The Wellness Author: Miriam Zylberglait Lisigurski, MD, FACP, ABOM

Transcript

[0:00] You know the holidays are a very busy time and as we approach this year’s season we’d like to hear about your experiences working the holidays as a healthcare professional.

[0:12] So please share your stories with us.

[0:15] Tell us what you’ve learned and you might just be featured in a very special RX for Success holiday episode.

[0:23] Just visit our X for Success podcast.com forward slash contact hyphen us that’s where you can leave.

[0:32] Music.

[0:46] Paging dr. cook paging dr. cook dr. Kirk you’re wanted in the o.r. dr. Koh.

[0:54] Music.

[1:18] Hello everyone and welcome to prescription for Success I’m dr. Randy cook your host for the podcast.

[1:25] Which is a production of MD coaches providing leadership and Executive coaching for Physicians by physicians.

[1:34] To overcome burnout transition your career develop as a leader or whatever your goal might be.
Visit MD coaches on the web at my MD coaches.com because you’re not in this alone.

[1:48] And don’t forget CME credit is available when you listen with us just look for cmf I in the show notes to learn how.

[1:57] My guest today includes Internal Medicine geriatrics and obesity medicine among her board certifications.

[2:05] She focuses her practice on wellness and somehow she’s found time to begin writing a new book so.
Let’s hear dr. Miriam zylberglait to lisigurski tell her story well I’m really looking forward to my conversation today.

[2:25] With dr. Miriam zylberglait who is coming to us from down in the Miami-Dade area Miriam thank you so much for joining us today and.

[2:34] Welcome to prescription for success we’re looking forward to it.
Thank you so much Randy for having me it’s a pleasure to be here well as I always do
I like to begin with the origin story and yours is not only somewhat more interesting than most there are some other things that I want to talk about as well now I knew I know that you grew up in Peru.
But if someone had told me that I’m about to meet dr. Miriam zylberglait.
I would not guess that you were Peruvian origin so you want to tell us that story
of course yes I am a Latin girl I speak Spanish and I grew up in Peru I went actually to medical school there and I.
Phase for 10 years as a geriatrician for the Navy of
my country Peru but probably what doesn’t make sense is my last name which in this case zylberglait it is the last time that I took from my husband my
original last name with lisigurski but both of them come from here up we come from families that escaped Europe during the second word.
They went to Argentina and kiss case and to Peru in my case and that’s where this last names that come from.

[4:03] I see.
Well that that’s a very interesting story and it makes a lot of sense because indeed with that last war there was a good bit of.
European migration so thanks for sharing that with us and I always like to know about where the guests
first interest in medicine originated as it’s something that kind of just occurred to you or their medical Types on your family what’s the story there.

[4:32] So my story is very probably different than the majority of stories I never wanted to be a physician
I don’t have family members that are Physicians I used to be terrified of needles
um faith in flutter in front of blood to the point that I am vegetarian and I am absolutely uncomfortable going to buy meat or
get that chicken and try to cut it even now for my kids I don’t do that yeah so yes I am not that typical doctor
my dream since I was a girl and I’m talking about for five years was too
help and to save their world and I saw that I will be doing this as a psychologist and that was actually the plan.

[5:27] I was in my last year of school when my best friend we were friends since we were three years old told me that she’s going to medical school so I should change my plans and set up in a psychologist to be a psychiatrist
which means that we will be together for all medical school I will use a white coat and everybody will call me doctor so looks like it’s more fancy and I was like oh sounds perfect I did a good night.
Yeah of course I didn’t know that that involves blood to write that was gonna be my very next question I didn’t very naive so I went to my parents that day and they were laughing about
me is like no way you cannot do that and you cannot.

[6:11] Understand that when you are in your 70s or 60s and your parents say you cannot do that that’s exactly what you will do
every time every time
so my parents had a plan my neighbor was a very well-known gynecologist
and they spoke with her and they decided that she will take me in Peru the hospitals are very open there is this Heap a doesn’t necessarily exist really so I was 16 or 17 when she took me
for I am to a C-section.
That was everything was planned by my parents and hair and the idea was that I will be on the c section I will find I will get terrified and that was the end of the story for some reason I didn’t faint
I love it it was my first experience with you know the Miracle of Life right.

[7:09] Um so she brought me back knock the door of my parents and she said congratulations you have a doctor in the family.

[7:22] Well I got to hand it to your parents for some.
Ingenuity it was probably a good idea to try to come up with some plan to really verify that this was a good idea but that’s it’s got to be the most interesting.
Test your ability to survive in this environment story that I’ve ever heard yeah they were very creative I guess so what happened next Once you got into medical school was it
largely like what you expected or was it dreadfully difficult and boring what was it like for you.

[7:57] So just to continue with the funny part of the story is that my sister my best friend decided to quit Medical School even
before she got in oh really oh yes actually she’s an economist right now nothing related to hell
and I was not able to explain to my parents that I changed my mind they already pay for their you know yeah
so I and I gather you didn’t have much interest in being an economist either no no way I am terrible with money
So I entered medical school well with the plan that I will be a psychiatrist
I discover at that point that I had so much to learn before getting to psych
um but in Peru things are very different than here and you are seeing patients who are in contact with patients since year one you don’t go for pre-med you have eight years or seven years or so
training in medicine not that in some way is great because since day one you have the ability to be in the hospitals and interact with patients and kind of.

[9:18] Discover if you belong to that environment but at the same time you are in front of difficult situations that when you are 17 or 18 you are not necessarily emotionally ready to deal with
that fairness of the system
you know cancer in a little boy so what I realized at that point is that I was not emotionally ready
for being a psychiatrist I am not a psychologist either I used to cry with my patients
awfully
if I will continue with the idea of helping people as a psychologist or a psychiatrist I will be a disaster because you don’t need your psychology starting your psychiatrist to cry with you that’s not the plan right you don’t pay for that service
yeah medicine actually was my best alternative because I was very curious I wanted to help and.

[10:20] Allow me to be the touch and not enough so I am not involved in the emotional aspect of the life of my patients but close enough that I care and I can help.
Um
so that actually probably saved my career because if I will go to psychology I will I will not succeed in any of you in any way I will probably will be quit in the first month
well I have a feeling you probably would have that you probably would have experienced some maturation and probably would have succeeded very well.
But
in the career path that you’ve chosen it sounds to me like and then in looking at the rest of your CV it sounds to me and looks to me as if you’ve been very successful with it and I hope very happy with it
I have him very happy and I have been able to navigate medicine in different ways
not only that I practice in Peru initially being
Internal Medicine geriatric doctor but then when I came here I
I had the opportunity of selecting what I will do with my life and that could be even to you know to be
working as a chef in a restaurant if I wanted since I was supposed to start from zero here anything was possible for me and I decided to do exactly the same
do internal medicine to do geriatrics and to work in the same type of environment.

[11:49] That was an academic environment because I love teaching and mentoring but also I explore Beyond medicine on my relationship with patients that is so valuable for me I explore Academia is plural research
right thing so
for me many thing is just the opportunity to expand yourself in many levels you can practice medicine in many ways.
It just depends who you are and what is your preference will get back to our conversation in just a.

[12:23] First I want to let you know about a great gift idea from empty coaches you can actually give the gift of coaching with an MD coaches gift.
All you have to do is let us know the amount you’d like to give and will issue a certificate that your special someone can redeem for a coaching session or sessions whenever they’re ready.
Just visit us at MD coaches.com to get started and now let’s get back to our conversation.

[12:50] We’ll get back to our interview in just a moment but right now I want to tell you a little bit about physician Outlook
if you haven’t discovered this remarkable magazine please do so very soon it was created by physicians for Physicians to showcase the intersection between clinical and non-clinical interests whether it’s writing
painting cooking politics and dozens of other topics physician Outlook gives a physician perspective
it’s available online and in print it’s really unique among physician lifestyle magazines and like the prescription for Success podcast physician Outlook amplifies the voice of any physician who has something to say
it also engages patients who still believe in physician-led team-based care.
And prescription for Success listeners can get 3 months free when you enter our promo code.
RX for success and select the monthly option at checkout that’s a really great deal on this stunning publication.

[13:53] And now let’s get back to today’s interview.

[13:56] I don’t want to get ahead of the story but I am interested in how you came to the decision to.
Move to the US this is another special story so yes I have been.
Workaholic on my life very type A like many Physicians I focus for long time only in my career.
So yes I was very successful in my professional life but I was alone
I had like to meet my husband that was living here at the u.s. my sister lives here so visited my sister I met him.

[14:37] And after dating back on for Miami Lima for a year.
Now that’s my idea of a long distance relationship that’s it wow I came
supposedly for vacations and he proposed
and I never went back to Peru and I quit my job Bri at that time we didn’t have so many it was via Skype and we surprised our parents with a wedding so wow
yes that’s how I came here and had you even given any thought to what was going to become of your career at that point
yes I was I was afraid but I will tell you how I took my decision something came to my mind
after 10 years of working in the same place you know very well your patience and your patients see you growing especially when you treat.
Geriatric patients and I met this couple they were married for more than 60 years they were in their 90’s.

[15:37] Or very close to the 90s and every time that they will come to visit me for their animals they will ask me if I am dating someone and my answer will be no dad not and
the last time that I saw them they said something and it is still in my in my mind and in my heart they told me do you understand that we are your patients we love you what we are your patient when we leave the hospital we go back.
Through our families and jurisprudence they do the same and the stuff they do the same who are you going back to.
And I stopped right for a second and they.
Then they continue on they show me my white coat and and they told me that.
Thing your white coat is what you use is not your skin.
And they were right medicine is not everything or your job is not everything that it has to be managed and could be absolutely anything else.

[16:36] So when I do this session of you know jeopardizing my career in order to establish a more complete life I took that risk and I did right.
That’s really profound I’m almost speechless but.
Isn’t it true that we learn so much from our patients yes and I believe that probably
people like you and me old-fashioned doctors we had more time to spend with patients and I always say that that’s the reason why we used to burn out less than now.

[17:14] Because we were able to have an interaction a human interaction with our patients and we were able to fill this
special connection and to receive the love and the care of our patients and also there are Vice
I’m creative and friendships I was like it to be.
Part of the family of my patients in many cases still today and he’s 11 years after I left
Sparrow I have patients that are still on their daughters right and families are in still still in touch with me celebrating you know my achievements and sending me
pictures or even videos of their parents getting 90 years old 91 years old because I am part of their family
so yes we we not only will learn from them but we receive what I call vitamin for my soul
that is the reason why I have been amazing for so long why I’m in love with medicine and why I refuse.
To accept that International 5 for 15 minutes with a patient is enough for me that’s not enough yeah well that is a great story of.
Gratification and I really appreciate you sharing that with us.

[18:32] I do want to move us along a bit and I’m really curious about the.
Transition to life in this country my understanding is that no matter how many years you might have practiced in some other country when you come to the u.s. you almost have to.
Begin Again is that the experience that you had.
Yes you have to begin again in many levels you have to first prove that you were a doctora also we’re so all the paperwork.

[19:05] Then you have to prove that you have updated knowledge which means that you have to take this long exams which they give you
in an average one to two years to get ready for them in my case was very interesting because many things that I have to study
you’re not real
regarding biochemistry or new treatment so how the MRI functions something that I didn’t have to study in medical school because those things didn’t exist at that point right so I learn about the MRI or
many things are new things new medications when I was already out
resident or at the end of medical school so I will not know that biochemistry of those things I didn’t you know you learned in the course of your new practice but you don’t go to the detail of the house
those pharmacological aspects of so medication you do know how to prescribe them but so I have to really start
from serum in many levels which was interesting and very challenging did you have.

[20:18] Pleat additional training residency training in Internal Medicine here as well.
I had to do residency in internal medicine again I had to do my training as a geriatrician again so yes I went from through all that I will lie.
If I say that I didn’t enjoy to be sincere I really enjoy it was fun.
In both cases for the residency and the and their Fellowship I was pregnant
goodness so I love running around Jackson Memorial of the Miami VA with by big belly and
yes many will think that that was a difficult situation I will say that that was the best situation ever I felt so.

[21:04] Hi little inspired by you know being a future mom and I was so energetic and.
I’m never alone I always had a reason to be awake area that these kicks you know in the stomach where it keeping me up.
So what’s a beautiful experience I have to I’m very grateful and in my case it happened when I was 40 and above so it was even a yes
something extra to be great and you were very productive during that period not only with patient care but
you were involved in clinical research at least it appears that way from your CV to me and published on number of papers so you were.

[21:49] You were not just being swept along with
the tide you were actually participating in creating and being a part of the advancement of the science it sounds like would you agree.
I was moving not as productive as I would like
do it again that my type A personality will always come to tell me that I am not doing enough but I was trying to find a balance which is very difficult and many women
will repeat the same when they are in careers that are demanding is how much
you invest in your career and your education in the excitement of you know being part of something amazing and when this time too
kind of calm down your own greed and your your dreams and think about.
What this really important long-term and and that your families are waiting for you and that part was very complex for me I have to admit that I was.
Again I was not emotionally ready for that challenge and that I have been learning during the last years and many times in this case not learning necessarily from patients but learning even from my kids.
When they remind me that I am too low too much on the phone or.

[23:09] Pat I should oh yeah my little one is really very upset with my phone.
He actually he goes and he hide it go in the garbage yes and he will come directly to me and asked me Mommy
if you have a phone why did you bring me to the world you should know my goodness yes.
So yes I do Connie philosopher you have there that’s amazing he’s six and yes he had it very clear and the big one that is a he’s a little more polite but
he will ask me about my day and if I will say that it was not so good he will send me to breathe in and out and.

[23:57] So wow so my kids are actually educating me so you had led them to have not only a philosopher but you have a practitioner as well I’m very impressed with that so.
Tell me some more about the evolution of your practice I know that you are very focused on.
Wellness as opposed to being entirely focused on Intervention and dealing with disease you’re focused on Wellness.
You got special certification and obesity medicine which.

[24:35] Yes we we need somebody with that skill and this country so can you tell us a little bit about how that evolved yes it’s very interesting.
I’m a list up I am going back to who I was when I was 5 years old.
And I was thinking about saving the world and helping people.
Who I was my 12th when I was 12 or 11 and I was thinking about being a psychologist.

[25:06] For some reason I am back to that Miriam again.
Which is impressive how how life you know go in cycle sometimes and the reason
mm big part is my location as a geriatrician I was very lucky to have an excellent Mentor in Peru and then another amazing Mentor here in the US they.
Explain clearly to me the importance of seeing patients as a whole you don’t see a hard you don’t hit CI kidney you don’t see high blood pressure or an abnormal
ask you see a human being that has emotions that has social problems that has fears
how’s this is a Stowe and so all my life I practice like that without necessarily knowing what Wellness
if because that term was not used as part of my education right.
It was natural for me to go for obesity medicine since that belongs to
internalizing and geriatrics mean fifty percent of patients are obese or
or overweight at least so I felt that it was very natural for me to learn a little more about what I was already doing.

[26:27] Um had that certification.
But the will be impart came in a very surprising way I was not looking for it initially and was not related to my medical practice in any way was actually very different
during covid or around covid-19 and not necessarily related to call it I had the experience of being an environment that was not necessarily very bad nine
we had new leadership that was that had different perspective of what
respect or appropriate interactions are defined for me that had different values than the ones that I have and this was very challenging for me
not because this attitude word
targeting me but because they were targeting people that in my in my mind are more vulnerable and we’re not able to defend themself and advocate for themselves
I took the
crazy idea of the you’re not become an advocate without even knowing exactly what.

[27:41] That means or the risk that this will you know bring to my life and without having even the knowledge of how you do this and when I discovered that I was
being that the Vita and and Goliad was very big I started to reach out to people and to learn and big part I did it through social media like without really sharing
any type of information but trying to contact people that are in the world while being wellness and advocacy and asking for what do I need to read who can teach me is there any way that I get
terrain and through that I access a training program.
Become an physician Wellness Advocate and during that training I actually learned.
So much not only about the Healthcare System about advocacy but then I learned also about burnout with this actually the opposite of well being.

[28:43] And that’s when I discover also several months later because I am a tough cookie that I was also affected by the same you know Monster which is burnout and that opened my eyes to.
The native change not only to keep advocating for others and to do things for others but it was my time for Advocate to advocate for myself myself my well-being and therefore the well-being of my family especially my kids
that’s a remarkable story of self-discovery that I think far too often just doesn’t happen.
Because people do burnout so congratulations to you for finding the right people and the right.
Pathways to work it out for yourself I’m sure will not be and I appreciate what.

[29:35] Run the your kindness and she’ll not be something where we should have access to this information and we should have
mentors that have access to this information and sadly what I discover I want to say too late but length enough
in my career is that we go to medical school and we learn so many amazing things
but until recently we never had any type of training on emotional intelligence.
The bottle of self-care will be what is war now how do you recognize it how you prevent that
how do you interact with bullies how do they look and I’m sorry too
you know I it’s so sad that talking about the Health Care System needs to include this topics now but it’s a reality.

[30:34] On one we see the data and we recognize that we have now I believe that the
the latest number is 65 percent of Physicians
burnout and when we have a 23 percent of Physicians admitting clinical depression around 60% admitting at least some type of MI.
Depression and.
This survey was done in 12,000 Physician’s 13% of them admit having suicidal thoughts in the last year.
1%
Having an attempt of suicide and we know that an average three to 400 Physicians die by suicide every year in this country and
this is data that is coming from before covid-19.
It’s getting worse week of it right or I do but but but these numbers this 300 to 400 cc suicides.

[31:41] Third year there are from before covid that’s very scary and I didn’t know those numbers I think not that this problem exists and when I started to
try to create awareness around me and I’m talking about people that these also in Academia people that has experienced they were absolutely surprised they didn’t know many of them date
they didn’t even want to know because it’s a scary to know and I know I took the responsibility too.
Create Some Noise around this I cannot ignore this because.

[32:23] Will be a friend of mine will be a family member could be me what’s the difference between.
Me on any of these mothers with small kids waiting at home that decide to take her life.

[32:40] What’s the difference why do you ask that what’s the point what’s where is that line that you cross at at some point.

[32:48] How you don’t how do you know that you will not cross it in the future well I’m very happy that there are people like you who are.
Attempting to shine a light on this subject and I and I do hope we will see.
How’s some improvement soon I want to bring the subject back to you and talk about some of your more recent projects the book that you’re currently working on so do tell us about it.
Oh my goodness that’s what my third baby and yeah so this book.

[33:25] This book is started as a very personal journey I was in the moment that I was taking the decision if I need to continue fighting the system where I was.

[33:39] Our I need to start taking care of myself on my family and remove myself from a toxic environment and.

[33:49] You know find another way to practice medicine and to help others and the opportunity of the book came in front of me so I started this kind of.
Way to escape are now to find myself and I didn’t know really that this will become the project of my life.
I was able to interview more than 30 experts around the world actually I believe four different continents and the beauty about.
Their life is not only that they are experts on.
Different topics related to burnout or a stress or post-traumatic grow or.
Teaching education Etc are many are journalists that stalkers our these well Wellness Advocates but
what’s more interesting is that all of them they have their own stories of burnout or.
There are no stories of facing adversity or trauma and at some point of their life and being able to succeed after that so the book really goes through ways to find.

[35:04] Well being
joy and meaning in life using these experiences but also using evidence-based data because I try to incorporate not only
the experience the personal experience of this experts but also their expertise and many research information that supports.
Why you should be doing certain things to achieve their well-being and the goal of the book really.
Is very benign and simple I want to raise awareness about mental health I want to remove the bias about that successful.
People
the do may be uploading on my way because they appear on TV or they have a words they also suffer they also have feelings
and they also have to work hard to be able to recover and keep going and that’s kind of the message of this book.

[36:12] Sounds like it’s going to be a good one have you got any prediction about when it might be available
so yes is supposed to be published as an e-book at the end of December this year oh coming right up there
you must be feeling really excited and pleased with yourself about that I should hope so
I have mixed feelings to this sphere now you will explain why I always have an explanation not always rational but I will explain why.
This journey was.
So meaningful for me I learn so many things about myself I learned so many things about others about Society I met.
Amazing people new mentors new friends people that I can even consider him family today and this was because of the book.
This has been an amazing part of my life so I have this mixed feeling of okay I am saying bye to that that moment that period in order to open another one.

[37:25] I understand that makes a lot of sense well
dr. Miriam zylberglait lisigurski this is a really been a delightful conversation and I do want to tell you how grateful I am that you took the time to be with us today but.
We’re at the point of the program that I like the best and that’s what I’m going to get out of your way
which I’ll do and audience dr. Miriam zylberglait lisigurski will share her personal prescriptions for Success before starting with my prescription I want to say thank you so much Randy I hope you
understand the value that you have when you allow people like me to share our stories and to share our dreams with others and hopefully
so we Inspire others to go after their own dreams and to hospital so I’m very grateful to be here
right now with you and my prescription for success
I will say that number one is to be self-aware you need to know who you are you need to know your heart you need to know your values and make sure that you follow those.

[38:32] Every time that you are taking a decision.
Because the best way to be successful is to be aligned with who you really are the second thing.
Comes together with self-awareness and is to be able to recognize your gaps to understand that you are not perfect and
don’t know that you can ask for help and that that is okay it’s ok not to be perfect it’s okay not to be okay but it’s not okay is to feel that.
You cannot reach out to others and ask for support so ask for help you will be amazed of the things that you will find around you.
The first thing is not consider yourself a victim you are not a victim victim stole half
Choice us are alternative being in front of adversity doesn’t make you a victim
otherwise give you the opportunity to find alternative and to be creative and to find the strength that you have inside of you so.

[39:42] Take control of your life and be yourself and look inside and find for that the strength and Advocate Advocate hard.
For yourself for your value some for what is important for you.
And last but not least what I would say right now is something that I learned from my kid early he said that when he was seven years and he said this is your life.
This is your choice this is your journey.
And I believe that’s the best message that I can share with any of you that are hearing me yes be you know being control of your life embrace it with good time with bats because.

[40:27] You can make everything better if you are involved in and taking decisions about what will happen to you.
Um that’s all what they have right now and I hope you find out full wow.
And I don’t think anybody could say it any better than that I’m very impressed and I thank you so much for sharing with us before we go today I want to give you an opportunity to tell our audience where you can be found and share.
Your social media connections and how to get the book and anything that you’d like to share with us.
Thank you you can find me on LinkedIn and looking for dr. C that’s the best way
um that’s the only social media that I have and the reason is that that keeps my well-being and give me extra time to share with my family and my friends in real life and my website is.

[41:27] . 3G as God cycle Dot.

[41:36] And I hope you connect with me and I would love to learn about you and learn from you and I hope you will join my my journey of helping ourselves while
we are helping also others dr. Miriam zylberglait lisigurski it has been a great pleasure speaking with you today and I thank you so much.
Thank you Randy I really appreciate and you are the only person that can pronounce my two last names so
follow me so thank you for that too you’re very kind I’m otter thank you so much.

[42:12] Thank you so much for joining us today you can really help us with a five star rating that’ll give our podcast much more visibility and
it helps us reach many more listeners exclusive content is available on our patreon page including membership only material.
Personal rapid fire Q & A sessions with our guests and to be sure you never miss an episode visit our website.
Had RX for success podcast.com to subscribe while you’re there.
Learn how to get CME credit from cmf I just by listening.
Special thanks to Ryan Jones who created and performs our theme music and also to Craig Clausen of Clausen solutions group.

[43:04] Music.