Sumita Khatri, MD

Podcast Transcript

Mary Rensel, MD:

Today we have a very special guest, Dr. Sumita Khatri. Sumita, Welcome.

Sumita Khatri, MD:

Thanks. It's great to be here with you.

Mary Rensel, MD:

How are you?

Sumita Khatri, MD:

I'm doing really well.

Mary Rensel, MD:

Excellent. Thank you for taking your time for us here at the WPSA podcast and we're honored to have you. I want to start with the FLEX program. Can you tell us about the program, and the early days of why that was born and how it has flourished over the years?

Sumita Khatri, MD:

Well, there's a fun story behind that.

Mary Rensel, MD:

Oh, good.

Sumita Khatri, MD:

Which I guess you might like good stories, right? So it was during one of our Women's Professional (Staff Association) Conferences that I happened to go to a session on executive presence. And it was about 45 minutes long as one of the great breakout sessions and I was curious about what that really meant. And the presenters were so impressive, because we were sitting there and we were just sort of reflecting on how is it that you deliver a compelling message? How do you do it as you mean it? And what are some tips and tricks to make it more effective? And literally in 45 minutes, posture, breath, diction was covered such that I was like, oh my goodness, I can do this. And everyone else was sort of transformed in that 45 minutes. And I thought, is that really all there is to this?

Sumita Khatri, MD:

And I realized that most of us are good communicators. We're smart, but we're not always good at advocating for ourselves in a moment. So it was with that experience that soon after that I was elected president of the Women Faculty School of Medicine (of Case Western Reserve School of Medicine), which is the sort of counterpart (to the WPSA) at Case (Western Reserve University). And I became president. And I was really interested in how it was a networking organization and social, yet I felt that there was room for it to become more of an advocacy organization and skill building organization. So soon I was meeting with Dean (Pamela) Davis, our woman dean (of the School of Medicine) at the time who I really admired. And I said to her, "What we'd really like to do is start a program where we teach or provide skills on executive presence."

Sumita Khatri, MD:

Sumita Khatri, MD:

Sumita Khatri, MD:

Mary Rensel, MD:

Wonderful. Well, I love that you put all that time and energy into that and have had such successes, and the success has kind of rippled through our whole enterprise. So thank you for all the hard work you've done because I know that doesn't come easy. There's a lot of hours and hours of hard work in there. So thank you. All right. Speaking of advocacy, maybe you use those same skills to advocate for patients. So we see you talking about air pollution and COVID vaccines and lung health. And tell us about that journey as well. The advocacy, the strong communication but yet for patient care and public health.

Sumita Khatri, MD:

Well, one on one with patients, I've sort of been that way probably since I was little. I was always a friend of the person who was the other in the classroom. The one who didn't have a friend I'd be sitting there with them. And of course that limited my friend group too, because no one else was sitting with us. So it didn't matter to me, I was just not able to handle anybody being lonely. So I just remember even back to elementary school and oh my gosh, those times of bullying in... I was just thinking about that today, bullying in middle school and just actually being the shrimp that used to get in the way, and tell people to stop doing what they were doing. So I guess that is vein of advocate that is probably a theme in my life.

Sumita Khatri, MD:

Sumita Khatri, MD:

Mary Rensel, MD:

I love it. Thank you for all that you do there too. Geez. Woo. I hope you get to rest periodically. Sometimes I sneak in a little public health on these podcasts. So if we have some ears of some people that aren't usually in front of a lung doctor, what do you want people to know? What's something they can do to keep their lungs healthy. I know you're so good at this advocacy work.

Sumita Khatri, MD:

If there were a time that we didn't need proof of climate change, it is now because we are seeing it all around us. It has come at warp speed. We were hoping to get there by 2030 by reducing our climate warming by two degrees. And now we made it more ambitious at 1.5 degrees and we are not going to hit that mark. And as a lung doctor, I'm seeing that changes in allergies and the allergenicity of allergens, with the longer springs, longer falls, shorter winters, the whole types of allergies there are has changed. So for people with allergies they're suffering longer. With the extreme weather they're suffering during the extreme cold or the heat and then moisture causing more mold as well.

Sumita Khatri, MD:

So it affects everybody, but people with lung disease more frequently. So that's one major thing that we need to advocate really among measures to clean up our use of fossil fuels, and the way we use energy so that we can reduce our carbon footprint. On the other hand, indoor air quality is also a major issue. I think we're seeing all the stuff about the clean building seals on commercials and everything. And there's something to be said about that because that's where we normally spend 90% of our time. And during the pandemic, like 99% of the time indoors. And so just being mindful of the pollutants inside, like the dust and the particles, and even gas stoves if you're not ventilating properly. Just to be aware so that we are all trying to breathe the cleanest air possible.

Mary Rensel, MD:

Thank you. And for those this is just a podcast, you can't see her but every time she's talking about this she's looking outside. And it's really amazing because she's showing us with her expressions on her face how much she cares about a healthy environment for her patients. So thank you for all you've done.

Cara King, DO:

All right. So I have been so excited for our interview today. I'm going to be honest.

Sumita Khatri, MD:

You say that to everyone.

Cara King, DO:

No. I really don't. I have just dove into just a lot of your publications and your recent podcast that you just mentioned, which was fantastic. And one theme that just keeps coming up is... I'm saying this with true honesty, that you are one of the most empathetic physicians that I've ever heard speak. I'm being honest. You discussed in your Cleveland Clinic video how when you interview patients, you're speaking soul to soul. And it just touched me so deeply, and I can just see it all over your face when you speak. And that story that you just talked about when you were at middle school about really not wanting others to be lonely, like you just truly feel other people's feelings and it's palpable.

Sumita Khatri, MD:

So true. No poker face here. That's for sure.

Cara King, DO:

I know and I just love it.

Sumita Khatri, MD:

Thank you, Cara.

Cara King, DO:

Yeah, truly. And so my question for you is how do you maintain this drive, or how do you maintain this empathy during difficult times? And maybe those difficult times are personal difficult times, or professional difficult times, or pandemic difficult times. How do you maintain that?

Sumita Khatri, MD:

It's come to a head I would say probably in the last several months where it's been taxed. Up until all of this happened, how I maintain that is to have people around me that think like me. So I'm not talking about group think, but my whole team outside you might hear them giggling. Honestly, it's like a family. We leave no man behind or woman behind at the end of the day, we make sure that the last person goes out with a second to the last person. And they do it truly from their heart. And I don't know what it is, maybe it's luck or maybe it's providence or maybe it's a little of both, that I find the people I need around me. And I guess people who don't have that thought don't really get attracted to the work that I do, so that's okay.

Sumita Khatri, MD:

They can do what they want to do, but I have the people around me who help me do what I want to do. And it's true, I remember I was doing the communications skills course and you're supposed to be able to reflect on how you do things so that you can teach others. And they said, "So how do you do that?" I'm like, "I looked into their eyes and I saw their soul." And they're like, "No, what are the skills?" I'm like, "I don't know what you mean by that." So I guess I've learned better to articulate what that means so when people ask me, I'm able to share that with them. But to the point of how do I maintain it? I worked with Rita Pappas (MD) on that hospital (Cleveland Clinic’s Hope Hospital built during Summer 2020), that was a scary time.

Sumita Khatri, MD:

She's an amazing leader. And then I've worked in the COVID ICU quite a bit. And even last week while we are seeing this fifth wave, and there's a lot of mistrust of the health system. And I will share with you that this was probably the hardest week in my career in the ICU. Not because of how sick the people are, but more that no matter what skills I use and how hard I try, I'm not getting through with the trust that needs to be there so that they believe that I wish the best for them. So that has been... When you talk about a core value for me is my integrity and my empathy that with most I'm still doing okay, but it's those few where I feel like I'm failing. And so now how I'm staying resilient is just to look within and to say, "Okay, I am doing my best.

Sumita Khatri, MD:

There's nothing I can do." And I'm actually not watching the news anymore because it doesn't help me. So this is how I'm surviving now. And I'm again, just thriving through relationships with people like you, these conversations where I'm not alone. I know we're all feeling this. So we will get through this and be changed forever I'm sure.

Cara King, DO:

That's just so powerful and so moving. And with you being in the ICU, you're feeling it. I'm a minimal invasive GY surgeon. I'm in the OR, I have a little bit of a bubble around me. But you're seeing these patients and you're feeling it. And I hear your words in that you just said right now, you just said how I'm failing them. Meaning you take this personal, we all do. And it's not you, it's a million other factors but we can't help but take it personal. So your emotions ring true for a lot of us. And thank you for being so vulnerable and transparent with that response.

Sumita Khatri, MD: We have to talk about it because I think especially people who are starting their careers now, who trained during the pandemic and they have not had the privilege of those normal relationships because it's not normal anymore. And I've seen that the generations after me are also very empathetic, very well rounded physicians, men and women. And I'm very proud to see that, yet they're not having the same developmental experience in the early part of their careers that I have had. So they don't have a track record they can say showed that it worked because nothing's working now. It is sometimes, but in this month I'm telling you, very little is working. Again, hopefully it'll get better.

Cara King, DO:

Yeah. Wears on you for sure. It's so true. And I keep going back to this, like seeing patient's souls. Your words are ringing so deep to me and you're making me reflect on my own practice.

Sumita Khatri, MD:

Okay.

Cara King, DO:

Truly. And when you talk about really looking into a patient's eyes and hearing their story, that takes a true presence. You have to be present with them, you have to listen for the sake of listening. And so many of us are listening for the sake of responding, because we're here to fix. But I can tell you have a true presence. Can you talk to us about how you get there? Sometimes when we have such a busy schedule, I've got a million things going on, my email doesn't stop, how do you find that presence? What do you do mentally to get yourself there?

Sumita Khatri, MD:

Again, having a team around me who can take care of some of the difficult stuff that I can sort of put to them. Sharing sometimes some of the hard things, because we take care of patients with complex conditions. So not to label them with the condition but to care for them. And they hold me in check too, at the end of the day it's very hard. But I have to say when I walk into a room and it usually starts with a joke or something, and I don't mean to be like ha-ha. It's just treating them as people. Oh, how was your trip? And oh, do you belong to this person? Especially the whole, are you the girlfriend, the wife, the... So how do you belong to this person?

Sumita Khatri, MD:

So just starting off with sort of a lighthearted comment, and then there's always clothing and shoes and jewelry we can comment upon. And so that sort of gets me... It's just kind of what I do anyway. And so it just shows, I hope that I'm just a human and then I think humor works too. I don't try to be funny, but I think just maybe lighthearted is just what happens naturally most of the time unless I'm really tired and hungry. So then it just becomes people hanging out, talking about a medical condition that I hope I can help them with.

Cara King, DO:

Yeah. I love that. Just understanding that all the patients that we're working with they're people. They have their own stories, they have their own fears, they have their own emotions and taking them outside of just the disease process and making them human. That resonates really deeply. Thank you for those words.

Sumita Khatri, MD:

Absolutely. And I have to tell you my own personal experience. So my father had lung cancer when I was 23. I was just... No, he died when I was 23. So like 18 months prior, I was a medical student. And he got lung cancer. And as in so many cases, non-smoker, not that it's anybody's fault. Nobody deserves cancer of course. Being on the other side, I literally was going to be a pediatrician prior to that. And then seeing him short of breath I... Actually, that's another reason I wanted to be a pediatrician, I couldn't handle seeing people who were short of breath.

Cara King, DO:

Yeah.

Sumita Khatri, MD:

But then I went to the ICU and I worked as a sub intern. And I worked with a really tough as nails guy. That's when you had to be in the jaws of death almost to make it to the ICU. And I was a fourth year medical student and I was good at it. And I was able to communicate with the people who had tubes in their lungs, and we'd squeeze and I got to know them. Then I realized maybe that is my calling, so I went into pulmonary and critical care. I don't think there's any coincidences to that at all, so that personal experience. I do actually when I say I look into their souls, which is a strange thing to say. Still, I feel like I'm talking to whatever it is that they have inside that is in common with what my father had.

Cara King, DO:

Wow. I have goosebumps. That's really an amazing story and really intense. And thank you again for sharing that. And it just makes me feel like I've heard you talk about your purpose. And like this you're living your purpose. And taking the space to understand what your purpose is and reflecting on that is just really important. And thank you for your work. It's amazing how your trajectory changed when you just sat and listened to what you couldn't ignore it sounds like.

Sumita Khatri, MD:

Correct.

Cara King, DO:

Wow. Thinking about that purpose, again, you talk about reflecting on that and understanding your own purpose. Has your purpose changed at all over time or has it always been pretty consistent throughout your career?

Sumita Khatri, MD:

Oh, it has changed. And sometimes circumstances change it for you. So being the head of a leadership program, I have always been able to lift up others to see their best potential. So I get the feedback, I just don't ask for it but I get that feedback that it works. That I'm able to really tap into what is their strength and really open it and show it to them. And Dr. Erzurum (Serpil Erzurum, MD, Episode 3), whom you've already interviewed, again she was the person I imprinted on when I was a fellow. Literally I was her duckling and she gives me so much credit. But literally she was an absolute inflection point in my career and life.

Sumita Khatri, MD:

And then being an advocate I ran this program and then I thought to myself, well, I also need to prove that I can be that leader of the traditional sense. So I've not held back from going for leadership positions. And there are many people who are interested in these positions, so you may not get the one that you think that you'll do best in. So I haven't gotten some positions that I've gone for and sometimes they're visible what others might consider failures. And now I would say that just as I tell other people, that it's really your job to go for the things that you think you'd be good at. And you know that you'd be good at. So whether I'd gotten it or not, I knew I would be good at it, so that's not the question it's circumstances which perhaps are propelling us to where we should be.

Sumita Khatri, MD:

And it takes time to get to that point. But I think this year, being at a place where I have all those titles that you will probably mention, I don't feel like I have anything to prove. I will be where I need to be at the right time. So I kind of trust at this point and I'm open to what's next, so that I would say is probably a big change in the last few years. And I think getting to the goal of professor was probably something that was a tangible goal. And once I did that and I got that, because of all my advocacy and my education and sponsorship and mentorship, I feel like, okay, I'll just do more of that. And I'll just wait to see what happens. I'll be where I need to be at the right time.

Cara King, DO:

Wow. I have so much to break down. That was amazing. You have such confidence, you're like, I know I'm good enough whether I get it or not like. That confidence we need to instill in other women. We are good enough, we should be at the table. Like stop self doubting ourselves, right?

Sumita Khatri, MD:

Yes. You will not get it if you don't go for it, that's a given. And going for it will always give you some experience that you didn't realize. But most importantly, when you go for it, don't fake who you are. I don't know if I should say it, but

Cara King, DO:

You should.

Sumita Khatri, MD:

I'm like full monty me all the time.

Cara King, DO:

Love it.

Sumita Khatri, MD:

Okay. On a very emotional level.

Cara King, DO:

Yes. I love it.

Sumita Khatri, MD:

But yeah, I can't hide who I am. And so it's not the cocktail for the moment for that position, I'm good with that. But that's how this vice chair came about because people know what I bring to the table, and I'm so incredibly fulfilled in that role right now.

Cara King, DO:

It's amazing.

Mary Rensel, MD:

Okay. So what I'm hearing is this deep ability emotionally to connect with people and professionally develop. So I feel like that the next thing to talk about then are boundaries, because I think we can give and give and we can deeply emotionally connect with someone. But somewhere in there, let's say we have our young learners, our residents, our medical students here listening today, or even staff that are just emotionally tired. What would you suggest for them to emotionally connect with the patients, but yet not give it all away or not to come home completely deflated or empty emotionally? So how do you practice boundaries that serve you as a person and keep you active at such a high level?

Sumita Khatri, MD:

It's an active practice to be honest with you. It's easy to go down a journey that you didn't ask for. I will always go back to the team idea because when you have someone to discuss something with like, am I missing something, they're like, no. My colleague will say they're just a little extra. And that sort of makes us laugh at you like yeah, that was a little extra. And one of the things I also tell my junior colleagues when they are feeling bad about how somebody is doing or they can't figure it, I say, "You didn't give this person this condition, but you're trying to help them." So just the idea that you can't own it. You can help but you can't own it and some conditions are bad. And so I'm in pulmonary most of the time... I'm not in the lung cancer space so much, so most of the time people get better.

Sumita Khatri, MD:

But if I can't get them better, I'll keep trying. But at some point I'll say, "I've done what I can, I'll help you. But I'm at the point where I don't have an idea of what else to do next, but I will still see you because maybe we'll come up with something." I never abandon people. I never leave them be. And then from the standpoint of mentoring, I think more recently I am learning that I cannot do everything. And this is probably more recently and because of everything else, just saying no, I'm carving time in my schedule that I called focus time. And then I am sticking to it to the best that I can. But saying yes is so easy and saying no is not. So I'm pushing things off to the new year. It's close enough. I can say 2022 sounds good, call me then.

Mary Rensel, MD:

Wait, I think I heard a real nugget of amazingness in there, the focus time. Tell me about that. I hear CEOs have this, so like you need CEO time to think so. I don't know that doctors put that in our schedule, but yes, we need to learn from you. So tell us about this time.

Sumita Khatri, MD:

Yeah, I learned this from Dr. Dweik (Raed Dweik, MD), who's my institute chair too. He just blocks off time so that people... I actually manage my own calendar, which is a mistake lately because I'm missing things all the time. But other than that I will block, what was really fun is I filled a doodle poll of my availability and I never took off the stuff that I reserved, which is really kind of cool. But this new program that we have in our email management system which says... Is a little creepy and says, "Hi, looks like you're busy today." I'm like, "I am, stop talking to me." Yeah. Stop reading my mind. "Looks like you have other things coming up, shouldn't you be studying?" I'm like, "Oh my God, stop talking to me."

Cara King, DO:

I can't stand that thing. It pops up, you've had zero time to think this week. Yeah. Thanks for letting me know.

Sumita Khatri, MD:

Speak for yourself. Stupid computer. Yeah.

Sumita Khatri, MD:

So I know where to be. But I've kind of thought I'm like, okay, you think I should have focus time now. Damn it. I'm having focus time. Thank you. Yes.

Mary Rensel, MD:

Well you help learners. You're a vice chair. You're a professor. You have led a professional development program for years. The one thing we have not mentioned is that you're a mom and I hear there are triplets and are boys, probably not so little anymore. Tell us how has it been? What do you say to young learners about, should I have a family? I don't think I can have a family. What do you say to that?

Sumita Khatri, MD:

I waited till after training was done. That's one thing and that was easier I think. But I am so in admiration of all my colleagues who are not waiting, there's a time to have a child and you have to have it when it's time to have a child. So good for you. And it's forcing us to do better. To accommodate that, not just accommodate that, integrate that into everything we do, we are way overdue for that number one. Second of all, yes, I had girls born at the same time, 17 years ago. So they're 17 now, they're seniors in high school and they have a younger brother who's only 15 months younger than them. So one junior, three seniors in high school and I am unashamed and to say that they are probably the best people I know.

Sumita Khatri, MD:

And I don't know what I did to earn the opportunity to be their mother, but I'm very thankful for it because I've learned so much from them. And watching how they... I don't need to interfere at all, they've raised themselves literally. But with obviously good family support, we're a three generation household. I'm not going to basically minimize any of that contribution, but truly who they are as people is unbelievable. And I've learned to be a good parent, which is just let them be and just don't let them burn themselves, like burn their fingers or whatever. And they study, they work hard and they learn from around them. And I guess I'm just very fortunate and grateful. And I am going to miss them next year, which is why I'll be saying yes to more things maybe again in another year. But actually, I'm just going to go visit them. I just want to see who they become because I'm just so proud.

Cara King, DO:

That is beautiful. You have a lot of children very close in age. That's amazing. So, you mentioned having a three level household, right? So was it your parents who helped out when they were growing up?

Sumita Khatri, MD:

Yeah. They're my parents now after marriage, so they're my in-laws.

Cara King, DO:

Your in-laws. Yeah.

Sumita Khatri, MD:

And I hate using that word because there's some connotation to it. But yes, three generation household and my sister-in-law, my husband's younger sister is a primary care doctor here. And she brings her kids over every day and so it's like it's a little bit like “Everybody Loves Raymond”. The door is always like who's here now, oh, okay. But now the girls drive, so it's not as chaotic. So yes, we're never really lonely, which is nice. But I think that atmosphere has shaped who they are obviously.

Cara King, DO:

Absolutely. You filled their house with love. You built your tribe around you and that way you could continue to focus at work. And the kids always felt loved and that's the most important thing.

Sumita Khatri, MD:

I highly recommend it if you can do it because it's nice. Because when you wonder about how you're doing as a parent and the grandmother says, "Wow, you're doing a good job. They're good kids." You have to find the right chemistry, of course not everybody is fortunate enough to have that. But I highly recommend a blended household. Hey, the Obama's did it.

Sumita Khatri, MD:

Other presidents did not.

Cara King, DO:

Yes.

Sumita Khatri, MD:

Yeah, but Obama's did it. And look how good their kids are too. So I just think that if they're around more people who give them the gifts of what they give them, they're better in the long run.

Cara King, DO:

So exciting. Well, I think that's all the time we have for today. Thank you so much again for spending your afternoon with us. You really touched my heart today and I greatly appreciate your time.

Sumita Khatri, MD:

Cara, it's been an absolute pleasure. Mary, thank you. And I hope somebody gets a little something out of this, if not it's at least a few laughs I hope.