Engel (18m 7s):
Sure. So Barb is a nurse for life. Barb was an ICU nurse and after my first major facial reconstruction, that
was a surgery that took 25 hours. I was put into the ICU post-op and Barb was my first nurse post-op and it
was also about, you know, that was, I don’t know, 10 days or two weeks after the trauma. So I was kind of
starting to come out of the fog of pain and morphine and loss and all that.
Marcus Engel (18m 41s):
And I remember my very first conversation with Barb. She set the tone for the rest of my hospitalization, just
with the way that she communicated. And you have to keep in mind at this point in time when Barb was
communicating with me, I’m TRAPed. So I have to write everything out on a pad of paper, but Barb came up
to me in my room. She shook my hand as if there was nothing wrong with me. As if every day she’s taking
care of patients that just went through 25 hour facial reconstruction, she introduced herself and she said, my
name is Barb.
Marcus Engel (19m 19s):
I’m a nurse here in the ICU, and I get to take care of you for the next eight hours. And when she said that
word, I get to take care of you. It really laid out the foundation of this person when we get to do something
right, we’re, we’re fortunate. We’re lucky, we’re privileged. And by Barb using that little three letter word, it
showed me that she actually wanted to be there invested and intentional taking care of me.
Marcus Engel (19m 51s):
Barb also asked me questions about previous surgeries that were not really relevant to why I was in the
hospital now, but it showed a genuine, as you said, genuine deep humanity for wanting to know this patient
as a person, not just a room number, not just a diagnosis or prognosis, not just as a procedure, but as a
human being, I fully functioning human being. And one of the things that are did as well, she asked me, what
do you want me to call you in that first conversation?
Marcus Engel (20m 26s):
What you want me to call you now, even a Barb could pick up the chart at the end of my bed and read it.
She didn’t. She asked that question, what do you want me to call you? Do you want to be called Marcus or
Mark? So she wasn’t just seen that, Oh, this is a <inaudible> three patient. She’s actually getting down to the
personal human connections that I have preferences and opinions and likes and dislikes, just like any other
human being would. And by her asking you that question, what do you want me to call you?
Marcus Engel (20m 57s):
It really showed me that she thought of me as a human bar became, she was my primary nurse over the
next several weeks of hospitalization. I was initially hospitalized for about six weeks and then back and forth
once or twice a month for more surgery for the next year. Barb just retired last year, after 42 years, working
on the same floor at the same hospital, that big rarity and anyone who knows Barb knows just what a
fantastic person she is.
Dr. Anthony Orsini (21m 34s):
That’s a great story. And you know, one word can change something, right? So I talk about that all the time.
So she said, I get to take care of you. You notice that. And I think as physicians from the other end or nurses,
can we get task oriented, right? We just, we get moving. We forget. We also, aren’t very educated on
communication and we don’t understand how one word makes a difference for decades. Many, many years,
I was taught because that’s the way everybody else introduce themselves.
Dr. Anthony Orsini (22m 4s):
As I’m Dr. Orsini, I’m one of the pediatricians. And when I did my interviews with dozens of family members,
more and more of them said to me, when you say you’re one of it kind of means like you’re not really taking
any responsibility for me. And I’d love to hear your comment on that. When you say I’m the pediatrician,
who’s in charge of your child today, all of a sudden they’re relaxed. I have a face of someone and a voice of
someone who’s taken responsibility.
Dr. Anthony Orsini (22m 36s):
And interestingly enough, we did a little poll and I asked parents what makes you more comfortable? I’m one
of the pediatricians, or I am the intern. Now, most of the parents knew that interns are right out of med
school. They don’t know anything. Right. They actually felt more comfortable with the intern just by changing
that word. And I said, you know that they don’t know anything. Right. And they said, yes, but that’s my
Marcus Engel (22m 60s):
Yeah. Yeah. Taking ownership, right? They feel a bit of ownership over the situation. I would say, especially
in pediatrics. Now you have to keep in mind. I was a bit of a different patient because I was just five months
past my 18th birthday. So I was on an adult floor while my friend who was driving in the car, went to a paeds
floor near opioids. And I’ve always found that kind of, I was walking that line between adulthood and
childhood, but my parents certainly needed that comfort to know that this was dr.
Marcus Engel (23m 34s):
Jones. He is Marcus’s plastic surgeon. He’s not a team member. He is the guy. He is the guy. And I feel like
when parents are in such a difficult time of having a child hospitalized much less hospitalized in the ICU, you
have no control. Right? You realize how little control that you have and how much you have to trust in the
physicians and the surgeons, and then in the care team and just in the process itself.
Marcus Engel (24m 6s):
But whenever you can build that trust in where parents feel a little bit of control, I think that’s giving them a
great gift when everything seems so out of their ability to control anything.
Dr. Anthony Orsini (24m 21s):
Exactly. And that is part of the patient experience, knowing that this person nowadays we’re in medicine is so
sub-specialized, you know, you have how many doctors, my goodness, I can’t even imagine how many
doctors you had, but you need kind of a captain of the ship, right? You need somebody to know that’s my
doctor. And sometimes people don’t know who their main doctor is. And it’s important for them to know that
as physicians. And you know, when I say that the physicians, they go, wow, that sounds great. I’m going to
use the from now on. But it comes back from 20 years ago. We, as physicians were taught to be, act like a
team.
Marcus Engel (24m 54s):
And that’s important too, but you can do both, right? You can say I’m in charge of your care and act as a
team. But back to your book, when you give some practical advice, one of the advice you give you talk about
you’re in the best place and that’s teamwork. I’d like you to talk about that. Sure. So that’s a Barb story too,
that when she asked me, you know, Marcus, this is at our first introduction, you know, I’m still coming out of
the recovery room. I’m still very, very doped up. And she asked me about if I had had any previous surgeries
before this terrible car accident.
Marcus Engel (25m 30s):
And I wrote out on my pad of paper, yes. Why is I’ve had hernia surgery? And she said, Oh, okay. Well,
made conversation, ask where those surgeries were done. What was the hospital? And I told her, and she
said, well, you know, that hospital is a great hospital. She said that now, Marcus, you need to know that you
are in the best hospital. And she went down the list of just a few different accolades and awards and
recognition that the hospital had received.
Marcus Engel (26m 3s):
And what does that say to the patient? It tells the patient that they’re in good hands, that they’re in a quality
competent facility that has been recognized for its quality and competency. I think it’s not only important to
build that amount of trust that the caregivers that are going to be laying hands on the patient are quality, but
also that the entire facility is trustworthy and has been recognized or how well they do things.
Marcus Engel (26m 35s):
I think that’s a really good way that clinicians can help patients and families feel more secure in the patient’s
care.
Dr. Anthony Orsini (26m 46s):
Yeah. I mean, I think that’s really important. I go out of my way to tell the parents two things. One is I’m going
to treat your child as if she were my own boop and you see their shoulders kind of drop a little bit with
relinquish. And the other thing is, if this were my baby, this is where I’d want him to be. And I think that’s so
important because no one wants to be in a hospital. That’s not the best. Right. So you don’t want to hear
that. I want to talk about one more thing from your book and then get some advice from you because it
struck me.
Dr. Anthony Orsini (27m 16s):
And I love this title of this chapter. Screw your policy because I talk about that all the time. And just a little bit
about that. I really want to hear what you have to say about that.
Marcus Engel (27m 27s):
So screw your policy, boy, that came from a night that, okay. So my university ride started off at college was
three hours away from st. Louis, where I was in the hospital. And I had several of my best friends from high
school had also gone to another state university that was two or three hours away from my hospital room.
And as you know, college kids don’t always keep normal businessman’s hours. So my friends showed up at
nine o’clock at night.
Marcus Engel (27m 59s):
And this, you know, this is back in the early nineties when there was a lot more restriction on the visiting
hours and how many people can be in the room, et cetera, et cetera. And I remember having one of my
clinicians or caregivers said that my friends, they just arrived. They didn’t get there until nine o’clock at night,
visiting hours stop at 10. And they wanted to shoe my friends out of the room. They wanted them to leave.
And gosh, especially you think about from a teenager’s perspective, their friendships are, you know, the
most important thing to them, friendships and relationships with peers and I, I was hold well, it’s a hospital
policy that visiting hours end at 9:00 PM.
Marcus Engel (28m 47s):
And I remember saying, screw that policy. I want my friends to stay. And where was the teaching point in this
is that that clinician actually let my friends stay. After hours provided that we were quiet and we kept the door
closed, didn’t interrupt in it, or, you know, bother any other patients. It made it feel very personal to me that
the clinician could take into account. This is not a normal situation. They looked at it as an individualized
personal situation, and then they acted accordingly so that there isn’t a, they weren’t necessarily following
the rules, but they were helping bend the rules for the benefit of the patient, which I think when we’re
benefiting our patients and families, that’s ultimately what we’re there to do, right?
Marcus Engel (29m 37s):
That’s ultimately what clinicians and care teams are there to do. I, and I always say that
Dr. Anthony Orsini (29m 42s):
Words, policy and rules should really be avoided as much as possible we can. And when you do bend the
policy or bend the rules, it goes a long way. I’ll share a quick story with you. When I moved to Orlando, my
inlaws were both in their upper eighties. They came to visit me and for no fault of my own, they both ended
up being hospitalized within the first week. My mother-in-law had congestive heart failure. My father in law
fell and hurt his knee. They were both in the hospital at my hospital at the same time. So my brother in laws
were called, what did you do to my parents?
Dr. Anthony Orsini (30m 15s):
I’m like, I swear I didn’t do anything. But so my mother is on the 10th floor and she’s in the cardiac unit. My
father goes downstairs and he’s an orthopedics. And the one of the nurses came in. It was, she was in
charge and I was doing around and she knows that my father in law was very sad, even though he’s kind of
always generally happy person. And she asked him and he said, well, to be honest with you, today’s my, I
don’t know, 50th anniversary. And it’s the first anniversary. I’m not going to scream at my wife. And she
spoke to him a little bit.
Dr. Anthony Orsini (30m 45s):
Didn’t really say much. And then about 10 minutes later, an orderly came in and when the wheelchair, and
he said, you know, cardiac units, not supposed to have any visitors, but I have been instructed to take you
down to the gift shop. And he grabbed his wallet. He bought a Rose and he brought her up for 15 minutes to
be with his wife. Well, it does not matter from that point on, it did not matter if anything went wrong with the
hospitalization, they could have forgot to feed him for days, no matter what happened.
Dr. Anthony Orsini (31m 19s):
My hospital was the greatest hospital in the world to him because somebody took a moment just to do
something extra. And so breaking that policy, I think just having your friends visit probably meant the world to
you.
Marcus Engel (31m 31s):
Yeah, absolutely. Again, anytime it’s a, a patient’s needs can be looked at individualistically and personally
you’re going to make such a great impression with patients and families.
Dr. Anthony Orsini (31m 43s):
Yeah. That’s just great advice. So in closing, being such a patient experience person, and I want this too,
you’re such an expert on it. I’d like you to go and speak to both dot both clinicians and to patients and what
made I’m putting on the spot. What’s just a few sentences of advice that you can give to physicians, nurses
first about how they can make being in the hospital as least horrible.
Marcus Engel (32m 10s):
I always say, and this is something that I teach my students at Notre Dame to my premeds, that human
presence, simple human presence is the cornerstone of caregiving. And you can convey that presence with
those words I’m here, but you can also convey that this is the, it’s not just the cornerstone of caregiving
presence is the, it’s the foundation of our humanity. So whenever you’re using those words, I’m here with
patient.
Marcus Engel (32m 43s):
You’re not just speaking compassionately. You’re speaking to them, human being to human beings. I just
always love for clinicians to remember that, Hey, you’re in the hospital, you’re in the assisted living facility or
in the rehab center. It may be an average day on the job for you. It’s just the Tuesday, but it could very well
be the worst day of that patient’s life. I literally keep that in mind that we have the opportunity to provide
compassionate, personalized care on the worst day of someone’s life.
Marcus Engel (33m 19s):
I hope that keeps us more aligned with our personal mission, visions and values to, to be the best, most
quality, compassionate caregivers that we can be. Patients. Boy, what is my advice for patients? Do what the
doctors say? Let the doctors say, I always want patients to, to remember that they are the focus. They are
the focus, but it does have to be mutual effort of clinicians and the patient working towards the same goal.
Dr. Anthony Orsini (33m 52s):
So sometimes I think patients get the idea of, well, I’ll lay here and you guys will fix me. You clinicians will fix
me, but there has to be some forward motion in the patients. I don’t want to say their treatment of him or
herself, but in their care process to where they’re putting one foot in front of the other to get better. That’s
great advice. So, well, I can talk to you all day long, but you’re a busy man. And I just want to thank you
again for coming on this podcast, taking the time out of your busy schedule.
Dr. Anthony Orsini (34m 25s):
It was really truly an honor. If you want to book Marcus to speak or get in touch with him in any way, or you
could reach them@marcusangle.com and that’s E N G E L, just to be clear and his books are still available.
If you enjoyed this podcast, please hit the subscribe button, leave a review. Reviews are really important to
get the word out. And if you’d like more information about your senior way and communication training, or
you’d like email me personally, visit me at <inaudible> dot com. If there’s a topic that you’re interested or you
want to nominate someone for this podcast, please let me know.
Dr. Anthony Orsini (34m 58s):
And finally, if you want to learn more about communication, remember my book just came out in March.
Marcus. I’m going to, if you send me your address, I’ll be happy to send you one. The book is called it’s all in
the delivery, improving healthcare, starting with this single conversation. And you can get that on Amazon
Kindle and Apple books. Thank you, Marcus. And thank you for all you do, and for being such an inspiration
to me and everybody else. Thank you. Thank you so much for having me and, and continued success when
bringing this notion of compassionate communication
Marcus Engel (35m 27s):
To all clinicians. Thank you. And I hope to work with you soon. That was great. Thank you.
Announcer (35m 32s):
If you enjoy this podcast, please hit the, and leave a comment and review to contact Dr. Orsini or his team or
to suggest guests for future podcast. Visit us at The Orsini Way. com.

Read the transcript of Dr. Orsini’s podcast with Dr. Michelle Neier as they discuss how to break bad news

Dr. Michelle Neier (2s):
One of the things I always try to stress to parents. He’s like being a kid comes first. That’s their job. Their job
is to have fun. Their job is to go to school. Their job is to see their friends. Having cancer is a side gig. If you
will, you know, that’s, that comes second. And I think we always have to remember that that without the
beauty and the happiness in life and without those wonderful moments, the rest of it doesn’t matter.
Narrator (44s):
Welcome to difficult conversations lessons I learned as an ICU physician with Dr. Anthony Orsini. Dr. Orsini
is a practicing physician and president and CEO of the Orsini way as a frequent keynote speaker and author.
Dr. Orsini has been training healthcare professionals and business leaders, how to navigate, to read the
most difficult dialogues each week. You will hear inspiring interviews with experts in their field who tell their
story and provide practical advice on how to effectively communicate whether you are a doctor faced with
giving a patient bad news, a business leader who wants to get the most out of his or her team members or
someone who just wants to learn to communicate t his is the podcast for you.
Dr. Anthony Orsini (1m 26s):
Well, welcome to another episode of difficult conversations lessons I learned as an ICU physician. This is dr.
Anthony or Sini your host today and every week moving forward. Now, if you’ve listened to this podcast
before you know that I promise my audience two things each and every week, number one, to feel inspired
and number two, to have valuable communication techniques that you can go and take home with you. The
next time you have a difficult conversation. And I am very certain that I will keep my promise today.
Dr. Anthony Orsini (1m 59s):
Today we have dr. Michelle Neier. Dr. Neier is a board certified pediatric hematologist oncologist and
integrative medicine physician. In 2005. She completed her pediatric residency at Schneider children’s
hospital at North shore university in long Island. She continued her training in New York city where she
finished her hematology oncology fellowship at Morgan Stanley children’s hospital in New York, Presbyterian
Columbia in 2008 after practicing pediatric hematology and oncology at Goryeb children’s hospital in
Morristown, New Jersey, she elected to further her training and recently completed an integrative medicine
fellowship through the university of Arizona integrative medicine department.
Dr. Anthony Orsini (2m 37s):
Dr. Neier has a strong interest in the medical humanities and especially narrative medicine. She is
passionate about teaching and as a breaking bad news instructor for the, or see any way in April, 2020, Dr.
Neier started olive tree integrative health olive tree integrative health mission is to provide quality integrative
medicine care, which honors each individual’s story. Dr. Nigher is passionate about her goal to help children
and young adults we’re dealing with chronic or life threatening medical illnesses, as well as those children
who have multiple symptoms, but do not yet have a diagnosis talk denier and olive tree integrative health
understands that disease is multifaceted and healing includes supportive her patients and the caregivers as
well.
Dr. Anthony Orsini (3m 19s):
She resides in New Jersey and in her personal time is an avid reader loves to practice yoga and spend time
with her family, and recently started knitting, but welcome Michelle. It’s so nice to have you on my new
podcast.
Dr. Michelle Neier (3m 31s):
Thanks Tony. It’s great to be here.
Dr. Anthony Orsini (3m 34s):
You know, we’ve never met in person, but we’ve been doing breaking bad news together. You’ve been an
instructor for the, or see any way for several years. And I try to get the most of the sessions, but our paths
never really crossed. We didn’t get to do the same one together, but everyone from the very beginning, so
nicely about you and said you had so much to offer the young residents. You were really passionate about
communication, just like me, and just received constant accolades about your wisdom and how well you
teach and everything that you say.
Dr. Anthony Orsini (4m 6s):
So I was really excited to finally get to interview you. When I decided to take this leap for this podcast, your
name was one of the first names that came up, because I think you’ll be easily full, be able to teach our
audience something about communication, especially in your field. One of the premises of this podcast is
that if you can have that conversation with someone about cancer or death, and pretty much the rest of the
conversations in your life will be relatively easy. So today I’m really excited for the audience to hear your
story and to really learn something about communication from you.
Dr. Anthony Orsini (4m 42s):
So thank you for coming on. I know you’re very busy these days
Dr. Michelle Neier (4m 45s):
I am, but I really appreciate the compliment. It’s a big honor to be here. I think what you’ve done is amazing
and what you’re doing is incredible, and it means a lot to participate in this.
Dr. Anthony Orsini (4m 59s):
You know, I have a, a personal story that I’ve shared on a previous episode about why I became passionate
about communication. It really started when I witnessed a physician, tell someone that their baby died in a
very cold manner and it profoundly changed me. And that was when I was a fellow in neonatology way back
when. And so everyone seems to have a story and I want to, if you don’t mind sharing with the audience
here, yours, I’d like to know why you chose hematology, oncology, and maybe a story about what really
moved you either with a patient or what made you so passionate about teaching communication to the
young doctors.
Dr. Michelle Neier (5m 38s):
So I think in hindsight, the seeds of hem-onc were back, even in childhood, I mentioned to you that I’ve been
an avid reader and as a child, there was a book I read about a girl with leukemia. And I think I must’ve read
that story over and over and over a dozen times. And it just always stuck with me. I started pediatric
residency and thought for sure, I was going to do general pediatrics.
Dr. Michelle Neier (6m 9s):
I just wanted to do good preventive care and sure enough, the best laid plans always change. So I was a
resident and I met a young girl. I still remember her and think of her fondly. She had a solid tumor. She was
probably about seven or eight when I met her. And she used to walk around her and her mother walked
around with a pin that said cancer socks. And I just thought it was amazing that this young kid could speak
so loudly to what was going on in her life and just be so clear about it.
Dr. Michelle Neier (6m 50s):
But yet at the same time, be so positive and so motivated. She started a jewelry shop, I guess you could call
it. And she was selling jewelry to raise money, to support cancer research. And I still have the necklace. She
sold me. She was just always happy and inspiring and amazing. Despite walking around with like pain that
clearly said cancer sucks. She wanted to change things. She wanted to make it better. And I think that
changed things for me a bit. It just moved me in a way that general pediatrics didn’t, it felt a little bit more like
a calling, something like I needed to do.
Dr. Michelle Neier (7m 30s):
And I think it just rolled from there quite quickly, actually.
Dr. Anthony Orsini (7m 35s):
Yeah, that’s a, that’s a really interesting hematology. Oncology always move me. It’s different, but it’s a lot
like neonatology and that there’s emotional highs and emotional lows. You’ve been given so many accolades
on how you communicate and how you speak to your patients. And it really shows when you give your
valuable lessons to these young residents, but there’s someone in during your training, either as a resident
or a fellow, or maybe earlier on that you looked at because there were people in my past, I told you about
the horrible story when the doctor did it.
Dr. Anthony Orsini (8m 10s):
So coldly, but you know, that doctor was extremely compassionate. That doctor he’s the opening story in my
book, he was one of the most compassionate people that I’ve ever known. And yet when he delivered the
news, he did it so quickly, I think because he was so uncomfortable to do it, but I’ve also had some really
good role models. Some of them in neonatology, some of them in palliative care, and I watched him speak
and give bad news or have those difficult conversations. And in the back of my mind, I’m thinking, wow,
that’s a golden tongue.
Dr. Michelle Neier (8m 42s):
Like I love that phrase. I’m going to steal that. And most of the stuff that I use today, I’ll be honest, has it
been stolen? So is there someone that you remember that you said, wow, I want to, I want to speak like that.
Without doubt, I Had two amazing mentors when I was a fellow Julia Glade bender and Linda Granovetter,
and I really credit the way I deal with patients and communicate with patients to them.
Dr. Michelle Neier (9m 14s):
They are two of the smartest, most incredible physicians, women I have ever met. And I, I look back and I
don’t, while there were so many things in so many words and so many phrases that they used with patients,
I don’t think it was about the words so much as about their presence. And, you know, I used to teach Julia
when we’d be in the work room, she was all over the place and doing a million things and distracted.
Dr. Michelle Neier (9m 46s):
But when she got in that room with the patient, she was there, nothing else mattered. She wasn’t in a rush to
leave. She was truly in that moment with them. And I remember she had a young patient who was critically
ill, was dying. And Julia just sat by the bedside without mother and talk to her and held her hand and listened
to her and really absorbed what that mother’s fears were and got her to a different place, a different place of
never acceptance, but of understanding and the same thing with Linda.
Dr. Michelle Neier (10m 30s):
I have clear memories of sitting in Linda’s office with a patient that I know Linda and I think of often and will
never, ever, ever forget. And I just remember Linda looking at those parents, not as a physician, but as a
human and really feeling their pain and absorbing their pain. And I think that alone changes the conversation
because I think, well, so many people remember the words and they remember little things that we say.
Dr. Michelle Neier (11m 9s):
They also just remember us being together. And I think that goes a long way. You know, I don’t think most of
us are in medicine. Yes. We enjoy the science and we enjoy, you know, learning about biology and all of the
other things, but we’re really in medicine because we want to help people. It’s not about being a doctor. It’s
about taking care of each other. And so when I saw LinkedIn and Julia work, that’s what they were about.
Dr. Michelle Neier (11m 40s):
That’s what they are about. And that always stuck with me. And it changed me.
Dr. Anthony Orsini (11m 46s):
That’s an excellent point. The word presence is a word that keeps coming up during this podcast. And I don’t
know if you’re familiar with a book called I’m here, but we had a few weeks ago, a guest, his name is Marcus
angle. And Mark his angle has an incredible story. If you haven’t heard the podcast, please go back and
listen to it. But Marcus was in a car accident when he was 17 years old, he was hit by a drunk driver, went
blind instantly. I had a facial fractures and ended up being in the hospital for almost two years.
Dr. Anthony Orsini (12m 21s):
And Marcus has the story that when he was in the trauma Bay, they’re putting in chest tubes or trying to
intubate someone who literally barely has a face. They had to do a cricoid split. And Marcus only remembers
that he was blind. He couldn’t see there’s all this stuff going on. And one woman grabbed his hand and said,
Marcus I’m here. And he didn’t find out who that woman was for another 20 years, but it changed his life
forever.
Dr. Anthony Orsini (12m 50s):
And that’s the exact word that he uses presence. And I agree with that. Totally. But it’s about being there.
And I think that if we can learn one thing from this episode of podcast, it is that is that physicians are all
compassionate people. I truly believe that that’s why we went into medicine, but no one wants to be the
bearer of bad news. And we’re all uncomfortable doing it to a certain extent. And I think when we’re
uncomfortable doing that, we tend to rush through it and want to get in and get out.
Dr. Anthony Orsini (13m 23s):
Now, Michelle, I’ve done a lot of breaking bad news programs. And sometimes when we do the videotape
filming with professional actors, the young doctor, and we’ve even done, senior doctors will just come out
and say, my name is dr. Orsini, you have cancer. And I’ll say, when we do the video review, I’ll say to the
doctor, why were you so abrupt? And he, or she will say, well, that’s what I was taught. I was told, get it over
with and get out of there.
Dr. Anthony Orsini (13m 54s):
And so we’re fighting decades of bad teaching. And I’m so glad that you had mentors that made you who
you are today. And I think together, along with other people, hopefully we can change that, but the word
presence, what a great word. And I think that’s probably going to be number one on the top of things that you
need to do when you’re having difficult conversations, just be present. It doesn’t have to be a medicine,
right? Someone could be a friend who lost a loved one. Someone had just got a divorce, other things, other
difficult conversations in our lives.
Dr. Anthony Orsini (14m 28s):
We have some guests that are going to speak about getting fired from their workplace. You know, there’s a
lot of bad things that happened to people. It doesn’t have to be health-related, but as a friend, people say,
what should I say? Well, maybe all you should do is just say, you’re sorry. And sit there. And that’s probably
the best advice. So thank you for that. That’s great. I want to ask you about the particular challenges of the,
as they say, tweener or a teenager, they tend to handle things differently, right? So teenagers, although they
might understand cancer, maybe they’re in denial or maybe they’re a little on the young side to understand
that.
Dr. Anthony Orsini (15m 7s):
I mean, that’s telling a five year old is a whole different skillset. What about that? 12 year old, 13 year old?
Are there any special advice that you can give to someone who has to speak to a 12 year old about cancer?
Dr. Michelle Neier (15m 18s):
So I think one of the biggest mistakes that we make in medicine, whether it’s an oncology or any other fields,
or even frankly in parenting, is that we underestimate our children. I think we underestimate our children,
whether they’re five years old or 25 years old. And we tend to think that they can’t understand or handle the
information we’re afraid of telling them things.
Dr. Michelle Neier (15m 53s):
You know, I’ve had friends say, well, I don’t want to tell my 12 year old daughter they ask because she’ll be
afraid because she won’t be able to handle it because she’ll freak out to a certain extent. They’re right. The
kids might freak out. You know, they might get hysterical, they might cry, but that’s normal and that’s
appropriate. And that’s okay, that’s a human emotion. But the point is that kids can also heal. And part of the
process of getting them to the other side is allowing them to have those emotions, allowing them to be
scared, to be angry sometimes to be in denial.
Dr. Michelle Neier (16m 35s):
I think it just depends on the kid. I’ve seen 12 year old kids who say, okay, I have leukemia. Let me get back
to my video games now. And I’ve seen other 12 year old kids who say, Oh, I have leukemia. Well, what type
and what type of chemotherapy are you giving me? And how long will I be in the hospital? And what are the
names of all my organizations? It’s so variable. I, I think more than the tweens, the younger adults are the
ones that I’ve really struggled with.
Dr. Michelle Neier (17m 12s):
I think tweens are still used to being taken care of. They’re used to being with their parents. They’re used to
being fed information. I think the young adults, the 19, 20, 23 year olds are the ones that for me have been
the most challenging, but also the most rewarding population. You know, their lives are interrupted at such a
crucial stage when they’re leaving the nest, when they’re becoming independent.
Dr. Michelle Neier (17m 49s):
And then in many ways, least in oncology or when someone’s diagnosed with a chronic illness, we take
away that independence. We completely interrupt and arrest their development at a certain stage. So I think
that’s the population probably more than the tweens that I’ve struggled with. I think the tweens these days
are so knowledgeable. They’re so connected. We very quickly develop amazing support systems.
Dr. Michelle Neier (18m 19s):
We have a young girl in our community who was recently diagnosed with leukemia and she very quickly
came out on social media and announced our friends. This is what’s going on. I’m going to lose my hair, but
it’s going to be okay. And so I think the way they communicate has changed, but I think maybe that helps
them. I think they’re able to find resources that even 10 years ago, weren’t available to them.
Dr. Anthony Orsini (18m 45s):
My niece, who was an ex premature baby. And then she got through that and then 17 years later finds out
she has lymphoma and they had to do reconstruction on her neck. And she went through chemotherapy and
I interviewed her. She became a instructor for breaking bad news. I got her because she was in nursing
school. And now I’m so proud. She’s an oncology nurse and Cincinnati, but she came to a breaking bad
news program as a student instructor.
Dr. Anthony Orsini (19m 19s):
And I said, you have such a wealth of knowledge because you speak from a personal point of view. And I
asked her during a impromptu interview, I’m trying to get her on this podcast because I’m telling you you’d be
blown away. And I’m so proud of her. I still cry when I, when I think of her. But I asked her about her
hematologist oncologist who took care of her at chop. And I said, what do you remember about her?
Because she was 17. And she said, what I remember most about my oncologist is that she said, I am not
going to forget that you’re 17 and that you have things to do.
Dr. Anthony Orsini (19m 54s):
And so we’re going to make sure you go to your prom. And if you need to skip a session or skip a
chemotherapy, we’re going to do that. And you’re going to live your life. And you’re going to get through this.
And you could hear my voice cracking because I’m so proud of her. She got through it. She went to her prom
with no hair. Her boyfriend also shaved his head and she had an great outlook on life. And now she moved
to Cincinnati because believe it or not, where she went to nursing school, she tried to get several jobs as an
oncology nurse.
Dr. Anthony Orsini (20m 27s):
But you know, there’s a long waiting list for that. I said to her, I said, Lauren, tell them that you you’ve been
through this. And so she is a pediatric oncology nurse in Cincinnati right now. I’m so proud of her, but that’s
what she remembers the most about her oncologist saying, I’m going to let you be a teenager. And I’m sure
if you,
Dr. Michelle Neier (20m 50s):
Yeah. So it sounds like you have a lot to be proud of about Lauren. She’s been through a lot. It’s pretty
amazing that again, a young person can recover the way they do and go on to do really tremendous things
with their lives. One of the things I always tell parents when I need them, whether it’s a parent of a kid with
cancer or a parent of a kid with sickle cell disease, which I saw plenty of and I think has its own challenges.
Dr. Michelle Neier (21m 26s):
But one of the things I always try to stress to parents is that being a kid comes first. That’s their job. Their job
is to have fun. Their job is to go to school. Their job is to see their friends. Having cancer is a side gig. If you
will. You know, that comes second. And I think we always have to remember that, that without the beauty
and the happiness in life and without those wonderful moments, the rest of it doesn’t matter.
Dr. Michelle Neier (22m 5s):
You know, we have to keep in mind, what are we doing this for? We’re doing this so that like you say, they
can go to their problem so that they can see their friends so that they can go to a barbecue. And I fully agree
with those people down at chop, those docs down there, do a great job. They’ve got it right. We have to
prioritize normalizing life for these kids.
Dr. Michelle Neier (22m 35s):
As much as possible life will be the same, but it will be someone always said it, Maurice town, it will be a
new normal, there’ll be a different kind of normal, but that involves all of the milestones. Whether they’re
graduations or communions or bat mitzvahs, they may not happen in the same way, but we have to find a
way to make them happen. And when they can’t happen, where they don’t happen on time, we have to really
acknowledge the sadness in that we have to, we have to again, feel their pain and relate to their pain, not
blow it off.
Dr. Michelle Neier (23m 24s):
I think that’s one of the things that we’re seeing in Corona right now. You know, they, kids are so sad about
missing things and it’s very easy to say, okay, it’s not a big deal. You’re missing something. But there is
sadness in that because for a child missing an event, missing a milestone is a big deal and it is a big
disappointment. So it’s okay to be sad for a moment. They, the work isn’t in not being sad, the work is in
healing from being sad and in getting over, being sad and recovering from that.
Dr. Michelle Neier (24m 4s):
And so when you think, whether you’re a pediatric oncologist or you’re a parent or a friend, the goal is the
same. It’s to be with somebody in their emotion and to help them process it so they can recover and get to
the other side
Dr. Anthony Orsini (24m 22s):
And not let it define you who you are. We talked about communication and in my line, there’s a lot of
emotions. There’s a lot of babies who are dying, who are very sick and they stay in my hospital. You know,
sometimes 30, 60, 90, a hundred days. These premature babies are with us. And I have a lot of emotional
times with the parents, but in between that, it’s very important for me to come up as a genuine person. When
I teach about patient experience and how to use communication, the patients and the patient’s families need
to know you as dr.
Dr. Anthony Orsini (24m 59s):
Neier who’s from New Jersey, who, you know, is a person, not just their doctor and doctors need to
remember that. That’s the person on the other side of this is going to lead me to the integrative medicine part
of what you do, but it’s important, correct? To start off the conversation by asking them how’s school what’s
going on instead of all business. And one of the problems that medicine has right now in my belief is that we
are pushed so much that we become very task oriented as physicians and nurses.
Dr. Anthony Orsini (25m 34s):
And that’s really affected the patient experience. We have 25 patients to see, we have to write notes. We
have to move on. And I discuss in my book how you can sit down, find something that’s common in
someone. Maybe you love reading. So if you find someone whose parents reading a book, when you walk in
to comment on that book and tell them about the last book that you read, especially if they’re a teenager, it
takes their mind off of it. You know, we don’t want it to be all business. It’s important, but you’re a person too
correct.
Dr. Michelle Neier (26m 4s):
I try to be a person. My kids might not always agree.
Dr. Anthony Orsini (26m 11s):
We see in my field, we see people that we feel that that’s just the parent of the baby. Who’s the 29 weeker.
And I discussed the importance of finding commonality with people in every day and with every single
patient, for instance, I’m down in Orlando now, but every now and then I will see a patient. And when I go to
call the mother cell phone number, it’s nine, seven, three. And that is an instant bond with that family,
because I can meet that family and say, nine 73 area code that’s where I’m and the patient’s family lights up.
Dr. Anthony Orsini (26m 48s):
He’s one of us with nothing to do with race or background or whatever. Just the fact that we both lived in
New Jersey, or I’m lucky enough to see a parrot. And during a very difficult time, over the course of 30, 60
days, maybe they might be wearing a Yankee hat, or there’s a book that I used to read and finding that bond.
And if you go back to the story of my niece, Lauren, she bonded with that doctor because her doctor came
up as a friend and a teammate we’re in this together.
Dr. Anthony Orsini (27m 22s):
And I think that’s what medicine is all about. Right?
Dr. Michelle Neier (27m 25s):
Yeah. I completely agree on so many levels. You know, I’ll tell you a brief story. When I was a fellow, one of
my very first patients at Columbia was a little girl. She was very, very, very religious Jew from upstate New
York. And I will never forget. I went down to see her in the ER. And I said to the family, Hanukkah was
coming up and I said to them, Oh, you must be so excited.
Dr. Michelle Neier (27m 58s):
How did I know it was coming up? And the mother looked at me and she said, Oh, you’re Jewish. I said, Oh
yes. And we started a whole conversation. And I told her where I lived and they lived in a very isolated
community of very religious Jews. We really, in many ways had nothing in common, but that was my way of
crossing a barrier.
Dr. Michelle Neier (28m 29s):
And it started a relationship that lasted for years long after I left Columbia, they taught me about their
community. I taught them about my community. Yes, I treated her leukemia, but it was so much more than
that. We developed a relationship. And you know, when I was a fellow and a resident, one of the messages
usually unspoken, but sometimes spoken also was that you have to maintain a professional barrier and that
you shouldn’t cross those boundaries.
Dr. Michelle Neier (29m 7s):
And I was always so afraid of crossing those boundaries. Did I cross the boundary? Did I cross the
boundary? I wasn’t sure as a young physician where that line was, but I was so fearful that if I crossed it, that
if I became too personal with families, I was risking something. And as I moved on in my career, I found the
opposite was true. That the more I gave of myself personally, and the more I crossed boundaries, and that’s
not to say, don’t be professional.
Dr. Michelle Neier (29m 42s):
I think that’s a different thing. You always have to be professional. You are a physician. You need to be a
leader, but when you let people into your lives, they let you into their hours. And I think that was what
sustained me as a physician. That was the beauty of my job. That was the heart and soul of the work.
Dr. Michelle Neier (30m 14s):
Especially with the young people, you know, the young adults. You talk about walking into the room and
asking about what’s going on. I never, I shouldn’t say never because I’m sure I did, but I’ve tried not to walk
in the room and say, are you taking your medicines? You’re getting this too much today. You’re getting that
today. I tried to walk in the room and ask an open ended question. How are you doing? What’s going on in
your life? Tell me about school.
Dr. Michelle Neier (30m 46s):
And I found that it changed our relationships. I am so blessed that I have a number of young adults in my job
who stayed in touch with me. And you were talking about your niece. It makes you cry. It makes me a little
verklempt, a little emotional to think about how those patients have really become friends. And I think by
crossing those boundaries, it allowed me to be a better physician.
Dr. Michelle Neier (31m 17s):
I’ll give you one more example. I took care of a young adult. He had leukemia and we became very close.
And when he relapsed, he didn’t want to get therapy he was so angry. And I understood that he had a hard
time. We had interrupted his life. It’s so much going on, but because I had taken the opportunity to get to
know him and his mom and his girlfriend, we were able to sit down and have one of the most emotional
conversations I’ve ever had in my career.
Dr. Michelle Neier (31m 59s):
But we listened to him. We just sat with him and he cried and he was angry and he yelled, and thank God.
He decided to go ahead. And he decided to continue with his, his therapy. And he’s doing great. Now he’s
back in school. He’s living on his own. He’s amazing. I speak to him all the time, but I do wonder if I hadn’t
crossed those boundaries.
Dr. Michelle Neier (32m 29s):
Would we have been able to have that conversation? Would we have been able to be that open with each
other? And I don’t know, I just don’t know the answer to that, but I’m grateful that we were, and I think that’s
the benefit of opening yourself up to people and to learn about who they are, not as a patient, but as a
person,
Dr. Anthony Orsini (32m 56s):
I would make two comments on that. First of all, you’re exactly right. The patient and the patient’s family. And
right now doctor is crying. So I just want everyone to know that. And the reason I want them to know that is
that that’s what medicine’s all about, right? Those bonds that we made through the years, and, and I got
emotional about my niece and you get emotional about your patients. I still receive Christmas cards. I think
we’re going on now. There’s one family, 14 years that I receive a Christmas card from a premature baby who
died.
Dr. Anthony Orsini (33m 31s):
And to me, that is one of the things I’m most proud of. Not that she died, but that, that family holds me in
their heart. Even in the tragedy, they could have been very angry. You didn’t see my baby, but we really
bonded. And to get a Christmas card from her 14 years later, it’s just one of the things I’m most proud of. So
another great teaching point here is that it’s okay to cross those boundaries. In fact, I think it’s preferable the
patients and the families will always know that you’re the doctor.
Dr. Anthony Orsini (34m 6s):
And I think that some of us make mistakes into thinking that if I crossed the boundaries, don’t forget that I’m
the doctor and that’s not true. They’ll respect you even more in my book, it’s all in the delivery. I go over the
five principles of patient experience. And number one is called, it’s hard to fire your best friend. And the point
of that whole section is find the commonality, build the rapport, cross the lines a little bit, and you will be their
best friend and who doesn’t need a best friend, especially during these critical conversations, right?
Dr. Anthony Orsini (34m 40s):
I mean, that’s, that’s what they need. They need a friend. They need, they know you’re the expert in the
room. They respect you. And they’ll respect you more when they realize that you are a real person.
Sometimes just going into a room and saying, my five-year-old just wouldn’t go to school today makes you a
real person, you know, you bond because they say, well, this is a real person. This is not just a doctor who
thinks that I’m leukemia or just calling me by my disease. So another great teaching point for the audience
before we go, Michelle, I want to talk about your integrative medicine.
Dr. Anthony Orsini (35m 12s):
So you made that change. And I, I kind of know, just from speaking to you, why you did that, but I want you
to talk about why you decided to, you had a very successful practice treating hematology, oncology patients,
but decided that I want to be even better and go back to school for integrative medicine. So tell me about
that transition and how that happened.
Dr. Michelle Neier (35m 33s):
Sure. So it was a slow journey in my personal life. I had struggled with some chronic pain issues, some GI
issues. And to be honest, wasn’t quite finding the answers that I was looking for in traditional medicine. And
so I started asking questions on a personal level. I am very blessed. I found some amazing practitioners.
Dr. Michelle Neier (36m 6s):
I really think of them as healers in my life. Physical therapists, massage therapists, acupuncture is yoga
instructors, amazing people with a whole different skillset than I had learned about in medical school and in
my training. And at the same time that I was on that personal journey professionally, I found that I was
opening myself up a little more.
Dr. Michelle Neier (36m 37s):
And as I did that, I was being confronted with different questions, questions. I didn’t know the answers to
questions like my kid is getting chemotherapy and I don’t think I should give them sugar anymore. What’s the
right thing to do, or my kid has nausea, but I don’t want to medicate them all the time. What else can I do
questions that I didn’t know how to answer? And so I started looking for the answers and my personal and
professional paths, I think really came together in that way.
Dr. Michelle Neier (37m 17s):
And as I started looking, I found that integrative medicine is the framework to answer those questions. So I
think people think of integrative medicine as being kind of hokey witchcrafty, weirdness. That’s not at all what
it is. And that’s what I love about it. It is really a framework for in fact, many of the things we’ve talked about
in my training, one of the things we’ve talked the most about is forming relationships, how to communicate
with people.
Dr. Michelle Neier (37m 54s):
That’s really the basis and the foundation of integrative medicine. The idea is to harness the body’s ability to
heal. So it’s not a replacement for traditional medicine. It’s a way to enhance traditional medicine the way to
enhance ourselves, to focus on the mind body and the spirit. And so for me, I think it was a very natural
progression into this type of medicine and for a number of reasons, it was the time it was the time to leave
my job.
Dr. Michelle Neier (38m 37s):
It was the time to take on new challenges, different challenges to learn different skills. And so everything just
kind of collided and came together at the right time. So here I am, it was without a doubt, the most difficult
decision I’ve ever made in my life. I love pediatric hematology, oncology more than anything.
Dr. Michelle Neier (39m 7s):
I am so grateful to all of the patients and their families that I’ve met, but it was time personally for a change.
And this felt like the right one,
Dr. Anthony Orsini (39m 19s):
One of our previous guests, Kathy Caprino who had a life changing moment when she changed from being a
big financial person to coach for women. I think her quote was, you know, when you’re not sure what to do
the universe steps in, and it sounds like that’s what happened to you, that everything came together and I
can see in your face, this is audio only, but for the audience I could see in your face, how you laid up when
you speak about integrative medicine. So it sounds like you’ve found your calling and you’re happy with it.
Dr. Michelle Neier (39m 51s):
Yeah. My second calling.
Dr. Anthony Orsini (39m 55s):
So you open the olive tree and that just opened up in April.
Dr. Michelle Neier (39m 59s):
Yeah. So a couple of months ago, I decided why not in the middle of a pandemic, I’ll start in your business.
So I opened that. I opened up olive tree to telehealth patients only, and my, now that things have calmed
down my physical office space in Springfield, New Jersey should be ready in about a month is a really, really
excited. It’s a beautiful, quiet, sunny space.
Dr. Michelle Neier (40m 30s):
And I really want it to be a place where people feel safe, where they feel safe to express themselves, to ask
questions, to talk about what they need so often and, you know, by necessity. So often many medical offices
are crowded. They’re busy, they’re sterile.
Dr. Michelle Neier (41m 1s):
We walk in, we have, you know, two minutes with the physician to ask all of our questions. I really want this
to be a different kind of experience. I want people to be able to sit in a comfortable chair, have a cup of tea
and to take a breath. You know, I always joked one of our amazing massage therapist at Mars town used to
say to me, Michelle, breathe, just breathe, just breathe. And I would joke around with her and say, Oh God,
leave me alone with the breath already. But she’s right. You know, I want people to just take a minute for
themselves so that we can really have a meaningful and productive conversation about how to improve their
lives, how to make things better, how to get to a better place.
Dr. Michelle Neier (41m 45s):
So I’m very excited. I’m very hopeful. I am looking forward to this next stage, this next journey.
Dr. Anthony Orsini (41m 54s):
That’s fantastic. As a osteopathic physician, that integrative medicine component has been kind of pushed
into me since I was, you know, first entered medical school. And so I think it’s so important. It’s something
that’s up and coming. I think more and more people are realizing that medicine is not about just giving
medicine, that there’s a whole body approach and you have to treat the mind, the body and the spirit. And so
I love the way you smile when you talk about that. And I’m so blessed that you agreed to come on this
podcast, we accomplished our goal of inspiring and teaching, and I knew we would.
Dr. Anthony Orsini (42m 33s):
So I want to thank you so much for coming on. It’s been really great. Thank you, Tony. And it’s just really an
honor. If you want to find out more information, you can contact me at <inaudible> dot com. If you enjoyed
this episode or any of the other episodes, please go ahead and hit subscribe, leave a review. It’s very, very
important. And anytime you want to refer someone to the podcast as a guest, please let me know again,
thank you to the audience and I will see you again next Tuesday, Michelle.
Dr. Anthony Orsini (43m 3s):
Thanks again. I really appreciate it. Take care Michelle.
Narrator (43m 7s):
If you enjoyed this podcast, please hit the subscribe button and leave a comment and review. If you would
like to contact Dr. Orsini and his team, or to suggest guests for future podcast, visit us at The OrsiniWay.Com

Read the transcript of Dr. Orsini’s podcast with Chief Heart Officer of VaynerMedia Claude Silver

Claude Silver (2s):
You know, just reminding myself that we’re all in this together. We are all humans. We are all going through
something before you enter that door. Or before you turn on that zoom, you have had a life, you know, you
have to homeschool your kids right now. You have to get lunch ready. You got to take the dog out, whatever
it is. And so let’s remember that when we enter in to a conversation or when we go to work, let’s remember
that other people are doing exactly what we’re doing or waking up.
Claude Silver (35s):
We’re putting our feet on the ground. We’re having a cup of coffee and we have other things going on in our
lives. Other than just the hustle that we do at work.
Narrater (45s):
Welcome to difficult conversations lessons I learned as an ICU physician with D r. Anthony Orsini. Dr. Orsini
is a practicing physician and president and CEO of the Orsini way as a frequent keynote speaker and author.
Dr. Orsini has been training healthcare professionals and business leaders. How to navigate through the
most difficult dialogues. Each week, y ou will hear inspiring interviews with experts in their field who tell their
story and provide practical advice on how to effectively communicate.
Narrater (1m 17s):
Whether you are a doctor faced with giving a patient bad news, a business leader who wants to get the most
out of his or her team members or someone who just wants to learn to communicate better, this is the
podcast for you.
Anthony Orsini (1m 30s):
Well, welcome to another episode of difficult conversations lessons I learned as an ICU physician. This is Dr.
Anthony Orsini and I’ll be your host again today. Today, my friends you are in for a special treat because
today I have the distinct honor and pleasure to interview Claude silver, who is the C hief Heart Officer at
VaynerMedia. And for those of you not familiar with VaynerMedia, VaynerMedia is a full service digital
agency serving fortune 500 companies.
Anthony Orsini (1m 57s):
Claude works alongside Gary Vaynerchuk, the CEO of VaynerMedia , who is a serial entrepreneur and
public personality. His podcast, the Gary Vee Audio E xperience is one of the most popular podcasts on
Apple for the last two years running. And I highly recommend it and I do subscribe myself as Chief H eart
Officer, Claude oversees everything at anything that has to do with the people who make up the incredible
company called Vayner media. Claude’s current role is the capstone of a career spending over 20 years at
numerous fortune 50 companies, she has known for taking a particularly human approach to human
resources, unlocking employee’s potential for forming close person to person connections, fostering an
inclusive culture, empowering purpose-driven teams and inspiring the entire organization.
Anthony Orsini (2m 44s):
Her success is driven by a passion for creating spaces in which people can succeed. So welcome Claude.
Claude Silver (2m 52s):
Wonderful to be here, Tony, thank you so very, very much. And thank you for all of the work that you’ve been
doing. Well, I have say that, although
Anthony Orsini (3m 0s):
It’s an often overused word, I really am truly honored that you are on this podcast with me. I’ve heard so
much about you and full disclosure. My daughter’s Summer works at VaynerMedia . I think it’s a little bit
more than two years now. So I know firsthand that when it comes to providing a supportive and empathetic
environment that Claude and VaynerMedia practice what they preach, my daughter loves working there and
she loves the environment that you and Gary have created. So I can attest to the audience right now that
Claude and Gary just don’t say the right things, they actually do the right things.
Anthony Orsini (3m 37s):
So please listen, because cloud’s can have a lot of great things to tell you COVID each and every week I
renewed my promise to my audience that by the end of the podcast, they’ll feel inspired and they will have
learned practical communication techniques that will help them in their private and personal lives. Especially
during those difficult times and having you on this show, I have no doubt that I’ll keep my promise. So
Claude, as you know, this is about communication and the difficult conversations that we have, but before
we get into that and go into the communication part of it, I just want them to know a little bit about you.
Anthony Orsini (4m 14s):
So tell us about who Claude Silver is, and maybe perhaps providing just a little context on the incredible title
that you have of chief heart officer.
Claude Silver (4m 25s):
Fantastic. Yes. Thank you. Thank you again, my name is Claude Silver. I am the C hief Heart Officer at
VaynerMedia and in a nutshell, Gary and I came up with the title chief heart officer for a very, very basic
reason. Human beings have hearts. Hearts are the central operating system of any human and human
beings are the central operating system of any organization. We consider people to be human and hearts,
not employees, not people that work for us.
Claude Silver (5m 2s):
We work for them. It really is a self fulfilling organism, if you will. And I got my start a long, long time ago, I
got into the digital world in 1998. I had been working towards getting my MSW. I thought that I would go
down the same path as my mom being a psychotherapist. I have a heart that wants to help. That is just the
way I was raised and the massive belief that I have that through compassion and empathy, listening, and
creating value for people that we can do just about anything.
Claude Silver (5m 37s):
So I’ve been in this world in terms of mentorship and coaching for a very long time, ran ropes courses,
outward bounds, you name it, and I’m here to hold space for people. And then to spring into action is what I
would say.
Anthony Orsini (5m 52s):
That’s fantastic. You once said, and I’m going to quote you here. ” I want to bring the human back into
human resources and humanity back into the corporate culture. I believe that everyone needs to know that
they belong. I believe in empathetic cultures and servant leadership, and I’m on a mission to create a
revolution of tenderness. We no longer need to be known as our titles. And that’s pretty important. I’ll get into
that because that’s another parallel between you and me. We are human beings. First. I’d like to know how
difficult has that been for you to do that at Vayner?
Anthony Orsini (6m 25s):
And why do you think other companies are lagging behind vain or when it comes to that?
Claude Silver (6m 29s):
Yeah. So I’ll start with the second part of the question first, which is, I believe that people see leadership as
an authoritative role. I believe people still see leadership as a title leading from an ivory tower. You work for
me. I don’t, it doesn’t really matter to me what goes on in your life other than the eight and nine hours that
you’re punching in and punching out, I report to, this is what a leader would say. I report to my shareholders,
or I have to hit my quarterly numbers so forth and so on.
Claude Silver (7m 4s):
And right then and there, it removes the entire human from the process. It’s an Excel sheet. It’s a, I need to
get from point A to B and you’re going to do that for me. So I think there’s a lot of micromanagement. I think
there’s a lot of power and control and we can get into that in my ideas of why now, the way that we do that at
VaynerMedia comes from the top. We have an incredible leader and Gary Vaynerchuk, who is not only a
CEO, he is a practitioner. He is an executioner.
Claude Silver (7m 34s):
He knows what is going on with all of the people there, with the process there, it’s amazing that someone
that is so busy can really concentrate as he calls on the sky and the dirt and the dirt, meaning like the
operations what’s going on under the hood there. So Gary is an empath. He is full of self awareness and EQ.
And if you’re going to work at VaynerMedia media and succeed, that’s the name of the game. It is very, very
rare that you will find a micromanager or a control freak there.
Claude Silver (8m 8s):
It just doesn’t work. You would be the odd man woman out. And you know, that’s not what you want to do at
Vayner. You want to be part of the collective. We are seriously a culture of we not, I. It’s something that I’m,
I’m so incredibly proud to co cultivate on a daily basis, along with everyone, including your daughter, you
know, it takes a village.
Anthony Orsini (8m 30s):
Do you think other companies are having trouble getting to where you are? Is it that they don’t want to, or
they’re just not evolved or, or, and, or maybe possibly they are, is this catching on?
Claude Silver (8m 40s):
Well, I think it’s a mixture of both. I mean, I think there’s a new Dawn right now. Now not only because we’re
in COVID and we’re really all awakening to the black lives matter movement. I mean, yes, that is incredibly
important where we are currently, but we’ve got the millennial generation with us and we’ve got generation Z
right on its tails. And these folks will not stand for the old guard. They will not stand for how it used to be with
boomers or gen Xers like myself.
Claude Silver (9m 10s):
They want to work at a place that makes them feel proud. They want to find meaning in their work. They
want to be given actionable feedback. They want growth and development. They want purpose. They want
to take part in something they don’t want to just be adjuncts. So that I think is one of the real reasons that we
do need to change to meet this incredible workforce and to retain this incredible workforce, because that’s
really key. The other thing is that as we know, you can open up any HBR article or any, you know, inc
magazine.
Claude Silver (9m 45s):
There is a lot of talk about mental health right now about anxiety. This generation, or these generations are
very open about what’s going on in their worlds and what they’re dealing with. And so we need to meet them.
We need to cross the bridge and link arms with them. Now, I don’t think we have a choice. And by the way, I
wouldn’t want the choice. This is the way to be. Why wouldn’t I treat the people I work with eight, nine hours
a day, the same way I treat my friends when I go out to brunch with them or my soccer team friends, or my
aunt, my, you know, whomever like why I don’t understand.
Claude Silver (10m 22s):
I never have really understood the difference between shutting off one part of your yourself, your being to
walk into a door. And all of a sudden it was just like, you don’t have no feelings or, you know, you’re much
more of a stick figure. So anyway, long way, winded saying times have changed. The revolution is
happening. And I do know that we will continue to evolve and transform into much more empathetic cultures
and companies.
Anthony Orsini (10m 52s):
So that, that leads beautifully into what I want to discuss next. And there’s so many parallels between what
you do and what I do as you know, I’m in the medicine space. Medicine’s a little bit differently in that, you
know, in the early 1900s, medicine was all about healing compassion. There wasn’t many procedures that
we had other than hold someone’s hand and say, you know, I hope you get better. But over the years, since
1912, to be exact over the years, physicians and nurses have been told not to feel.
Anthony Orsini (11m 23s):
And they’ve been told that you can be a better scientist if you’re not empathetic. And what I saw in medicine
over the last hundred years is that you see that the rigors of being efficient, the administration coming down
on physicians saying that you need to see more patients in a faster amount of time and economics of
medicine. And then being told from the beginning that you’re not supposed to feel, but it’s happened is
there’s been this major gap between the healthcare providers and the patients, and that has led to burnout.
Anthony Orsini (11m 55s):
And we were told to beginning that we wouldn’t burn out. If we didn’t feel when actually the opposite now is
coming to light. And that there’s more and more studies showing when you feel, when you show that tear,
when you show that compassion and you actually protect yourself on burnout. So I guess there’s a question
in there somewhere and what I mean by that. And so, by the way, the RC, anyway, that’s what we do. We
teach people how to reconnect. I believe that every human being has compassion or empathy, it’s there,
whether you’re a physician, a nurse, or you’re a business leader, but I think what happens is the rigors of
everyday life just kind of get to you.
Anthony Orsini (12m 31s):
And sometimes we forget. Do you think that’s what happened in business is, was the pursuit of the bottom
line and the perception that if you’re feeling and compassionate and empathetic, that you were weak, is that
how we got here in the first place? And now we’re recovering?
Claude Silver (12m 46s):
Well, I think that’s, you’ve, you’ve summed it up pretty well. For some reason, I believe probably in, after the
great depression people had to feed their families and people had to punch in and punch out. And there was
not a lot of emotion required, required. I saying in parentheses required, needed, or probably desired at the
workplace. It was a place that you were potentially moving up a ladder, but really you were bringing home
bread and butter for your family.
Claude Silver (13m 19s):
And the working world was very much still manual. We started going into our head towards the information
age and you know what, that the head right there, if you’re, you know, going in and building code or techie or
whatnot, you’re really almost decoupled from your heart. I mean, you work in this world. It’s incredibly, very
scientific and it’s very analytical and it’s very left brain. So I think what ended up happening towards, you
know, this is just a one person’s opinion, but I think at some point in the late seventies, the markets opened
up and people began to see that they could make a lot of money.
Claude Silver (13m 58s):
And I think Michael Douglas portrayed it incredibly well in wall street. That greed is good. That’s the
American way, having whatever you want when you want it and work hard, put your head down, you’ll get it,
you’ll get the boat, you’ll get the cars, whatnot. But that is so devoid of heart. That is so, I mean, put your
head down right there. There’s not like w w how about the notion of get your heart into it? So I think society
in many ways, dictated or translated to people what they needed to do if they wanted to get from a B to C,
and here we are, you know, 20, 20, 20, 20, 21 in a global pandemic where what we need to be doing, what
we are doing is putting our hearts into it, to help one another.
Claude Silver (14m 51s):
We are in this collective pandemic together, regardless of what, what, what race you are, regardless of who
you’re going to vote for. We’re all experiencing the same thing. And there’s something I think, incredibly
special and tender about this collective and this experience that we’re going through right now.
Anthony Orsini (15m 10s):
Let’s talk about the pandemic. You once said that it’s your job to keep the pulse of everybody at
VaynerMedia to know about what’s going on. I’m a big body language person. I teach a lot of body language.
70% is nonverbal of our language. I would think that that’s easier to do while you walk the floors of
VaynerMedia to look around, to see what’s going on and pick up things. But now all of a sudden everyone’s
working at home. And so how difficult has it been for you, during COVID to keep the pulse of the company?
Claude Silver (15m 39s):
It’s actually not that difficult because I’m sitting here on a screen and other people are coming on and they’re
sitting on a screen. So, I mean, there’s a real presence here. I mean, when you and I are on a screen
together right now, and we’re looking at one another, I’m not reading the magazine or I’m not looking up and
down. So I’m very focused on you. And you’re very focused on me. And I think that that’s something that by
the way, takes intention, I have to read you in a different way. I have to hear your tonality in a different way
when we’re on these zooms.
Claude Silver (16m 10s):
And we all occupy the same size square. There’s something really fascinating about that, right? It really like
it strips power and superiority and leveling just right out of the window there, because we all take up the
same amount of square. It’s, it’s fascinating. But the thing that I’ve been talking about since we entered the
pandemic in March is that there is a, an incredible awareness that we need to have as we enter someone
else’s domain. As I enter your living room, your closet, wherever it is, you’ve set up shop because, you know,
look, we’re doing what we can.
Claude Silver (16m 45s):
You’re, you know, some people are sitting in a closet, some people are working from bed and as leaders, we
need to be incredibly sensitive and aware and awake to what we are being invited into, because that’s not
the way the working world really was set up. Right. You go to an office, you all look the same for the same
cubicle. So I think there’s this extra element of a listening, making sure that everyone has an opportunity to
speak is incredibly important. That is an and I think ritual.
Claude Silver (17m 15s):
And it’s something that I’ve talked quite a bit about because as you walk around the office, as you walk
around the hospital, you’re able to say, hi, how are you? How high five, you get a coffee with someone you
check in, whatnot. You go to the bathroom, that’s three minutes of interacting with people, right? And now
you don’t have those micro breaks and you don’t have those micro moments to kind of decompress and
cognitively shut off for a second. So now what we need to do is make sure is make sure that we’re getting
those micro breaks and being able to take our mind off of the screen for little moments in time.
Claude Silver (17m 52s):
So, you know, checking in with people, making sure that you have the rituals when you get back online. No.
How are you talking about something that’s very, almost very benign just to kind of, you know, shoot the, you
know, what, for a bit to remind each other that we’re human and we’re each going through this and then get
into whatever it is you want to get into.
Anthony Orsini (18m 10s):
Great, fantastic. So let’s shift over to difficult conversations now. So what is the most difficult conversation
that you have with your employees and what advice can you give to managers? And to have those
conversations, I’m a firm believer that the difference between a manager and a leader is how they
communicate. And that the biggest problem that companies have is promoting the smartest person in the
group who can’t communicate, who doesn’t have any empathy and then can’t retain employees.
Anthony Orsini (18m 41s):
So what would you say in your every day, or even either a common communication that you do every day
that’s difficult or maybe the most difficult?
Claude Silver (18m 51s):
Yeah. That’s, I mean, it’s a great question. I think that, you know, obviously when you are terminating
someone and letting someone go, it’s a terribly challenging conversation because you are changing that
person’s life right there, you are eliminating a paycheck, potentially. However, those are not the difficult
conversations for me. In fact, when I have those conversations and the person is sitting there with me, what I
will say is this is going to be a challenge in conversation, or this will be a difficult conversation because that
is the truth.
Claude Silver (19m 24s):
So those aren’t the hard conversations. The harder conversations for me is when I have to get out of my own
way and stop chickening out. And I need to tell someone feedback and observations, and what’s really going
on, where are they not excelling? How are they misbehaving? If you will, what we need to see from them?
Performance plans. You know, those are harder for me because look, I know the minute I start that
conversation, the person is waiting for the other shoe to drop.
Claude Silver (19m 55s):
And so how am I holding that person? And how am I holding that space? Whether or not it’s on a screen or
in person so that I can really, really try to help their cortisol levels go down. So their anxiety goes down.
That’s really key. Otherwise, look, fight or flight is happening every minute of the day. If not. So the harder
conversations are more challenging for me because I have to make sure I can be honest and empathetic.
But the honest part is really, you know, I have to be crystal clear with feedback.
Claude Silver (20m 26s):
You have to be very specific with feedback because me telling you, Hey, great job. Nothing. That means
nothing me telling you it was okay. You could have done better. That means nothing, but so I have to go the
extra mile and that’s what we have to train people to do to go the extra mile of the why and how am I going
to help you get there? My book that
Anthony Orsini (20m 48s):
I just published with a few months ago, it’s called it’s all in the delivery. And that’s a quote from WC Fi elds
that old comedian, they asked him why his jokes were so funny and his, his answer was it’s all in the
delivery. And I stressed that so much during my communication training. And it sounds like you’re very aware
of that. How do you teach your managers to do that? Do you use certain exercises or how do you teach our
manager to give good feedback?
Claude Silver (21m 13s):
Well, we role play. That’s exactly how you do it. And so, you know, whether or not we’re doing improv or I’m
giving them some examples to get up on in front of the room and role, play that out with a colleague. That’s
what you have to do. And yes, it’s funny, right? It’s almost like an SNL skit, but why is it also funny is
because we also know how poor we do feedback. It we’re laughing because it’s, it’s, you know, so Kim Scott
wrote an incredible book called radical candor and radical candor is a way to critically give someone
feedback while caring about them personally.
Claude Silver (21m 47s):
And she’s got some steps that are lined out, which is, you know, being clear, being specific, being kind,
obviously being current. So don’t give me feedback from something I did three months ago, or even three
weeks ago and actionable. And we use those principles to really train people on feedback. I call it feedback
training one Oh one, and we take the org through it at least three or four times a year and do a lot of
practicing. And so that’s what, you know, that’s what some of the learning and development that we’re doing
and training and development, because we can’t expect as much as I would love to say, everyone knows
how to turn on their empathy gene.
Claude Silver (22m 28s):
And everyone knows how to turn on their compassion. That’s not the case. People are wired differently. So
the training and getting it instilled into their DNA really is what we need to do.
Anthony Orsini (22m 40s):
When I train physicians on how to have interactions, especially during break venues, we use professional
actors, actors that have been on Broadway, who volunteer their services. And we’ll play a mother who just
lost the baby, or we’ll play a husband who just heard that he had cancer because it has to be so real. We
bring these doctors in and nobody wants to be videotaped. We actually videotape them. And then we bring
them in the room and that’s where they really look. And they see their body language and how
uncomfortable they were in this situation.
Anthony Orsini (23m 11s):
We had one doctor, I was asked once by a hospital administrator to speak to a doctor who was particularly
not very pleasant to his patients. And he was, he was in trouble losing his job. And so we put him through an
improvisational role-playing and he didn’t want to be there. He was very angry. This was remedial stuff for
him. And we brought him in and he had to discuss a medical error. He had to tell the actor that they left a
sponge in her and the actors. She’s amazing. And she was great. And she was playing this old Italian
women with the Italian accent.
Anthony Orsini (23m 43s):
It was really, it was very, it was very clever. The point is he sits back after the conversation is over. He sits in
the room with me, we’re watching the video tape with me and my team and my team is going, he was so bad
and he was such a jerk like D r. Orsini, you’re going to take this one. I I’m not even gonna say anything to
him. And I said, just let him watch. So he watched for about two and a half minutes and part of my language,
he looks up at me and he goes, I am such an asshole. I said,
Claude Silver (24m 15s):
Okay,
Anthony Orsini (24m 15s):
You said, you think so like, well, you know what, I’m trying to be positive with them. But the point is that that
kind of role playing, he is now an instructor for me. And he teaches other doctors on how to be empathetic
and compassionate. He just didn’t know. And I think the role playing really makes a big difference. The back
to the COVID in the last few months, there’s, you know, the hospital’s been so busy. I haven’t been doing a
lot of training with the hospitals, but what I have had is I’ve had several companies contact me, one
international company that said our human resource, people now are in a position for the first time to call
people on the phone and say, Sally, John who sat next to you for the last five years, just die to COVID.
Anthony Orsini (24m 57s):
And we can’t have a Memorial service because we have to do it by zoom and I have to call. And they’re just
not prepared for that. So what advice for, I don’t know if you’ve had to do it personally, and I don’t know. I
hope they enter, hasn’t lost anyone to COVID. I know you’re one over 800 people, but that’s an incredible
conversation to have. How would you approach that? Or what would you say to your HR people that need to
learn how to do this? This is a terrible time,
Claude Silver (25m 25s):
Terrible time. I mean, it gives me shivers. We have not had that situation happen. Thankfully, there are times
that I’ve had to share with other people that one of their parents has died because I got the phone call first,
but that is a, that’s a different story. You know, my version and my vision for HR is that we are seen as
coaches and we are seeing much more as, you know, Sherpas, if you will. So guides and guides like anyone
else need the same type of training.
Claude Silver (25m 57s):
They need to know what the trail is going to look like before they get on that trail. And so the training is really
important. How you enter into that conversation is with as much grace gentleness and what I like to call, you
know, a generosity of spirit, because you are delivering such life altering news to another person that you,
you may feel ill-equipped, but you know, the idea of empathy is that I’m walking alongside you.
Claude Silver (26m 32s):
And so let’s try to imagine, even though it’s a horrendous leap to imagine that one of your coworkers has
died or your, your family member has died, try to imagine it would be like hearing that news, put yourself in
that position and what would you need to hear and how you need to hear it and then go forth and do it.
There are tons of ways we can step in the doodoo tons of ways, but there are even more ways that we can
leave someone at least feeling held and seen and cared for.
Anthony Orsini (27m 8s):
My audience is probably getting tired of me, quitting rabbi Kushner, they author of When B ad Things
Happen to Good People. I I’ve read everything that he ever had. And Rabbi Kushner talks about those times
and says, when you don’t know what to say, just say, you’re sorry. And shut up for you. Say something
stupid. We teach this, I developed this acronym called program on how to discuss bad news. And the P is for
P lan. It’s amazing how many people go into these difficult conversations, no matter what they are review a
termination as separation as they like to call it without a plan.
Anthony Orsini (27m 40s):
And I think that’s the first step. And the G is that is gradual and genuine. If they feel that you genuinely care.
And part of the plan is that take a deep breath, imagine what it’s like to be that person and then speak to
them. So I think it’s just wonderful advice that you gave before we close. Just a couple other questions,
difficult conversations with your boss, you and you and Gary. I’ve seen so many different interviews with
you,. And you and Gary have this great relationship.
Anthony Orsini (28m 11s):
And you’ve, I think you’ve even described yourself as two sides of one coin, but good leaders don’t surround
themselves with people who say yes all the time, because, and I’m sure Gary doesn’t want to do that either.
So although you guys are so great together, there’s probably, I’m sure sometimes you disagree with Gary.
How do you think that conversation? Cause that’s a difficult one.
Claude Silver (28m 32s):
It is a difficult one. You know the thing about Gary that I know, I always know ahead of time, is that at least
he’ll listen. And I mean, at least isn’t even the right word. Gary will listen and he may disagree, but he will
always hear me out. And then tell me his side of the coin. We’re always going to come at things with the
same type of heart, which is based in humanity. And we’ve had a lot of these conversations as of late, as
there have been things due to COVID are due to diversity, equity and inclusivity that we’ve had to move on
very, very quickly.
Claude Silver (29m 8s):
And so there’s not a lot of planning that takes place. So some of what we’re doing is shooting from the hip
and you know what? His hips may say something different, but they’re always going to be aligned in some
way, shape or form or else. I wouldn’t be able to work there if he and I were so off base, if the way he and I
communicated was so off base or our beliefs, then it wouldn’t be the right match. So that’s the first thing. I
think the second thing that he and I are both getting much better at is being candorous with one another is
just there and where my, you know, none, he, he nor I like conflict.
Claude Silver (29m 47s):
And that’s kind of where, again, we’re the two sides of the same coin, but you know, well, so be it, you got to
get involved in some of these conversations. So we both been doing a better job at being much more
candorous with one another.
Anthony Orsini (30m 4s):
So there’s a millennial out there, or a gen Z or someone who is in a position they’ve been at work for three,
four, five years. They want to have that conversation with their boss and they want to go in and they want to
say, you know, I don’t think that I’m, I’m not going to put words in your mouth, but they want to move up.
They want to do more. What advice can you give that person to say, this is how you speak to your boss
about, Hey, I’m ready to do more. I’m ready to move up.
Claude Silver (30m 30s):
So the boss is always going to be listening for what are you going to do for me? How are you bringing me
value? So, I mean, I think that’s really a huge part of it. So I think that you want to couch that conversation in,
I believe I’m a good fit for this role because I have done X, Y, and Z. And I can bring more value to you by
training the rest of your staff or by going after the bigger kahuna or whatever it is. So, you know, look bosses
are going to, managers are going to want to hear, like, in a way, like, what are you going to do for me?
Claude Silver (31m 4s):
What are you going to alleviate for me or for the team that is, that is true, right? Because we’re all hustling
here. But I also want to just say for that gen Z or that millennial, it is also okay to say this is a hard
conversation for me. I’m working on myself, confidence, hear me out. I may stumble on my words. Like,
there’s nothing wrong with saying things like that because it’s real. And I know not every place is like Vayner.
I know it. So these are not easy conversations, but when someone takes that second to just, you know, give
them the real, real, I believe that you are then activating some kind of feeling of goodness in that other
person, the person listening, where you can almost be like, okay, I can get a little soft here.
Claude Silver (31m 50s):
I can be vulnerable here as well. I remember what it was like to be 23 years old asking for a raise. And the
drum that I want to always beat at is, remember you were there. Remember you were there. There’s no
difference between me and someone that I manage. I was already there. And also that’s why as a leader, I’m
very, very clear that I’m here to turn them into a champion I’ve already been there.
Claude Silver (32m 20s):
So they, yeah. So, so they got me whatever they needed.
Anthony Orsini (32m 24s):
So one final question before we leave, I had something happen to me early on that we discussed earlier
about why I got into communication and compassionate and medicine. And I know Gary’s had a big
influence on you, but other than Gary or your parents, I see the soul in you. And it comes through in your
body language and what you do in this heart and this really full soul, if you would. So other than your parents
or Gary, who was it that you can look back on and say, I happened to see him or her and I, she just had such
an influence on me.
Anthony Orsini (32m 58s):
Was it one person that you can name or maybe two?
Claude Silver (33m 1s):
I mean, it was my Nana. So I talk a lot about, yeah, she would have been 105 yesterday. She had the most
empathy of anyone I’ve ever known. She had the biggest heart. In fact, we called each other Heart. I’ve
written a couple of pieces on that. And I’m telling you, she wouldn’t leave trading. I mean, it’s, it’s incredible.
And she was alive, you know, when I got the role, but she would leave trader Joe’s or leave the bank or
leave whatever. And she would say, Tony, cause she’d see your name tag.
Claude Silver (33m 33s):
Would you do me a favor? Would you have a nice day?
Anthony Orsini (33m 39s):
That is so sweet.
Claude Silver (33m 40s):
I mean, right. And so she’s with me every day. And you know, just reminding myself that we’re all in this
together, we are all humans. We are all going through something before you enter that door. Or before you
turn on that zoom, you have had a life, you know, you have to homeschool your kids right now. You have to
get lunch ready. You got to take the dog out, whatever it is. And so let’s remember that when we enter in to a
conversation or when we go to work, let’s remember that other people are doing exactly what we’re doing or
waking up.
Claude Silver (34m 19s):
We’re putting our feet on the ground. We’re having a cup of coffee and we have other things going on in our
lives. Other than just the hustle that we do at work.
Anthony Orsini (34m 27s):
Tony Robbins talks about building rapport with people and how you connect with people and finding
commonality. And we’re so different. We’re so diverse. And that’s a great thing. When I teach physicians and
healthcare providers and even resource people. What I try to say to them is there’s commonality in everyone
that there is the matter of who you are. There is something that we have in common, right? It doesn’t matter
how many differences we have. And you could find that commonality in just a few seconds, because what
you said was people are going through the same things that you’re going through.
Anthony Orsini (35m 1s):
And so I teach physicians, you may walk into a room and see a book on the table, or you may walk in a
room. And you know, I have patients down in Florida that I’ll walk into the room. Maybe the mother or the
father is not happy because something went wrong with the hospital. Stay, I walk in the room, I see a
Yankees hat and I know bingo I’m in. Right. And so be genuine. And I see that in you. And we can find
commonality with everyone. And this is a time where everybody’s so divided. But if we think about it, no
matter how divided you are, there’s something in common.
Anthony Orsini (35m 34s):
It probably can take less than 30 seconds to find it. Yeah. Well, this has been incredible. I know how busy
you are and I really appreciate you being here. I think my audience is going to be really thrilled when they
hear this drop and it’s just another journey and I’m so happy what you’re doing. And I see so many common
things. I’m in the healthcare, moving into the business. You’re already doing this hard stuff in the business.
My daughter loves working for you. She loves working at VaynerMedia. My cousin also works there. James
Orsini. I hope to have him on to someday.
Anthony Orsini (36m 6s):
I’ll speak to him about that in a few weeks, but thanks again so much for coming. I really, really appreciate
that. Thank you. Thank you and to your audience. So thank you so much for doing what you do every single
day. I really appreciate you. Thank you so much. If you enjoyed this episode, please click download and
please share on social media. You can hit the subscribe button. If you want to learn more about the Orsini
way, we’re at TheOrsiniWay.com and you can contact me with any questions and I’ll be posting this up soon
and we’ll let you know. So thank you so much.
Claude Silver (36m 36s):
Thank you, Tony.
Narrater (36m 38s):
If you enjoyed this podcast, please hit the subscribe button and leave a comment and review to contact Dr.
Orsini and his team, or to suggest guests for future podcast, visit us at TheOrsiniWay.com

Read the transcript of Dr. Orsini’s podcast with Dr. Larry Barton as they talk about Difficult Conversations in the workplace

Larry Barton (3s):
No, the person may have padded their travel expenses. I’m not trying to say it’s not an important issue, but
the war is nothing about it. This person has to go home with their family, right? And this is what, again, the
people that just praise in HR, sometimes they’re also part of the problem or their supervisor. You know, Janet
Marco, I’m placing you on leave because we’re conducting an investigation. What in God’s name are we
doing? Why do we have to say that? So what I try to say to people is we’re conducting a review and some
people might say, well, that’s too soft. Well, I have to take that word investigation home to my family and say,
listen, I’m on leave.
Larry Barton (38s):
Why am I at home rather than going to the office of the plant every day? So it’s the words we use.
Announcer (43s):
Welcome to difficult conversations lessons I learned as an ICU physician with Dr. Anthony Orsini is a
practicing physician and president and CEO of the Orsini way as a frequent keynote speaker and author. Dr.
Orsini has been training healthcare professionals and business leaders. How to navigate through the most
difficult dialogue each week, you will hear inspiring interviews with experts in their field who tell their story
and provide practical advice on how to effectively communicate whether you are a doctor faced with giving a
patient bad news, a business leader who wants to get the most out of his or her team members or someone
who just wants to learn to communicate better.
Announcer (1m 28s):
This is the podcast for you.
Dr. Anthony Orsini (1m 31s):
Hello everyone. This is Dr. Anthony Orsini. Welcome to this episode of difficult conversations. I’m very
excited to have another amazing guest today, dr. Larry Barton, I’ve had the honor of knowing Larry for years,
he’s somewhat of a friend and a bit of a mentor, and I promise you that you are in for a real treat today. Dr.
Larry Barton is one of the world’s leading experts in crisis management and threat assessments. He
currently serves as the distinguished university professor of crisis management and public safety at the
university of central Florida, barely graduated Magna cum laude in speech and communication from Boston
college.
Dr. Anthony Orsini (2m 6s):
He earned his master’s of arts and international law and diplomacy from Tufts university. And he continued
his education at Boston university, where he earned his PhD in international relations and public policy. Dr.
Barton has the distinction of being named the very first ever Fulbright scholar to Japan and crisis
management prior to his current position. Dr. Barton served as president and CEO of the American college
from 2003 to 2013. And for the past 14 years, dr. Barton has remained the highest rated instructor at the FBI
Academy in us Marshall service, where he teaches courses in threat evaluation to federal and state law
enforcement, Dr.
Dr. Anthony Orsini (2m 46s):
Barton design strategies and solutions addressing workplace violence prevention and crisis mitigation is a
frequent commentator on television networks during and after incidents of public violence for CNN, the BBC
and CNN, BBC, and other news outlets. He is the GoTo man. Larry is the author of four bestselling books on
crisis response. His book crisis leadership now was voted one of the best business books of the year and his
latest book, which I just finished reading and really enjoyed it is titled the violent person at work.
Dr. Anthony Orsini (3m 16s):
The ultimate guide to identifying dangerous persons and is already a big hit in 2018, dr. Bart was named the
recipient of the distinguished service award from the international security management association. The
world’s latest organization of chief security officers prior recipients included the director of CIA, the director of
the FBI and the U S secretary of state. That’s quite a list. Larry, thank you so much for coming on and thank
you so much for accepting this invitation. I’m really very excited.
Larry Barton (3m 47s):
Well, I’m delighted to be with you, Tony, and thank you for the opportunity. Yeah.
Dr. Anthony Orsini (3m 50s):
You know, each week I promised my audience two things that they’ll be inspired and they will learn
something about communication. And I have no doubt that I’m going to keep my promise this week. So
thanks.
Larry Barton (4m 1s):
I’ll try not to let you down.
Dr. Anthony Orsini (4m 3s):
Well, you and I met about, I think about four or five years ago, and we have so much in common and you
came over to see what I do with breaking bad news and wanted to observe. So you drove into Orlando and
was one of our instructors. And for those people who don’t know our breaking bad news program, trains
young doctors on how to give tragic news to patients and families. And we use videotaped improvisational
roleplaying with professional actors. And Larry sat in and the other instructors looked at Larry and you were
so nice and immediately had such amazing advice for the doctors.
Dr. Anthony Orsini (4m 39s):
Even as someone who’s not a physician, because you’re so good at having those difficult conversations.
And we became instant friends and you’ve been giving me advice ever since. And so thanks for being kind of
a mentor to me.
Larry Barton (4m 51s):
Oh, first I think you really struck something in me, Tony, which I had never thought before, just as a civilian, if
you will, that you know, many physicians and you taught me something, which was, people don’t think about
this, but physicians are really not given an hour in medical school on compassion and empathy and death
notification. You’re a specializations. You know, the curriculum is so robust in every other area, but when it
comes to people’s skills, it’s just something that you either have it or you don’t where you learn it or you
don’t. And you’ve brought that now to be really a center of excellence.
Larry Barton (5m 23s):
So I learned from you just to, hopefully it’s a two way street, so thank you. Thanks,
Dr. Anthony Orsini (5m 28s):
Larry. I want to talk about your books specifically, your latest one, but I really can’t even start until we begin
to talk about what’s going on in the world today. And I’m sure that you are busier than ever. We have the
COVID 19 crisis, which is worldwide and the United States, we’re experiencing some difficulties with racial
relations right now, and tensions are high everywhere. How has that really affected what you do and your
phone must be ringing off the hook?
Larry Barton (5m 58s):
Well, it’s very Interesting. My phone was ringing off the hook until February in terms of daily, multiple calls
regarding really my specialization know people that are posing a risk of suicidal employees, people that are
on a performance improvement plan, someone who threatens to retaliate against their employer, somebody
who might be going through intimate partner violence, and she’s a victim. And she’s concerned that, you
know, the husband is in the parking lot and may come in and basically shoot up the place. So workplace
violence and threats is the heart of what I care about.
Larry Barton (6m 30s):
And I would say, yes, the phone was going crazy in that realm until February, and then not surprisingly with
people working from home for the most part globally, it was a dramatic shift to stress and fatigue and sleep
disorders and people who could not process the new world of work. And so my practice, this is really bizarre.
It’s stronger than ever. And that’s a, I don’t like that. In other words, it’s not a good thing to be able to say
businesses up. It’s a different kind of business.
Larry Barton (7m 1s):
I’m still dealing with the occasional difficult employee and the person who is mentally ill or dealing with some
type of personal or professional stress bullying. You know, you think about all the different situations, but I’ve
had a really readjust my way of thinking Tony and support for employers in terms of dealing with fatigue and
the case load. And whether you’re a supervisor in a manufacturing plant, or you’re working in a hospital
wherever you may be, you’re an accountant, you’re a real estate broker.
Larry Barton (7m 31s):
You’re the way you look at work and the way that you’re even dealing with your children and your personal
life work balance. You know, we talk a good game about it, but we’ve had to relearn a lot. And candidly, I
think we’re at the first chapter of a very long novel. I don’t think we’re in any way, even close to
understanding the enormity, the gravity, and maybe the opportunity. And I like to know I’m an optimist. I’d like
to think this is an opportunity, but we have to look at it that way. What are we learning about the way we
govern ourselves and our people,
Dr. Anthony Orsini (8m 4s):
You and I worked on a project COVID related with some human resource people that are finding themselves
in situations that they really never were prepared for. And we have a guest coming on shortly from human
relations also. But from your point of view, what advice are you giving them? And how are the human
resource professionals holding up during this COVID crisis?
Larry Barton (8m 27s):
Well, before this call with you today in this podcast, I had a call with the senior HR person for huge company.
And I will tell you what she basically said about her people is they’ve gone from being recruiters, worrying
about compensation and benefits and performance reviews to being caregivers, internal caregivers. They’re
actually calling employees, Tony in the hospital saying, how are you? He goes, many people don’t have as
you and I have a spouse or partner or a so for single people, especially, it’s a very troubling time, whether
they’re at home, possibly sick symptomatic or in a hospital.
Larry Barton (9m 5s):
And regardless of that, a lot of people just worried about their future. So human resource people are dealing
with the uncertainty of, will there be a job for me if the company or the nonprofit can even survive what
they’re going through. So HR is probably the greatest unsung heroes of this whole COVID process.
Dr. Anthony Orsini (9m 22s):
Yeah, it’s been very difficult. I think in years, if I talk to my human resource, people they’ve told me before,
the way they separated people from employment was very legal. They had to do it very particularly now,
chief of human resources are now being renamed, chief heart officers, and compassionate is something
that’s becoming more and more part of their job. I would imagine
Larry Barton (9m 43s):
One of my favorite HR people in the country, she’s in the hospitality industry, but they’ve renamed her chief
people officer. And I just think that’s a wonderful way to look at it, which is human is kind of distant, right? It
sounds a little too formal and businesslike and Harvard business school. But when you’re a chief people
officer that kind of speaks to the compassion that you’re talking,
Dr. Anthony Orsini (10m 2s):
My daughter works in a very large company in New York city and they have a chief heart officer. And when
she told me that was the name of her chief of human resources, I thought that is great. What a great idea.
Cause it really does really does show that the employer cares. So that’s awesome. Let’s talk about your
books for a little bit. You know what I love about reading your books and I’ve read the last two is that,
although they’re very informative, they’re just not to do books. This is how you should do this.
Dr. Anthony Orsini (10m 32s):
Although again, there’s a lot of that in there, but what you do in your books is you tell real stories about real
things that happen and show the consequences of what happens when you do it correctly. And what
happens when you don’t do it correctly. And a lot of that has to do with the communication and how you deal
with that crisis afterwards. So tell me how important in your mind is communication during the crisis and give
us any advice that you can to someone out there who is dealing with the crisis.
Larry Barton (11m 4s):
Sure. Well, part of this, I think kind of parallels what you’ve done in the ERC. Any way communication is the
heart. It’s absolutely the dominant issue in terms not always, but it’s the dominant opportunity as to whether
or not when you’re giving somebody performance review or you’re giving them some kind of insight as to
whether or not they’ll take it well. And I’ll give you a couple of examples. Many of the companies over the
years, Tony, that I work with and you know, I’m on call to them 24 seven. Sometimes they’ll get on a call and
say, Hey, dr. Barton, you know, we’re currently pursuing an investigation of this person in accounting.
Larry Barton (11m 38s):
And in the moment I hear that it’s like kryptonite. I go like, I’m like curly from the three Stooges of Whoa. I
mean, I would so want to say to them, like, what are you MCIs what are you the FBI you’re conducting an
investigation. You know, the person may have patted their travel expenses. I’m not trying to say it’s not an
important issue, but the war is not think about it. This person has to go home with their family, right? And this
is what, again, the people are just praise in HR. Sometimes they’re also part of the problem or their
supervisor. You know, Janet Marco, I’m placing you on leave because we’re conducting an investigation.
Larry Barton (12m 10s):
What in God’s name are we doing? Why do we have to say that? So what I try to say to people is we’re
conducting a review and some people might say, well, that’s too soft. Well, I have to take that word
investigation home to my family and say, listen, I’m on leave. Why am I at home rather than going to the
office or the plant every day? So it’s the words we use. I’m talking about, you know, and this is the policies
and not, I think we’ve made a huge impact in the past couple of decades with many, many employers. Think
about the handbook that you have at your place of employment, Tony and many right up to, and including
what’s the phrase termination.
Larry Barton (12m 47s):
Now thinking about it, that’s one of the most offensive, outrageous phrases that we should ever have in a
human resources manual, where we talk about we’re going to terminate you and it’s, to me, that’s like
cancer. It’s terminal. You may or may not come back, but it doesn’t sound good. So I try to say up to and
including separation and people say, well, again, that’s kind of soft. Well, you know what? Separation is a
hell of a lot better. If you’re in a headline or God forbid that person comes back with a gun or a knife or
retaliate or engages in self harm. You know, I would like to think that when you are in front of a jury or in front
of just your own conscience that you review, the inventory of words you use, so communication, the way you
speak, the way you give them an opportunity to hear and process, to not be routine, to not go through a
checklist who actually give somebody a fair hearing before you make a decision, that’s how you reduce the
opportunity and their interest in retaliation, or even just bad melting your company.
Larry Barton (13m 44s):
So even if you’re not interested in workplace violence and how many people, you know, nobody comes to
work thinking someone is going to be violent today, right? Nobody ever has come to work saying somebody
is going to shoot up the place or do something outrageous. Think about rehearse, take your time. Those are
qualities of communication.
Dr. Anthony Orsini (14m 2s):
In a previous episode, I interviewed Kathy Caprino and Kathy Caprino is a life coach for women. And she
has a amazing story. She was a senior vice president at a big firm. And after nine 11, before nine 11, her
president told her to go ahead and buy a big house because she’s got a great teacher. So she did that. And
then after nine 11, she was one of the vice presidents that they decided to let go. And the words that she
remembers is our boss telling her this hurts me more than it does you.
Dr. Anthony Orsini (14m 33s):
And when I speak to physicians about breaking bad news tragedy cancer, I explained to them that at that
critical moment of their lives, that person is going to remember every little thing about what you said, your
body language. And I want to talk about language in a second, but they’ll recall everything in that one phrase
or the word termination will stick with them forever. And so, you know, many years later, Kathy keeps
remembering that this boss, that it hurts me more than it hurts you, is that she just bought a big house.
Dr. Anthony Orsini (15m 10s):
I doubt it really hurt him more.
Larry Barton (15m 12s):
Right? But your whole point here, Tony is really important for people to understand, which is you do recall
that years and decades later, the way you were treated, was it done with compassion was a genuine, you
know, I try to really focus on authenticity and I’m very blunt and saying to people, you and I were given the
gift of intuition at birth. Your mum and dad gave each one of us intuition at birth. What happens in the
workplace is we tend to tune it down. We just want to get back because we’ve got the badge we’ve been
vetted. You know, we’re part of this community.
Larry Barton (15m 43s):
We can, but guess what? If your intuition kind of says, this isn’t going well, or when Kathy was told, this hurts
me more than it hurts you. If her intuition was what a phony might be a really nice person, but that statement
is a phony. It’s just not believable. That can turn a really wonderful trusting relationship. I’m not sure it’s into a
toxic one, but it’s into one that certainly will never be the same. And that’s how friendships, it’s how you lose
people in your family that you love. You know, why, why to brothers and sisters stop talking to each other,
right?
Larry Barton (16m 16s):
Why, why do we cut off neighbors? It’s because of that one moment in time where we just didn’t manage it
properly, it doesn’t mean you’re going to be perfect. Six Sigma 24 seven, but you can’t screw up the big
ones, right? Yeah.
Dr. Anthony Orsini (16m 29s):
Yeah. I’m going to quote your latest book and you wrote, I quote, it sounds menial, but in the midst of this
crucial conversation, the words chosen an even in the way a person is escorted out of the building are
subsequently cited by violent offenders, as something they recall as a key determinant in why they assaulted
a supervisor, their recall can be uncanny. In other words, an ounce of prevention, amazing thought. I think
that that on. So I want my audience to be inspired and to learn something.
Dr. Anthony Orsini (17m 2s):
So what advice do you, You have to the, The leader out there, the manager who has to separate an
employee, what do you tell them? Give me just a few do’s and don’ts
Larry Barton (17m 13s):
Sure, I think it’s a couple of things. One would be, and we’re talking here not about the routine, right? We’re
talking here more about where, again, back to intuition, your gut basically says this person may or may not
take the news. Well, and it might be because of past infractions, their attitude, something they’ve put on a
blog, whatever it may be. But your gut kind of says, this is not going to be a routine separation from the
company. Or even if it’s not a separation, it’s a timeout. You know, we need to go home for a few days and
hula while we conduct our review.
Larry Barton (17m 43s):
So a couple of things I try to say to them is first rehearse, rehearse the conversation. Don’t assume this is
going to be a routine conversation because it’s likely not going to be. And that’s where you can kind of
remind yourself of some of the words to emphasize such as your employee assistance program, such as I
encourage you to reach out to me, but I’d like you to do it between two and 4:00 PM in the afternoon. And
people say, well, Larry, why would you give them a time? Well, one of the reasons we’ve learned, you know,
you steal this from psychology. If you say to an employee, you can call me anytime in the next few days, but
please do it between two and four.
Larry Barton (18m 18s):
That’s a test Tony of compliance. Are they going to be a compliant person and respect boundaries? But if
they start giving you voicemails or calling you at seven o’clock in the morning, that’s another indication that
this is probably not going to have a good outcome. So first rehearsal, secondly, kind of set boundaries as to
who can do what during this period of anxiety and the third. And this is what you mentioned in the book.
That’s gotten a lot of attention because I interview offenders. I actually interviewed people that have become
violent and I interviewed them in prison. Interview them as part of my work for the FBI and elsewhere is that
they do recall this parallels, your work in terms of what you do with physicians.
Larry Barton (18m 54s):
They do recall the manner in which they were treated. And so, for instance, let’s say you worked at a facility
30 years and they’ve made a determination that because you sexually harass someone or bullied or racial
slurs or whatever it may be, you’re you are being separated. Can I go back to my locker? I go back and get
the things on my desk. Well, the time to sit there and fumble is not in front of the employee, think about it in
advance and have a process, right? Which might include, you know, Carlos, I’m sorry. We do not allow that,
but you have my promise.
Larry Barton (19m 25s):
I will package up everything in your desk or in your locker. And we will have it delivered to you within the
next day, telling them that and tell him who will be accountable, because they don’t want some fumbler to be
going through their personal things. You’ve given them accountability and you’ve told them how it will be
delivered. So that matters. Also, if you do walk them out of the facility, how that’s done, right? Think about it.
If it’s done at shift change, when you have 300 people coming into the facility, you’ve just humiliated them.
Not just personally, but in front of an audience, it’s like a mini theater.
Larry Barton (19m 59s):
So how you do it, where you do it, what you say to them and from a safety perspective, one more, and I’m
sorry for the long answer, but this is the heart of keeping people safe will be, if you are worried, if your
intuition says this person could be violent to themselves or to someone else, while you’re conducting, think
about this while you’re conducting this conversation, you have someone go out in the parking lot and kind of
walk around their vehicle, just walk around it gently, because I don’t know if in the back seat there could be a
rifle.
Larry Barton (20m 29s):
There could be a Bible. I mean, there could be, it could be living in squalor. What if this person is literally
living in their car? So that kind of soft Intel can be very helpful, but when you have a security guard, walk
them to the vehicle, just remember you’re putting that guard at risk. If they reach into that vehicle and grab a
pipe baseball or something else. So those are just a few quick top of mind ideas.
Dr. Anthony Orsini (20m 52s):
That’s great advice. And in medicine and in my world, even when there’s a medical error that occurs, if we
teach the physicians how to discuss that medical error, how to be genuine, go in there with a plan. You
talked about having a plan and have your answers ready. It’s amazing to me, how many people that I’ve
trained. And I said, what was your plan when you went into that difficult conversation? I don’t know. I didn’t
have a plan. Like how could you not have a plan like Nirvana? Even if it doesn’t work out, you should have
something ready, but it’s amazing how many people don’t have a plan, but how you discuss a medical error
can make the difference between a lawsuit or in some cases, a hug, right?
Dr. Anthony Orsini (21m 34s):
And hospitals and lawyers sometimes get this all wrong. There’s a medical error. The doctor’s told that he
has to be honest, or she has to be honest, but he or she walks in with risk management, the legal team, the
CEO of the hospital, and the patients looking at them, what is going on? And I’ve given advice to risk
managements in hospitals before. And I said, listen, I know you want one of your representatives there. But
if you walk into my room as a patient with six guys wearing suits, I’m going to say, Oh my God, what just
happened here?
Dr. Anthony Orsini (22m 10s):
But if a physician walks in and says, listen, I gotta be honest with you and says it in a compassionate
manner, that patient is much less likely to be super angry, to file for a malpractice lawsuit or everything
worse. So it’s amazing to just have a plan, right? That’s the biggest bite.
Larry Barton (22m 26s):
Yeah. You nailed it. I’ll tell you one strategy that your listeners can definitely steal. And this is part of the
whole reason that I think your program as real value, I do a lot of work in retail and we’ve done. I think a
great service to the, you know, think about a customer service desk at a target, a Walmart, a CVS, whatever.
It may pick a region. Those people get abused every day. I mean, they just, they are slammed their body
slammed. They are verbally slammed. I’ve tried to encourage them, their leadership to allow them to say the
following sentence. And it’s going to sound a little awkward, but just stay with it.
Larry Barton (22m 56s):
And I think your listeners will get it 20 years ago. If you and I went into one of those retailers, Macy’s pick it
up. You were just losing it, right. That person basically did have to take it, but they weren’t allowed to say
anything right now. We are encouraging them to say, I’m sorry. You feel that way. Ma’am I think about that for
a minute. I’m sorry. You feel that way, sir. Now a lawyer. And I’ve had a lot of, you know, a lot of battles with
lawyers. Oh, Larry. We can’t say we’re sorry. Oh really?
Larry Barton (23m 26s):
But guess what? You’re going to really feel sorry when that person has their cell device that you didn’t know
is on and you’ve got a really toxic person on the other side of the counter, let’s empower them. There is no,
no acknowledgement of guilt. When you say, I’m sorry that you feel that way. So this parallels what you just
said, you’re not saying, I’m sorry that we screwed up the app index to me. Right. Or we cut out the wrong
artery. Okay. There’s a big liability issue with that. But there’s no liability in saying, I’m sorry for the way that
you feel.
Larry Barton (23m 60s):
That is an act of goodness. That’s an act of compassion. And guess what? Tony, when people do it, they
have come back and reported years later, literally the number of incidents and blow back and compliance
calls people calling corporate has gone down. And in fact, a number of people will say to that person, wow,
that’s nobody. Nobody has ever apologized to me. Thank you. So it kind of ends it, it takes away part of the
sting,
Dr. Anthony Orsini (24m 24s):
Probably the biggest piece of advice that’s going to come out of this interview today is say, you’re sorry.
Medical errors. Even when a patient dies and doctors were told when they were in medical school, not to
say, you’re sorry, it could be natural causes that. You’re not saying you did anything wrong. And in medical
errors, even if it was something that you did wrong, you cut off the wrong leg. It’s okay to say, I’m sorry. The
system broke down. I’m sorry that this happened. And in fact, in many States right now, the words, I’m sorry,
can’t even be brought up in court.
Dr. Anthony Orsini (24m 58s):
It’s not part of the litigation because we’ve seen that patients cope better short term and longterm and are
much likely to Sue. If someone just says a lot of people Sue, because, and they’re in the courtroom and
they’re saying, I just wanted someone to see,
Larry Barton (25m 13s):
You’re going to find this not I’m using because you know me pretty well, but I, every morning I wake up and I
say to my wife, you know what, good morning. And then I say, I love you. And then I say, I’m sorry. And
there’s growth. And I did this going back 17 years. She’s like, what are you? Sorry? I was saying, you’re
sorry for. I said, because whatever I do today already absolved by saying, I’m sorry. Okay. So you gotta have
a little levity with this. You have to be able to say it and to, you know, for a situation, we mean it. And, but
also understand that this is part of the compassion that you’re talking about saying, I’m sorry for how you
feel. It just diffuses a lot of anxiety.
Larry Barton (25m 45s):
That’s healthcare.
Dr. Anthony Orsini (25m 46s):
Yeah. I agree. A hundred percent. You know, neuroscientists tell us that our hindbrain, our ancient brain
makes millions and millions of assessments on someone’s body language per second. That in less than a
second, you’ve already made an assessment of someone. If you’ve read Malcolm Gladwell’s book, the blink,
he calls these slices. They’re split second decisions that you make about someone usually they’re correct.
Not always. And they really depend on the body language and the message that you receiving.
Dr. Anthony Orsini (26m 16s):
Non-verbally when you train people on how to speak to people during and after a crisis, how much of that do
you go into the, you go into their body language to tell them to sit down and things like that.
Larry Barton (26m 28s):
The answer would be no, not the way you just described. And I’m glad you asked, because I think your
listeners will really appreciate this. It’s not really about trying to read a person who does that best would be
police officers. It would be interrogators. It would be those that are conducting formal authorized
investigations, but I’m more interested in, in trying to help people would be where to sit. In other words,
before you bring someone in, as you do in a physician’s capacity, but in an employment setting, when you
preset yourself at the edge near the door with your paperwork, so that the employee you’re talking with
giving counsel to maybe promoting, maybe demoting, have them be further away from you.
Larry Barton (27m 7s):
You don’t want them at the opposite end all the way down the end of the table, because that obviously is
offensive. But the point is presetting the room, thinking about having an exit strategy. If back to intuition, you
think that it may not be a positive. The person might slam their fist, might yell, might turn the table over.
That’s why having security around the corner. Discreetly if need be to intervene matters. So I’m into more of
the situational safety aspects, as opposed to reading people. I’ll give you a ten second story about reading
people.
Larry Barton (27m 38s):
It has nothing to do with rancor, but I think might be of interest to your listeners. But this is kind of a, it’s one
of my moments from I watched somebody do exactly what you’re talking about. Maybe eight years ago, I
hosted a huge banquet at the Kennedy library in Boston presidential library. And the guest speaker was
Kathleen Kennedy Townsend. And she was the former Lieutenant governor of Maryland and really smart
person. I’d never met her before. Now, the audience, this is important to the story she’s coming in, getting all
ready to talk about at that point, Obamacare and what was going on with national healthcare.
Larry Barton (28m 11s):
She had her whole presentation, but those are the big black tie bank, but in about 400 people, well, she
comes in and she realizes at the cocktail hour, because if one comment by one person, Oh my God, this is
mostly a Republican audience. And it was, it was mostly a conservative audience. Now she tried him and
she goes, Oh my God are most of these people conservative. And I said, yes, they are. All right. She put her
notes, which are in her pocket book aside, this woman got up 20 minutes later and she just talked about
winging it.
Larry Barton (28m 42s):
She did a whinging and it was the most amazing, authentic, genuine, because she talked about nothing that
she had visited talking about, talking about Rose Kennedy, her grandmother, and the rosary. She talked
about living in a Kennedy household. She talked about, you know, what? They had to eat naughty. She
talked about the levity of family and the importance of love and compassion. And the point is she did a
complete about face. And I love that because she read the whole audience by one little slice of a couple of
people.
Larry Barton (29m 13s):
And she looked around, she was like, Oh my God, this is going to be a complete disaster. So there’s
different ways to read people. And it’s not always one-on-one. I mean, why does an entertainer, why does a
singer Frank Sinatra who I, you know, I had the privilege to watch him eight times in concert. You know, why
would Sinatra before every, and we’re going back to the paramount in 1940, all the way back into the 1980s.
Why did he always peak around? And you’ve got video of him doing this. Why did he always peak around
the curtain before even Frank Sinatra? Right? The most consummate performer ever.
Larry Barton (29m 44s):
Why did he peek around the curve? He wanted to read the audience. That’s a really insightful to me, slice of
just being human.
Dr. Anthony Orsini (29m 53s):
That’s a great story. I didn’t know about that. That was, that’s a great story. Yeah. So, you know, we talked
about having a plan, but there’s a great example of sometimes your plans not ready and you have to change
it
Larry Barton (30m 3s):
Quickly.
Dr. Anthony Orsini (30m 6s):
And in medicine, I do that. Sometimes you walk into a room and we’re going to have an episode on program
pro G R I M, and the O stands for observation. And you have to walk in to a room and you have to say, okay,
I had this plan, which you have to have it, but this is not going correctly. You know, sometimes I’m,
unfortunately I have to give bad news to a parent about their child not doing well. And the parent reading the
parent in a he or she is smiling, right? My intuition says, okay, they’re not getting this.
Dr. Anthony Orsini (30m 38s):
We need to start over again. Or I’m giving good news and they start to cry. So you have to think on your feet.
I think that’s a great story. So I know you’re, you’re a busy man, but I want to talk about your book, your
newest book and what people can expect. I already read it. It’s awesome. And to my surprise, I was in it,
Larry Barton (30m 56s):
Which I,
Dr. Anthony Orsini (30m 60s):
I think you checked me, cause you said, I told you I’m reading the book, but you didn’t tell me. And I think
you were probably testing me to see if I said, Oh, the book was great, but didn’t mention that I was in it. He
probably would have said, Oh, he’s lying. He never read it. So
Larry Barton (31m 13s):
Yeah, it was two years of work. And I, a lot of people don’t understand how much time goes into writing a
book. It is. And especially this kind of book of business book, because it’s filled with facts, right? So the fact
checking as opposed to a novel, which can go in any direction, but when you are writing a business book
about cases of caring for people, litigation, security, human resources, just the governance of people and
being good to people and also being prepared for crisis management and business recovery. And you’d
better know your stuff. So it took two years and a lot of fact finding, but it was a journey that I loved because
30 years ago, I was not very interested in violence at work.
Larry Barton (31m 51s):
My background was really focused on crisis management. You know, the storm, the hurricane, the
earthquake, the issues of any calamity that could disrupt a business. But about 20 years ago, I really started
to move into this journey because of the postal service killings and many other issues that were happening in
society. And because with the prevalence of guns, we just saw more people acting out with school shootings
and houses of worship, et cetera. So to make a very long story short, I’ve really spent 20 years now, deeply
looking at victimology. Why are people injured at work?
Larry Barton (32m 22s):
Why do people become perpetrators or wonderful employees and very good people, but why did they turn
and trying to understand and demystify for the reader? Because to your point, I’m not a physician, I’m a
behavioral scientist, but I try to really demystify what is mental illness and understanding why we have
counselors and why sometimes people need time off. And those words that we talked about earlier and how
you use them appropriately and helping keep an employer safe, but we lose two people a day on average,
Tony in the United States, they’re killed at work by coworkers in the midst of COVID.
Larry Barton (32m 58s):
Nobody’s talking about that. But you know, in the past couple of weeks, we’ve had three shootings in three
different workplaces. One of them was at a hiring event. Okay. It wasn’t a retaliatory issue of just X employee
was just at a hiring event. So it’s really trying to help people understand. And we’ve tried to unlock the
reasons why people become angry, how you can diffuse them and just be a better employer and stay safe.
That’s ultimately what it’s about. That’s fantastic. And I really did enjoy it. I love the stories. That’s the best
part of it because you don’t, like I said, it’s not just do this, don’t do that.
Larry Barton (33m 31s):
And it brings a real, it’s interesting you say that because I would say, you know, you get a lot of feedback
from meters, right? The one story in that book that probably more people than anyone has said to me, Hey,
Larry, I have either forgotten or didn’t know that story is actually about a psychiatrist in Seattle and we won’t
get into it here, but it’s the story of somebody who is very well vetted, highest credentials. You could possibly
imagine incredible impeccable pedigree as a professional, and yet who was a very deviant and a very
disturbed individual.
Larry Barton (34m 3s):
So helping to understand that it can be people in all walks of life, right? Not necessarily who’s down and out.
People in all occupations can be deviant. And to try to understand that psychopath, that sociopath, or just
that individual who is on a journey of evil is an important one for us to discuss. That’s great. And your book is
available right now on Amazon and other outlets. And if anyone wants to get in touch with you, what’s the
best way to do it, Larry. Sure, absolutely. Just write to me.
Larry Barton (34m 33s):
My email is larry@larrybarton.com and I’ll be glad to hear from all of your listeners happy to, well, thank you
so much. I am really honored to call you a friend and I am very excited that you agreed to do this. I know that
you are extremely busy. So for you to take an hour out of your time to speak to my audience, I really do
appreciate that. Thank you so much. Thank you for what you do for all your people, Tony. Great to be with
you. Thank you. If you enjoy this podcast, please go ahead and hit the subscribe button and leave a review
and download more episodes.
Dr. Anthony Orsini (35m 3s):
We have some great guests every single Tuesday. So I want to thank everybody for joining us. And once
again, thank you, Larry. Appreciate it.
Announcer (35m 9s):
If you enjoyed this podcast, please hit the subscribe button and leave a comment and review to contact Dr.
Orsini and his team, or to suggest guests for future podcast, visit us at The Orsini Way.Com

Read the transcript of Dr. Orsini’s podcast with Dr. Helen Reiss - The Power of Empathy

Dr. Helen Riess (1s):
The fact that the human brain is still so wired to perceive difference is a real challenge in our global society. I
do believe that the survival of our planet and our species is going to depend on seeing humans as human
period and a story. You’re a human I’m a human
Narrater (28s):
Welcome to Difficult Conversations Lessons I learned as an ICU Physician with Dr.
Narrater (1m 11s):
Anthony. Dr. Orsini is a practicing physician and president and CEO of The Orsini Way. As a frequent
keynote speaker and author. Dr. Orsini has been training healthcare professionals and business leaders,
how to navigate through the most difficult dialogues. Each week, you will hear inspiring interviews with
experts in their field who tell their story and provide practical advice on how to effectively communicate.
Whether you are a doctor faced with giving a patient bad news or a business leader who wants to get the
most out of his or her team members or someone who just wants to learn to communicate better. This is the
podcast for you.
Dr Orsini (1m 14s):
Well, welcome to another episode of Difficult Conversations lessons I’ve learned as an ICU physician. This is
dr. Anthony Orsini and I will be your host again this week. Today, we are very blessed again, to have another
amazing guest, dr. Helen Riess talk the reef as a psychiatrist, an associate professor of psychiatry at
Harvard medical school. She has a director of the empathy and relational science program at Massachusetts
general hospital in Boston, and is widely considered the leading expert on the topic of Empathy. In 2012, Dr.
Dr Orsini (1m 44s):
Riess found empathetics.com, which was an organization that provides empathetic training for healthcare,
business education and law enforcement. She has devoted her career to the art and science of healing
relationships. Her research has been published in leading medical journals and has won many awards. Her
groundbreaking Empathy training research, which was highlighted in a 2012 New York Times article was the
first study to demonstrate that empathy can indeed be taught. This was the answer to decades of major
media attention, demanding more empathic care from medical professionals.
Dr Orsini (2m 17s):
Helen’s amazing TEDx talk titled the power of empathy has been viewed almost 600,000 times so far. I saw
it. It’s amazing if you haven’t seen it, go do it as soon as this podcast is over. Her new book The Empathy
Effect has been translated. Helen I think in 10 different languages now, is that correct?
Dr. Helen Riess (2m 36s):
It’s been licensed in 10 countries.

Dr Orsini (2m 38s):
That’s fantastic. Dr. Riess and her teams are dedicated to transforming health care into compassionate care
systems, and I’m especially excited to have her on this podcast, especially during that time, when we need
empathy more than ever. Thank you, Helen, for accepting my invitation. It’s OK that I call you Helen right?
You know, you and I had so much in common. We are both dedicated our careers to bringing compassion
back into health care. In full disclosure. You and I have never met before.

Dr Orsini (3m 9s):
In fact, up until just a few minutes ago, we’d never even spoken, but I’m a big fan. And when I decided to do
this podcast, you are on my short wishlist. But I thought about just taking a shot inviting you. And I think I
contacted you through LinkedIn and you immediately you got back to me and you were a gracious with your
time. And I want to thank you again for being here.
Dr. Helen Riess (3m 26s):
My pleasure. Thanks for inviting me.
Dr Orsini (3m 28s):
OK. So this is a time in each podcast and I renewed my promise to the audience. By the end of this episode,
you will feel inspired and you will have learned valuable lessons to be a better and more compassionate
communicator. So get ready audience you are about to be blown away. So thanks Helen for coming again.
I’m so excited, Helen, as I mentioned before, my big hurdle in preparing this talk was really getting it down to
a reasonable amount of time. I had so many questions for you after I read your book. I know what about you
for a while now? So there’s just so many questions that I want to ask.
Dr Orsini (3m 58s):
I’ll try to keep it down to just a few questions, but lets start off with what we really need to do is get on the
same page. if you would just defining what Empathy is and, most time we get that mixed up between
empathy, sympathy and compassion. And if you don’t mind just telling me audience how you perceive
Empathy and how that relates with those other terms.
Dr. Helen Riess (4m 19s):
Sure. Those terms are often confused. So it’s a great place to start. So Empathy is the newest of those
terms. It’s only been around for a little over a hundred years and it is defined as the ability to feel with and
understand the emotions and situations of others’ as if they were our own without losing the, as if quality.
Dr. Helen Riess (4m 51s):
So we temporarily our brains are hardwired to resinate with the feelings of others and we have the capacity
to use our imaginations to perceive the situations of others and because of this really unique capacity human
beings and some animals too are moved to help. And so when we perceive suffering in others, we feel

something and we’re often able to imagine what that might be like.
Dr. Helen Riess (5m 27s):
And that creates empathic concern. And once we feel concern were then at a decision point of whether we’re
going to act on what we have perceived or whether we’re not going to. And if we take the action, which can
be as brief and simple as a caring, look, a touch on the arm, a phone call or making a large donation to a
nonprofit organization. Those are acts of compassion because I view compassion as the action arm that is
motivated by empathy Sympathy, on the other hand is a really old term that really recognized that people
have similar feelings and that we catch emotions from one another, but it has really kind of morphed too
mean, feeling bad for people taking pity on them and feeling sorry for them.
Dr. Helen Riess (6m 26s):
And it’s a much more sort of self-focused feeling like I feel so bad. Like that happened to me too. I feel so
bad for you. Whereas Empathy really stays with the other person’s experience and mirrors that for the other
person.
Dr Orsini (6m 41s):
The key word that you said was Imagination there and when I talked to Physician, it’s so important that we
do imagine or put ourselves in the other person’s shoes, especially before we give tragic news to the patient,
but even during our genuine interactions with patients. How do you train that? I know that you do a lot of
training of young physicians. How do you get them to that point where, you know, we’ll talk about burn out
later on, but how did you get them to that point where you train them to just imagine for a second, the they’re
the patient, and go from the sympathy to the Empathy to the compassion?
Dr. Helen Riess (7m 17s):
Well, it’s not a one-step process, but it does begin with opening our perceptions. So one of my favorite
sayings is the face is a roadmap of emotion and its the only part of our body’s that we don’t routinely cover.
So if we just start with looking at a human face, there is a wealth of information about the emotional state
that one of our key pieces of training is just open your eyes, go get your head out of the computer and out of
your iPhone or whatever you’re looking up and really just appreciate that there’s a unique human being
sitting in front of you.
Dr. Helen Riess (8m 1s):
That’s not just bringing a broken arm and illness or a disease to you, but a whole person with a background
and relatives and a past and a the future. And just to take that moment and recognize that this person, you
know, maybe hanging on every word you say, and if you don’t first perceive where they are emotionally, you
can create a disconnection, you know, in a half a second.
Dr Orsini (8m 30s):

So one of the things that I really love about your book is that you really go into the neuroscience of empathy
and we think that Empathy is something that either way you have, or you don’t and you have proven beyond
a doubt, but I think that’s true that empathy can be taught, but Empathy sometimes there’s a lot of, it was just
a soft thing, but there’s actually neuro-transmitters and there’s a Science basis for empathy and it’s based on
survival. Correct? Absolutely.
Dr. Helen Riess (8m 57s):
Right. I mean, if you really think about the most basic function of Empathy, it starts with mother infant
bonding. You can imagine if a mother is not moved by the sound of her crying baby or can’t feel a pit in her
stomach, if her baby is sick or about to, you know, step on glass or do something really dangerous, not too
many human infants would survive. So Empathy is built in to the human caring for offspring.
Dr. Helen Riess (9m 27s):
And of course it extends because we don’t live in isolation. We live in communities and it’s thought to be
hard wired because especially in the days of Hunter gatherers, most of the time males would go off hunting
and the women would be left in the village where they had to cooperate and collaborate to take care of
children while some of them sought food and you know, picked berries or whatever they did. And that they
had to perceive not only their infants cries or distress, but those of their, you know, fell on mothers and their
children to keep the community safe and well
Dr Orsini (10m 10s):
That’s great. And later my big question at the end, we are going to talk about In-groups and I can’t wait to
talk to you about that, but we’re going to save that for later. A question that you might not have been
expecting today is I want to talk to you about before we go on to talk about more about Empathy and, and
communication training in your relationship with Alan Alda because, and I’ll tell you why they have a special
story about Alan Alda. I’m a big fan of his, and I know that he wrote the foreword too. Your book, people ask
me on a regular basis, what made you decide to go into medicine and without hesitating my answer is
Hawkeye Pierce.
Dr Orsini (10m 41s):
It’s exactly true. Alan Alda. talks about in your book and he talks about it in his book and I love his book. The
title is amazing if I understand you, would I have this look on my face. I just love that title. But he talks about
very similar things that you speak about. It was very important to Alan all the way that the character of
Hawkeye Pierce was not just funny, but that he was a real person, and Alan Alda really show that he was a
doctor who cared. That character, Hawkeye Pierce, had Empathy flowing and compassion and you can see
that he would cry and he would get upset.
Dr Orsini (11m 19s):
He would get mad. He would go through anger. And if it sounds weird, but I’m a big MASH fan. I can

probably give you the lines of every MASH that was ever shown on TV, but that’s the kind of doctor I want to
be. How do we teach doctors? How to do that? How do we teach them to feel that empathy? You spoke a
little bit about imagining being the person in there, putting yourself in that shoes, but tell me about your
empathy training when you train young doctors.
Dr. Helen Riess (11m 49s):
So I’ll get to that, but I just, I am a true fan of Alan Alda and I just want to share that’s the way we got
connected is when he reached out to me to see if he could interview me for his book because he
understands Empathy like no other when it comes to putting himself in the shoes of others and being a
genuinely caring, connected person. But he wanted to learn about the neuroscience. And, you know, he
spent 10 years interviewing scientists’ on Frontier’s of American Science.
Dr. Helen Riess (12m 23s):
And the way, he could fully immerse himself in wanting to learn how Empathy works. It was such a great
example of his two interests coming together, being a TV doctor, but really also wanting to understand how
do we teach this in? How do we enable this in physicians? So I guess it really goes back to the reason why I
got interested in empathy training first, I really was watching a lot of burnout, a lot of patient dissatisfaction.
Dr. Helen Riess (12m 55s):
This is going back 10 to 15 years. As you know, you know, in the introduction of the electronic health record,
there was a lot of distraction and having to learn new ways to input information was requiring physicians to
load information into computers. Some of whom have never taken a typing coarse. And so they’re really was
a breakdown in the doctor-patient, patient- doctor relationship, because we just didn’t have the focus.
Dr. Helen Riess (13m 26s):
And as a psychiatrist, I was hearing a lot of pain about this feeling that people just weren’t paying attention to
them. Didn’t hear them ask the same question over and over again. And I could see that this was really
causing harm. You know, patients were losing motivation to stop smoking, to lose weight, stay on their
medication. That’s the first oath we take when we graduated from medical school is first do no harm. And I
realized that through these communication gaps and lapses that we were doing harm.
Dr. Helen Riess (14m 2s):
And so I reasoned that empathy can be beaten out of people. We certainly should be able to put it back in
because most people who choose medicine and nursing professions are they have some empathy, they care
about people or they would be doing other things. And so it just didn’t seem right, but well, meaning people
were suddenly just not connecting in a way that that was helpful to people.
Dr. Helen Riess (14m 32s):
So I studied the neuroscience of empathy for a couple of years. I did a fellowship at Harvard and got to really

immerse myself in that literature. And that’s where I realized that this is a brain-based capacity. It’s not just a
nice to have like being nice skill. It’s a survival skill. And if we could get physicians to lift their heads up and I
mean, physicians, nurses, medical students, residents to the whole team, PAs NPs, and really connect with
the humanity.
Dr. Helen Riess (15m 6s):
I really believe it, that is what’s needed to really engage people in being partners in their own healthcare.
And so it became a real quest of mine to understand how the brain perceives processes and expresses
empathy and compassion. And then to figure out ways that we could kind of expand this awareness building
and perspective, taking through some classroom instruction. And that’s when I did a study to see if what I’ve
put together actually could be perceived by patients in a study in a randomized control trial.
Dr Orsini (15m 44s):
And one of the things that I noted early on in my story that I talk about and my book about how I saw an
incredible doctor and mentor of mine, who was a very compassionate person who couldn’t communicate that
compassion to a patient. And that’s what made me so interested. He just, and the story, he just comes out
and tell somebody of your baby’s dead. And I knew this man was such a compassionate person, as most
physicians are empathic. And so I really understand what you’re saying is it’s all about the patient experience
that I think as physicians, we all get tied down, we get busy as nurses, but it also think, and I would like you
to comment on this there’s a lot of communication techniques out there that a lot of people don’t know, a lot
of people don’t understand.
Dr Orsini (16m 29s):
And when you teach them these techniques like tone of voice, which I’ll ask you about thinking really convey
that Empathy, that they had inside. But maybe didn’t know. When I was at a young resident, did a rotation
with the doctor who delivered me. That’s how old he was. And he practiced almost 45 years and was never
sued. And I had a great role model and he was able to look at each and every patient that came in there,
whether he met them are not and he was best friends with them in one minute.

Dr Orsini (17m 1s):
And he looked in their eyes really, really close. And I had a great role model. So talk a little bit about you talk
about the acronym that you used. Empathy a little bit about how some practical tips on how physicians or
anybody. I mean, it’s all about building rapport, right? And so give it some tips. There’s a great example. You
talk about in your book “Nice Shirt” and the different ways you’d change the tone. I love that because that’s
something that I also discuss all the time. So tell us about these, some of these techniques that you can give
to our audience.

Dr. Helen Riess (17m 33s):
Well, you’re starting with the middle of the acronym. Is that where you want me to start?

Dr Orsini (17m 37s):
I got to keep my promise. You’ve already inspired them. So I’m want to keep my promise. We’ll give them
some tips on how they can in the short version. I know this takes a long time to learn, but just little tips about
eye, posture, all of that stuff
Dr. Helen Riess (17m 52s):
Okay. So after doing all this neuroscience research, I just thought, how do we compress this into, you know,
teachable skills and human behaviors that people are gonna remember? And you know, on a walk in the
woods one day, it sort of came to me that the word Empathy held, I like most of the behaviors that express or
perceive empathy. And so the first one you already said is eye contact. And so we all think we’re making eye
contact. When we say hi, Mrs.
Dr. Helen Riess (18m 22s):
Smith, how are you? But one tip I give is to notice the person’s eye color. And when you leave, I don’t mean
staring at anybody. But when you meet someone’s gaze with intention, it’s a very different experience than if
you glance up and say, Oh, hi, Mr. Smith, how were you doing? And then you start typing. So write in that
first, second, you have a choice to either connect meaningfully or to just treat the person more like an illness
or an injury.
Dr. Helen Riess (18m 54s):
The M in Empathy stands for muscles of facial expression because there’s no F in Empathy for face. So I
had a fudge that one a little bit, but part of our empathetics training has facial expression, decoding
techniques, so that we learn the subtle differences between anger, disgust, contempt, and sadness. For
example, they all sound very different, but it’s hard for people to see the difference unless they get training.
Dr. Helen Riess (19m 25s):
And we also just try to get people to look at others, faces. Cause as I said, there are a roadmap of the
motion mixed facial expressions or a very common and suppressed emotions are common in patients. So
they won’t necessarily show you that they’re confused or angry. That’s why we have to become better at
reading the face. The P stands for posture. And there’s a lot, you can tell about a person’s mood just by how
they sit or stand.
Dr. Helen Riess (19m 55s):
And also we really encourage physicians to sit down at eye level. So they are not in a dominant position,
which doesn’t really foster collaboration in a cooperative conversation. The A stands for an Affect, which all
of your doctor, audience and nurses will know stands for emotion. And many people have used the term. If
you can name it, you containment. So if we can name an emotion like that person looks really anxious or
agitated, just naming in our heads.

Dr. Helen Riess (20m 30s):
It makes us attend to that differently than if we are just getting kind of catching the agitation and feeding off
of it. And then deciding I need to be more soothing. I needed to help calm this person down. T is tone of
voice. And of all of these empathic behaviors, tone of voice actually conveys the most about what we are
truly feeling. And so in the example you gave, that’s a nice shirt compare to that’s a nice shirt or that’s a nice
shirt.

Dr. Helen Riess (21m 6s):
So one of them sounds like a genuine compliment. And the other one sounds critical and the other one
sounds like I can’t believe you’re actually going to walk out of the house wearing that.
Dr Orsini (21m 19s):
Even the way you say, how are you when you meet someone, it’s something that you notice all the time.
People will see somebody in the hallway and say, how are you? And it’s clear that they don’t really care. Your
just being polite. And you’re walking by in the other person who could say my dog died and you probably
wouldn’t even notice, but you can come and say, Hey, how are you? And that shows that you really care
what, and how you smile with your eyes or with your eyebrows. You know, we talk about that all the time. So
yeah, tone of voice, I think, is something that most people don’t pay attention to, but once it’s brought up and
they realize that I think they noticed it a lot more.
Dr. Helen Riess (21m 52s):
It’s something that a lot of people are not aware of. Like, I think that this is one of the ways that couples off
and get into arguments is that they’ll say things to each other where they’re not aware of just how like
disrespectful or disgusted they sound. They just think, Oh no, all I said was, you know, X, Y, and Z, but it’s
the tone. And 90% of what we are talking about is conveyed in tone. So that it’s really important. And there
are specific skills like trying to match the volume of the patient that you’re talking with.
Dr. Helen Riess (22m 28s):
So that if someone talks softly and slowly that we don’t come with a booming, you know, wild, fast voice, and
just, we talk about many adjustments. People can become more conscious of with tone,
Dr Orsini (22m 40s):
A famous director, Gary Marshall, I saw something on him, a documentary about him. They were talking
about when he directed during the scene, when the scene was filming, he would turn his back on the actors
and just listen to the tone and the cadence and the reflection of the voice. And he would be able to say, that’s
a wrap or do it again without ever seeing the scene. And that just as a great example, I think of how
important tone is

Dr. Helen Riess (23m 4s):
Definitely. So H stands for hearing the whole person, not just hearing and listening, but embedded in hearing
the whole person is perspective taking which means viewing the person and looking at their lives through
their lens, not our own. I think about like taking off my glasses and putting on yours so that I can see the
world as you see it because many people will say, Oh, treat the person like you would want to be treated.
Dr. Helen Riess (23m 38s):
We really need to treat the person like they would want to be treated. Right. So hearing the whole person
gets at that cognitive arm of Empathy, which is perspective taking and other people have talked about
perspective getting. Some people will say, well, why aren’t we are just trying to imagine, why don’t we just
ask the person so we can get their perspective. But sometimes we’re thinking about a patient before they
ever come into the office, you know, will know that a woman who’s husband died four weeks ago is having
chest pain.
Dr. Helen Riess (24m 14s):
And so we might think about that woman differently than if she were just coming in with chest pain. Cause
we can maybe imagine that there’s a lot going on in there. And then the final letter of the Empathy acronym
is Y, which is your reaction to the person. And that is to me like the key piece, because we all do share
emotions. And if we are at a pretty mindful place, when we enter a patient’s room and all of a sudden we’re
feeling either annoyed or agitated or confused, we must consider that we’ve just picked up their emotion
because we weren’t feeling that before.
Dr. Helen Riess (25m 0s):
And that’s the importance of settling ourselves before we walk into a patient’s room or bedside so that if we
start to pick up other feelings, we can really think about why am I having this reaction? And if we are
suddenly feeling agitated, you know, maybe you were picking up at that person is agitated or all of a sudden
we’re annoyed. And this is so important for medical professionals. Think about, could that person be
annoyed?
Dr. Helen Riess (25m 33s):
And I’m feeling annoyed. Cause they were annoyed in us. Like maybe if we said, we’d come back in 20
minutes with some results and now it’s four hours later and now they’re a little bit nichey or ya know, put out
and they are not being super respectful. And so is it our place to now be annoyed at the patient? Or should
we be really thinking maybe there are annoyed because I didn’t follow through with what I said and maybe
there’s an apology that’s needed.
Dr Orsini (25m 59s):
Well, it’s important to know that, you know, we are talking a lot about Healthcare because you and I are both
physicians, but these are great tips, no matter whether you’re in healthcare or not. In fact, a lot of my

audience is not in the health care sector. In fact, every other week in this podcast, we generally have a
guest, not from a health care at all. So these, our communication, as I say, if you can learn the communicate
and convey our empathy or compassion, you’re pretty much gonna be great in both your professional and
your personal life. The people who are good communicators, people who show empathy, as you say in your
book, just tend to do better in life, better for themselves and seem to go further.
Dr Orsini (26m 37s):
So it’s really important that these tips that Dr Riess is giving us are important for everybody and not just for
medical professionals. I know time is running out. So I wanna get to my, a great question that have been
waiting to ask for a long time. He goes the, the times here are very difficult times in the world right now. And
you talk about in your book about in grouping and I’ve long known and they say, neuroscientists have said
that within the first or second that you meet somebody, your chemicals in your brain have already decided
that whether that person is like or unlike or a friend or foe.
Dr Orsini (27m 12s):
Correct. So this is something happens quickly. And I do this talk sometimes about that. I called what
happens in a second second, and let’s discuss about how that you talked about empathy and the in
grouping. And that really came from survival and evolution. But now we’re not the same as we were when
we were in little tribes and caves. And we’re more of a global people. How do you get there? Because it’s in
your DNA per-say. How do you get to the second, second where we can then all be one?
Dr. Helen Riess (27m 44s):
That’s really the $10 billion question? Isn’t it? You know, I think it’s so important to recognize that it’s not that
long ago, given human history, that we were often separated by mountains, rivers, oceans, where we never
saw people that weren’t like us. And if we did, it was usually an invasion or somebody who was going to
compete for scarce resources.
Dr. Helen Riess (28m 14s):
And so recognizing Other was crucial to survival and that unfortunate change where nothing separates us
now, you know, except COVID shut down, but we can travel anywhere. I see people that are totally unlike
us. The fact that the human brain is still so wired to perceive difference is a real challenge in our global
society. I do believe that the survival of our planet and our species is going to depend on seeing humans as
human period End of Story.
Dr. Helen Riess (29m 1s):
You’re a human, I’m a human and all of these labels and identities and all of these things that we attribute to
one another that separate us. We’re in a very critical moment in history where we have to challenge these
automatic fears, mistrust difference competition, and be. There are so many feelings that go with perceiving
otherness. So I do think it’s the question of our time.

Dr. Helen Riess (29m 32s):
And I think we’re at a level of national discourse about this that’s different than its been before because of
our great conductivity. We have all seen the, of George Floyd dying, these ideas that certain people deserve
tough treatment. Like we just can’t accept these things anymore. So our work is truly aimed at humanizing
everyone and to stop dehumanizing anyone.
Dr Orsini (30m 4s):
Tony Robbins talks about building rapport and defines it as a finding commonality between two people. And I
think that is where the key lies. But when I coach physicians on patient experience or I talk to people about
teach them how to build a rapport, it’s all about finding commonality. And although your tribal response would
be, that person looks different once you can understand that no matter what they look like or where they’re
from there is something in common.
Dr Orsini (30m 34s):
And that gets you into the second, second, if you will. And when I discuss how to improve patient experience
scores, the physicians, and how to make that a patient experience better in build a relationship with the
patient. It’s been shown that you can do that in 56 seconds. A lot of it is just as you spoke about eye contact,
posture mirroring, but it’s also finding commonality. And as a physician, I’ll walk into, I’m a neonatologist. So
they take care of babies. So its not the patient experience. So I’m looking at it’s a family experience, but a
walk into a room when a mother who’s very upset about her baby, be in the neonatal ICU.
Dr Orsini (31m 10s):
If that mother was upset and before I would just introduce myself, I can find at sometimes it will be a book on
the table or they’ll have a TV. Sometimes they’re upset about something that happened. Maybe they’re angry
about something that they can go well. And I see that they have in New York Yankees hat on where they’re
wearing a Yankee shirts, what are they have a 973 area code? What I call them on the phone if I can just
say, Oh my goodness, are you from New Jersey? Because I recognize this area code. It’s an instant bond.
And that’s what you were talking about In-grouping. So the in group might not be our group here.
Dr Orsini (31m 42s):
I think we could find it in group with anyone. Don’t you agree?
Dr. Helen Riess (31m 45s):
Sure. Hope so. I mean, I think one in the most powerful ways to find common ground, his people who have
suffered in similar ways, you know, so if you’ve been through a loss and you’re patients going through a loss,
you know, to say, I really get this, you know, I’ve been so close to this, myself and people who are in support
groups together, let’s say something tragic, like losing a child or a teenager in a car accident.

Dr. Helen Riess (32m 18s):
It’s amazing how quickly the difference is between those people disappear. They have what your calling
common ground like. So common suffering is an incredibly powerful bond and but it really does mean
exposing vulnerability, right? Yes. And that I think is the key. Like we’re all human. We all have our foibles.
We’ve all had our disappointments, our rejections, our trauma’s or whatever.
Dr. Helen Riess (32m 48s):
When we share these things, that’s what unites human to human. But if we stand apart in judgment or
superiority or whatever, that does not allow these human bonds to form.
Dr Orsini (33m 2s):
And if you’re a physician who’s speaking to a patient, the first thing you want to do, I use an acronym called
PROGRAM and the G is for a genuine, if you could show that patient, you’re not just a doctor, that you’re a
real person. I’m from New Jersey. You had a rough day because you’re five-year-old, wouldn’t go to
kindergarten. Then you got off to the late start or going on vacation. Well, where you going Dr Orsini? I’m
going to see Mike family. And the important thing is too for leaders, right? What’s the difference between a
manager and a leader, a manager doesn’t know how to communicate and convey empathy.
Dr Orsini (33m 34s):
Right. But a leader knows how to do that in the best bosses I’ve ever worked. They were real people. They
didn’t stand up on the top. And I think that’s, that goes back to that commonality. Right?
Dr. Helen Riess (33m 43s):
I would hope that there are a lot of managers with Empathy and I’m sure there are, but I think what you’re
saying is the managerial role might be just to get tasks done, but a leadership role is to build morale, you
know, inspiration and to connect people.
Dr Orsini (34m 2s):
Yeah, that brings you to a different level. That’s my point is that for the whole thing? So why is it so important
to have empathy in that we’re not changing our first second or those neurotransmitters are those tribal
instincts immediately, but back to the Empathy we can train. Empathy like you’re doing such a great job in
medicine and in business. And we can train people to be more empathetic, to be better communicated, to
find commonality than maybe we can go to that global, scene that you’re talking about because we can, it’s
going to take time to change our DNA, but we can fix The Second Second, very quickly.
Dr Orsini (34m 38s):
And I think that’s how this relates.

Dr. Helen Riess (34m 40s):

I really loved that idea of the first and the second second, because you know, Empathy is automatic in most
people. There are certainly some people who just don’t have it, but it’s the exception of the rule. Many
people feel empathetic and were able to shut it off. And especially if we’re tired, hungry, overworked,
overwhelmed, sick. That all interferes with expressing empathy.
Dr. Helen Riess (35m 11s):
And so I think it’s so important for the Physician and health profession audience to understand that Self
Empathy, which is the last chapter in my book. It probably should be the first one that if we don’t treat
ourselves with proper care, sleep, nutritious food exercise, if we don’t fill the tank, we are going to get
depleted and it will show up as burnout. And when we’re burned out, we tend to objectify people, refer them
by their, to them as their disease or their condition, you know, instead of the human being that they are.
Dr. Helen Riess (35m 53s):
So empathy is really a key input output, just like so many things. There’s an afferrent and efferrent. We’ve
got take good care or to put us in the best position to give good care.
Dr Orsini (36m 6s):
I think that’s a great way to finish this whole interview. Take care of yourself first, because we’ve all been
there before, where we get for a lack of a better word, grumpy and we lose our Empathy. We talked about
In-grouping and that we tend to have empathy towards people that are like us more than people that are
unlike us. So I think the solution to that is to find commonality and perceive everybody is like you, and it will
be easier to empathize. And I think the work you’re doing is just absolutely amazing in my small way, I’m
doing the same thing, but I really love the way you’re doing all the teaching that your book is phenomenal.
Dr Orsini (36m 43s):
Your Ted talk is great. What’s next on the horizon for you? You’re doing so much.
Dr. Helen Riess (36m 48s):
I mean, I think it, as you said earlier, we were in a very critical time in the world where we need empathy
more than ever. And you might be noticing it’s mentioned in the news, like almost constantly. The most
exciting new development is being approached by law enforcement to help police forces, to humanize many
of the situations that they find themselves in many, the challenges because our police are being called in to
take care of mental health issues, domestic violence issues, you know, violence issues and getting a cat out
of a tree issues like they are, they pretty much have to do everything.
Dr. Helen Riess (37m 29s):
And you know, many of them are being asked to take roles that they’re really not trained to do. So I see this
as an opportunity to really make a difference in how just everybody, every professional is trained to like
appreciate the human being in front of us and to bring our best to every interaction.

Dr Orsini (37m 53s):
I think it’s great that you’re starting to work at law enforcement. I in fact, come from a whole family of law
enforcement. I’m the only physician in my family. Everyone else is police officers as a retired police officer for
my father, my uncle, my brother, my cousins. And so I think the topic that we really have to speak about is
that self empathy for themselves because they talk about burnout. My father said to me, when I was very
little Anthony, my mother and father are only ones that call me Anthony, Everyone else calls me, Tony.
“There’s only two people in the world that have to be perfect doctors and police officers.”
Dr Orsini (38m 24s):
And he said that for many, many years. And I think that that pressure it’s something that needs to be
acknowledged. So that Self Empathy that you talk about is so important because you do get jaded and
physicians to the exact way. We have a highest burnout rate of any profession right now. And so taking care
of ourself, I think is really a great thing. So it’d be want to be empathic towards other people. You have to first
like yourself,
Dr. Helen Riess (38m 47s):
It’s called putting on your own oxygen mask first it’s we get this instruction every time we’re on an airplane,
but so few people apply it to self care. People think of self care as being selfish. Yeah, there are definitely
ways people are selfish, but attending to your own physical, emotional, and social needs is just critical to
being effective in the world.
Dr Orsini (39m 13s):
You love that analogy, put your own oxygen mask on before he can help anyone else. And that’s fantastic.
So Helen thank you so much for doing this interview. I can talk to you for hours, but I know you have to go. It
was really a great interview and you certainly inspired the audience because I think it’s going to make people
speak about Empathy more, the more we speak about it, the more we’re aware of it. The more we’re aware
of when our Empathy slides up in their slides down, we can catch ourselves finding that commonality, using
the great techniques that you gave us communication techniques with the eye contact in the Empathy
acronym is really going to help them.
Dr Orsini (39m 49s):
And I think, especially when you’re doing Difficult Conversations, which is what the name of this podcast is.
So I really wanna thank you for being here and I just love the work you’re doing and I’m just make sure to
see what your next big thing is with the law enforcement. I think that’s awesome.
Dr. Helen Riess (40m 4s):
And might be picking your brain about that.

Dr Orsini (40m 8s):
I don’t remember as a kid, someone who would say to me, who is a police officer or in your family, and I
would say my uncle three cousin’s father and grandfather’s then they say, well, why don’t you go into the
police Academy? My answer was I’m afraid of guns. So I decided for something easy, like to become a
physician. So it’s so easy, right? So, but thank you for all that work you’re doing. Thank you for being such a
gracious host and for taking the time to be out here and thank you for inspiring our audience. Thank you.
Dr. Helen Riess (40m 35s):
You so much for having me. It’s been a genuine pleasure getting to know you.
Dr Orsini (40m 39s):
Thank you. And I hope we can speak again sometime soon. If you liked this podcast, please go ahead and
hit subscribe. Go ahead and download all the episodes. You’ll see a new episode downloaded every single
Tuesday. If we need to learn more, please contact me@yoursiniway.com and Helen, how can they contact
you? What’s the best way. That’s great.
Dr. Helen Riess (40m 58s):
His info@empathetic.com.
Dr Orsini (41m 1s):
Okay, so please contact telling if you have any questions, if you’re interested in her training, its amazing in
go ahead and I hope everyone has a great week and I will be here again next Tuesday. So thank you again.
Have a great day care. If you enjoyed this podcast, please hit the subscribe button and leave a comment in
review contact dr. Sini.

Dr. Helen Riess (41m 22s):
Yes

Dr Orsini (41m 25s):
Orsini way.com.

Read the transcript of Dr. Orsini’s podcast with Elizabeth Poret-Christ

Elizabeth Poret-Christ (2s):
What I’m trying to explain to them something maybe they could have done differently. I say, as the patient or
family member, I heard you say this, so it’s not necessarily what you said. It’s the perception of what, you
know, I heard you say when this doctor to take the bad example, when he was saying that my husband was
circling the drain, he wasn’t trying to be callous. That might just be a medical term that he would use with a
colleague, but explaining to him how it felt to hear him say that might make him stop and pause in the future.
Elizabeth Poret-Christ (37s):
If he goes to say it to a non-medical person. So I’ve tried to really make my comments with the doctors and
the nurses that we train more neutral and more, you know, I’m explaining to them what the patient feels or
hears, as opposed to maybe what they’re trying to say. It doesn’t matter what you said, it’s it matters what
my perception was.
Announcer (1m 3s):
Welcome to difficult conversations lessons I learned as an ICU physician with Dr. Anthony Orsini. Dr. Orsini
is a practicing physician and president and CEO of the Orsini Way, as a frequent keynote speaker and
author. Dr. Orsini has been training healthcare professionals and business leaders. How to navigate through
the most difficult dialogues each week. You will hear inspiring interviews with experts in their field who tell
their story and provide practical advice on how to effectively communicate whether you are a doctor faced
with giving a patient bad news, a business leader who wants to get the most out of his or her team members
or someone who just wants to learn to communicate this is the podcast for you.
Dr. Anthony Orsini (1m 45s):
Well, welcome everyone to this episode of difficult conversations. This is dr. Anthony Orsini. I’m happy to be
with you again today. You know, one of the most exciting things of having my own podcast is that I get to
interview some amazing people from every field today. I’m especially excited because I get to interview
Elizabeth Poret-Christ. Liz is a dear friend of mine who I’ve known for, I think, eight years. She also works
with me at The Orsini Way, where she is director of operations.
Dr. Anthony Orsini (2m 17s):
Liz really runs the Orsini way. She’s involved in really every aspect of marketing, scheduling, and teaching.
And I know she already knows this, but I want everyone else to hear this without Liz, there is no, or see any
way it would not exist. So my would not do it without her. I asked Liz to be one of our first guests, because
she has an incredible story to tell actually several incredible stories to tell, and I’ll let her pick which one she
wants to choose to speak about. But Liz has been on the receiving end of several difficult conversations,
more than her fair share.

Dr. Anthony Orsini (2m 49s):
I might say what’s so amazing about Liz is what she’s been able to do with each and every life changing
situation. And what is most incredible about her. And thankfully, this is not a video podcast because I’m sure

I’m going to make her blush, but what’s most incredible about Liz is that she took every one of her
experiences good and bad and found a way to turn it into a positive and early on, she saw a contrast in
medicine between healthcare professionals who communicated with her beautifully and helped her in the
most difficult times and other healthcare professionals who just seem to make things worse with their actions
and in their words.

Dr. Anthony Orsini (3m 28s):
And so I was want to say, thank you, Liz, for being here. Thank you for all you do. And I think everybody is
going to be so excited to hear your story. So thanks for being on.
Elizabeth Poret-Christ (3m 39s):
Sure. thanks for having me, that’s quite an introduction.
Dr. Anthony Orsini (3m 42s):
I don’t give you too many compliments, but, but now that you’ve got a fat head, but you deserve every bit of
it. And I really look up to you and I think you’re an amazing person. And so I want everyone else to hear
about your story. So, as I mentioned in the introduction, you are the director of operations, which means you
do everything and you and I first met when you worked with me at the BBN foundation. And that’s kind of an
interesting story on how we met. You want to just go ahead and share that with everyone and just tell them
how you became involved in the parent advisory committee and how we were sure.
Elizabeth Poret-Christ (4m 17s):
So it’s my pleasure to tell this story. I was a very successful fashion industry person had a really great job
that I loved. They traveled internationally. And then in 2001, I gave birth to boy, girl twins. And as any parent
knows traveling, when you have little ones is super complicated. So I decided to stay home. And then in
2003 Annabelle was diagnosed with cystic fibrosis. So I was already a stay at home mom.
Elizabeth Poret-Christ (4m 47s):
And now I was the stay at home mom to a child with a medical condition and a pretty serious one at that. So
I felt the need to help and to become involved in my community so that I would have, I went, could go from
having no medical knowledge to at least being part of a community where I could get some. So I became
part of the family advisory council at our local children’s hospital. And as part of that, we were sent to a
conference in Washington to talk about the new patient and family care initiative that was being promoted
within our hospital building.
Elizabeth Poret-Christ (5m 25s):
So during that conference, I saw a presentation by a very large local children’s hospital that talked about the
use of experiential roleplay in teaching healthcare providers, what it felt like from the patient perspective.
And I thought that was so insightful to have doctors and nurses act like patients or family members so that

they could see what it was really like. And I thought it was such a great idea. I went back to our director of
our children’s hospital and said, I have a great idea have to do this.
Elizabeth Poret-Christ (5m 58s):
And he said, actually, there’s somebody already doing that. I want to introduce you to Dr. Anthony Orsini. So
I think I called you and never stopped bothering you until you let me come and help you. The rest is history.
Dr. Anthony Orsini (6m 11s):
So what’s really interesting is the funny part of that story. And what I remember is that after I met you on that
day, that you came to our first breaking bad news session, you were not very happy with the chairman of
pediatrics, because you had said that you had heard that dr. Orsini was using professional actors to train the
residents on breaking bad news. And you felt that that was just terrible and that it should be parents that are
playing this. I had already tried with parents and just realized that they just didn’t have the depth of acting
ability.
Dr. Anthony Orsini (6m 41s):
So, but you said something really funny after the whole day was over. And I guess that comes out, your
Brooklyn comes out and you said, I really, really p****d that. I said, why? And you said, now I have to
apologize to the chairman. And I hate, I hate to apologize
Elizabeth Poret-Christ (7m 2s):
So true all the time with my head hung down and was like, I was so wrong. How could I be so wrong?
Dr. Anthony Orsini (7m 11s):
Yes. And I know from personal experience that my wife doesn’t like the vet she’s wrong either. So, but that
was the beginning of our relationship. And we did BB and foundation for awhile. And you were a volunteer
teacher and then became a volunteer instructor, I should say, to teach these doctors how to communicate
better. And then you just stayed along with me as we went through the Orsini way and started teaching
patient experience. But you were such an important part in the teaching of these young residents on how to
discuss bad news.

Dr. Anthony Orsini (7m 43s):
And what’s really great about what we do is in your senior way, as we, we get non-medical people, who’ve
had some great stories, validate that what we’re teaching is correct. And so the topic of this podcast is
difficult conversations. And as I mentioned in the introduction, you’ve had some difficult conversations in
your life and tell whatever story you want to tell, because I think there’s so much that the audience can learn
from your experience and, and how you were able to get through these tragic times and now be someone
who’s teaching physicians, how to communicate.

Dr. Anthony Orsini (8m 20s):
And so I think everybody should just hear one of the great stories that you have.
Elizabeth Poret-Christ (8m 25s):
I don’t think I would be able to be of any help to you if I didn’t have these stories. And I think that a lot of
times when I share them with the people that we train, there’s kind of an aha moment that happens when
they say, wow, people really do communicate this way. So, I mean, I can give you a good one or a bad one,
which one do you want? First?
Dr. Anthony Orsini (8m 46s):
I think the, we had talked about the contrast between the, when your husband was sick and you, your
husband, and you had a of difficult conversations and what you learned at that experience that you had
already been working with me. But I think it’s a great story to tell everybody about what happened to Ken and
what you learned from that, and the difference between the two positions.
Elizabeth Poret-Christ (9m 10s):
So I thought that having a child with a medical condition really made me an expert in how to be an advocate
and how to be a mom and how to be a communicator, and then working for you for so long, I gained so
many incredible skills in communication, and then my family was just thrown for a loop. So as you know, Ken
was on a business trip to Orlando and turned out, had a raging sepsis infection that was ravaging his body
as he traveled.

Elizabeth Poret-Christ (9m 43s):
And when he got to Florida from New Jersey, he was very, very, very ill. And within 48 hours of landing in
Florida, he was in the hospital. And by the time I got there, he was dying and he had a full sepsis infection
caused by diverticulitis and a blockage in his colon and had an eight hour surgery. And when he came out of
the surgery, he was in the ICU and they let me in to see him.
Elizabeth Poret-Christ (10m 16s):
And when I asked the resident how he was doing, the resident very casually over his shoulder, said, he’s
“circling the drain”. And as a wife, as you know, thinking about my two children at home who may never see
their father again, and as an instructor of communication skills for physicians, instead of just collapsing to the
ground, like I think anybody would have, and probably what I would have done had I not have the experience
that I’ve had with you.
Elizabeth Poret-Christ (10m 53s):
I was able to say to him that that was not inappropriate way to communicate, and I’d like to speak to you
outside. And that’s when the Brooklyn really came out because I was angry. That’s just a horrible thing to say
to somebody. We don’t know whether he’s going to live or die the next minute. And here’s this guy equating

my husband to the water in the toilet bowl. So channeling every instructor ounce of existence that I could, I
pulled him outside and said that I would like for him to speak to me the way he would speak to a colleague
and I would stop him if I didn’t understand him.
Elizabeth Poret-Christ (11m 33s):
And he couldn’t believe that I would even dare to tell him that he wasn’t communicating well. And it turns out
I had to have him removed from my husband’s case because he just couldn’t communicate with me in any
way that made sense. And I had to have a new resident come in, but throughout that time, Ken’s 23 days in
the hospital, 12 days in a coma, there was a lot of times where I was very grateful for the communication
skills that I had, but always thought to myself What about the family member that’s sitting by the bedside that
doesn’t have the ability to question the physician, question, the nurse, or just say, I think something’s wrong.
Elizabeth Poret-Christ (12m 16s):
I need your help. And what tragic events would occur if people didn’t felt like they could say something.
Dr. Anthony Orsini (12m 22s):
I think that’s a couple of things you said that are really profound. One is that the doctor had no idea what he
did wrong. And I think, you know, most people who are lay people wouldn’t don’t know this, but there’s very
little communication training for physicians. Some people are natural, good communicators, and some
people just aren’t, but there’s certainly no excuse not to show or try to show some compassion. If you’re
trying and you trip over your words or have a difficult time. That’s one thing that I can teach communication
to just about anybody as you know, but that was pretty profound.
Dr. Anthony Orsini (12m 58s):
The other thing that you said is that you felt empowered as an instructor because you’d knew what to expect.
You, you knew that this is not appropriate and that you were emboldened to say something, but it is sad that
many people would not be able to speak up or just think that it’s not their place. And certainly when you are
worried about your husband, literally dying, those are not really words of comfort are they?
Elizabeth Poret-Christ (13m 27s):
It really? And what was the interesting part was my inlaws had flown in the next day. And every time I went
to question a doctor or nurse, whoever they would get upset with me, they would say, it’s not your job. Don’t
say anything. Don’t ask them a question. Don’t and a couple times, you know, we caught some medical
errors. We caught some things that were making my husband uncomfortable. That didn’t have to happen
because I was not afraid to say “Hey, wait a second”.
Elizabeth Poret-Christ (13m 59s):
Can we just stop for a second and see if this is okay? But the older generations don’t feel like you can do
that. They feel like, well, what do you know? You didn’t go to medical school. And I didn’t know the medicine.

And I never said I did, but I do know my husband and I did know when something was wrong. So yeah,
every time, and I’ve been given quite a few aha moments and life lessons I say to myself, like, how do I help
the next person from not having to experience that kind of thing?
Elizabeth Poret-Christ (14m 32s):
So if that doctor never says, circling the drain again, I’ve done my job. Like I’ve accomplished my mission.
Dr. Anthony Orsini (14m 39s):
Yeah. Because the way you describe him, he was shocked that he even said anything wrong.
Elizabeth Poret-Christ (14m 44s):
He couldn’t imagine what he could have said to upset me and or how he needed to change the tone of the
conversation to be more accommodating, which I found horrifying because my husband was not sick when
he left or at least we didn’t think he was, this was all quite shocking. And now he’s in a coma and he could
potentially die. And this guy just needed to get to the next patient. And he wasn’t stopping to acknowledge
the moment that he was in.

Elizabeth Poret-Christ (15m 16s):
And I felt the need to have this teaching moment with him, which is your fault, by the way, to take him
outside and be like, no, no, we need to have a chat about how this is supposed to go and this isn’t it. So
yeah, it’s just it. And it’s happened more than once. And it’s hard to be level headed when you’re calling
somebody out like that. But your level had prevails because they’ll remember the conversation. They won’t
remember if you yelled at them, but they’ll remember, you know, the calm approach, I guess, I hope.
Dr. Anthony Orsini (15m 46s):
And as you know, I really do believe that physicians, I believe in humans in general, are compassionate
people. And that physicians and nurses and healthcare professionals are especially compassionate. It’s
conveying that compassion. That sometimes is difficult and that’s what you and I teach. And there’s ways of
doing that. And I think perhaps that position has never been called out on that before perhaps he was caught
up in a busy day, perhaps he was being very task oriented.
Dr. Anthony Orsini (16m 17s):
But in the end, when you have a patient who’s sick or is dying the, the words and the manner in which you
convey that compassion makes all the difference in the world. As I tell my fellow physicians, and when I do
my workshops or in my book, it’s not about you. And I may be as a position, extremely busy, but I have to
remember, it’s not about me getting home or getting to the next patient that if I just took two more minutes
and sat with you and leaned over and used the proper body language, that interaction would have gone
much better for you.

Dr. Anthony Orsini (16m 53s):
I think you’d agree.
Elizabeth Poret-Christ (16m 54s):
Absolutely. And I could even tell you, so when we got home from Florida after 23 days, it was very important
that can have a surgeon at home that could follow his case. And we were referred to somebody who is very
prestigious in his field, and we were told you’re not going to like his bedside manner. You’re not, may not like
his attitude, but he’s really, really smart. And he’s a really great doctor. And I agree with you. I do believe that
physicians want to be compassionate and want to help their patients, but other things get in the way.
Elizabeth Poret-Christ (17m 27s):
So I kind of braced myself for what this visit might hold and walked in, you know, kind of on my guard. And
when we got there from the minute we walked into the office, so Ken was 200 pounds. When he left, came
home, he was 140 pounds with a Walker, really very, still very ill. And we, you know, came into the office and
the nurses literally came out from behind the desk and they were like, Ken, we’re so happy to meet you.
Elizabeth Poret-Christ (17m 59s):
Come with us. You don’t have to wait in the waiting room, come right inside. And they made him comfortable.
And the doctor came in the room and he rolled up his chair and he sat right down in front of Ken with this
hundred page file folder of everything that had occurred in the past 23 days. And he sat down and he looked
Ken right in the eye and said, I just want to tell you that you are incredible and you have done such a great
job, getting better and doing everything that you should.
Elizabeth Poret-Christ (18m 30s):
And the very worst part is behind you. And that every day from here on, in is going to get better. And we’re
going to get you back to where you need to be and get you back to your life. But you’re great. And from now
on, everything’s going to be okay. And I swear, he walked out of the office, standing a little straighter, his
head a little bit higher because he really felt like, Oh wow, I’m going to be okay. The doctor just said, I’m
going to be okay. And it really was astounding to me. And I’d already had all this experience and all this
knowledge, but there it was right there in front of me.
Elizabeth Poret-Christ (19m 2s):
I just witnessed it firsthand.
Dr. Anthony Orsini (19m 4s):
What a contrast between how someone who communicates well and someone who doesn’t. And I think now
with your work with me, and you’re seeing the way we’re trying to teach that. And not only when it comes to
difficult conversations with tragic news, but just how, how to speak to somebody, you know, in everyday life,
how’s a doctor speak to a patient when they say hello and make them seem special. We’ve done some,

some teaching of HR professionals. So those are difficult conversations, too.
Dr. Anthony Orsini (19m 34s):
Life changing moments don’t have to be about death and dying life changing moments can be about
separation of employment can be about divorce. As one social worker once told me many, many years ago,
there’s very similarities between death and divorce. It’s just defining yourself,
Elizabeth Poret-Christ (19m 51s):
Your job, losing, you know, all of that is so they’re also linked together your emotions and your grieving
process of any loss. It doesn’t matter what the loss is, the grieving process exists. So, yeah. And when we’re
training family advisors, it’s also really important to explain that it’s not just about your pain when you’re
telling your story, it’s important to express your pain, but it has to be done in a way that the doctor can take
something from it and grow and change.
Elizabeth Poret-Christ (20m 24s):
It. Can’t be, you know, I have this terrible story to tell, and I’m going to keep telling it because it makes me
feel better. There has to be the evolution of what happens next.
Dr. Anthony Orsini (20m 34s):
So that that’s actually leads me into my very next question. You know, as a nonmedical person who spends
most of their time, training physicians, nurses, and medical people on how to have those difficult
conversations, it’s difficult, right? Because some would say, well, you’re probably going to be, maybe people
won’t take you seriously because you’re not in medicine. What’s been your experience when you’re giving
that news from the patient point of view. And how do you get around that?
Elizabeth Poret-Christ (21m 2s):
So I definitely at first felt there was some resistance that I wasn’t a medical professional telling medical
professionals how to do their jobs. So the way I learned to rephrase my communications with them is when
I’m trying to explain to them something, maybe they could have done differently. I say, as the patient or
family member, I heard you say this, so it’s not necessarily what you said. It’s the perception of what, you
know, I heard you say.
Elizabeth Poret-Christ (21m 35s):
So like when this doctor to take the bad example, when he was saying that my husband was circling the
drain, he wasn’t trying to be callous. That might just be a medical term that he would use with a colleague,
but explaining to him how it felt to hear him say that might make him stop and pause in the future. If he goes
to say it to a nonmedical person. So I’ve tried to really make my comments with the doctors and the nurses
that we train more neutral and more, you know, I’m explaining to them what the patient feels or hears as
opposed to maybe what they’re trying to say so that they can’t dispute.

Elizabeth Poret-Christ (22m 15s):
Well, I didn’t mean to say that, or I didn’t say that it doesn’t matter what you meant or doesn’t matter what
you said, it matters what my perception was. And that’s something that I think we’ve all learned. And with
your help, I’ve learned to reword and rephrase things so that there’s not a battle. I’m not trying to give
medical advice. I’m not trying to act like the doctor or the nurse. I’m just trying to tell you what it feels like
from the patient perspective. And that’s a perspective that most medical professionals never get.
Elizabeth Poret-Christ (22m 46s):
They never hear in a safe environment, what it’s like from the patient perspective, they’re only either getting
yelled at about what they said after the fact, or, you know, being complimented, but they never get that safe
environment to learn how to say something. That’s really hard to say.
Dr. Anthony Orsini (23m 2s):
And I have to say that I do when you and I are teaching together. And we’re teaching some, even senior
physicians who maybe been at this for 20 years, that we train, I can see they pay even more attention and
hang on to even your words, even more than mine. And because you validate what we teach and you can
say, well, I’ve been there. And I can tell you that just the idea that you sat down made a huge difference, or
you just didn’t connect with a patient.
Dr. Anthony Orsini (23m 34s):
And so it’s been, I think I agree a thousand percent that any training of physicians when it comes to
communication has to be done with both people inside, outside the medical field. If you just do one or the
other, I think you’re, you’re losing something. And the fact that you’ve had to get through many of these
difficult conversations is, is a testament to your resiliency and really what you’ve been able to do that. And so
each physician that you train sees about 250,000 patients, that patient interaction.
Dr. Anthony Orsini (24m 7s):
So that’s a lot of physicians over the last eight or 10 years that you and I have trained in. And that’s a lot of
patients and that’s why we continue to do this with the patient experience. So, you know, the name of my
book is called it’s on the delivery. That’s the name of our program. You and I have come up with that for a
patient experience. And communication is all about it’s on a delivery. And so I’ve had people tell me, boy, this
works with my husband too. So I don’t know, has, as Ken said, that deal because Lauren says that to me,
Elizabeth Poret-Christ (24m 37s):
Definitely not, my two 19 year olds might say, you know, we think you might’ve been working when we were
having that conversation.
Dr. Anthony Orsini (24m 44s):

Yeah. If I want to get Lauren to let me buy a car or something like that, and she’s saying no, cause she’s,
she’ll always say, wait a second. I know what you’re doing here. This is all in the delivery and
Elizabeth Poret-Christ (24m 56s):
Don’t give out our secrets, you can’t do that.
Dr. Anthony Orsini (24m 58s):
I know I wrote the book and now every spouse can be, but we can use communication to really help form
relationships. And really that’s a medicine is about right. That’s what, you know, we’re going to talk to some
other leaders in business about, you know, leadership is all about communication, right? And we’ve done
that together. And we all have had bosses who were great communicators. And we loved them. One of my
first bosses, I I’d walked through fire for her because she created such loyalty, but it’s all about
communication.

Dr. Anthony Orsini (25m 31s):
And I don’t think there’s a person in this world that hasn’t had a difficult conversation. And so I’m really
excited to continue to work with you. And so what advice do you have any family member just in closing
here, if you could just say to somebody who’s listening out there, who’s either had a really difficult
conversation in healthcare. Let’s go back to the tragedy of either can or some of the other tragic news that
you’ve heard when you are on that end. Now you were felt emboldened because when that doctor said,
circling the drain, you were already an instructor and your personality is not quiet.
Dr. Anthony Orsini (26m 11s):
You’re not a quiet personality. And so you were taught up to speak up, but what advice do you have when
the person who is receiving the tragic news from the first responder, from the doctor, from the nurse, the
person sitting on the chair and being told that they have cancer, what, what advice would you give to them?
Elizabeth Poret-Christ (26m 32s):
So having sat in that cancer chair myself, I think there’s a couple things I think that resonate with me. One is
I think it’s important to remember, like we said, in the beginning that the physician or nurse really does want
to help you. They’re not trying to hurt you or communicate badly. They just might not know that they’re doing
it. So it is okay to ask a question, ask for something to be repeated or ask for something to be explained that
you don’t know, it’s okay to do that.
Elizabeth Poret-Christ (27m 12s):
It’s okay to stop and say, I’m not really sure I just understood what you said. Can you write that down for me?
All of these things help you process the information that’s being given to you because especially when it’s
tragic or even bad news, you’re really not going to remember much about the conversation. So asking for
clarification or for something to be written down is not disrespectful and it will help you going forward. And

just understanding that physicians really do want to do the right thing.
Elizabeth Poret-Christ (27m 44s):
They just might not have the skill. And I think it’s really important to understand. And I think it’s a very, little
known fact that doctors and nurses, they don’t get any training in how to do this. And that’s why I think the
way we train and the process that we put our students for lack of a better word through really leads to some
aha moments because they just don’t understand how they’re being. I keep going back to the word
perception, but it’s everything.
Elizabeth Poret-Christ (28m 14s):
So if, as a patient to feel even just a little bit more empowered to say, I need a little bit more help than this,
that will change the course and the trajectory of your outcome as well.
Dr. Anthony Orsini (28m 27s):
I think that’s great. One of the things that you’ve heard me, quote, rabbi Kushner, who is the author of when
bad things happen to good people. And I am a big fan of dr. Kushner, but rabbi kosher makes the distinction
between curing and healing and he’s carrying is making a problem, go away. Caring is caring cancer, but
healing is providing people with the resources and other people to help them get through a problem that they
may or may not have go away.
Dr. Anthony Orsini (28m 59s):
And I think if we can just remember those kind and wise words that the healing starts from the moment that
you’re told you have cancer. And when you’re in your second story, that the surgeon who told Ken that he did
wonderfully and how great he was. And Ken stood up a little bit taller in your words, with just his words, he
started the healing process, and this is why I love communication. It’s so powerful by changing one word, by
doing something different, you can make the difference in people’s lives.
Dr. Anthony Orsini (29m 35s):
You can make your patients start to heal immediately and or you could just make people better by being a
good communicator. So this has been a real pleasure. I shall speak to you again later on today because
we’re working together, but, but I want people to hear your story. And so I think this is really a good, I think
people are going to be inspired. I think people will be emboldened. I think people will understand how
important communication is in medicine and their private lives.
Dr. Anthony Orsini (30m 7s):
And, and I think you’ve been a great and inspiring guest. So thank you so much. Thank you again, Liz for
coming. If you want more information about the, your way, you can find this on social media, also the
website, or see any way.com. If you have any questions or if you have an interview that you think someone
would be a great person to interview, please do not hesitate to email either me or Liz, and you can contact

us through the website. So if you liked this podcast and you want to hear more inspiring stories and learn
how to be a better communicator, we are going to have some great experts in their field.
1 (30m 46s):
And I think you’ll leave feeling a little bit better about the world each and every time, please go ahead and hit
that subscribe button and I will be back again next Tuesday. So thank you and stay safe everyone.
Announcer (30m 55s):
If you enjoyed this podcast, please hit the subscribe button and leave a comment and review your contact
Dr. Orsini and his team, or to suggest guests for future podcast, visit us at The Orsini Way.Com.

Read the transcript of Dr. Orsini’s podcast with Noelle Moore

Noelle Moore (3s):
And to be honest with you, a lot of times, you know, you asked about that first conversation. It typically looks
like this. I’ll say things like, I cannot even believe that you’re having to deal with this. I cannot, I just don’t
understand. It sucks. It is awful. I just don’t get it. I mean, I, cause people would ask me, what do you say?
I’m like, that’s what I say. And then their walls come down. Cause they you’re meeting them in a place that’s
ugly and it’s not pretty.
Noelle Moore (35s):
And they they’re embarrassed. They finally can say to themselves, Oh my gosh, somebody gets it. I’m not
embarrassed.

Announcer (41s):
Welcome to difficult conversations lessons I learned as an ICU physician with Dr. Anthony Orsini. Dr. Orsini
is a practicing physician and president and CEO of the Orsini way as a frequent keynote speaker and author,
Dr. Orsini has been training healthcare professionals and business leaders. How to navigate through the
most difficult dialogues each week, you will hear inspiring interviews with experts in their field who tell their
story and provide practical advice on how to effectively communicate whether you are a doctor faced with
giving a patient bad news, a business leader who wants to get the most out of his or her team members or
someone who just wants to learn to communicate t his is the podcast for you.
Dr. Anthony Orsini (1m 24s):
Welcome everyone to this episode of difficult conversations. I’m so excited today because I get introduced to
you a truly amazing and inspiring person. You know, when I decided to launch this podcast, Noel was one of
the first people that I called to be a guest. I have to this episode and listening to what Noel has to say. I
promise you that our story will move you emotionally and inspire you to turn your own tragedy into something
good. If anyone can speak about difficult conversations and how they affect our lives, both in a positive and
negative manner, it is Noel.
Dr. Anthony Orsini (2m 1s):
You know, I’m so excited that I think I’m jumping ahead a little bit of myself here. So let me introduce Noel
properly. Noel is a lifelong central Floridian, Flo grown, as they say here in Florida, she attended the
prestigious Rollins college located right in our hometown of winter park at Rollins. She earned her degree in
marketing and communication, and she later returned to wrongs the receivers certificate of nonprofit
management. After experiencing the loss of her precious baby Findlay in 2013, Noel was forced to deal with
the tragedy.
Dr. Anthony Orsini (2m 32s):
Few people could ever imagine, but somehow she was able to come out on the other side of darkness. And
later that year she started the nonprofit organization. The Findlay project, the Finley project is the nation’s
only seven part holistic program for mothers. That experience infant loss. It is served nationwide hundreds of

families that represents 28 States and 78 hospitals around the country. The Finley project is a founding
member of the pregnancy and infant loss resource network of central Florida and participate in the national
organization, pregnancy loss and infant death Alliance.
Dr. Anthony Orsini (3m 5s):
Noel serves as a grief share facilitator and breaking bad news instructor for the her Sini way. And if that’s not
enough, Noel seems to find the time to become involved in her community. Noel’s a board member of the
winter park YMCA and as a member of the association for fundraising professionals and an active member
of the winter park chamber of commerce, as well as the rotary club of Lake Mary Noel was awarded the Paul
Hawkins lifetime achievement award in 2019 and led the Findlay project to win the 2017 and 2018 winter
park chamber of commerce ovations award in April, 2020, Noel was awarded Orlando family magazine, top
15 super women award.
Dr. Anthony Orsini (3m 47s):
That’s pretty incredible Noel doesn’t move far. She now resides in Maitland, Florida, just about five miles
from where she grew up. She loves the beach working out and serving families who have experienced loss.
That is quite an introduction. Noel,
Noelle Moore (4m 2s):
Thank you. What an introduction. That’s pretty awesome.
Dr. Anthony Orsini (4m 5s):
You deserve it. I mean, I, I don’t know. My introduction would probably be about one third of that. So you’ve
kind of quite accomplishments and all since 2013, but I mean, it’s amazing. So you’ve spent your whole life
in Florida. Never moved.

Noelle Moore (4m 17s):
No, I’ve actually moved around quite a bit. I landed here about seven years ago and I was out on the West
coast and San Diego and then went up to the mountains of North Carolina and then ventured back down.
So,
Dr. Anthony Orsini (4m 30s):
So you’re back. And I didn’t know all that because I met Noel and full disclosure. Noel is a good friend of
mine. We met, I guess in 2015, I was doing breaking bad news programs in six or seven States when I
moved from New Jersey to Florida and I wanted to bring the breaking bad news program to Orlando health
and the breaking bad news program. For those of you who don’t know, we teach physicians how to discuss
tragic news with patients and families. And we use improvisational roleplaying with professional actors,
they’re videotaped.

Dr. Anthony Orsini (5m 4s):
And then after the videotape improvisational roleplaying, the physicians get to come into a room, reviewed
the videotape with instructors, both from DRC anyway, but a key component of the breaking bad news
videos is that we use instructors that are nonmedical. So the physicians not only get the, here are some
communication tips from medical instructors, but from lay people, who’ve experienced tragedy themselves.
So one of the first things I did when I got to Orlando is I said, Hey, I want to bring breaking bad news here.
Dr. Anthony Orsini (5m 37s):
You know, who do you think would be a great instructor? And of course Noel’s name came up first. I think we
met in a little small conference room and the rest is history. Noel’s been a good friend of mine. She’s always
available when we teach. And I think at the end of this podcast, you are going to be pretty inspired. So that’s
how Noel and met. And I’m so excited. So Noel, I just want you to tell everybody your story because it is
quite a story and it’s moved me and it still touches me every time I hear it.
Dr. Anthony Orsini (6m 9s):
Tell me about 2013 and Finley and just let them know the story that I know.
Noelle Moore (6m 15s):
Absolutely. So kudos to dr. Or Sini or Tony, just for all the work that he’s doing, honestly. And the fact that
he’s asked me just to share my story today, because really it’s, it’s a hard one. And for those that are
listening, I would say kind of prepare yourself, embrace yourself because what I went through, I pray and
hope that nobody ever has to go through. But basically in 2013, you know, I was just a young professional,
like looking to live my best life and be successful and have a great career.
Noelle Moore (6m 50s):
But I was pregnant at that time, which I was super excited about always wanting to be a mom and just so
excited to have this little girl and her name is Finley, but in 2013, February, my dad passed away. And that
was my first encounter with grief of someone close to me. And I just didn’t know how you great. I was never
around grieving people. I was never taught the skills really to grieve. And I felt, I felt really blindsided with the
fact that the first person close to me to really die was my dad.
Noelle Moore (7m 22s):
And, but the crazy part was at that time I was pregnant. So I felt like I saw like the full circle of life. Like
here’s the end of an error. However, here’s the beautiful beginning of something new. And four months later
in July, I was full term and I was admitted into a local hospital and all the fabulous things that occur the day a
woman goes into to deliver a baby and everybody was happy and we were celebrating and the induction
process started.
Noelle Moore (7m 55s):

And after approximately 24 hours, there were some physicians OBS that made a decision that ultimately
changed my life and they left the property. And shortly thereafter, my daughter Findlay needed to come out
and I was rushed into the, or, or an emergency C section. And this is just the part of my story that I think is
very, very difficult. I think it’s what helps me connect with other people, but basically she needed to come out
and there was no one there.

Noelle Moore (8m 28s):
And there was no one there for a long time to do a C section. And there was a lot of trauma that happened at
that time and the things I saw and eventually after 40 minutes, a OB got there and did the emergency state
section and got her out and she was lifeless and pale. And just the most horrific thing I think a mother could
see and they resuscitated her and put her on life support. And that moment was started journey of all the
stuff that I’ll describe later.

Noelle Moore (8m 58s):
But, you know, seeing your daughter on life support and just not looking how she should is just absolutely
devastating. No one prepares you for that, just that, even that visual, but after 23 days and multiple EGS and
just different tests and whatnot, the doctors had to tell me that she will never walk or talk or know me. And as
her parents, we had to make a horrific, but I guess now a selfless decision. And that was to remove her from
life support. So, yeah, that was in 2013.
Noelle Moore (9m 30s):
And then part of my story that sometimes I don’t share, and I think that’s really important. I think it will be a
brilliant, important part of this conversation. Two weeks after she died, my husband made a choice to leave
and what ensued six months later was a divorce. And, you know, it’s just all of those things combined make
for a really, really difficult journey. But once again, I’m here today to help educate and help people know how
to navigate some of these hard conversations.
Dr. Anthony Orsini (9m 57s):
I could still have these years. And again, I can’t imagine what it would be like to lose a child, but I could just
hear the tone of your voice, just telling the story up to so many years. And I’m sure you’ve told this story
many, many times. So take us back. If you will, to the first conversation that you had with a physician or
maybe the first physician that told you how sick Finley was, as we say, the first physician that broke bad
news to you. And we know that parents and family members understand and remember every aspect of it.
Dr. Anthony Orsini (10m 33s):
So if you will just take the audience back to that time,
Noelle Moore (10m 38s):
You know, when I think about breaking bad news, I actually think about gradual can happen in different

ways, right? It actually can happen within a span of a few minutes, but actually can happen in a span of a
few days or weeks. And for me, that gradual was really important in the life, the little life of my daughter. And
I think planting the seeds early on, actually just in thinking of this, the fact that the doctors planted the seeds
early on and were very careful because they wanted to keep that hope alive.
Noelle Moore (11m 10s):
But behind the scenes, they all knew that she wasn’t going to bounce back and that there was no cure for
what happened to her. So when they would say things like, you know, you can be her mom and, you know,
we want you to give her a bath and be there with her, but you know, it’s just, she’s struggling. Like she’s
having a really difficult time without this oxygen. And then maybe I remember like a week later, the tone
started to change of their approach with her condition. You know, things aren’t looking good, this last EEG
was not good, you know, but you know, you can continue to spend time with her, et cetera.
Noelle Moore (11m 46s):
And then the third week, it got to the point where, you know, it was serious and you could tell by their, and
the words that they were using, that something had to give. And, you know, I can elaborate more about the
two conversations that like went well or I felt helped me in that process. And then I can share with you about
the one that was different. But I remember the first E G we did, we committed to doing three. And then after
that, we kind of knew we had to do something.
Noelle Moore (12m 19s):
So I remember standing in this dark NICU pod and a neurologist, I think it’s who it was. I don’t even
remember who it was. That’s, that’s how devastating it was. I had a person tell me news that changed my life
forever. And I don’t even know who they are. I mean, the thought of that is just, it’s terrible, but I was
standing there and looking at my daughter and somebody walked up and introduced themselves. They don’t
know their name and basically said, I’m looking at her results and there’s no brain activity and she’s dead.
Noelle Moore (12m 55s):
And you know, here you are looking at a 10 pound baby with every finger and every toe. And that just
doesn’t, it just doesn’t connect. The human brain is not able to absorb such an abrupt message, you know,
and I remember that day was probably the worst day for me, the way that she said it and how she said it.
And I had no rapport with this person. I honestly, in that, that moment, everything flashed before me and I
just, I wanted out, I remember saying I need out.
Noelle Moore (13m 27s):
And I went out on the garage parking garage of that hospital and I just, I wanted to run, like I just wanted to
run the information was so just smack dab in my face that I, my brain couldn’t process it. And so over the
next few days and whatnot, after some different conversations, we kind of fell into some piece and just tried
to enjoy our time with her. And then I had a neonatologist actually. And I remember where I was sitting. I can

remember the way the chair was facing. I can remember how small a room was.
Noelle Moore (13m 59s):
I remember the smell of the hand soap on the wall. And I was just sitting in this small room. It was actually a
lactation room, just for some peace in this particular neonatologist found me in there. And he said, can I talk
to you? And he knelt down next to my chair. And he said, you know, I love Finley. I love your family. And then
he started to cry and I remember his tears were dropping on his khaki pants. And he had just shared with me
that, you know, I know you love her, but you know, she, she will never will never walk or talk.
Noelle Moore (14m 37s):
And I know that you would want her to have a great life and that you would want the best for her, and you
wouldn’t want her to be in any pain or suffer. And so, you know, one of the most selfless, he used the word
selfless things you can do as her mommy is to let her go. And the tone that trust that I had built with him, the
rapport that we had, I believed him. And I believed his words. And the support that I felt from him ultimately
is what allowed us to take our off of life support.
Noelle Moore (15m 14s):
So two polar opposite ways of sharing horrific news, the first making me honestly wanting to leave this earth,
the second empowering me and allowing me to make the worst decision of my life.
Dr. Anthony Orsini (15m 32s):
Yeah, I am an emotional tie in person. And so even after all these years, I still get tears in my eyes. When I
hear that story as a neonatologist, I’ve had that conversation with parents more than once, and it never gets
easy. But as I said, in my first episode, these conversations affect you either on a positive or a negative
manner. So you don’t even remember that first doctor’s name, but I’ll bet you remember this.
Noelle Moore (15m 58s):
Am I allowed to say it? No.
Dr. Anthony Orsini (16m 2s):
Well, I’m not sure, but all I can say that there was a doctor that was there and for whatever reason, he
showed his compassion and we all have compassion, but I think some of us either push it down, thinking
that we’re protecting ourselves, but telling someone bad news, whether it’s in medicine or in business, if
you’re firing someone or whatever it is, is a skill.
Dr. Anthony Orsini (16m 32s):
And if you do it right, it’s a gift. And I learned that from you. And I learned that from other mothers and other
patients. And what do you think if you had that first doctor in the room with you right now, then you weren’t
allowed to hit her, but if you had the first doctor in the room right now, let’s say you and I were doing

breaking bad news together. And she was one of the participants. And what advice would you say to her in
comparison to the second doctor, as far as this is how you have a difficult conversation?
Dr. Anthony Orsini (17m 6s):
And I don’t mean like by the book, but what would you say from your heart is if you had just done this, or if
you had just thought of this, what would be your advice to her?
Noelle Moore (17m 17s):
I think, I think for her, it would have been setting the stage to know that something was about to be said, that
would be my number one thing, breaking bad news. Like she did standing up in the middle of a room. I had
no idea it was coming. So I think first for her would be say like, you know, can we step aside and talk? And
then secondly would be to build that instant rapport would be, you know, sitting across from me, like chair to
chair and just making eye contact and not being afraid of that conversation.
Noelle Moore (17m 52s):
So for me, what eye contact would say would be, I’m not afraid of this conversation. I need to say it, but I
need to say it with compassion. So I would say that’s the second thing. And then I think the third thing would
just be allowing me the space to just process, like in that moment, like just if I cried or yelled or whatever, I
had nowhere to go, I felt trapped. I felt when she hit me with that, I didn’t even, I didn’t know what to do. So I
would certainly say setting the tone, bringing me somewhere separate or making sure I’m sitting down.
Noelle Moore (18m 26s):
The second thing would be to make eye contact and, you know, lean into the conversation. And the third
would be just allowing me that space to grieve.
Dr. Anthony Orsini (18m 35s):
Yeah. You know, I think that as human beings know in months to make someone’s side and we’re
uncomfortable in certain situations, especially when we’re not trained. And I’ve said this before, even beings
are compassionate. People, physicians and nurses are compassionate people, but we get in these situations
where we don’t know what to say. We don’t know what to do. We don’t know how to help. And we feel like I
just gotta get it over with, you know? And you know, when I go around teaching communication to physicians
or business leaders, once you explained to them that communicating and especially during difficult
conversation, it’s a skill and you should be really proud of it that second doctor.
Dr. Anthony Orsini (19m 18s):
And I don’t want to put words in your mouth, but I I’m sure you would agree, but that second doctor gave you
a gift, right? It was a gift of compassion. And, you know, you said at one point you, so you remember the
tears hitting his khakis. And I think that’s, if we can think about difficult conversations as a skill, this is how
you do it. I’m really good at it. And I want to be good at it because I want to help people and we won’t rush

through it then. And I think that’s what this podcast is all about.
Dr. Anthony Orsini (19m 49s):
It’s about understanding how we communicate. It’s understanding the verbal nonverbal communications, you
know, even something like silence, right? I mean, you and I talked to physicians all the time about this, you
know, sitting there silently shows that you care, even if you don’t say anything, you know, I always quote,
during my lectures, rabbi Cushner, who wrote the book when bad things happen to good people, he’s got a
quote in there. He said, if you don’t know what to say, just say, you’re sorry. And then shut up.
Dr. Anthony Orsini (20m 19s):
You know? And we teach that all the time. Right. You know what, no. And I teach that all the time, like just
saying, you’re sorry. And sitting there with the person and being there and looking in their eyes, like you had
said makes all the difference. So, so you have a perfect contrast. And that’s why I thought you’d be great
guests here because you have a perfect contrast. And if anybody’s listening out there about how
communication during these difficult conversations can make things worse, like the first person and make
things better. But you came out on the other end and in 2013, the same year, right. You started the Findlay
project.
Noelle Moore (20m 50s):
Yeah. And if it’s okay, I wanted to go back on something you said, because I think it can really help people.
You know, like I’m really big on the why, like, why does any of this matter? And we talk about this gift and
some people go, why is it a gift? It’s just easier to tell it quick that way they know, and then they can move
on and.it up. But what I’ve seen and I can’t claim to be, you know, a clinical psychologist or whatever, but in
my own life. And then, then the families we help is this fact that they’re already traumatized by the death
itself.

Noelle Moore (21m 22s):
And the last thing that they need is to have to go to counseling and get support because somebody was
cruel or shared with them information that was done in a non-compassionate way. So for me, the reason this
is the gift is because, because you’re showing them that you’re a piece of the compassionate pie in the
process and it really, really is a gift. So I just wanted to elaborate on the why it really is important. And the
other thing is like a lot of times, and we talk about this in the training, but in breaking bad news, but some of
the families that for us, that experienced death, or like you said, in a business setting, sometimes people are
apprehensive of, what’s been done to get them to the place that they are.
Noelle Moore (22m 8s):
So they’re already leery of the institution, the organization, the business. And so if you can be a part of, you
know, the good part, the good experience that they have with that institution, then there’ll be less likely to
retaliate. There’ll be less likely to accuse. There’ll be less likely to make things more difficult for you on the

backend.

Dr. Anthony Orsini (22m 31s):
That’s a great point. Even in business, we’re going to have a guest, Dr. Larry Barton, who’s one of the
leading experts in crisis management and dr. Barton and his latest book actually talks about how human
resource people have that conversation with an employee who’s being separated and how that can predict in
many ways, whether that person comes back and becomes violent to the hospital. So I think that’s a great
point. So now we’ve gone through this total darkness that you talked about and you had the two difficult
conversations.

Dr. Anthony Orsini (23m 4s):
How did you get to that point? Because it was the same year. You were able to get food to the other side and
start at the Finley project in the same year, correct?
Noelle Moore (23m 12s):
Yes and no. So when she died, the reality is I couldn’t find any help for somebody like me. And I say like me
in quotations, but where does a woman go? Who’s lost an infant that has plenty of great friends and family
and has some resources, but not a lot, but like where does somebody like me go that can find somebody
that’s walked that road? And I couldn’t find that. And I was just, you want to talk about adding fuel to the fire
that added fuel to the fire? I already felt like an outsider to all my friends who were having children.
Noelle Moore (23m 46s):
And so now I’ve lost this child now. I can’t find anybody like me. And so it started me just looking around and
researching and calling and things like that for help. And I obviously got my own help, which included
counseling and going to support groups. But in that process, that’s when I started researching to see what
was out there. And that’s where I discovered this huge gap. I say, there’s a huge gap between the hospital
and the home because nobody steps into that.
Noelle Moore (24m 16s):
I feel very well. And so that’s how the family project started. It started because I noticed the gap between the
hospital home. And so for that next year after her death, I got a lot of help for myself and also started to build
a foundation for the organization. So in 2014, the Findlay project launched when, as you shared earlier, we
are actually the only organization in the whole country that addresses, you know, body, mind, spirit,
spirituality, all of it together.
Noelle Moore (24m 48s):
So yeah, we started officially in 2014.
3 (24m 51s):

So I mentioned in the introduction that it’s a seven part holistic program. So tell me more about that.
Noelle Moore (24m 57s):
Sure. So the people ask me this question a lot. You know, this is all based on my own findings. And what’s
funny is what I thought was really what people needed. Isn’t what they needed. And initially, all I wanted to
do was provide counseling for people because who can afford counseling. I mean, well, the average person
cannot afford 80 to $150 a session. And especially after loss, I mean, it is so needed, but basically the first
person I tried to help, they were not open to counseling at that time.
Noelle Moore (25m 31s):
And their response to me was, you know, listen, I been living in this on-property housing, you know, place
while my daughter was in the NICU, she’s died after three months and I don’t even have food in my pantry.
My house is gross. I don’t care about myself or my body. Like I just counselings the last thing I need right this
second. So that’s what made me take a step back and say, what were all the things that I was a recipient of?
What were the things that other people benefited from?
Noelle Moore (26m 3s):
And so that’s how the seven parts were developed and what that looked like was helping plan their funeral. A
lot of times people don’t even know, like what does a child’s funeral look like? So we help them, the funeral,
we provide meal gift cards so they can feed their family. And the next thing we help with is we send out
house cleaners to their house. The fourth thing we do is we provide massages just to provide a moment of
peace and relaxation. Then we connect them with a support person.
Noelle Moore (26m 35s):
So we try to find somebody that has walked a similar road and had somewhat of a similar experience just to
be there with them and help them navigate strange journey. And then the bulk of what we do is eventually
get them into licensed mental health counseling. And so we cover 12 sessions. So whether we do it, or if
they have insurance, we just make sure that they get into counseling and that it’s something that’s a good fit
for them. So, yeah, that’s the whole program in a nutshell.
Dr. Anthony Orsini (27m 4s):
And I can attest personally, what I amazing program is I’ve referred. When I see a mother who’s had a loss
or mother who I’ve been treating the baby, and that is having a difficult time as they all do. Noel knows that I
have her cell phone on speed dial and I called Noel and Noel takes it from there. And it’s amazing things. I
go to the Finley project gala every year, the fundraising gala. And you do a great thing. And that you have
mothers who, who were in the darkest places that you’ve helped come and give little 10 minute speeches
about how the Findlay project.
Dr. Anthony Orsini (27m 40s):

And there’s usually not a dry eye in the place. And I think that’s just wonderful. I’m really interested in the
conversation that you have, you know, I call you and I say, Noelle, here’s a mom was agreed to have you
call her. And then I don’t know what happens next. I mean, I know that they get help from you, but boy, that’s
gotta be a really difficult conversation when you call that mom up or offer your help. How do you approach
that? And how, tell me how that works and give some tips.
Noelle Moore (28m 11s):
I don’t think there’s a harder conversation than telling someone that their loved one has died. So if we can
learn how to do this, we can do it at any situation. And what that looks like is taking a step back and saying
to yourself, I’m about to tell somebody or approach somebody that has gone through the most horrific thing
that they can go through. So I need to do it carefully and I need to have a very careful conversation with
them. So I think just the fragile oddity of that conversation and knowing that before you go in, so that what
that doesn’t look like is calling when you’re driving in the car or calling while you’re, you know, playing golf,
you know, having this real Kurt or, you know, quick conversation with them.
Noelle Moore (28m 57s):
So for me, when I know I have to talk to a mom, I make sure I’m calm. I’m quiet. Every word does matter.
Even after they’ve had the loss and for me, I’m able to relate to them. So I go back to that experience. So I
try to put myself back to what I went through for somebody that hasn’t gone through, that I would say, just
being really open and compassionate and saying just encouraging and empathetic words is really helpful.
Dr. Anthony Orsini (29m 26s):
Yeah. That’s, that’s a difficult conversation to have. Absolutely. You know, you said a couple things that I
really want to reemphasize. One is that, you know, you’ve gone through this and so you share your story
with them, correct?
Noelle Moore (29m 43s):
I don’t know if it’s so much share it. I think it’s allowing myself to remember what it felt like. I think for people
that have to do this breaking bad news is go back to a time where something bad was said to you or hard
was said to you, and how did it feel? Whether it was, they did it well, or they didn’t do it well. And so how
would you want it broken to your, how would you want that conversation? What would you want that
conversation to look like? And to be honest with you, a lot of times, you know, you asked about that first
conversation. It typically looks like this.
Noelle Moore (30m 13s):
I’ll say things like, I cannot even believe that you’re having to deal with this. I just don’t understand. It sucks.
It is awful. I just don’t get it. I mean, I, cause people always ask me, what do you say? I’m like, that’s what I
say. And then their walls come down. Cause they you’re meeting them in a place that’s ugly and it’s not
pretty. And they they’re embarrassed. They finally can say to themselves, Oh my gosh, somebody gets it. I’m

not embarrassed like that.

Noelle Moore (30m 44s):
I feel so bad.

Dr. Anthony Orsini (30m 46s):
Exactly. And I’ll say, when I speak to parents too, and I’ve learned from you and from other mothers and
family members that I do say that this is terrible. This sucks. Not very professional to use that word, but I say
it, yeah, this sucks. And you don’t deserve this. And it’s important to tell them, and maybe you could
elaborate on this and it’s not their fault. Some people think there must’ve been something, you know, through
the years I’ve been doing this, telling a mother that it’s not her fault seems to, you can see it a little relief in
their shoulders.

Dr. Anthony Orsini (31m 20s):
When you say that, because I’ve heard different things from, you know, I’ve, shouldn’t have gone up the
stairs so fast or I shouldn’t have worked as stuff that’s not rational, but as a mother, you’re going to be
thinking about that. So just saying, and acknowledging that it’s not their fault, I think makes a, makes a big
difference.

Noelle Moore (31m 39s):
I can elaborate a little more on that. Like I think it’s a lifelong of pressing that guilt down and I had a mentor
tell me at that time you did everything you knew to do. And he would make me repeat it over and over and
over. And what that did was, you know, hindsight is 2020 for everybody in every situation. But it made me
remember that at that time I picked the best hospital. At that time, I picked the best doctors at that time. I
was as healthy as I knew to be et cetera. So just repeating that over and over to myself, helped a lot.
Dr. Anthony Orsini (32m 11s):
Do you find that people are that sometimes you have to share your story, that initially people are reluctant to
ask you for help, but that once you share your story with them, they maybe feel a little bit more acceptable to
getting help. Tell me about that.
Noelle Moore (32m 27s):
You know, infant loss, child loss is an elephant in the room. It’s people’s worst nightmare. And all of us had a
hard time trusting anybody after it, whether it was, you know, there was a fault a physician or if it was just,
you know, not trusting life in general. And when I can build that rapport with them and say like, I know your
neighbor doesn’t understand, but I do on some level, not fully, but on some level, once again, the wall comes
down and in your mind you say, okay, I found one of my people, it’s a weird experience, but it’s like finding
your tribe.

Noelle Moore (33m 5s):
And it’s a tribe that like who in the world was signed up for. But once you find it, you’re like, ah, I need these
people because they get it.
Dr. Anthony Orsini (33m 12s):
It’s an amazing, and, and I’m, I’m so passionate as you know about helping people communicate better. You
said something before that, I say all the time, you know, if you can have this discussion, everything else
seems to be easy. And that’s, that’s my personal story that, you know, once I learned how to have that
discussion about a baby who died with a family and I learned to do that as best as you could, because you’re
only making a horrible situation, maybe a little bit better at the very least you’re not making it worse.
Dr. Anthony Orsini (33m 48s):
Right. And that’s why business people and nonmedical people have come to me and say, you know, can you
teach us how to communicate? It’s cause it’s not bad news. Right? You know, I do a lot of work at the RC
anyway, with patient experience, not bad news, just how to build a practice. How do you build rapport with
somebody? How do you connect? Well, it’s the same concepts of verbal nonverbal language showing
compassion. Even if it’s, you know, a broken leg or something that’s not devastating.
Dr. Anthony Orsini (34m 20s):
So I thought it was interesting that you used that because I say that all the time, if you can, this is the
hardest conversation in the world. If you can get through this, you can get through anything. And then just
finishing up. There’s so many people out there that are friends and family who maybe avoid that
conversation. They don’t know what to say to you. Right? And there was a book that I read, someone lost his
child. He said he called it the bushes effect. He said, he noticed that once he lost his baby and his son died,
that the neighbors would see him pull into the driveway and jump into the bushes because they didn’t know
what to say.
Dr. Anthony Orsini (34m 56s):
And so for the average person out there, who’s not dealing with, maybe it’s not medical. Maybe doesn’t give
difficult conversations or have be involved in them frequently. I think you can learn from your experiences
from this podcast, just, you know, when someone dies in your family, what to say and how to say it. And I
think you’ve given some, some great tips. So I am, I mean, all of you, you know that, right? So, so I’m
blessed to know you.
Dr. Anthony Orsini (35m 26s):
I want the Findlay project to be available to every mother in the country. I want your project to grow. And
because I think it’s needed that you have shed some light on how much of the conversation can really
change your life, both in a positive and a negative manner. And so I just want to say, thank you. If people
want to learn more about the Finley project, they can go to www.thefinleyproject.org and contact either Noel

directly or someone from the Finley project, if you want to donate.
Dr. Anthony Orsini (36m 6s):
So are you looking to expand the well, I mean, how are we going to make this be nationwide? I mean, you’re
already in so many areas, but we want to help thousands, not hundreds, right? How can we do that?
Noelle Moore (36m 16s):
The best way that people can help the Findlay project would be if you have an area hospital that you have a
relationship with is to help us get into that hospital, to help educate the physicians and the social workers
and, and whatnot, to then be able to refer to us. We’re solely based in Orlando. So we have one chapter, but
the way that our program is since we use national partners, we’re able to help everywhere. We are
technically a nationwide, but we need more connections within each hospital and hospital system.
Dr. Anthony Orsini (36m 46s):
Fantastic. Well, as you know, I’m a big fan. I want to thank you again. This was an awesome interview. If you
liked this episode or you want to learn more about difficult conversations, please go ahead and hit that
subscribe button. You can also learn more about difficult conversations and The Orsini Way in the training
that we do by going to The Orsini Way.com. Thank you, Noel. Hope to see you soon and stay safe.
Announcer (37m 8s):
If you enjoyed this podcast, please hit the subscribe button and leave a comment and review to contact Dr.
Orsini and his team, or to suggest guests for future podcast, visit us at The Orsini Way.Com

Read the transcript of Dr. Orsini

Announcer (1s):
Welcome to difficult conversations lessons I learned as an ICU physician with Dr. Anthony Orsini. Dr. Orsini i
s a practicing physician and president and CEO of the Orsini way as a frequent keynote speaker and author.
Dr. Orsini has been training healthcare professionals and business leaders. How to navigate through the
most difficult dialogues each week. You will hear inspiring interviews with experts in their field who tell their
story and provide practical advice on how to effectively communicate whether you are a doctor faced with
giving a patient bad news, a business leader who wants to get the most out of his or her team members or
someone who just wants to learn to communicate better.
Announcer (42s):
This is the podcast for you.
Dr. Anthony Orsini (48s):
Hello everyone. My name is Dr. Anthony Orsini , and I’m so excited to welcome you to my very first podcast.
You know, I’m passionate about two things, medicine and communication communication as a powerful tool
that can be used to convey compassion, forming relationships quickly and build loyalty. It affects every
aspect of our personal and our professional lives, but it is especially important during those critical life
changing moments. And we’ve all been involved in difficult conversations and how we communicate during
those conversations can make the difference between helping someone or making a bad situation worse as
a neonatologist, caring for the most critically ill newborns for almost 25 years.
Dr. Anthony Orsini (1m 32s):
Now, I have certainly had more than my fair share of difficult conversations. Telling someone that their
babies died or has suffered severe brain injury, no matter how long you do it just never gets easy. Like most
people giving bad news is something that no one ever wants to do. But I found out during my personal
journey that doing it the right way is truly a gift more on that leader, but difficult conversations don’t just occur
in medicine. They happen every day when sometimes we don’t even know they’re occurring in business
managers become true leaders when they know how to communicate and get the most out of their
employees and build loyalty.
Dr. Anthony Orsini (2m 12s):
Team members are more successful when they communicate well. And HR professionals who know how to
navigate through the most difficult dialogues are able to avoid bigger problems later on in our personal lives,
knowing how to communicate can help us build friendships, help our marriages, and sometimes even get
through to our teenagers. This podcast is about learning to communicate effectively and with compassion
each week, we’ll discuss practical communication techniques that will help you convey your natural
compassion, build loyalty and form trusting relationships.
Dr. Anthony Orsini (2m 50s):
You will hear inspiring stories of tragedy and triumph, and in each story, we’ll learn together about the major

role that communication played. Now, if you subscribe to this podcast, I promise you that you will never think
about communication the same way. Again, you’ll be inspired to learn more and eager to try out what you’ve
learned. I’ve dedicated my entire career to learning how to help people, but not with just medicine, with my
words and my actions as well. And I’m eager to share with you what I have learned.
Dr. Anthony Orsini (3m 22s):
Let’s face it. If you can tell someone their child is dying with compassion, every other conversation, it’s
relatively easy. I have fantastic guests lined up both from inside and outside the healthcare industry. I’ll be
interviewing some amazing people who will share their stories with you and what they’ve learned about
communication along the way. We also have experts in every field who will provide you with practical tips on
how they’ve learned to use communication to succeed. Now, it’s only fair that if I’m going to ask personal
questions of my guests and I will, that I share with you my own personal story.
Dr. Anthony Orsini (3m 59s):
My personal story starts 25 years ago. I was a neonatology fellow. And for those of you who don’t know the
medicine nomenclature, a neonatology fellow is someone who’s already completed their pediatric training
and has decided to train for another three years to be certified, to take care of the sickest, premature and
newborn babies. It was early on in my fellowship when I was on call at nighttime and I received a call from a
desperate pediatrician in New Jersey. You asked me to pick up a very sick baby.
Dr. Anthony Orsini (4m 29s):
It was my job as a neonatal fellow to go and pick up the baby with the transport team. When I arrived at the
hospital, I found the baby who was just desperately clinging on to life. The ventilator that he was on was
working at its hardest and his oxygenation and his blood was barely high enough to keep him alive. The only
chance he had was to get them back to my hospital and place them on a heart lung bypass machine. The
parents gave the baby a quick kiss on the cheek. We ran to the ambulance lights and sirens going, but as
we went over the Ben Franklin bridge back to Philadelphia, the baby’s heart rate started to drift.
Dr. Anthony Orsini (5m 6s):
We gave extra medications. I called my senior physician that night, dr. Smith for advice. And he assured us
we were doing everything possible and that the baby just needed to get back to the hospital. Sadly, as we
got to the hospital, the baby’s heart rate had dropped so low that we started full resuscitation dr. Smith, that I
continued the resuscitation at the hospital, including full CPR, but sadly, the baby passed away. Soon after
baby passed away, the charge nurse informed me that the father had followed the ambulance and was
waiting for us in the back room.
Dr. Anthony Orsini (5m 43s):
Now that night I felt very fortunate because I was on with my senior dr. Smith. I have known dr. Smith for
three years and I have known him to be one of the most compassionate people I’d ever known. He was a

great, super smart. He was kind and caring. He was the kind of doctor that I wanted to be like when I grew
up now at the time also, I was very fortunate in my own personal life. I had a newborn baby that was healthy,
lovely wife.
Dr. Anthony Orsini (6m 14s):
My parents are both alive. I really had no tragedy in my life. And so the thought of telling someone that their
baby died, scared the crap out of me. So I decided to use this terrible event as a possible way of learning,
how to speak to a father about death. I asked dr. Smith, if I could watch him tell the parent that has baby a
died. He of course said, yes. We walked down the hallway to the waiting room. We opened up the door. We
found a father who was frantically pacing back and forth.
Dr. Anthony Orsini (6m 47s):
And what happened next is still unexplainable to me almost 25 years later, this kind compassionate doctor
whom I had known for three years, simply blurted out my name’s dr. Smith and your baby’s dead. I thought,
did he just do that? Well, the father, he went crazy. I remember he punched the wall. I think he put a hole in
the wall. He knocked down the table lamp. He was screaming at a sound that I had never heard before.
Dr. Anthony Orsini (7m 18s):
Dr. Smith just stood there. I thought I need to do something. So I took a step forward towards the father and
dr. Smith just put the back of his hand on my chest. And he said, let him be few moments later. The father
calmed down. We got them to sit down and we spoke to him. And at that point, the true compassion of dr.
Smith came out. We walked the father down the hallway to show him where his bed, baby lay. When we
decided to give the father a few moments with his baby, I walked out of the room into the hallway and dr.
Dr. Anthony Orsini (7m 48s):
Smith was waiting for me. He grabbed me by the lapel, pulled me really close, and I could see that there
were tears in his eyes. And he said to me really firmly. He said, do you see what I just did? Don’t ever do
that. He turned around, walked down the hallway towards the fire escape. He spent the next 20 minutes on
the fire escape. No doubt crying. Well, that was a life changing moment for me profoundly changed me.
Dr. Anthony Orsini (8m 20s):
I thought, if this gentle compassionate man does not know how to give bad news in the kindest way possible.
What chance do I have at that moment? I decided to spend my career trying to answer two questions. One,
is there a right way and a wrong way to give tragic news to a patient and two, if there is a right way, how do
you teach it? So for the next 10 years, I poured through all the literature on how to break bad news.
Dr. Anthony Orsini (8m 55s):
And there was very little, but more importantly, he interviewed dozens and dozens of patients and parents
and family members who had received bad news from doctors. And I asked them what worked, what made

you feel better? What made you feel worse? And I started to see a pattern that there really was a right way
and a wrong way to tell someone their baby died or that they have cancer or their husband and wife passed
away. That there were certain fundamentals that if done correctly can really help somebody when they need
us.

Dr. Anthony Orsini (9m 29s):
The most 10 years later, I started the breaking bad news program, which since then has trained thousands
of doctors and nurses, how to give tragic news and the most compassionate and effective manner. But along
the way, I started to notice one thing, the same communication techniques that are required to give someone
tragic news and the most compassionate and effective manner are the same communication techniques that
help us in everyday life. I wondered why is it that some physicians are able to build great practices and other
physicians would just as good clinical skills seem to struggle.
Dr. Anthony Orsini (10m 9s):
Why is it that some people succeed in life and others just can’t seem to get ahead? Why is it that the
smartest person in the room will becomes the manager can’t lead? The answer is simple. If you can learn to
communicate, then you’re good for every situation. And trust me, if you can teach someone how to give bad
news, how to tell someone that they have cancer, the rest of it’s easy. And so currently I train a lot of
physicians on not just how to give bad news, but how to build rapport.
Dr. Anthony Orsini (10m 42s):
Had a formulation ships managers who learn how to communicate, become true leaders. And that’s what
this podcast is all about. Difficult conversations occur every day in our lives when we don’t even know they’re
happening. And yes, we notice them more during tragedy, but communication fascinates me how we
communicate verbally. Non-verbally the messages that we send changing one word in a sentence and how
that’s perceived can make all the difference in the world.
Dr. Anthony Orsini (11m 15s):
So we have some great guests who are going to tell you about critical times in their lives. When
communication really made a difference. We have some guests, who’ve had some tragedy and came out on
the other end because someone built a relationship with them. And so I’ve learned through many, many
years that building a good practice, making a patient experience as least bad as possible, has everything to
do with communication. During my training sessions, when I train nurses and doctors, how to communicate,
we’ve shown what a big difference it makes in the patient experience.
Dr. Anthony Orsini (11m 52s):
And we’re going to have some guests that we’re going to talk about patient experience, but I don’t want you
to think that this is just for healthcare workers, because I’ve worked with HR professionals. How you
separate someone from employment can make a big difference. It’s not what you say. It’s how you say it.

And I love communication. I think it’s fascinating. And I’m so excited to keep learning because I’m going to
learn from some of my guests. I promise you that if you listen to this podcast every week, every week, you’ll
be inspired every week, you’ll learn something.
Dr. Anthony Orsini (12m 26s):
And as I’ve been told over and over and over again, once you start thinking about communication, the way
that we discuss it, it will rewire your brain. You’ll understand what it means when you move your hands at a
certain way, you understand how one word changes everything. And you’ll never think about communication
the same way again. So my personal journey started with a profound moment of watching someone be told
that their son had died abruptly, but that doesn’t need to happen to you to learn communication.
Dr. Anthony Orsini (13m 1s):
Many of you that are listening to this podcast are going to be healthcare workers, and we’re going to learn
some great techniques on how to improve the patient experience, how to build rapport with your patients.
But again, these techniques work every day at home, in your marriage, in business, it works for everything.
So if you really are excited about this podcast, we already have great interviews already recorded. I can’t
wait for you to listen to them. And I promise you, if you hit subscribe, you will never think about
communication the same way again, and you will be inspired.
Dr. Anthony Orsini (13m 37s):
So please go ahead and subscribe. Download, give us a great review. We really would appreciate it. I’m
telling you, just give us a chance and you’re going to be excited. Thank you. And I hope that I’ll see you
again. If you enjoyed this podcast, please hit the subscribe button, leave a comment and review
Announcer (14m 0s):
If you enjoyed this podcast, please hit the subscribe button and leave a comment and review to contact Dr.
Orsini and his team, or to suggest guests for future podcast. Visit us at the Orsini way. Com

Read the transcript of Dr. Dike Drummond

Dr. Dike Drummond (1s):
When a doctor or nurse or anybody who works in healthcare, walks into their practice, they walk into the
middle of a small whirlwind. And the thing about the whirlwind is from the inside of the whirlwind, all you
could see is the inside walls at the whirlwind and most of what you see sucks. So the question is, how do
you step out of your whirlwind set the whirlwind off to the side. It will be there when you come back. So have
you step out of that is the points were you need to, but point’s do you need to number one, when you are
going to go into a room or into an encounter with the patient or a patient’s family, number two, when you’re
interacting with your team.
Announcer (41s):
Welcome to Difficult Conversations Lessons I Learned as an ICU Physician with Dr. Anthony Orsini. Dr
Orsini is a practicing physician and the president and CEO of the Orsini way as a frequent keynote speaker
and author, Dr. Orsini has been training healthcare professionals and business leaders, how to navigate
through the most difficult dialogues each week, you will hear inspiring interviews with experts in their fields
who tell their story and provide practical advice on how to effectively communicate whether you are a doctor
faced with getting a patient bad news, a business leader who wants to get the most out of his or her team
members’ or someone who just wants to learn to communicate better.
Announcer (1m 23s):
This is the podcast for you.
Dr. Anthony Orsini (1m 26s):
All right. Welcome everyone. To another episode of Difficult Conversations the lessons I’ve learned as an
ICU physician today, we are very, very fortunate to have a very awesome guest today. Dr. Dike Drummond.
Dr. Drummond is a Mayo trained family doctor, a professional coach, author, speaker, and trainer. Who’s
sold professional focus since 2011 has been addressing the modern epidemic and Physicians, and that is
professional burnout. He is a graduate of the Mayo clinic medical school in Rochester, New York.
Dr. Anthony Orsini (1m 59s):
He then went onto the completed residency in family medicine in Redding, California, and practice full
spectrum family medicine in Washington state for over 11 years. Dr. Drummond is currently the CEO and
founder of the HappyMd.com, where he receives over 25,000 website visits per month, and hosts an online
community of over 18,000. Physicians from 63 countries around the world. He is the go to man and leading
expert, as I say on Physician Burnout.
Dr. Anthony Orsini (2m 28s):
Dr Drummond has logged over a 3000 hours of one-on-one Physician coaching and has trained over 40,000
doctors are on behalf of 175 corporate clients in 2014, his book Stop Physician Burnout, which I just finished
reading. And I’ve also actually quoted during some of my teachings and my presentations, his book Stop
Physician Burnout what to do when working harder. Isn’t working has sold over 40,000 copies worldwide.

Well, thank you. Dike for agreeing to be a guest on my podcast as a, you know, I launched this podcast just
a few months ago, and I’m really happy to say that in 48 hours, the Podcast went to Apple at 200 and we
actually went as high as number seven and medicine in the first week.
Dr. Anthony Orsini (3m 13s):
So, wow. I’m very happy with that. I’m really honored with the number of people who subscribe and the
reviews that we’ve gotten. So I’m really excited. I know that your just about, or you just have launched your
podcast and I believe that’s called Physicians on Purpose. Yes, it is. Physicians on Purpose. Yes. Tell us a
little bit about that first we’re on the topic of Podcast. So what’s the mission to that podcast. And where do
you see that going?
Dr. Dike Drummond (3m 40s):
One of the things that I know about physicians who are burned out, having experienced it myself, and
worked with hundreds of doctors is that it’s a experience of waking up, right? You’re trying to comply with
somebody else’s job description and it’s painful when you try to see color inside their lines and do what they
expect of you, because you didn’t play any role in developing the job description. It’s not your ideal job
description. And so what you do is you wake up through Burnout, it gets so painfully you can keep going
down that same path. Then you wake up to take control of your practice.
Dr. Dike Drummond (4m 13s):
Instead of being a physician on somebody else’s path, you become your own physician on purpose. It’s an
act of waking up then. So what we are going to do on the Physician on purpose podcast is talk about
Burnout stories, how you made the turn, what difference it made in your life, because it’s almost always a
very positive transition, as long as you survive it, it has a crisis point that you have to turn towards the light
that as long as you survive it, it’s usually a positive thing in your life. So Burnout stories, we’re not
prevention, tips and wellness leadership strategies as well.
Dr. Dike Drummond (4m 47s):
That’s what we’re going to talk about.
Dr. Anthony Orsini (4m 48s):
Well, I’m looking forward to it and it, soon as you have all the information about that, please let me know. I
will share it through all of our social media’s and will help you push that. And I’m certainly gonna subscribe.
So I’m looking forward to that. You know, every episode I review my promise with the audience, my promise
is two fold. One is that there’ll be inspired by the end of this episode and two that their going to leave with
some good communication techniques and some good sound based evidence on what to do the next time
they’re involved at a Difficult Conversations.
Dr. Anthony Orsini (5m 20s):

And I have no doubt that I’m going to fulfill my promise today, I guess you and I spoke about a month ago,
and you told them your story, and we all have a story, right? I have a story of how I started getting into
communication and medicine, how I started teaching, breaking bad news. People ask me all the time, how
did I get here from a young altruistic physician who just wanted to cure cancer? And, and then something
happens along the way that changes you and the universe kind of pushes you into a different way.
Dr. Anthony Orsini (5m 51s):
Now I’m still practicing medicine. I know your not, but do me a favor and just share your story about what to
you, you were practicing
Dr. Dike Drummond (5m 59s):
And then something happened. He decided I’m going to make the switch. I think in 2011, correct? Actually I
always practicing medicine and until the year of 2000, and that is my first episode of Burnout. And by the
way, I would argue with you that I still practice medicine. I just don’t see patients for insurance money.
Excellent. All my patients are doctors. So just shoe on that for a second. I like that. So when I grew up, my
doctor was named Dr. Schmitt, and he was a classic old guy with a button up vest, and he looked like a
captain kangaroo. We had the silver beard.
Dr. Dike Drummond (6m 30s):
Then, you know, the Norman Rockwell, a picture of the kid, looking at the doctor’s qualifications, all while his
pants are down. He is going to get the injection. I I think most physicians do. His office looked like that and
when I went to medical school, when I thought about what it would be like to be a doctor, there was only one
choice. I was going to be a GP, a small town GP. So ultimately I ended up practicing for 10 years. I counted it
up once about 35,000 patient visits, 500 babies delivered all of that kind of stuff. Been there done that got to
the T shirt. And then one of the things that hit me was my mom and my grandma.
Dr. Dike Drummond (7m 2s):
really wanted me to be a doctor. They were both dead at that point in time when I was 40. And I had gotten
to that point in a primary care practice, where part of what I enjoy is new stuff, right? So the thrill of not
knowing what was behind the next door and seeing new things every week was part of what I really enjoyed
about being a doctor. And that’s true about a lot of primary care people. And that starts to peak and fade
when your about 10 years into a practice. So what ended up happening to me was over the course of a
couple of weeks, when I would come in to work, it felt like somebody was putting me in a choke, hold it a
physical sensation.
Dr. Dike Drummond (7m 37s):
I didn’t understand. In the UFC, they call it a rear naked choke. And it had been going on for a couple of
weeks. And I said, wow, this is really strange. And I took a sabbatical, it took a month off, shaved my head
did a bunch of yoga, prayed that I would come back and I would be better. But the feeling returned the

minute I came back into seeing patients and I didn’t have a lot of coping skills at the time, it was very
disorienting. So I basically walked into the CEO’s office, sign my resignation and walked away from my
medical career, which I don’t recommend is a transition strategy because it just burns too many bridges.
Dr. Dike Drummond (8m 11s):
And so if anybody’s listening to this, if you’re listening to this and you’re saying, yeah, yeah, I want to chuck it
to don’t don’t you keep listening here and will give you some tactics, some conversations to have so that you
don’t have to burn all those bridges cause you work hard to get here. So I put food on the table. I was
walking clinic doc for a couple of years. Then my now ex wife’s business took off. We were trainers of
teaching business and leadership, facilitation skills. So meeting facilitation skills as a training business.
Dr. Dike Drummond (8m 43s):
And we grew that to be a pretty successful endeavor. And then in 2010, that marriage in that business went
away. I was burnt to the ground that the second time, and I’ve had been at a coach for a decade and he got
certified as a coach back in 2000. And I decided I would try to see if there was a way for me to make a living
as coach, to burned out doctors like I had been. And I launched a little website called the Happy md.com.
And fortunately or otherwise its not fortunate for the professional, but it was fortunate for me, but the interest
in Burnout and the prevalence of Burnout have peeked over the last decade or so.
Dr. Dike Drummond (9m 21s):
And so I’d been basically riding a wave of learning from my client’s all the different ways burn out, can get
ya, learning all at different things that work and taking that body of knowledge and turning it into training’s
and consulting in taking it out into the real world.
Dr. Anthony Orsini (9m 39s):
It is extremely common, both in Physicians Well first of all, do you also counsel nurses because we know
that nursing burnout is also very high. How prevalent is physician burnout and nursing burnout for those
non-medical people that are out there? Well, I will say that if you’ve use them as a back burner, right
Dr. Dike Drummond (9m 59s):
used Maslach Burnout Inventory which is the gold standard for burnout prevention for you, is there a
standard cutoffs for the last six or eight years in Physicians 40 to 50%, have doctors are burned out on any
given office state suffering from at least one symptom of burnout is the way it’s usually stated that most
common symptom has basically exhaustion. And that that’s a prevalence that is right now today snapshot 40
to 50% of your doctors are burned out right now. I don’t know the nursing literature, by heart, right? I’ve
trained lots of nurses in mixed audiences with doctors inside healthcare organizations got to try to train all
the employee’s when I can cause the lessons we learned with doctors apply to anyone who draws a
healthcare paycheck.

Dr. Dike Drummond (10m 39s):
So anybody is in a situation where you’re organization sees patients. The mantra that a patient comes first is
in play. You got the same risks as a doctor. It’s just not the same level of responsibilities. So the prevalence
of Burnout we’ll be lower or the farther down the responsibility chain you go.
Dr. Anthony Orsini (10m 56s):
And I know that physicians have a very high suicide rate, which is I’m sure related to other things as well, but
I’m sure if a physician burnout plays a major role in that, all right,
Dr. Dike Drummond (11m 5s):
You have double the risk. So I always explain it like this. Everybody who is now a doctor at one point in time,
was that a fork in the road? I call it the Lightworkers fork in the road. When you were trying to decide
whether to go to medical school or do anything else. And this is where all your stone are. Friends said, heck
with that. And they went and did anything else while you went on the path to medical school and you had no
idea what you were getting into, but what you did when you took that path and chose to be a doctor, was you
doubled your suicide rate man or woman or the rate is double.
Dr. Dike Drummond (11m 36s):
And I just wanna say really clearly I just ask Pam, why will this question? We believe that Physician suicide’s
are dramatically under reported, right?
Dr. Anthony Orsini (11m 45s):
Hm. So it was much higher than we even think
Dr. Dike Drummond (11m 49s):
People say 400 doctors a year. I’m sure it’s more than that. And we have,
Dr. Anthony Orsini (11m 54s):
I work for very large hospital system in, we here every now and then about another physician who took his or
her life in, you know, we don’t know what was going on in the background, but it’s certainly something that
we need the help with. So I’m going to guess, and you are going to tell me more about this, that for every
doctor that is starting to realize that he’s got signs of burnout or she has signs of burnout, there’s a bunch of
doctors who wonder if they do right. And I guess they can call you or they can take some tests and find out
that you haven’t really feeling burned out.
Dr. Anthony Orsini (12m 30s):
And the name of this podcast has Difficult Conversations. So I always say that every critical moment in our
lives, there is a difficult conversation. The first conversation that one has to have then is I’m burnt out or I
feel burned out. Do I ignore this and push through because I have a family to Thiede and I have

responsibilities and it’s embarrassing to say, cause that physician’s right, we’re supposed to B we know
everything. That’s the way we’re trained. Like we’re the leader we’re in there.
Dr. Anthony Orsini (13m 2s):
And I would think that physicians have a hard time asking for help. How does the first conversation happen?
Or what do you, for someone out there who’s listening? How do you have that first conversation with yourself
to say, am I burned out and how can I go to the next step to get help?
Dr. Dike Drummond (13m 18s):
Yeah. Great question. To realize that it’s a conversation with yourself. It’s actually a conversation between
your heart, your soul, your actual self, and the conditioned automaton that the medical education systems
spits out the far side. So lets just talk about this a little bit. And it’s something that is not taught in medical
school or residency and the 40,000 doctors that I’ve trained in. This is one of the lessons we have to share
every single time. And that’s the conditioning of your medical education. So at that light workers fork in the
road where you decided to go to medical school, just so you know, you did that because you were different
than your stoner friends, right?
Dr. Dike Drummond (13m 57s):
You are a help. You are a healer, I’d call it a Lightworker in that choice, you’ve chose to be a helper. A healer
specifically chose to ally your professional career. From this point forward to the forces of light in the
universe. As we battled the forces of darkness, illness, suffering, death, dying, and family members, crazed
attempts to deal with it. And you chose as an NICU, doctor to put yourself in a crucible wear, that kind of
stuff happens all the time. Nobody’s baby’s in the NICU for a good reason, right?
Dr. Dike Drummond (14m 31s):
You’re going to have those conversations. It’s a disaster in the family. Any time you meet these people. So
your a Lightworker impulse and in the forces of darkness are right in your face all the time at work. But what
happens is you don’t start a practice. When you decide to be a doctor, you go to four years of medical
school, do you go to a minimum of three years of residency. I’ve seen people who spent 16 years in the
medical education system. The reason you went is because you wanted to be a light worker, but you also
had certain characteristics because remember you weren’t one of the stoners you are getting straight A’s
right?
Dr. Dike Drummond (15m 6s):
So we have these personality traits, workaholic, perfectionist, lone ranger, right? All of these things are well
developed in us. They are supposed to be tools, but you take out and use for a particular purpose and then
put away. But the instant you enter medical school for anywhere from seven to 16 years are gonna be using
these tools every single day. So workaholic, lone ranger, emotion, freight perfectionist is a peace of who we
are and we come out dramatically conditioned.

Dr. Dike Drummond (15m 37s):
And in addition to those character traits there’s to prime directives, everybody knows the first one that patient
comes first. The second one is never show weakness. Yes. And that’s the one that’s an underground, right?
And remember too medical school and residency have really nothing to do with the medical practice. They’re
a survival contest. And you’re going to be put to the test. I say medical school and residency is the energetic
equivalent of water-boarding. So I’m going to be held under water to see if you can take it any falter, any
hesitation you’re out.
Dr. Dike Drummond (16m 11s):
Okay. It was much more severe in the years when we had no work hour restrictions, but even with the work
hour restrictions, it’s still like waterboarding. And so when you pop out the other side, you’re programmed to
work you’re programmed to keep pushing your programmed, to see things like fatigue, hunger, having to use
the bathroom as things you have to hide from other people because someone might consider it a sign of
weakness. And then there’s always a generous dollop of bullying and all sorts of other things that happen in
medical school too.

Dr. Dike Drummond (16m 45s):
So often times as you come out of your education process and you get your first job, you’ve completely
forgotten. You have free will because until now you’ve just been doing what everybody wanted you to do. All
you have to do is make it to the end of these tracks because honestly what do they call the person who
graduates last in their medical school class Doctor. Yeah, exactly. So all I’ve got to do is make it to the other
end. And then when I go to get my first job, I’ve completely forgotten””
Dr. Dike Drummond (17m 18s):
I have free will. Doctors are terrible at job search, right? All I’m looking for is somebody else to tell me what
to do. And in your first job, there are more than happy to do that. They call it the way we do things around
here. And you say, awesome. All you got to do is the way we do things. And this is going to be great. And
you start doing it just like a resident working real hard to what everybody expects. If you have to color inside
the lines until it gets so uncomfortable, you can’t take anymore. He goes, what are the odds that this job
description is actually your ideal job description.
Dr. Dike Drummond (17m 51s):
It starts with the Z is zero, right? If you had no role in designing this job description. So what I like to do when
people are waking up and in the agony of Burnout, they can not continue to go any longer. They’re physically
incapable of going back into the office, their dying on the inside, in a battle with their programing. What I like
to do is actually work to open back up what you were thinking at the fork in the road, way back in the day,
what were you thinking?

Dr. Dike Drummond (18m 27s):
This choice to be a doctor would provide for you and your family in terms of your profession and in terms of
enabling an extraordinary life, it’s an extraordinary choice. How can it, it enable in an extraordinary life and
how’s it going so far? And then all I have to do is start talking a little bit about Einstein’s insanity trap is even
a doctor who understands that.

Dr. Anthony Orsini (18m 54s):
This brings up so many questions just with what you said. It was just so great. I remember if it was just
yesterday, I was sitting on a deck with, my an adult children. And one of my adult children’s best friends is
finishing medical school and he’s starting residency. He was talking about relationships with his girlfriend and
how he studying all the time. And the girlfriend kind of understands, but doesn’t understand. And I said to
him as advice, I just said, listen, when you are under that kind of pressure in medical school, that most
people don’t understand that you and I would wake up at eight o’clock on a Saturday to study, at least I did
any way.
Dr. Anthony Orsini (19m 36s):
Maybe you were brighter than I was, but I’d wake up at 8:00 AM medical school study until 12, eat lunch
study til six, eat dinner or a study to 11. And I go to bed and that was my life. And I said to my son’s friend’s,
girlfriend and said, this is his life. And you know, if you tried to stop that he is going to end up resenting you
because we’re so driven. Right? And then when I went to did my residency, there’s a lot of stories that you
and I could talk about forever or what they made us do, right? It was actually the first year that they have the
laws that you weren’t allowed to work more than 80 hours a week.
Dr. Anthony Orsini (20m 12s):
And

Dr. Dike Drummond (20m 12s):
Right. So you’re a little younger than me.
Dr. Anthony Orsini (20m 15s):
And this was in New York. I’m 56. And in New York they would say to us, listen to the law, says you’re
supposed to clock out at midnight because we can’t have any more than 80 hours a week. But after you
clock out, you still have seven history and physicals to do all night, but we’re not going to tell anybody. So I
was still working 36 hour shifts. And then it, from my point of view, now things have gotten a little bit easier
now, but I thought this was what was supposed to happen. You’re supposed to be abused, almost kinda like
you’re joining a fraternity and their going to haze you.
Dr. Anthony Orsini (20m 48s):
And I personally thought that when I got out of my training and I did that internship, I did a residency. I did a

fellowship. So it was seven years after a medical school. I thought that I was going to have what my family
doctor, it sounds like the same is your family doctor. And all of the guys have a family practice. He delivered
babies. He had his own practice. And when he walked in, he did whatever he wanted to do. And then I get to
Neonatology I join a hospital and they were saying, here’s your hours. This is when you’re going to sleep.
Dr. Anthony Orsini (21m 18s):
This is where you’re not gonna sleep. And so, so there’s a question. And this long statement, I just want him
to let you know, like, as you were speaking, thinking about all this kind of stuff, the millennials or the people
that are coming out of medical school now into residency one yesterday, I interviewed someone from human
resources and they said the millennial’s, they don’t have that kind of hazing. They don’t tolerate it as much
as you and I do that. Millennials are working a little bit less. Do you think that we’re going to have less
physician burnout because of the millennials haven’t been through that or you think it’s just going to keep
getting worse and worse?
Dr. Anthony Orsini (21m 51s):
It, it has nothing to do with it.
Dr. Dike Drummond (21m 53s):
I would say only time will tell because there’s many, many forces at work here. And let me just say two that
this statistic I hear most frequently is that the difference between a non work hour restricted residency and a
work hour restricted residency is about one third. Meaning if you were in a work hour restricted residency
compared to boomers like me, who were not, you have one third, less hours of experience when you come
on shift in your first job.
Dr. Dike Drummond (22m 24s):
And as a matter of fact, I hear CMOs all over the country, say, yes, we actually have extended on boarding
and we don’t let these people see patients unsupervised when they first come on, because they’re not ready
to join a group of mature baby boomers style doctors, they’re graduated with an incomplete education. They
also what you’ll see. And again, we’re into a generational issue here. The CMOs will also tell me that these
young links, if they don’t know how to work hard and they just don’t care. And the reason is this, okay?
Dr. Dike Drummond (22m 56s):
Imagine the water-boarding analogy than I said. Imagine you come out with a third more experience and
having been waterboarded twice, as much as somebody who comes out without that kind of basic abuse of
your physiology and your ability to tolerate that, It’s a different person. They have different loyalties. They
feel different levels of guilt when they don’t complete a task. And it’s a much easier for them to draw
boundaries. Then us where we would have somebody would ask us to do something and we would do it out
of a feeling of obligation, or you wouldn’t want somebody.

Dr. Dike Drummond (23m 30s):
You think we couldn’t handle, it’s a sign of weakness. So these are fundamentally different animals. Yes,
we’re practicing medicine, but I’ll work hour restricted graduate and a non work hour restricted graduates
have gone through a different conditioning process. So time will tell the other thing that millennials are as
typically digitally native. So they don’t struggle so much with EMR like us older doctors to, you know, there’s
a lot of different moving parts here. I think it’d be really interesting. The thing that I’m most distressed about
as being a patient, right?
Dr. Dike Drummond (24m 2s):
So my experience of being a patient has dramatically deteriorated over time and what’s gone away is not
anything to do with millennial or a baby boomer. It’s people’s, they’ve completely let go of the physical exam.
I mean, they click boxes and’ talk to me and maybe put an automatic blood pressure cuff on my wrist. And
it’s like, hang on a second. Aren’t you going to examine me? But it just doesn’t happen in the way it used to.
Dr. Anthony Orsini (24m 28s):
All right. And patient experience is the hottest topic and medicine right now. And we are pushing a lot to
improve that patient experience. It’s an uphill battle at the Orsini Way when I do, you know, I have a program
called its all in the Delivery and that’s the name of my recently published book two. And that book and this
program, the address is exactly what you said is that what’s missing in the patient experience right now is
that one on one connection with your physician that you had with your family doctor and I had with my family
doctor.

Dr. Anthony Orsini (24m 59s):
And now we have a whole bunch of physicians who are feeling task oriented. They have to get their work
done. They are feeling maybe a little bit burnt out at the hospital is telling them that they have to see more
and more patients and there’s no relationship building. And we know that when a physician has a
relationship with their patient, even if that relationship is a short term, I mean an emergency room visit five
minutes that that patient is more likely to follow their medication treatment. They’re more likely to follow up
with a subspecialist and they have better outcomes and they’re happier.
Dr. Anthony Orsini (25m 33s):
And what I teach in that it’s all in the Delivery is that you can form these relationships and very quickly by
using a certain communication techniques, difficult conversations and not to take that long, have a period of
time. And I think in the programs that we’ve done and I can tell you from personally that I go home about the
same time every day, but I go home with a smile on my face because I had that human connection. And so I
think you’re exactly right. Pick your head up from the iPad that your typing on or to the laptop and as a
patient, something that opened the question, talk about the Yankee’s or I guess in, in your area to Seattle,
let’s talk about some baseball and we’ll spend a minute doing that and what I leave here, they’ll go.

Dr. Anthony Orsini (26m 18s):
Well, that was a great doctor. He’s a really nice, she’s really nice and I’ll leave here going “I know that
patient” to me that helps me with my Burnout symptoms when I’m feeling really bad because I left there just
rushing around to see patients. I find I go home, I’m a little more sad. You know, we would, do you agree with
that? Made it this way. We crave that relationship so that our patients, right.
Dr. Dike Drummond (26m 40s):
He just built a case that it’s actually even more connected than people realize. When I say this, you’re going
to agree with me. Everybody always does. Right? The number one determinant of the patients experience is
the doctors experience, how can I ask a patient to give me a top score on their satisfaction? If the doctor is
going to give the organization a three out of five and what I’ll also say is all of the techniques and all of the
dialogue that you teach has a predecessor.
Dr. Dike Drummond (27m 10s):
And so let me teach you what I teach people in terms of how to, how to be awake in your workday. So when
you look at patient satisfaction, it’s all linked to one thing, the doctor’s attention, the doctors focus. And I
actually have a drawing behind me hear that you were asking about earlier. I have a stick figure with a
stethoscope on and it’s in a whirlwind and then a scribble whirlwind all around them. In my experience is this.
It doesn’t matter when you graduated from your training program, when a doctor or nurse or anybody who
works in healthcare, walks into their practice, they walk into the middle of a small whirlwind.
Dr. Dike Drummond (27m 50s):
Things are coming at you from all different directions. Patients only bring complaints. Your staff only bring
prompts, questions, decisions, responsibility, busy work, charting, all that kind of stuff. It’s like being in a
whirlwind. And the thing about the whirlwind is from the inside of the whirlwind, all you could see is the inside
walls of the whirlwind and most of what you see sucks. So the question is, how do you step out of your
whirlwind? Set the whirlwind off to the side. It will be there when you come back.
Dr. Dike Drummond (28m 20s):
So you step out of that in the points where you need to, what points do you need? Two number one, when
your going to go into a room or into an encounter with the patient or a patient’s family, number two when
you’re interacting with your team.
Dr. Anthony Orsini (28m 34s):
Yes. That’s so important. Yes.
Dr. Dike Drummond (28m 34s):
So how do you do that? And what I’ll tell you is They would have to do this in order to use your
communication techniques to cause ideally they com communication techniques, phrases, things that work

in terms of speaking to a patient are building on your undivided attention with that patient. And so what I
teach is a simple single breath technique called a SqueeGee Breath. So you take a big breath to the top of
your head, hold it in two, three, and then exhale to your toes for and hold it out two or three, imagine a giant
squeegee, has wiped you completely clean when you turn that knob?
Dr. Dike Drummond (29m 13s):
When you go into the room, right?
Dr. Anthony Orsini (29m 15s):
I think that’s great advice. We talk about that all the time. We joke around, we say, take a deep breath in and
take your own polls, you know, calm down. Right,
Dr. Dike Drummond (29m 22s):
Right. We already know this as a habit. Cause the what is the first step? What is the first step in an
emergency? You take your own Ples so we already know this as a mantra. It’s just a question of it. Doesn’t
have to be an emergency to center yourself. Right? So what I teach is a BJ Fogg technique for, for it to have
a, so what is going to be your trigger to take a big deep breath and recenter yourself multiple times in your
day. And it’s easy to find triggers in doctors because we all have lots of work habits between patients.
Dr. Anthony Orsini (29m 52s):
We have our “it’s all in the delivery” training, I took a major unit and we tested the hypothesis that we can
improve patient experience scores by doing absolutely nothing but training the entire staff on how to
communicate, not telling them what to say, but to understand how human beings connect and they
communicate. And so we trained the doctors, the nurses, the chairman of the department, we train the
receptionist, et cetera. And the patient satisfaction scores went up 60% in the rankings and have stayed
there for two years.
Dr. Anthony Orsini (30m 24s):
And our trigger is we have to understand that even if we’re really good at this, we understand this, that
there’s going to be a point during the day, during the week, maybe several points. Then you can comment on
this where you forget about it. Okay. I’m feeling rushed, I’m feeling hurried. And so here you go to the
whirlwind. And so what we teach is maybe an offensive for a nurse to come up with me and say, Dr Orsini,
you know, that was a bad interaction that you had when a patient that’s not going to happen or your head
spinning you’re in a whirlwind.
Dr. Anthony Orsini (30m 54s):
So what we have as a code is everybody gives permission to positively and negatively reinforce this. And
that means the receptionist can go up to the chairman of the department and say, Dr Orsini, it’s all in the
delivery. And that means I can see it in your eyes. You’re there speaking. Yeah. I saw it. And the response

that we all make and what we promise it will always be, thank you, Nancy. I needed that. You know, I needed
that because I got caught in it. And so what your saying is just, is just amazing.
Dr. Anthony Orsini (31m 26s):
So, but before we finish up, I have a couple more questions for you. So Now, there’s a bunch of healthcare
providers out there. A bunch of Physicians are going, Oh my, God, I’m so glad I listened to this because I got
the symptoms. I’m feeling burned out besides going to the HappyMD.com, which was going to be a big step.
What do they do to get from? I’m afraid to tell anybody I’m afraid to admit it. To I have to reach out Dr.
Drummond How do they go from that point to that point?
Dr. Dike Drummond (31m 55s):
Oh, there’s a whole bunch of intermediary steps. So let’s just talk about this for a second at the act of waking
up. So here’s what I know from inside the whirlwind. I can see it as the inside the walls of the whirlwind are
and all you see any of the things that don’t work. Then when I meet somebody whose burned out exhausted,
by the way, the symptoms of burnout or exhaustion, cynical, sarcastic venting about your patient and feeling
like what’s the use to inner voice phrases. You’ll hear when you’re around, when you’re flirting with burnout
are number one. I’m not sure how much longer I can keep going like this number two.
Dr. Dike Drummond (32m 29s):
And this is a huge red flag. Maybe if I’m lucky, I’ll get hit by a car on the way to work today and I won’t have
to see patients. So be on the lookout for those. But here’s what I’ll tell you when you’re stuck in this trap of all
the stuff that sucks about your practice, you really know what you hate, but you know what? This is a word to
live by. You can avoid everything you don’t want and you still won’t get what you want. Cause the only way to
get what you want it’s to decide what that is and go get it.
Dr. Dike Drummond (33m 0s):
And these are almost opposites of each other. You can figure out what you want, starting with what you don’t
want, but their not the same thing. So what I try to get doctors to do is to wake up a way of looking at life that
was beat out of them in their education. And that’s the word satisfaction. So if you want to do the exercise
with me, it’s very easy. You take a big deep breath and let your mind and your energy just wander back
through the last couple of weeks of your practice on a scale of zero to 10, what’s your level of satisfaction
with your practice, whatever your practice is.
Dr. Dike Drummond (33m 36s):
What’s your level of satisfaction are over the last couple weeks or so the zero to 10. What’s your number
two. The second question is, OK, what’s your number or how do you feel that that’s your satisfaction number
with your practice? Are you okay with it or is it a distressing to you? What I find is anything less than about a
six or a seven is felt as some level of distress. If your down to three For you’re hurting, right? And if things
don’t change your days are probably numbered in that particular position. OK.

Dr. Dike Drummond (34m 7s):
So to start with satisfaction, okay. Not am I burned out? How satisfied am I? Then what I want people to do
is to start, and this is a process. It takes a while to wake up. Cause it’s been asleep for a very long time to
write the down on a piece of paper, my ideal practice description. And then just start to write down over the
next couple of weeks, the pieces of your practice you would like to see in an ideal world, if you were the
boss, if you were the King of the forest, if you had a magic wand, what are the things that you would run
toward, not run away from one of the things that you would run towards if they are available to you.
Dr. Dike Drummond (34m 45s):
And what you’ll end up with is a list of the kind of things you have in your dream practice. This list might’ve
come from as far back as the light worker’s fork on the road, where are you imagined what it was like to be a
doctor. And at that point, what you can do is you can actually create a Venn diagram in your head. If I know
what my ideal job description is, and I imagine what that would feel like, and I know what this practice feels
like. I can create a two circle Venn diagram compare my ideal practice to this practice of that’s a Venn
diagram, how much overlap is there between those two circles right now.
Dr. Dike Drummond (35m 20s):
And it tends to correlate in percent. It tends to correlate with your satisfaction score. So as soon as it says,
my satisfaction is a two, this overlap and the Venn diagram is gonna be about 20%. It’s just an association
I’m seeing if you’re satisfaction, seven is going to be about 70%. And then the question is okay, if I we’re
going to make this practice a better match with my ideal practice, what’s one little tiny thing I could change
right now.
Dr. Dike Drummond (35m 50s):
Because the reason that you Burnout is because your satisfaction and your overlap is low and you have no
sense that you can change it. This is that term loss of autonomy that people talk about, right? But you
always have the ability to get new results. If you take new actions, Einstein’s insanity trap. It’s easy to bust
out it, but if you know what direction you’re headed and in that direction, that target that bulls-eye is your
ideal practice description.
Dr. Anthony Orsini (36m 19s):
And that is perfect advice from the conversation that you need to have with yourself. Cause you gotta get
there right. And then once you’re there to say, I’m going to make some changes. Then if they need help, then
they can contact you. I was on your website. You have so many programs for Physicians. I mean, there were
so many choices. It’s for physicians who are feeling burned out or educational things. I was really very
impressed you’ve been at this for so long. And as I said, you are the go to man for this.
Dr. Dike Drummond (36m 46s):

You say that I’ve never seen anybody who said their practice satisfaction was at 10. So you can approach us
from two different perspectives. I need to work on this because I’m burning out. I’m a two or three or a four,
right? And I’m not feeling well. And I need to make a change because I’m exhausted. Or you could say, look,
I’m an eight. I’d like to be a nine and a half. This is like the Olympic athletes have more than one coach. It’s
not because they suck. Okay. Its because they want to be the best. So there’s all sorts of different reasons to
get support. And remember that Burnout is not a mental illness, depression and other things like that are
complications of burnout.
Dr. Dike Drummond (37m 21s):
And then they are not frequent, but they’re more frequent than in the general population. We’ve got all sorts
of self study and books and all sorts of things. That’ll help you turn this around by identifying what you really
want and heading in that direction.
Dr. Anthony Orsini (37m 34s):
And that’s fantastic. I just want to say thank you. I mean you’ve fulfilled both my promises and so I’m really
happy. I think there are people out there that are inspired right now that they can do something. If they’re
feeling down, if their feeling burned out, they now know what to do. And I think you’ve helped them to have
that conversation with themselves and how to get there. And I think it’s so needed right now. We talked
about the physician suicide rate. We need to make medicine a better place. We need to bring it back to
where physicians and nurses are happy to be, where they are.
Dr. Anthony Orsini (38m 5s):
We need to bring, I know nobody’s ever said a 10, but it’s a great goal, right? That’s what your here for it.
Let’s push that. Every doctor says that my practice has a 10. I want to thank you so much for being on here.
If anyone wants to get in touch with Dr. Drummond, please don’t hesitate. He’s a very easy to speak to as
you can see. And that’s the best way to contact you is through the HappyMD.com, right?
Dr. Dike Drummond (38m 27s):
HappyMd.com and there’s the contact form there. Just blast me a contact request or just look at all the
different self study courses that we there, and your welcome to
Dr. Anthony Orsini (38m 36s):
Join us at any one of those experiences and look for his podcast Physicians on Purpose get ready to dive to
that is coming up. I can tell you its a blast to have once I highly recommend and I love it has a warning. It’s a
lot of work, there’s preparation and there’s audio and there’s the whole thing, but it’s definitely worth that. I’ve
met some great people on a very short period of time, including you so, I want to say thank you again.
Thanks for being here. If you loved this podcast, you like this episode, please go ahead and hit the subscribe
and download and tell your friends about it.

Dr. Anthony Orsini (39m 7s):
Share it on social media. If you want more information about the Orsini way, you can reach us out the Orsini
way.com. It could also email me for that, but again, go ahead and hit subscribe and we’re going to be
dropping a new episode every single Tuesday. I will let you know Dike when this will air, it will probably be in
about a month or so. And then you talked about that picture behind you. So when we’re done and we signed
off, I’m going to take a screenshot of you in that picture. We’ll go ahead and put that on social media
because I think everybody’s going, I really would love to see this picture.
Dr. Anthony Orsini (39m 37s):
You’re quite the artist there.
Dr. Dike Drummond (39m 37s):
Let me say, let me say to that, this basic understanding of the difference between what you don’t want in
what you want. We built on top of that. We have 235 different tools that can help. So there’s plenty more
conversation to be had here on passing what we love to have you on it again.
Dr. Anthony Orsini (39m 54s):
So, but in the meantime, thank you so much again, thank you for being on this podcast and I hope we’ll
speak soon. Thanks.
Announcer (40m 0s):
If you enjoyed this podcast, please hit the subscribe button and leave a comment and review. To contact Dr.
Orsini and his team or to suggest guests for a future podcast, Visit us at the Orsini Way
3 (40m 16s):
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