In this episode, I sit down with Dr. Angela Edwards about her career in academic medicine. We discuss her leadership in local and national societies, as well as some of the surprising career twists and turns that she has taken.
Learn more about Dr. Edwards: https://www.wakehealth.edu/Providers/E/Angela-Edwards
Justin: 00:04 Hey, it’s Justin Harvey. Thanks for tuning in to the anesthesia success podcast where we take a close look at important topics pertaining to business practice management, personal finance and careers for anesthesiologists and pain management positions. On this show, I worked hard to take your critical questions straight to the experts. Thanks for listening. This week I talked to Dr. Angela Edwards about her career in academic medicine. We discuss her leadership in local and national societies as well. Some of the surprising career twists and turns that she’s taken. We also talk about how she has intentionally invested in her marriage and her family when her work has been crazy and she herself is married to a position as her husband is a vascular surgeon and we also talk about some of the financial decisions that she’s made to which she attributes her family’s financial success. As always, thanks for tuning in. Welcome
Justin: 00:55 To episode 31 of the anesthesia success podcast. This week I’m pleased to be joined by Dr. Angela Edwards. Angie is the current president of the society for perioperative assessment and quality improvement as well as an associate professor and section head of perioperative medicine in the department of anesthesiology at the wake forest university school of medicine. Angie, thanks a lot for being with me today. Oh, thank you for having me. It’s my pleasure. And to start off, I’d like to just dive in with an interesting story or fun fact or something. So, you know, we were talking before this recording. I’m curious to know the craziest clinical situation that you’ve ever found yourself in as an anesthesiologist.
Dr. Edwards 01:30 Oh, this is a good one. So you know, I had a chance to think about this before we got online to chat and, and there have been many, there’ve been, I think in throughout the last 20 years in my career. There’ve been several cases that stick with me. But when you said the craziest, I had to attach a little piece of my personal life to this. So my full disclosure, my, my husband’s a surgeon an early in my career, probably the first five to six years out. I was predominantly a vascular anesthesiologist. My husband’s a vascular surgeon and we did not overlap on cases until this particular request. And you know, we’re sitting as sitting in my office one day and he asked, he called, he said, Hey, I need you to do this case for me tomorrow, can you, I’ve got a couple of meetings coming up at noon.
Dr. Edwards 02:12 I need you to just kind of get me in and out. Really straightforward case. It’s a AAA open infer rental, cross clamp, straightforward, otherwise really, really healthy tree farmer who has no other mental problems. And I’m thinking, ah, you’re always look at this through a, through a different lens. When a surgeon says this to you, even though it was my husband, and I said, you know, we have a couple things we have to do. One, you, we’ve got to, you know, ask the patient if he’s okay with that, full disclosure. And two, I said, let me look a little closer at this case. And he said, Oh, don’t worry about it. You sit in preop clinic right now as being seen when you’re, when your colleagues, he’s coming in, he’s going to spend the night here in a hotel. He said he’ll be fine. So I look further into this.
Dr. Edwards 02:51 Turns out this patient has four plus mitral, great regurge and, and for the, for those who are not familiar, that’s pretty significant issue when you’re talking about an open AAA aortic cross clamp. And of course the surgeon says, and from this point on, I referred them over for it. I miss the surgeon said, you know, you know, it’s just simple, straightforward, and for renal cross clamp. Well, so I thought, okay, well hell, we’ll see how this goes. So I go down to the patient pre-op, get all the information I need, set everything up. And it turns out I need an intraoperative echo with a thoracic epidural. Talk to the patient. He’s great with it. In the holding room, I have everything set up and I will tell you during the course of that, the next two and a half hours, it went from straightforward to complex to complicated to disastrous to a great outcome.
Dr. Edwards 03:40 So it turned out for those and anesthesia who really want to know and are curious. It was a went from Infor Ronald to supra, celiac cross clamp in a matter of just a couple of minutes with unanticipated blood loss. But with, thankfully with an intraoperative echo and thoracic epidural post-op, this lovely gentlemen was extubated on the table, did great in the ICU, saw him that night and he was up eating breakfast the next morning and out the door within three days. So that’s a, that’s a, but that one was, I can’t make this up. April 1st, 2007. Those things stay with you over time. And you know, you know, a couple of dinners later and a few conversations, put the marriage back together. We were all good. We were all good after that. And so, you know, we just celebrated our 20th 22nd wedding anniversary and after 20 years, you don’t, you know, this much, but you know, it.
Dr. Edwards 04:33 So it, it’s, it was a unique experience and I think probably one of the take home points with that was, you know, when you when you have a dual physician marriage, there are, there are inherent issues there. And then when you cross talk professionally and you overlap professionally there issues there. And then the third piece of that was when, you know, when it came to the folks that we were working with in the operating room, my observation of their interactions and their perceptions, we have had to be mindful of how of their comfort level because they were so intricately involved in the success of the end point of that case. So, you know, all, all said, it went very well. And everyone left the room quite happy and, and, and I will say, entertained for those of us at home that know us. But that by far is probably the most the most, but sort of the most exciting case I’ve had in quite a long [inaudible].
Justin: 05:31 Wow. I’m curious, you know, being married to a vascular surgeon, do you find that, and obviously, you know, if you get all the anesthesia anesthesiologists together yeah. You’re like sidle up to the bar at the ASA meeting and everyone’s telling the stories about the surgeons that they have to deal with. I’m curious, you know, you being married to a surgeon, does that, does that inform the way that you interact with other surgeons or vice versa? I’m sure you’re obviously more sensitive to the types of issues and interacting in the or with the surgeon just because you’re married one, you know, it’s,
Dr. Edwards 05:58 It’s interesting. I think it, it works in globally, not just with surgeons in the LR, but also with the nursing staff. And all the support staff. My interactions with the surgeons. I think early on it was a little challenging as a woman in medicine and an anesthesiologist sometimes that, that colors the glasses a little bit so people may see you and have a perception of you that is different than what you actually are. So you have to be careful of that at baseline. And, and then when I see these folks out in social settings over the, over the last 20 years, it’s, it’s softened a little bit. But I think initially it was difficult. It was very difficult. There were things you had to be mindful of when you when you went into the room, when you talked about the case the night before, when you were in the moment, in those cases, you had to be very, very careful of the language and the tone that was used. Yeah. Cause you, well, the benefit is you keep friends afterwards and that’s the goals.
Justin: 06:55 So you’ve been doing this for 20 years now. Done at wake, you just said happy anniversary, upcoming anniversary. And you have not only, you know, local leadership there, but also nationally with Spanky. So why don’t you just give us an overview of your current responsibilities, both clinically and leadership wise?
Dr. Edwards 07:12 Okay. Currently, so I have been blessed with many opportunities both with the society for perioperative medicine and quality improvement specie. And you can look us up online, just Google spiky would come right up. This is actually a group of colleagues, sort of an interdisciplinary multidisciplinary network of, of team members who are interested in preoperative evaluation, sort of perioperative medical management and optimization of patients before surgery. And so I started as the secretary treasurer about six years ago and sort of gradually worked my way up towards president just in sort of a service line really. I was passionate about this area, was working in the preop clinic when I started as a secretary treasurer and found that quite frankly networking with people outside my own institution and connecting with people who were like-minded and had similar interests was invigorating.
Dr. Edwards 08:10 And quite frankly, professionally sustaining there were, is a lot to be learned from people who were doing things outside and different, both academic and PR and the private sector in this space. And it’s not just physicians, anesthesiologists, hospitalists, internal medicine, physicians, everyone comes at this. Same with the same project with a sort of a different perspective. So we’re all trained differently. We come at things with a different perspective and, and work in different areas. So whereas mine, I may look at preoperative assessment from sort of, with an intra operative lens looking, looking backwards and also looking from the ambulatory perspective. I, I kind of also work with my intraoperative right, my internal medicine members who look at it from the ambula ambulatory perspective. So we do a lot of work together. It’s been great. I’m also our anesthesia champion for enhanced recovery after anesthesia at wake.
Dr. Edwards 09:06 I’ve been doing that for the last two years. Also providing lectures to medical students. I’m on a few review boards and educational subcommittees for the ASA. I’ve worked with the IRS and the ed Palm, which is the evidence-based perioperative medicine group and also a PSF. So doing, starting out in PREA and the preop clinic and working with specie has really opened doors to other opportunities. You know, in the last few years I’ve had some international speaking engagements both with the, the Asian and Australian Congress of anesthesiologist last year in Beijing. And like I said, the IRS and the, and there’s an international scientific symposium that also is on sort of the side of the planet, the Chinese with a Chinese society of anesthesiology. So there’s been a lot of doors that have just opened from simply starting as the medical director of the preop clinic.
Dr. Edwards 10:02 So if we look back about, so six, seven years ago I started as just a project for our, of our institution. We was approached by our clinical director of operations who said, you know, we’ve got this problem down in our preop clinic and we probably need somebody to work on that for a little bit. Would you be interested? And I initially said, no, I would not. No, I would not. I’m, I’m really happy working in the O R and I know I’m not ready to, to leave the or just yet. And, and he said, well, you know, think about it and, and let me know what you would need to do that. Well there thereby, you know, the sort of the operative phrase, what do you need to make that happen? And so I kept, I eventually said yes when I went down.
Dr. Edwards 10:46 Right. Well, no you’d think so. But you know, my motivation was driven more by projects. You know, like, like I said before, we when we were talking earlier that, you know, anesthesiologists thrive on change. I think what drives us and what keeps us inspired is that there is no day that is ever the same. It’s always different. You might be in a different location, different hospitals. Certainly the cases are different, the patients are different, the surgeons are different. We thrive on change. And so, you know, this was an opportunity for change. This was an opportunity for a project and to improve something. For patient care. So there, that was my motivation. And you know, then, then again I needed to ask for resources. Okay, who’s my team, who’s going to help me with this? And I was fortunate there was a well established team in our preop clinic we just needed more of a clinical direction.
Dr. Edwards 11:36 So I took on that role. But again, I kept sort of 50, 50. I wasn’t ready to leave the or yet not as, you know, I’m still not 20 years into this. I’m still not point. How long had you been doing Orr anesthesia? A solid, somewhere between three and five years. Cause I was also down preop clinic maybe one day a week. Okay. So it was all, I had a little bit of time everywhere. So that, and that’s about right. So somewhere between [inaudible] and this is just, you know, my general theory is somewhere between about years three and six, your career’s going to take a shift at some point somewhere. It seems like most anesthesiologists who were predominantly clinical in the or and, and whether you’re academic or private, you’ll be asked by your colleagues to take on a leadership role. Here’s a project we’d like you to take a look at this, look at this through a different lens and lend us and tell us what you would do with this.
Dr. Edwards 12:30 I think that it’s, it happens to everybody. Even the folks that are finishing now who are in kind of that, you know, three to five year window of post residency. And if you’re lucky you get that much time to actually hone your craft and get comfortable in the or. So when I moved into the preop clinic, that’s when I was introduced to the group with the perioperative medicine summit, which at the time was an independent entity out of the Cleveland clinic and university of Miami, a group of internal medicine hospital physicians who put this meeting together. And so my first one I, I went to it, it just was all struck by all the information that we could take back home and began to sort of gradually make some changes. And, and improve our processes for managing patients in the preoperative sector. So, well before surgery.
Dr. Edwards 13:20 And that has to do with anything from medical management, but just the basics of what are the, is there other anesthesiologists involved or is it mostly other specialties? Oh, it’s apps, absolutely. You’ve got anesthesiologists, hospitalists, internal medicine physicians advanced practice providers. So we have physician assistants and nurse practitioners who are actually sometimes independently running their own preop clinics and very likely out in the private sector because just because they’re not as well-resourced as, as we are in academics. So it is a, we have national experts actually, I think one of the speakers you’re getting ready to have on is coming out to the summit. You can ask him about this. In, in March, our, our meeting is in March and you can go online. I just, again, just simply Google perioperative medicine summit will come right up. And our program is usually designed for the preoperative or perioperative medicine specialist.
Dr. Edwards 14:16 We try and make it applicable to both anesthesiologists and internal medicine physicians who are working in that space. So that it’s, it is a balanced multidisciplinary program. Again, it gives us an opportunity to share information and crosstalk and provides internal medicine physicians. I think that the ability to understand what happens in the anesthesia world, sort of what happens in that interoperative box, which for places who are, who have preop clinics that are run by medicine physicians, it helps our interoperative colleagues across the, across the country have better preoperative workups. So we have that piece of it. And at the same time we learn a lot from our internal medicine colleagues. So it’s a balanced approach.
Justin: 14:54 It makes perfect sense. And so talk a little bit about, you know, in the different different, I guess operative models. What is the role of a, a preop clinic, a and w what are the sort of one of the other alternatives there where you’re taking a peri-operative sort of, it sounds like kind of like a beginning to end, sort of a holistic, trying to get a high level view and then optimizing all the different parts of the process along the way rather than I mean, I guess I’m interested to know what are the alternatives to what you’re doing. How are others doing, who aren’t doing it this way?
Dr. Edwards 15:26 So those who don’t have a preop clinic is kind of what you want to say in a way. If you don’t have the ability for the staffing and the location or the, the physical setup, what do you do? And quite frankly, I, I do wonder about my colleagues who don’t have preop clinics, how they navigate getting their patients ready for surgery. There. There are, and we’ve entered a world of telemedicine where there’s a lot we can do remotely and just like you and I are talking now, we could pick up the phone and call a patient and ask a series of questions to get a basic understanding of where they are at present. And a lot of places do that. I think, you know, even maybe where you are up in the Northeast, there’s several places that do not have established preop clinics.
Dr. Edwards 16:06 They might outsource this work to the primary care physicians they could easily do. And then in your preop, your pre anesthesia workup is actually done in the holding room just minutes before you see your patient and the consent is done at the same time. You know, I’ve, I’ve, I’m biased, so let me just, let me just preface everything I’m about to say with that statement. I, I think it’s very difficult to do a preop, an effective preop workup in the holding room before surgery. One, you don’t get effective consent. I think that’s pressured and the patients are simply, they don’t, cannot possibly process any of the information that’s being brought towards them. I think, you know, they’re lucky if they hear a little bit of the detail about a, about a regional anesthetic, but in terms of getting true informed consent, I think that is a strained opportunity. So we talk a lot,
Justin: 16:53 Haven’t been a patient on that side a couple of times. I remember like sitting there in my gown getting ready to sign a form thinking like, well, I’m here, they’ve gone, they’ve drawn on my arm with the sharper, I’m getting ready to get rolled in. You’re telling me that I have an option to not sign this thing and then go home. But that just seems weird to me. It’s disjointed.
Dr. Edwards 17:09 Right, right. And so you don’t have it. It eliminates an opportunity for conversations with patients and you know, you being young and healthy, think about it. If you’re, you know, 85 to 90 are you taking your grandmother and she, he or she can’t process the information you’ve there. There could be, you know, other issues to address, sort of advanced care directives to address. So the preop clinics are really designed as an opportunity to engage in both medical optimization and shared decision making. So that’s, that’s a big buzzword in our, in our world of providing information to a patient about their risks, about their current status, what you can do to change their medical medical or the degree of readiness for the surgery. And there’s, there’s a whole school of thought out there on prehabilitation like, you know, we talked about rehabilitation after surgery, but there’s a prehabilitation beforehand that you can do to get people ready and to optimize their physical status.
Dr. Edwards 18:03 And then, Oh, by the way, have a conversation of are we doing the right surgery at the right time for the right purpose on the right patient? And there’s a whole lot of conversation and that takes time. We don’t in five minutes in a, in a preop holding room, I don’t have that time and certainly don’t feel like I can devote the time to patients. So, you know, I, what our colleagues are doing is hopefully getting on the phone with patients ahead of time or having some prescreening done on the phone and hopefully educating their primary care providers on, on some of these issues that need to be addressed ahead of time.
Justin: 18:37 So you mentioned telemedicine. It’s interesting, as I’m sort of playing the cert in my mind, I think this feels like, eh, you know, there are some places where telemedicine is like a little bit tough, like no one’s ever gonna receive generally anesthesia through an iPad. But there are some parts of the process that where this seems optimal and frankly I think the preop clinic sounds like, well this is like a no brainer. I’m curious to know how has the telemedicine revolution, that’s sort of ongoing, how, how does that factor into this equation?
Dr. Edwards 19:04 So [inaudible] I’m glad you asked. There are several mechanisms that you can put into place to ease that preop process in terms of time. And, and the old fashioned way is just to pick up the phone and have a series of questions that may be a nurse or who’s well versed in preop or pre-surgical care can ask a patient to get an idea of, you know, basic co-morbidities, allergies, if they’ve ever had any problems with surgery, anesthesia and go through a basic review of systems to figure out if they need to physically come in and be seen. And we’ve been we have the benefit of having that here at wake where we have several nurses who may pick up the phone and make those phone calls. That’s not necessarily telemedicine, but that is sort of a, that’s a mechanism that almost all of our patients have.
Dr. Edwards 19:46 And the assumption is everybody sort of carries their cell phone around. That phone call might take 10 minutes, 10, 15 minutes once you get somebody on the phone. And that is a way of triaging patients to, you know, whether or not they actually need to come in or whether or not they can just go back to their PCP primary care provider and see and see them to get something taken care of. And in some instances they actually need to come in and be seen. Now the telemedicine piece, that’s in terms of your, your physical assessment, the piece that’s lacking is the ability to do a physical exam preoperatively. So we just don’t have a good mechanism in place to listen to heart and lungs and, and, and assess, you know, we could do a video chat, we could do that and that would give us enough of what we, of what we can see.
Dr. Edwards 20:29 And we could have someone, you know, potentially do part of our physical exam for us, but to be able to actually, you know, auscultate what you need to and listen to what you need to. We don’t, we don’t have a good mechanism for that. So there are few pieces that are still missing. And again, it has to do with your institution’s bandwidth and whether or not you’ve got with the time you have and the resources to put personnel in place to do those to serve those roles. Yeah. So in terms of preop, that’s where we live now. If you talk in terms of the anesthesia world, we’re getting into more more automated systems and, and artificial intelligence. And that’s a whole different conversation. Yes, yes.
Justin: 21:04 Perhaps a fodder for a future episode.
Dr. Edwards 21:06 Right, right.
Justin: 21:08 So I’m curious, you know, you mentioned this is a, an intra or inter specialty consortium essentially [inaudible]. So maybe give us a couple of examples so we can get a little bit of a flavor of what are, what are some of the inter specialty dialogues that are happening, what types of issues are you addressing and how does that external perspective help bring light even either between specialties or even between like physicians and other sort of strata in the care provider totem pole.
Dr. Edwards 21:36 Oh yeah, absolutely. So the and I, I can just run through some of the topics. We have our planning committee for the summit. Does a nice job of this. We sort of have this open dialogue between our internal medicine colleagues and anesthesiologist on the committee that we’ll talk about. So what is the latest in evidence based care that’s coming out. And you can actually, as a sidebar, you can actually follow a lot of our conversations on Twitter. You can find me on Twitter AFL Edward MD, that sort of they’re everywhere. You can also follow us Bacchae it’s sets. I said this Bacchae handle up before I really knew anything about Twitter. So that’s my disclaimer when I was too young to really know anything about Twitter. So the stacky handle is that specie EDU and we’ll, you’ll see a lot of our conversations back and forth on that.
Dr. Edwards 22:21 And, and there’s also, you know, is this back he account will retweet some things that might come up at different meetings. And so we talked about specific topics. Let’s talk about, you know, just simply medical, you know, met, met management of medications preoperatively. There’s a lot of dialogue about what to do with anti-hypertensives, anti-psychotics, you know, antidepressants. Bridging therapy is always a big topic. What to do with Santa coagulants. So we’ve got our asthma guidelines and we’ve got clear guidelines for, you know, preoperative management depending upon what our anesthetic plan is going to involve. And, and our co or anesthesia or intermittent colleagues may not be as aware of that because they may not be aware of what the, what the intraoperative plan would be for a certain surgical case. And so, because again, because we live in the intraoperative space, we have the, I have an opportunity to discuss why we might choose to do a thoracic epidural or a peripheral nerve block with, with or without a combined general anesthetic.
Dr. Edwards 23:19 And there’s a lot of overlap in terms of, of those conversations. We’ve, it, depending upon what papers come out when one of the most recent conversations over the course of the last 18 months has involved the Mets trial that came out in Lancet, not 2018. That will change the way we deal with cardiac patients prior to non-cardiac surgery. I think we’re hopeful for a new set of ACC guidelines coming out because that branch point of physical activity was changed by what came out in that Mets trial. So we have a lot of ongoing dialogue about current evidence recent publications and how that impacts our preoperative management to really get ready for the interoperative plan.
Justin: 24:03 Okay. So I saw the statistic recently, and I’m sure you’re probably familiar with it cause this is pretty renowned in the in the academic medicine world is that it’s, there’s about a 17 year lag between the time that you know, a white paper shows conclusively that on an evidence based perspective, here’s how things should be done to the time that it actually takes to implement institutionally. So I’m curious, you know, your, this is a perfect, I think landscape for this. You know, it’s, it’s important to figure out the best way, the most optimal path for a patient, the safest. And then to quickly as quickly as you reasonably can implement things that seem like they make sense. So can you talk a little bit about how do you try to take that 17 year gap and perhaps shorten it a bit?
Dr. Edwards 24:45 Oh, I love this. This actually goes into the Twitter med ed conversation. Is that, is that where you
Justin: 24:51 Yeah, we can. And by the way, so anybody who’s interested in all the referee, all the resources that Angie’s referencing, Twitter handles, websites, et cetera, that’ll all be available on the show notes. Anesthesia, success.com/ 31 so go there and we’ll, we’ll have a list of all the resources discussed here. So yeah, go ahead and tackle that for
Dr. Edwards 25:08 So. So a lot of, you know, which you mentioned in terms of, you know, publications, the peer reviewed publications, but the time they actually get out into the literature, if you’re, if you’re one of those people that follows two or three journals, you might see it, it might catch your eye, but then it’s in pub and it sits there until somebody references it. Again. I’ve had papers that I wrote back in 2003 that still have, have really yet to be referenced. Whereas with this new, with sort of the new social media platforms with Twitter and the, those are the hashtag med ed conversations that are ongoing and, and these Twitter feeds and what do you call it? Tutorials that come out. You’ve got more of an opportunity to learn what’s out there. The latest in literature, someone will tweet out something in a paper.
Dr. Edwards 25:51 I mean, I can say that I have been in an elevator and probably read two or three papers before I hit the ninth floor to my office and I would journal that I would have never covered. So my, you know, my colleagues in, he may be reading different journals. I, they don’t read Ana, they don’t read, they may not catch BGA, but they will all, but there’ll be certain to read and it’s society of hospital medicine literature or JAMA and maybe tweet something out and so on that platform or mentioned something in a meeting. And that’s very typically where we get it at the, at the summit. That platform has enabled us to, to rapidly share and disseminate the latest and evidence-based perioperative care and what’s coming out and, and the literature much faster than I would ever find it on pub med or that I would ever find that otherwise. So again, this Twitter crosstalk and the medical education and through that, through that has been fantastic. And I think there’s other, there are other platforms I’ve seen more on Instagram lately, but that’s sort of the where we’re living now.
Justin: 26:49 Yeah, it’s interesting. I have a, I would say it’s a love hate relationship with Twitter. It’s more like a frustration and skepticism and like I don’t really understand it and I feel like there’s a lot that can go wrong and it doesn’t add much to my life. So why don’t you just give us like your best 60 seconds on, you know, the physicians out there who were like, I don’t do social because it could get me fired, but it’s not going to make my job better. So it’s all downside. No upside. Why should I have a Twitter handle? Why should I be involved in that conversation? Oh my gosh. Well that’s how I feel about it. So just convince me right now, Angie,
Dr. Edwards 27:18 A whole episode in and of itself, I will say that that have a, you have to manage it. Like anything else, you have to manage what comes across your feet. So you know, the first thing you do is when you set up your turtle hand and you figure out what’s the purpose, why am I going to get on this platform? And I wanted to see what my colleagues were reading, what they were. I wanted to follow certain people and follow certain conversations. Is that hashtag conversation or a little at symbol with the people you’re following? I wanted to know what, what is everyone else talking about? It’s more the medical education and [inaudible], which is directly pertinent to my practice. So I would follow anesthesia journals, I would follow medicine journals and whatever’s coming out in the literature. And I found that to be quite frankly refreshing.
Dr. Edwards 28:05 And I didn’t pick it up right before bed. I made sure that I, you know, again, like anything else, you have to manage it and make certain that, you know, you do have to take a look at it maybe once a day for a few minutes, but that’s it. It does not need to be all encompassing. I haven’t countered a few trolls and a few bots and different conversations and they quickly get deleted. Thank you so much. I don’t really want to have the part of my conversation. And you know, occasionally I’ll get sucked into a conversation some Twitter feed where someone’s talking about and we’ve, I’d be very careful and be very respectful of each other’s perspectives on the literature as people are tweeting out their thoughts. But it’s almost like an online journal club. So I’ll, I’ll use it in that in, in, in that regard, just to make certain that I stay up to date and just to read the literature for myself.
Dr. Edwards 28:52 What I love is when people actually will treat the paper itself. So I can actually look at the direct [inaudible] what the literature said rather than sort through, you know, having to sort through another, another platform. So I think in that regard it’s helpful but you have to be careful cause you can find that what you say is, again, it’s being mindful of what you say and how you put it out there and how often you put other, cause you can completely overwhelm someone’s Twitter feed where if you’re putting something out there twice a day, it’s just, it’s in my opinion that it might be something that I pause on a guy that’s a little bit too much, but every now and then I think it’s, it’s helpful to our professional development. And so you’ll find that if you’re a regional anesthesiologist or if your pain pain medicine, acute pain physician, that you might want to follow certain journals and then you find will come, you just, it’s a way to connect and enhance your professional development. I think. So I viewed it as a positive. But again, it’s a tool that has to be managed.
Justin: 29:51 Sure. And I know, I think it was dr ed Mariano who we sort of referenced earlier, was it him that he had sort of a brief like here’s how you use social for physicians, for anybody who is kind of like interested in dipping a toe in the water and hasn’t yet achieved comfort in the Twitter sphere, which I’ll try to find that and we can put it in the show notes.
Dr. Edwards 30:10 I think it’s great. It does a great job of Twitter education. There are several, and I’ve got a couple of friends actually if you wanted to follow them, I can share that too in your show notes. They’ve got great tutorials out there on how to use Twitter, how to make it such that it’s a professional development tool and it’s a way to connect with people who you might not know otherwise. And counter, I mean I’ll give you a perfect example. I had was following the conversation of a few folks from the ASN. That’s typically how I start. I started with a meetings, followed the meeting conversation. And so the whole reason I got on Twitter was with ASA a couple of years ago. I sort of following the conversation and found that I could be aware of certain things that were going on in different parts of the meeting, maybe sessions I was unable to attend because I was in another session and I felt like I was also able to engage with highlights of the session I wanted to be in, but was busy with another one at the same time.
Dr. Edwards 31:04 So I didn’t miss anything. And that’s the benefit of Twitter at a lot of these professional meetings. And then staying connected with the same people afterwards. And so I digress briefly, but I was following some folks after one of the ASA meetings and happened to literally physically, finally run into someone at the IRS meeting a couple years later. And it was really funny. We’d been dialoguing online for so many years on this social media platform, but yet had not physically met in person. So it was a little backwards. You know, normally we meet somebody, we talk, we have a conversation and then we might dialogue and interact over email and we’re going to project together that way. Well this was worked entirely the opposite direction of we met on Twitter, talked, had some cross talk on Twitter had some another dialogue on email and then finally met in person. So again, it’s just a different way of, of connecting any people and staying professionally engaged and expanding your network. I guess that’s, if, if I had one thing to say about it, use it as a tool to expand your network.
Justin: 32:00 Yeah, yeah, that makes perfect sense. Cool. Well I’m gonna check out those resources and maybe try to do a little better with my, with my Twitter. Gosh, it just stresses me out though. But we’ll, we’ll see. We’ll see if I can get there. We’ll, we’ll see if we can’t share and expand your network a little bit this way you’ll have a good time. Honestly, I do, I do. I mostly use it as like a curated sort of newsfeed cause I like to see not as much of the clinical stuff, but what are the things that people in anesthesia and pain are talking about? What are the issues from like, especially if like a business career, financial, economic industry impact, insurance, all those types of things. Cause that’s very helpful obviously for me in my practice, helping to, you know, help my clients make informed decisions about their own lives. But, but as far as the interaction, that’s where I sort of get traded to get tripped up.
Dr. Edwards 32:47 And I think you, you know, I’ll, I’ll send you some links. There’s there’s the, I started with actually women and anesthesiology, which is at women MD in anesthesia. It’s a N E. S. T. H. they started with a basic Twitter feed in a way to stay connected. And then there’s several academic and private programs across the country who are, believe it or not, are on Twitter. I think the medical community has decided this may be a platform for use just to stay connected. Yeah. Yeah. Agreed.
Justin: 33:18 Cool. Okay. I want to pivot a little bit here. There’s, there’s so many interesting things that we can talk about here, Angie, and I want to think a minute and, and talk about what it’s like to be in a, a dual physician household. Your husband, you said as a surgeon, you’ve got some kids, it sounds like everybody’s doing well and you’re maintaining sanity. But I’m curious, you know, I’m, so my wife is a resident. I, I’m not a physician, but I’m a, you know, a business owner. And so I’m, we’re both very busy. We’re expecting our first kid here in December, which we’re really excited about. But frankly, I’m, I’m kind of intimidated as I look at the next three to five to seven years and we, maybe there might be other kids and it’s going to be probably, you know, job changes, maybe like geographic movements. And I’m thinking, how the heck do you keep it on the rails? So I’m curious, how was that, how did that play out for you?
Dr. Edwards 34:06 20 years? So [inaudible] summarize 20 years in less than two minutes
Justin: 34:09 Or maybe just take the first like five or seven years of that,
Dr. Edwards 34:12 You know, I’ll, I’ll take it in five year chunks. So the way I look at it, you know, we we we were married in the middle of residency and thought initially the plan would be to have children after residency and start our family at that time. Well our first came, I guess I was an intern and a little unexpected challenging to navigate. But we took one day, one month at a time and, and outsourced as much as I could, as much as it was reasonable. And this may run counter to your financial conversations, but this was key to our sanity and our ability to function and quite frankly stay married.
Dr. Edwards 34:53 Right. And so this was hard for me to get my head around initially cause I’m a saver. And so the whole concept of outsourcing and spending money on things and people to do things for me was hard for me to get my head around. But I think if I had, if I had to say anything, the key to success was learning to outsource. So we had I had nannies helped me through and the craziest things, we had nannies help us during the day. We had daycare at the same time for the first five years for my son. And then my daughter came along and so I had both. He was in school, we had, we had nannies at the same time. It, the numbers would blow your mind if I had to run through it with you. But it was the way to make, to get through and to survive and to, and to at the same time that we were navigating it, an early port portion of our careers starting out the first five years in practice.
Dr. Edwards 35:44 And he finished, my husband actually finished his vascular surgery fellowship and then went on to do a master’s program and did two years in a lab at the same time. So that helps. So he pivoted his career a little bit so and so that we could balance a little better and make sure that we had plenty of time at home with our children while I was in the midst of so much change and, and getting my practice up and running, getting comfortable in the ORs the first five years. And this may not this Megan run counter to your, your your theory on anesthesia success, but we, we spent money to help us thrive in the midst of all that and outsourced the next couple of years. We spent a lot of money, our children, you know, watching your children grow and getting help where we needed it to again, you know, be able to continue growing in our careers.
Dr. Edwards 36:30 My husband didn’t travel as much as I did in terms of meetings and speaking over the next that, that following 10 years. But again, we kept the same base. We always had help at home and lots of help at home. And that was a hard thing to find. I find that one of the biggest questions I had people asking me coming along is, how do you find your nannies? How do you find your home health had, and honestly it was just talking to people in online networking. I think there’s so many websites now you can go to to find people that fit and actually understand that to physician family, the lifestyle that we live is very different than most people. We don’t come home at five. And that’s very hard for someone who’s going to help you to understand that we don’t know when we’re coming home and we’re, we’re, we all, we’ll let you know as soon as I can, but I need to be flexible and I will pay you to do so.
Dr. Edwards 37:12 And you know, it’s so, it’s a, it’s an interesting relationship. And it’s very different relationship from my husband with the nannies and the home helping me. With that, with that group, it was but it was the key to our success. I will say my kids have a funny story about the whole thing and the way that their perspective is. But my son who is now started his first year in college seems to be thriving and has done quite well with it. My daughter had came along behind, he was used to a houseful with, with some of the help that we had at home and my son and all his friends who started high school now is actually happy to have the quiet not entered a new phase. So I think, you know, between the two of us, we balanced call schedules and I will say balance is a little oxymoronic.
Dr. Edwards 37:55 It’s not really balanced. It is, it is. Again, you’ve got to pause and pivot and decide who’s going to be taking a heavy load and who’s going to go part time actually went 75% clinical and cut my workload a little bit a few years ago in order to have some more office time to have some more flexibility because you know, you leave the house at, you know, five 30 or six o’clock, depending upon whatever you’re doing and how far you are from home and you don’t see your kids get on the school bus. And that can be hard on the kids. So there may be an opportunity to pivot if you’re both, if you both have that type of schedule. But the whole success, I think it goes back to my theory that I think I shared with you earlier is that, you know, your profession, you’re going to have to at some point pause pivot a little bit and decide, you know, which direction am I going in the correct direction?
Dr. Edwards 38:44 Is this the right path both for me professionally, personally for my family. And if it’s not, how do I adapt and how do I make the change so that it is, and then you know, it same time you gotta be feeding your passions and amplifying your strengths so that you feel professionally fulfilled. You’re doing the right thing. Cause you’ve invested a lot of time in this, in this process to, you know, get through medical school, go through residency, fellowship and start your practice in the first five years that that’s way too much time invested to simply stop.
Justin: 39:16 Totally. And honestly, I think it sounded, based on what you just described, it sounds like you showed an incredible amount of wisdom as a young physician married to another young physician when you’re not making a ton of money yet, but still investing your money. And when I say investing, I mean spending in this context in a way that’s going to make your life better and or even bearable. And you know, you were sort of joking about, you know, how I would think about like spending versus saving or whatever, but I’m a proponent of spend money in ways that make your life awesome. And there you get hit a point of diminishing returns, right? Where additional expenditure doesn’t make your life better. But to a certain extent, like if you’re working 70 80 plus hours a week and three or $500 a month on somebody to clean your house and paying for childcare is, is sort of necessary for you to maintain sanity, then that is the best money you’re going to spend every month. And I would absolutely say yes and amen to that.
Dr. Edwards 40:08 Yeah, it was the, it was the key to our ability to make it work. And it didn’t, we had to balance that, that would making sure we spend enough time with our children over the course of, you know, their, their early years, the middle years, which I will tell you is a, is a whole different ball game and then and then getting them off to their next phase of their life. But I will say to your point in most of your podcasts, we did do the very smart thing and that’s save and hide money from, from what we saw coming into our bank account each month, such that, you know, we are comfortable and in a really good place in terms of, you know, retirement funding and saving for our children’s education. Those were, we, I’m blessed to have a partner in life that shared the same school of thought on that, that, you know, that was, that was key to my ability to be comfortable, was knowing that we had all of that taken care of.
Dr. Edwards 41:00 The kids were taken care of and whatever we had left over, we could use to, to pad our lifestyle such that we could function and pay the nannies, pay the housekeepers, all this stuff. So we had a tremendous amount and certainly didn’t at various stages because depending upon what, you know, over the course of years, people change. They need different things. And so we’ve had a few folks in our lives, we’ve not been blessed to have the same person for it for the last 20, 15, 20 years. But, but it is, it is, it is a worthwhile investment.
Justin: 41:29 Yeah. And so maybe talk a little bit about sort of the financial part of your journey. Cause as a, as a physician, you kind of go through these phases, same as with family life where the front end and the middle and the, you know, established attending hood all look pretty different. So how did you and your husband communicate about that? Establish like here’s our values and goals. Here’s, here’s what we want to prioritize. Here’s the place we’re going to spend when we don’t have a lot to spend. And then once money becomes a little more abundant, how do you, how have you guys sort of navigated that discussion?
Dr. Edwards 41:58 That’s, that’s, that’s a great conversation. So we w w again, I’m blessed. We kind of grew, came from the same school of thought that we had longterm goals. The short term goal was to get rid of as much school debt as we possibly could, as quickly as we could. So we didn’t go out and buy the big house. We didn’t go out and buy new cars. We kept what we had for as long as we and what was safe. I embrace the minivan. I have to tell you. I did. I, I loved, I’ve heard you, I’ve heard a previous guests talk about the minivan and my friend Dr. Turner, I believe. Oh yeah. Yeah. I love my minivan. I have to tell you, my friends made fun of me and my kids were honestly just embarrassed after a while because they swore you could hear the road, the bottom of the thing.
Dr. Edwards 42:39 But I have friends that say they’ll never own one. But you know, it’s the basics of keeping, of not having a car payment of keeping our house payment low so that we had extra cash around to take care of the necessities to keep our lifestyle functioning and our kids, our time with our kids was valuable. So we were able to, to do that. And at the same time, taking that, taking what would initially come. I remember the first day, my first, my first attending paycheck, I remember where I was standing when I saw the number coming across and I looked up at one of my colleagues who had been on practice for 10 years and I looked at him and I said, is this number real? Really be your, so you get so used to, you know, my husband, I were actually also wouldn’t college together.
Dr. Edwards 43:24 So we remember the day, you know, we just tried to think about I’m going to buy a pizza tonight. Wheat, we can’t go out tonight. We’re just gonna, you know, I’m not sure we can afford a pizza. And then we shifted to residency where we’re just used to not spending and living kind of a low key lifestyle. That was just our common practice. And then shifting to that attending mindset of, Oh my gosh, this is real, but I ha I’ve got to remember my longterm plan because I, if it’s here sitting in my account, then it’s going to get able to get spent. So, you know, maxing out that retirement accounts, whatever that is, that children and finding the, the educational funds we did a lot of that upfront. That was just part of our makeups. So it really, we didn’t, we didn’t really have the conversation because we were fortunate enough to come along from the same, we kind of came from the same mold, similar backgrounds, but I would imagine for those who didn’t, you’d have to have that conversation up front.
Dr. Edwards 44:14 Especially if you have, if you’ve had previous careers and there’s an expectation from your spouse that all of a sudden you’re making attending money and you should have more time, more cash on hand and be able to do more things. Like I would, that’s a conversation it would have be had. And if I had a spouse who looked at me and said, you know, I married a doctor, I would think that I’d have to have an extra cash on hand. Whereas all this going and then I had a different school of thought to that, that would, those would be challenging times. So again, finding common ground I think is of of what’s important. And again, I’ll have to give my husband credit for this. He told me early on, look, it’s okay to spend the money to have the nanny’s whatever it costs to keep us comfortable and able to spend time with the kids and not doing the not doing stuff that we just are too tired to do.
Dr. Edwards 45:01 And missing out on opportunities with the children is worthwhile. So I have to say too, he taught me how to, how to do that. But I will say I had the whole opposite experience with some of my friends. I think I mentioned this earlier, what am I best friends? When I came out of residency, she was an attending, she’d been on practice, you know, 10, 15 years, was it a hoe, didn’t have children, how it had had a whole different lifestyle in private practice before she came to the academic sector and had a whole different school of thought on spending no, no retirement account. And I remember the first time we went to New York together where she took me to dinner, I thought, Oh my gosh, I can’t know. I don’t know how to, I don’t know how to live this way. And so I would say probably to, I, if I were to give advice to anyone, it was just, you know, hide it from yourself where you can put it away because you’ll need it later.
Dr. Edwards 45:52 And so now I sit 20 years into this, I’m very comfortable in the fact that, you know, my children’s college education is, is, is covered. And my, my retirement account looks really good and I will never stop funding it now. I mean, I will be funding that retirement account until I stopped clinical practice or stopped practicing entirely. I think that’s just the smart thing to do. And you got to look at your actuarial data too, especially if you’re, if you’re a woman, most of the women in my family make it till they’re 95. I think I’ve got a long way to go
Justin: 46:22 And it’s only going to be higher 30 years from now or 50 years from now.
Dr. Edwards 46:26 And, and again, like I said, your career changes over time. So my, my colleagues who are mid fifties are practicing interoperative anesthesia a little bit less than they were. And so as you, as you age up, I think you might your career pivots a little bit and, and you have to adapt. You gotta be ready to adapt to that. So the time to put away and the time to save for retirement is the first five to 10 years of your career.
Justin: 46:52 Yeah. Yeah. I mean, you’re preaching to the choir, so. Totally, totally agree. I’m curious, you know, you said that when you get that first paycheck, I was thinking, did you do anything to celebrate when you saw that thing hit your checking account? No. Oh, I didn’t know. I got a little nervous. I did a podcast episode recently where I said, what I recommend when you, when you first started make attending money is a do something to celebrate that only costs you once. Nothing with a recurring payment. That’s when you’re getting into trouble. It doesn’t matter how much you spend, but as long as you can get it all, you know, with one shot, then probably different
Dr. Edwards 47:26 Than most. I had the, I had sort of this recurrent anxiety of the, of the debt that I incurred from going to school. I had to go out of state and so, and I didn’t have any help finding my education early on. So I knew that I had that debt looming over my head and I just, I had my comfort zone was to have that disappear as quickly as possible. Pay that down and get rid of that just so that I could breathe a little bit again, maybe different from others. But I preferred to live in a, in a debt free world if it’s possible. And, and this served me well thus far, so
Justin: 47:53 Awesome. Totally. so we’re coming up on the hour here. Angie. I want to be sensitive to your schedule. Are you doing a count in time? Maybe we could think of just like three to five more minutes.
Dr. Edwards 48:01 Sure. Yeah, yeah, I’m good. I’m fine. Cool.
Justin: 48:05 Okay, so I’m sure there’s some listeners out there who, you know, they’re in residency or maybe they’re early attending hood and they’re really liking their academic medicine experience. They like working with trainees. They like using the cutting edge technology and doing the research and advancing the field and they’re looking at your career path and they think, I’d really like to emulate that. I’d like to grow my sphere of influence and my impact as a professional, as a physician, the way that Angie has. What kind of advice, if you had to give like one or two things, like this is definitely something to think about. Something to work on, something to push towards if you’re looking to build a successful career in academic medicine.
Dr. Edwards 48:46 Oh gosh. Well first off, you touched on this already and that’s, find your passion. What are you passionate about? What interests you? What makes you excited to get up and go to work every day. And I think you spend the first, maybe five years figuring that out unless you’ve done a fellowship and you happen to know early on. And I think surrounding yourself with people who have different talents that you can pull from. Cause we all have our weaknesses and, and I think to do, it’s easy to capitalize on your strengths, but to develop your weaknesses will help tremendously. And then when there’s opportunities that come available, say yes. Say yes. And then if you don’t know, say you don’t know how to ask for help. Never be afraid to ask for help when something is, is not clear, it doesn’t make sense. Maybe it’s not a skill set you’ve been able to develop yet, but you want to find mentors, find coaches, find a sponsor.
Dr. Edwards 49:37 I think then again, knowing the difference between those three, those three, those three were not distinctly clear to me when I was coming along early. So I’d have people ask me to, who are your mentors? And, and well I think back about it. I can think of, you know, my mentors, my sponsors I had coaches along the way and who all were sort of a combined entity. But you pull from the pool, different, you develop different talents along the way from the people you are around. So again, being blessed in an academic medical center, and I think this is also true for those from the private sector, you can find a number of people who have different interests, different talents, different strengths and then just not being afraid to ask for help. So like you’ll hear me talk about this pause, pivot and adapt to career changes.
Dr. Edwards 50:25 But I think part of that is like finding and feeding your passions. Working on your weaknesses, amplifying your strengths and, and finding ways to connect with both people in your institution and outside your institution. And anesthesiology. We have a, we have a tough time seeing beyond our immediate sphere because we’re in the intraoperative world. We know the hallways at the end of the, or we know the, the hallways that lead to the, or we know the, the, the holding room in the PACU. But beyond that, our scope sometimes is limited. And again, I think this is where it’s helpful to when, when there’s an opportunity for a project with say education or there’s an opportunity for collaboration across maybe service lines or there’s an opportunity for collaboration with a different a different set of experts say yes. Say yes and say, and again, recognizing that and if it’s not within your area of expertise, be willing to grow.
Dr. Edwards 51:22 And I think having a growth mindset is probably the key to career success. Understand what you don’t know. Be a, be okay saying, look, this is not within, that. Maybe may not be within my wheelhouse, but yes, I’d like to try. Is that too much? It’s like covering it all. I’ve got this great, one of my favorite books that I’ve, I’ve, it was recommended to me. One of my favorite authors Bernay Brown wrote several books that I’ve seen a couple of Ted talks, Oh, dare to lead. And the power of vulnerability, yes, dare to lead and daring greatly. And she’s got a lot of phenomenal just soundbites throughout all of those, whether it’s podcast, whether it’s I just listen to an audio book. They’re fantastic and she just reminds people that sort of you have to be courageous.
Dr. Edwards 52:14 And again, one of my favorite statements that she says, sometimes you just have to embrace the suck but true hold true to your values. And that’s, you know, things are not always going to be easy and it’s not always going to be a straight path. But again, pause, pivot and adapt and see, see where it, see where things go. Another one of my favorite authors and again this, this one really hit home. If you haven’t read it, grit by Angela Duckworth is you’re in Philly I think at university. Ah, fantastic. And you know, I, if, if you think about this, you’re getting ready to have your first and how you establish grit in your children, how you establish grit in yourself. She talks about, you know, talent and effort and skill. And I think this is applicable to careers because your careers, you know, and I, and I’m again, here’s my bias.
Dr. Edwards 53:03 I’m a little of my perspective is a little different than others. And that as a, as a woman in medicine my career path did not take a linear trajectory. It was more of a patchwork quilt if you will, little bits and pieces coming together that that didn’t, didn’t have the same pattern, didn’t have the same flavor at the same time. But it’s turned out to be quite quite an amazing project. So, you know, establishing recognizing your talents and that it takes effort to develop a skillset while at the same time, you know, using the skill you have and putting in a little bit more effort is sort of the key to success. And again, that’s all in, in Angela Duckworth’s book. It’s one of my favorites is grit, growth, resilience, inspiration, tenacity is what she taught me.
Justin: 53:52 Oh, I see what she did there.
Dr. Edwards 53:54 Yeah. Awesome. I know, I know.
Justin: 53:58 So that one in the show notes as well. I should, I should get put that one on my list.
Dr. Edwards 54:01 Yeah, I have to do that. That should be on your list. Okay, awesome. Good recommendation. And again, if you have, let me, I’ll give you one more too to get to listen to. So I’m a podcast. While we’re at it, I’m going to give a shout out to Mark Shapiro. I’m with explore this space. He has had some fantastic physicians and leaders in his, on his show. It’s at T show. I think he’s probably got over 180 episodes now, but just for inspiration and something different to listen to that might just give you something to reflect on outside of the anesthesia world and finance. It’s, it’s, he’s got some great stuff and great content.
Justin: 54:38 Awesome. Well this is a great list of resources. I’ll definitely want a link to all these in the show notes. So guys, don’t miss these. Anesthesia success.com/ 31 we’re going to list all of Angie’s favorite resources that you just listed here and we want to get those into your hands. So I wanna I want to bring it to a close here in a minute with, with this question, Angie. And this is something that I close with, with, with all my guests when I can. So yours is a very demanding profession. And with what you just described about grit, perseverance in the face of trial, I’m sure you’ve had those times in medicine and probably in parenting and probably in life. So I’m curious, tell us a brief story about a time when you had to really, you know, sacrifice, put it all on the line to work through a challenging season or a challenging situation. And then in that moment, you know, just reflecting like this is like, I’m doing it, it’s working. This is something I’m grateful for. And this is like, you know, the way to use your phrase like living out your passion. This is something that you’re really happy about.
Dr. Edwards 55:37 Oh wow. I’ve got a couple. Their personal and professional, there’s a, there’s a, there’s a combined, and this may take more than just the last few minutes, but I’ll quickly summarize, you know, at some point in my professional career I had to rethink what I was doing. So locally things changed, the culture changed, the needs changed and I wasn’t ready. I was ready to change, but the system was ready for me to change and had me change. And I think that was a challenge. That was a challenging time. I was unaware of why. And sometimes we look as physicians, we look for the why to solve. The problem is to get to the next step. And there wasn’t a Y, it was just change. And so to again, to have to look at that and say, okay, what, what’s next? Invested a lot of time, energy, effort and emotion into one piece.
Dr. Edwards 56:32 And now it’s time to pivot. I don’t want to pivot and I didn’t want to pivot. So I had to think and restrategize and again, keep my eye too to make the career sustainable, keep my eye focused on what I was passionate about. And I will say that going you know, staying within my institution on projects, but then going outside with likeminded clinicians, people who were still passionate, who had had similar experiences, I can promise you if, if there’s something you’re going through, someone else has already been through it. And it’s just connecting with those folks to make it a sustainable phase and keeping your eye on the future and knowing that quite frankly, whatever it is, is temporary. So I had the, in the midst of all this, I had a senior executive colleagues say to me I know it seems bad right now, but take a moment, realize this is just the now and get ready.
Dr. Edwards 57:31 And I thought, get ready, get ready for what? But it was the get ready for where I am now. And so where I am now, I can look back and say that was really painful phase. But you know, along the way you find things that you’re passionate day to day, you have to find something, find joy in something, find joy in the patient, you take care of fine. Join the project you’re working on. Find, join your family, find joy and recognizing that quite frankly you get to go out and get to leave the hospital every day. And we’ve even invested a lot of time and a lot of effort in the education and you have a great job a great career in great profession. And so those temporary phases, whether it’s a one, two, three or five year block of time is temporary.
Dr. Edwards 58:12 Feed your passions and keep going. And so again, just keeping my eye on the future and realizing that there are realizing what I find Joanne. And I can add a little side to that. Now I find great joy in amplifying others. So I’ve done a lot of fun stuff along the way. I’ve got a lot to put on my CV, but now where it’s fine is connecting other people who are interested in doing more, can’t find a path and finding that path for them, opening that door and letting them walk through. So that’s kinda where I am now and that’s fun. So again, it is, I guess, you know, along the way throughout those you’re going to have trials, tribulations and challenging times, both personally and professionally. But again finding a network of people who are, you’ve been through something similar and learning from them and they’re all out there and I had to, I had to do it again, but there it is. They’re out there on social media. You can put those folks. They’re out there. And, and, and again locally and finding, keeping your, keeping your tribe close. We’ll get you through those tough times. Awesome.
Justin: 59:14 Well that is absolutely excellent. Dr. Angela Edwards at wake forest university. It’s been a pleasure speaking with you for joining us on
Justin: 59:21 The anesthesia success podcast. That’s my pleasure. Thank you for having me, assistant. Great. If you liked what you heard this week, head on over to anesthesia, success.com where you can find more content and free resources to help you build a successful career in anesthesiology and pain management. If you want to leave a review in iTunes, I would also really appreciate it. Thanks for using some of your valuable time to join me today on the anesthesia success podcast.