Kendalle Cobb, MD

Podcast Transcript

Mary Rensel:

Everyone, well, we are so honored today we have our Associate Chief of Staff, Dr. Kendalle Cobb. Welcome.

Kendalle Cobb:

Thank you.

Mary Rensel:

We are very pleased to share some time with you today because we know you're a very busy woman. I'm going to get right to it, Dr. Cobb. I hear you're from San Francisco, that you grew up on the hills and you couldn't have a bike it was so hilly there. Tell us some stories back from the old days growing up in San Francisco.

Kendalle Cobb:

So I grew up in San Francisco, it's true, around the corner from The Painted Ladies, which are the Victorians that are always photographed, have two older sisters, first person in my family to go into medicine. My mother's an educator, my father's an accountant.

Mary Rensel:

Love it. Love it. So then the story goes that you found your way to Harvard. So how does one who grows up on the hills of San Francisco find her way to Harvard and who might have pushed you or encouraged you and who was on your team then as far as your encouragement team?

Kendalle Cobb:

Yeah, it's actually my history teacher in 10th grade I want to say, Carolyn Myszak, was her name and she just introduced me to Harvard. And I had always thought that I would go to UC Berkeley, which is where my sisters and my mother went. And she told me about Harvard and I applied, the other three schools I applied to were all in California and I headed out east.

Mary Rensel:

Wow. Impressive. Now, as a graduate of Harvard, does that just put you in a special club that you have access to the thought leaders in the world? And tell me about alumni weekends or how does all that go?

Kendalle Cobb:

Well, my class is very impressive. So Ketanji Brown Jackson, the new Supreme Court justice is in my class. But Thomas Lauderdale and China Forbes, who are part of Pink Martini are in my class. Kevin Young, who is the executive director of the National Museum of African American History and Culture is in my class. Julie Pottinger whose nom de plume is Julia Quinn who wrote Bridgerton is in my class. So I think that one of the things I appreciate about my... Matt Damon was in my class, though he didn't graduate, Meredith Salenger. So I think that one of the things I appreciate about Harvard is that there are people that excel in lots of different areas. I think of it similar to Cleveland Clinic. You often hear about the doctors being great. I've found that people in marketing and finance and all sorts of areas of the organization are excellent at what they do. And so it's exciting to gotten to know people who just follow their passion and are good people as well.

Mary Rensel:

Amazing. Wow, that list that you just dropped, I'm going to need a few days just to process that. That is a heck of a list. So, what was it like to see Ketanji Brown Jackson be appointed to the Supreme Court and know you were classmates or just that moment? What is that moment like for somebody that knew her?

Kendalle Cobb:

So I was relieved. We were in San Francisco on spring break in March and we watched the hearings and so that was challenging for me, partly because her husband, Patrick, was my study partner for bio in college. And so we had been exchanging emails and what really helped me when I heard the news is that I texted my daughter. I might have emailed her because she doesn't have her phone with her during the day. And then she called me back when she got out of class and like I said, she had watched the hearings with me and I asked her how she was and she said, elated, thrilled. And so knowing the excitement that she had watching the treatment that Ketanji had received didn't impact her joy with the moment really helped me to have perspective. But it was definitely hard watching the hearings.

Cara King:

So your story to me is incredibly interesting, especially your background with the integration of when the fork twisted between you going into this area of wanting to be a ballerina versus shifting into academic medicine. I love hearing about this point in time when you really had to decide which path was right for you. And what I heard you mention is that you're the first person in your family to actually go into medicine. Is that right?

Kendalle Cobb:

Yes, that's correct. So my sister went to law school about the same time that I went to medical school and my mother got her doctorate in education either when I was in college or when I was in medical school. So education is really important in our family and they supported me fully when I was doing ballet. It was a lot of driving me to lessons and that kind of thing. But I think that had I not broken my ankle, then the finite nature of a career in dance might not have been as clear to me. And I might have followed that, but it felt very ephemeral. And so then it was clear to me that academics was the way to go. And I think it's funny in retrospect that I considered ortho orthopedics. I mean, it makes sense. A lot of dancers, athletes think about orthopedics and my way of being in the world is so different than being a fixer. So family medicine makes a lot of sense to me and if when I look back on my life, it's clear to me that family medicine was what I was meant to do.

Cara King:

It's funny though, sliding door moments. If you didn't break your ankle, who knows if you would've gone to college for ballet and then had such a different trajectory. Right?

Kendalle Cobb:

It's definitely true.

Cara King:

What did your parents think when you made that decision? When you said, you know what, change of plans, I actually want to go into medicine. What did they think?

Kendalle Cobb:

So they were supportive. I think partly because I had made a full comeback to ballet. I think that I decided not to go through my recovery, then they probably would've pushed me more. I think that the bigger issue for my mother in particular was when I decided to major in history because like I still knew that I wanted to go into medicine. Her thought was, what are you going to do with a degree in history? So I think that that was more a cause for concern than not doing ballet.

Cara King:

And your mom has a doctorate, doctorate in education, so she knows all things education. So she was like, listen, I know some things and I have a concern.

Kendalle Cobb:

Yes, exactly.

Cara King:

So you're breaking down this timeline for me. So in my mind, you broke your ankle and during that recovery, you were like, yeah, this is hard, I'm going to shift. But you actually went through full recovery, got back into ballet, and at that time had enough self-reflection. How old were you? Like 14 or 15?

Kendalle Cobb:

Fifteen when I made the decision not to continue. So I performed again, I was back on point. So basically was back to where I was beforehand, if not a little bit better actually, because sitting, I went to classes and observed the classes when I was casted and I had always had a mental block for double and triple pirouettes. And so that opportunity to visualize for that period of time where I was in a cast or I think was eight weeks, really helped me when I went back because I had had it in my mind. And I often talk with students, medical students and residents about visualizing what they see themselves doing 10 to 15 years from now. Because what I tell them is that I believe that that vision will become a reality, which means that any challenges or hurdles that they're enduring are going to be overcome because they're meant to do that thing in the future.

And so that gives people a lot of calm because I think that a lot of times people think that when they see somebody who they consider to be accomplished, they assume that the road has been smooth and there haven't been any challenges. And I think that helping them to know that everybody has challenges and it's a matter of persevering, I think helps.

Cara King:

I'm in love with this. I'm in love with two main aspects of this. So number one, I envision you in a cast on the side of this room. I do not dance, so I'm not going to use the right terminology, but I see visualization in two ways. I see visualization in that you're watching the technical component of what the other dancers were doing, and you were actually actively watching that to actually incorporate that when you got back into dance. And I believe in that so much as a surgeon, I make all my learners watch their surgical videos for just that because there's, I would say, make the invisible visible when you actually watch yourself in that way.

But also envision a young you having this space of self-reflection being like, is this where I want to be? An actual five to 10 year plan. As a 15 year old, I was not doing that. So my question is, how did you have this space of self-reflection? You seemed so much wiser than your age. Was anyone guiding you through this area of self-reflection coaches or your parents or how did you have this kind of shift during this time?

Kendalle Cobb:

I had a lot of great teachers. I mentioned Carolyn Myszak, my English teacher. I feel really fortunate because the teachers in my life, in addition to my mother, really helped me to feel special and safe to dream and explore and pursue things. And so I can't identify anyone in particular. And I think that I used to read a lot of books like Leo Buscaglia is one of my favorites, and he talks about, I'm paraphrasing, but basically if you're a plum, then you have the choice to be the best plum. Or if you realize that somebody doesn't like plums, you can try to be a banana because realizing that they like bananas, but they'll never choose you because you'll never be the best banana because you're a plum. And so I think that reading different things that had that message of being true to who you are were very helpful to me, so.

Cara King:

Amazing. And also that space of growth mindset. I lot about fixed mindset, versus growth mindset. And like you said, when you see someone successful, it's easy to say, man, they've never had anything hard. They've always been on this trajectory of just greatness. But understanding that this growth mindset takes things like you breaking your ankle, which I'm sure just felt like the heaviest thing in the world at that time and spinning it in a way that really changed your entire career.

Kendalle Cobb:

Yeah.

Cara King:

My last question in this space before handing it back to Mary is your choice to be a history major. So shifting into the space of saying, okay, I want to go into medicine, and then having a mom who is a professional doctorate in education and also questioning your decision for a history major. I feel like this says a lot about you as an individual, why you chose this and then stuck with it. Why did you choose history?

Kendalle Cobb:

So I like history, I like the humanities, but I remember thinking that I was going to be doing science for the rest of my life and that I wanted to be able to talk with people about other things. Now, I do work with the National Board of Medical Examiners, and right now I'm prepping for a meeting where all of the questions are basic science questions. And so medical school wasn't easy for me, and I still think that pathophysiology isn't my strength. I'm much better at the clinical aspects, the interactive aspects, but this idea of knowing something else and being able to talk about something else was very appealing to me. And I ended up taking organic chemistry over two summers at UC Berkeley, and using my electives for my pre-med requirements. But I think that the type of analysis that I did, so I would look at primary sources and have to analyze what was implied but not written. I think that that's something that helps me when I'm interacting with people, what are they not saying that I can follow up and ask them about? I think is something that I learned through studying history.

Cara King:

Brilliant. And I heard you, it was either on a different podcast or I read something that one outlet is you have friends outside of medicine. And I was like, oh yes. I cling to my non-doctor friends and my husband was an anthropology major. I married a physician completely by accident. That was not the plan, but at least he was an anthropology major. And your guys' brains are totally different. I just value that so much. So I knew that there would be more to that question. Thank you so much for sharing.

Kendalle Cobb:

Yeah.

Mary Rensel:

Okay. If we're talking brains, I got to jump in. Kendalle, as Associate Chief of Staff, let's go back. Let's focus on what's happening in the last few years. Here you are with this perspective, with a history perspective and now Associate Chief of Staff during a global pandemic, and you are tasked to retain and recruit physicians during this time. Tell me about what you've seen. What do you think works at this moment in medicine, where our opportunities?

Kendalle Cobb:

Yeah, I think that the pandemic really showed the organization at its strongest in that there were people that were charged with task and the expectation was everybody was going to follow and make it happen, which felt very different than what we sometimes see, where it's a lot more relationship management and slower process. So that part of it was very exciting to me. I think that one of the things that's challenging right now because of what's going on with the economy is the pandemic really allowed us to take a step back and say what's important and what's the work. And especially in primary care, there's so much that is, and I think it's true in lots of fields, but in primary care there's so much that is not work that gets done when you're face to face with a patient. And so there was this opportunity to really honor that work and make sure that we build in time for people to do that.

And so I think that that's still a goal that I have because one of the things that's great about Dr. Ridgeway is that she recognizes that she knows the work of a pelvic floor gynecology surgeon, but she doesn't know the work of a family physician. And so she looks to the different leaders and says, “Tell me what your work is”. And so that's exciting. I think that sometimes leaders don't trust that they can sort of say, hey, this is what we do, this is what we need time for. And so it remains to be seen whether or not people have the courage to say, these are the things that we do, this is what we can contribute to the budget. And I think that that piece is so important to retaining. And as I talk with students and residents to recruiting them or retaining them for their next chapter, because I think things are really different.

I mean, yes, there are still people that are practicing here that are in their seventies. One of the challenges, again, in primary care is that you want people to be able to do this work for decades. And what has happened over the last 10, 15 years is that you'll see people that do primary care for a while and then they'll become a hospitalist or they'll go into women's health. There are many areas of women's health that you have this continuity of care, but they're choosing areas that are chronic pelvic pain. And so it's different than the longitudinal nature of having a relationship with patients and being responsible for their care. And part of that is that there is all of that other patient care that's non-facing, whether it's refill requests or phone encounters or lab results. And so I think that people sometimes feel like there aren't enough hours in the day and how do they balance their family, their other things that are important to them, and this true commitment and sense of calling to their patients.

Mary Rensel:

So I'm hearing curiosity, a leader with curiosity, back to Dr. Beri Ridgeway, who's our chief of staff, for those who aren't aware, but she's leading with curiosity and asking her leaders and her team for their opinions. What are the opportunities right now in physician recruitment and retention here you think we need to be even more curious? Because there's many opportunities. I mean, one thing obvious to me is diversity and equity and inclusion. Obviously that's an area that's been part of your professional roles and your personal experience. Where can we open the door and remain curious to change the face of medicine right now? There's just seems like the DEI leaders in this space are maybe given no time or money to work on it. So tell us where do you think we need to be more curious or what are some next steps as an institution that we can take?

Kendalle Cobb:

Yeah, I think that part of it is one of the things that we've started doing in the last year, which is having department chairs talk with program directors and having department chairs talk with trainees, not at the end, but at the beginning so that we have a better idea of what they want in a career. So for example, there's a woman who is very interested in of community health and she received a Catalyst Grant. And so I started talking with the department chair a year ago about sort of, okay, what are the options? And so part of it is being proactive.

One of the things that happens is that some people have National Health Service Corps scholarships, and so they have to work in certain sites in order to have that repaid. And I think that part of it too is making sure that the organization is identifying and go through the process to get our sites that would qualify. And so it's a lot of intentionality. I think that historically sometimes we've thought, oh, well, we have an opening in this area and we're going to hire whomever as opposed to being more intentional about our placement and our planning for who works where.

Mary Rensel:

Gotcha, gotcha. And what are some next steps or some tangible results you'd like to see in the next year in that space?

Kendalle Cobb:

I would love for us to have the creativity to honor what people want to do. And I think that that's scary and hard because it's much easier to have everybody doing the same thing. And one of the things I appreciate about the Women's Health Institute a few years ago is, okay, Dr. Ridgeway's ability to say, okay, this is what we need to do. How do you want to do it? And I think that that's really the empowerment of the physician is so important. We can ask people to do things and let them have some say in how they do it. And I think that that helps people feel like they have some autonomy even when there are a lot of demands.

Cara King:

You nailed it on the head. And I was lucky enough to be recruited by Dr. Beri Ridgeway. I am here because of her. She is an amazing human. And that sense of autonomy goes so far. If you say, I have to see five more patients, no problem. As long as I can put them where they fit, they fit into my life. I'd rather see patients personally for me at 6:00 AM virtually than at 6:00 PM in the same type of day. So I cannot stress enough how amazing Beri is for having that forward thinking and how much of an impact it has on physicians.

I want to shift just a little bit into this area of really recruiting younger than medical students and residents, young Black college students into this area of medicine. So the most recent statistic that I saw was that African Americans make up only 4 percent of physicians, which is mind blowing to me. And I love the saying, if you can't see it, you can't be it. Right? These people aren't seeing people who look like them in these roles. And so oftentimes they don't even think it's a possibility. I interviewed Dr. Lash Nolen; do you know Lash Nolen? So, she is the first African American Harvard Medical School Student Council President 2023. And she talks a lot about this. And so my question for you is, what advice do you have for young Black college students who are considering going into medicine?

Kendalle Cobb:

What comes to mind is what we say when people are experiencing something that shouldn't be happening. So I'm thinking about if a child is getting inappropriate attention, it's sort of keep talking to people until you find somebody that's going to listen. So I think that sometimes people will get discouraged or be told that like, oh, well, you should consider doing something else. And I think that part of it, and it's hard because it's vulnerable to put one's dreams out there. And so I guess that what I would say is keep on going to people until you find somebody that's like, yeah, absolutely. Because I remember talking with a woman a couple years ago who wanted to go into OB-GYN and she had met with a career advisor and he had said, I don't think that you're going to be able to match successfully with your board scores.

And so I told her, I was like, he does not know what God has planned for you. She's a spiritual person, I'm a spiritual person. I wouldn't say that to somebody if that wasn't going to have meaning to them, but in her case, I told her. And so she agonized and continued to agonize and she ended up ranking her top choice, which was a top hospital matching there.

And so I think that part of it too is that we look to other people as somehow they're knowledgeable and they know what our future holds. And I think that that's not always true. And so I think that just continuing to look for support and not being discouraged. Similarly, I think that sometimes people get into the pattern of, okay, well I have to fight everybody and there are people who don't think that I can do this. And so when they run into trouble, sometimes they feel like they have to deal with it on their own. And one of the most important things is that recognition that we all run into challenges. And that I tell my students all the time, no judgment here. My goal is to help you navigate this path. And so know that there are people that are going to help you move forward and just seek those people out.

Cara King:

So powerful. So really finding these psychologically safe cultures that you can express what can feel vulnerable that I want to be, let's say a physician and feeling like you can say that out into the universe and it's not going to be laughed at or said that you can't do that. Again, I think it was you, I heard either an article that I read or a podcast that I was listening to about even students asking for help, being self-conscious because they're already having a little bit of imposter syndrome, which I have every single day. And so being fearful that if they're going to ask for help, they're going to have the lens of, well, obviously you need help. You shouldn't be here anyway. And that is just so terrible to even think that that students are feeling that and students' job is to learn, they should be going for help. But acknowledging that as physicians and teachers, it's so important. Don't you think?

Kendalle Cobb:

Yeah, I do. And I think that part of it too is, and I have to do this myself, is remembering how I feel and what I think when people come to me with a question or for help. I'm really excited to help them as opposed to when I'm on the seeking side of help, then I all of a sudden think that people are going to think all these negative things about me and that. So I think that it's helpful to think about the people that approach us for help and how we respond to them to give ourselves the courage to seek help.

I am not a statistician by any means, and I'm glad that we have great statisticians here. I'm grateful that we have great communication people here. And so, again, that's one of the things I love about working here is that early on when I was here working in the medical school, Cleveland Clinic Lerner College of Medicine at Case Western Reserve University, I was working with some pancreatic surgeons, some colorectal surgeons, and this idea that they recognize that they couldn't do what I do as a family physician, just like I can't do what they do, that's huge. And it doesn't happen every place. I think that we each have our unique gifts, talent, strengths that we bring to the world. And so it's not that we need to do everything to solve a problem, but we can do our part. And so that has been really empowering and freeing for me because I want everything to be better and I can contribute my part, but I can't make everything better. I can do my part to make things better.

Cara King:

You're touching me so deeply with the words in that number one, self-talk is so critical. Things that I say to myself, I would never say to somebody else, so I should not be talking like that to myself. And keeping that lens is, I think so important. And then the other part of this is modeling what it looks like to ask for help. Having learners and our colleagues see what it looks like to be asking for help in stats or again, my brain goes to the operating room because I'm a surgeon, but if you need help in the operating room, putting ego aside and asking for an inter-OP consult. And I think sometimes just modeling that. That I am really good, really good at some things. I acknowledge I'm not really great at others. I'm at the Cleveland Clinic, which is the mecca of brilliant minds. And just having that culture that you can ask for help and it's for patient optimization and it's okay. And it's actually congratulated.

Kendalle Cobb:

Yeah. It's funny because I was just meeting with a couple of students on Saturday and I was feeling conflicted because I made a commitment to attend the WPSA dinner on Thursday and I actually had invited a bunch of students and then I found out that curriculum night for my daughter is the same night. And so, I asked the two students I was meeting with who are OU, Ohio University Heritage College of Osteopathic Medicine, students and they have another event that night, so weren't two of the students. I said, I'm really conflicted about this. And so I also think that sharing, recognizing that I don't have all the answers and getting other people's perspectives is really helpful. And of course both of them said, well, you should go to the WPSA thing because your husband is already going to go to curriculum night and he's going to take notes.

And I was really proud of them because of course I was doing the whole, my daughter has one mother, she's in ninth grade. And so to have that perspective was really helpful. And my daughter didn't care whether I go or not because she just wants to make sure that somebody's going to pick her up after rehearsal so that she doesn't have to stay at school until curriculum night's over. And I told her I could take care of that, so.

Cara King:

I love that. You got her priorities out of the way. You had your own securities brought to your psychologically safe tribe and now you have a great plan and you'll be at WPSA dinner this Thursday. Right?

Kendalle Cobb:

Yes.

Cara King:

That's the most important part of that. Okay, great. I'm just kidding. Great. Mary, you want to close this out?

Mary Rensel:

Oh, Kendalle, thank you for your time. I want to ask you one last question. If you had to think of medicine in the last 12 months compared to when you got into medicine, what are some changes that you've seen and maybe something that you also have seen mirrored in your students, because you're very close with so many learners at various levels. What do you see coming up in medicine or a change in medicine?

Kendalle Cobb:

So I'm not sure it's a shift in medicine as much as it's a shift in me. I think that I was better about it with patients than I was with students. But now it's extending to students, which is this what I was talking about no judgment. So this isn't really answering your question because it's not how I heard the question. I mean, there are lots of things that have changed in medicine as far as people feeling like they can question. And I think students and patients all want to be involved. The thing that, going back to what I can control, I think that I can be very hard on students in that I want them to do their best.

And one of the things that fascinates my family and friends is that I'm, as a person, pretty judgmental. But I don't carry that into interactions with patients. I feel like everybody's self-critical enough that that's not what they're coming to me for. And sometimes patients will want me to take on that role and I can't take on that role. That's not who I am in that space.

But I think that one of the things that I realize having been away from medical education for a couple of years is that the same thing is true of students. I think that I'm nurturing and I also have high expectations, but I think that I tend to air more now on that you know what, this is a rough road and it's hard and I'm with you. The accompaniment piece of life is so important to me. And so that has changed. And so I think that regardless of what somebody decides, then that idea of like, okay, I'll tell you what I think and I'm not necessarily going to agree with your decision, but I'm with you to make the best of your path. And so that I think has changed.

I think that one of the things that I realize is that students, similar to patients, I can withhold judgment and really, regardless of what they decide, I can share my opinion, but really my purpose is to accompany them on the journey. And so I think that that has allowed me to be more kind and suspending judgment with students in the same way that I do with patients.

Kendalle Cobb:

Thank you so much. This was a wonderful experience and I appreciate your taking the time.