How to find your way out of the slump with Dr. Inga Lennes

“I do think that the relationships we have, especially around work, are so important. And there is great research that shows that those relationships and being able to be vulnerable with at least a few people are what, A) keep us loyal to the jobs that we have, and B) keep us happy in the work that we’re doing, and C) help propel us to the next level of achievement in the things that we are hoping to achieve.” -Inga T. Lennes, MD, MPH, MBA Senior Vice President, Ambulatory Care and Patient Experience, MGH/MGPO

In today’s episode, Master Certified Coach Jill Farmer discusses slumps and how to get unstuck with director of clinical quality and director of ambulatory care at the MGH Cancer Center, Dr. Inga Lennes. Dr. Lennes shares with us her tips for getting unstuck when she feels like she is in a slump, you will hear the key things that she checks and then does when she is in a slump, so that she can move through it. First, she reminds us to take care of ourselves as well as we take care of others. Next, she reminds us that it’s okay to switch into neutral. Tune in to hear how Dr. Lennes accomplishes this, and to hear the rest of her sage advice for moving through a slump and from there, into our next exciting phase. We are thrilled to have her return to the podcast so we can further learn from her leadership and wisdom! 

Dr. Inga Lennes is the SVP for ambulatory care and patient experience at Massachusetts General Hospital and for the Mass General Physicians Organization, as well as a practicing thoracic medical oncologist and quality of care researcher.

She went to the University of Massachusetts Medical School and completed internal medicine residency training and chief residency at Beth Israel Deaconess Medical Center. Dr. Lennes completed a fellowship in medical oncology at Dana Farber Cancer Institute and joined the MGH and Harvard Medical School staff in 2009. At MGH, she has served as the director of clinical quality and director of ambulatory care at the MGH Cancer Center. In 2016, she joined senior leadership at MGH and the MGPO and has focused her administrative efforts on improved ambulatory access, operations and patient experience.

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Podcast produced by: Amanda Taran

Please enjoy the full transcript below

Dr. Inga: I do think that the relationships that we have especially around work are so important and there’s great research that shows that those relationships in being able to be vulnerable with at least a few people are what ‘A,’ keep us loyal to the jobs that we have. ‘B,’ make us happy in the work that we’re doing, and ‘C,’ help propel us to the next level of achievement in the things that we’re hoping to achieve.

 

[DocWorking theme]

 

Jill: Hello and welcome to DocWorking: The Whole Physician Podcast. We are so glad you’re with us today. I’m Jill Farmer, one of the cohosts of the podcast and a lead coach at DocWorking. Today, I am really excited to be joined by Dr. Inga Lennes, and Inga is the Senior Vice President for Ambulatory Care and Patient Experience at Massachusetts General Hospital and for Mass General Physicians Organization as well as a practicing thoracic medical oncologist and quality of care researcher. She went to UMass Medical School, completed internal medicine residency training, and chief residency at Beth Israel Deaconess Medical Center, and fellowship in medical oncology at Dana-Farber Cancer Institute.

 

You have been working as both a physician and a leader now for a number of years. Inga, thank you so much for being with us today. What we’re going to talk about today is something that I think so many of our physician listeners can really connect to, particularly, in this season of time that we’re in right now in the world of practicing medicine. I don’t want to say post-COVID, because I don’t think we’re quite post-COVID yet, but where we are, and that is what happens to you when you get in a slump. I want to know kind of how you define slump. What do we mean when we’re talking about somebody being in a slump?

 

Dr. Inga: Well, first, Jill, thanks for having me back. This is a great forum and I love being here. I think when I think about a slump as a physician, I have to preface this by saying probably what we’re not talking about is a diagnosis of depression or something that’s clinically treatable and diagnosable. But we’ve all been there when those parameters aren’t met. But we still don’t feel great and I would define it almost as feeling stuck, able to go about daily things in our lives that we do, but feeling like we’re not moving forward, or we’re not excited, or interested by what’s around us, or what we’re doing every day. That’s how I define a slump when I feel like I’m in one. 

 

Those are some of the things I think that as we see those characteristics coming together, should be a red flag that I’m not thriving in what I’m doing. I’m not engaged, I’m not energized, I’m not feeling excited about getting started with my day. We all feel apprehensive about challenges and challenging situations. But I always say to myself, if I can’t find something about the day that I’m excited about, or something about my upcoming work, or a project, or presentation, or something that’s going on that gives me some life, then I feel like, “You know what, I’m in a slump.”

 

Jill: I guess, in general, with anything we’re talking about feeling stuck around, the first tool that I try to give people is just to notice it. To pay attention to it, to not fight it, and to not use it as a vehicle to beat ourselves up. It’s just simply noticing is how we change things or how we move through things. So, I would guess that’s got to be a meaningful first step is to sort of lovingly pay attention to what’s going on, be willing to name it and notice it. What are your thoughts on that?

 

Dr. Inga: Absolutely. I think that physicians especially are used to working in fifth or sixth gear. We’re multitaskers by training or juggling a lot of different things. I do think that one place that sometimes what we forget to do is take a step back, as you said, and just notice what’s going on. I also think sometimes we have sort of a scientist brain. I think it is important to actually, I think about things like, “How many days in a row has it been since I’ve been happy, since I’ve smiled, since I laughed at work?” Even counting those days like as silly as it sounds, it helps me to keep track. Be mindful of how I’m feeling and how I’m engaging with the day, and it’s also a flag for me. 

 

When I see that a week has gone by, two weeks have gone by, and I’m dreading Monday, more so than like the usual Sunday blues, but really dreading starting the next week, it’s a flag. So, developing those checkpoints for yourself to say, “What is it for me that helps me pause and reflect on what’s going on around me, where am I?” Those will be I think unique for each individual, but there are things that you can develop for yourself. And those are just some of the things that I use to try and figure out where I am.

 

Jill: Yeah, brilliant. Once you have paid attention and created, it’s really too strong of a word but for lack of a better term, a benchmark, so to speak of, “Oh, this isn’t just a couple of days or maybe, whatever those other causes sometimes of being in a slump could be hormonal,” all of the other factors that are certainly part of that. And you’re noticing now this has been, as you said, a couple of weeks where, “I am just feeling like the spark, isn’t there? I’m not as jazzed up to do things that even normally I’m pretty interested in.” And again, not talking about clinical depression, but just kind of this sense of losing some of that spark, what are some ideas for where we can take that when we’re in that space, what we can do with it, and how we can move forward?

 

Dr. Inga: I always start with a quick assessment. You mentioned a few things, you even said hormonal, so biologic. Starting with the basics, some of the same way I approach patient care, or taking care of my kids, or some of those things, are our basic needs met. Am I sleeping, am I eating right, am I getting some exercise, am I drinking water? Like, I usually start with those basics, because we forget those first. We stop doing the things that keep us healthy and going. 

 

They don’t fix everything, but paying a little bit of extra attention, for me, it’s making sure I pack a snack with some vegetables and fruits. That always helps me feel like I’m getting back on track if I can do that. Making sure that I get some water in. Beyond that, it’s a quick analysis of what’s going on around me, being aware of what’s causing me the most stress, and for me, what on my calendar has me dreading things the most, what is it that I’m really not looking forward to? Those are the things that I try and pay attention to and use that as a signal for where I have to spend some time. 

 

I think the other thing is that, one of the key takeaways that I hope that people hear when we discuss this is that, a wise person once told me is “You can’t change directions until you stop moving in the direction that you are currently moving towards.” I think for physicians that can be really hard. So, part of this process of taking stock, making sure that our basic needs are met is also figuring out how fast am I going and in what direction and how do I pull back and slow down just a bit? Because we can’t make changes while we’re moving in a direction and oftentimes, we are moving in a certain direction, it may not be the one that we want to, we feel stuck but we’re still kind of the train wheels are trying to move forward. So, consciously taking a look at what’s on our plates trying to deliberately slow down the train’s wheels and come to a stop because that’s what needs to happen before we can start moving in a different way.

 

Jill: We slow down, change direction, pay attention, I love how you said. You kind of got to notice what’s the stuff that I’m dreading, what’s the emotion that’s coming up around those things on my calendar or these experiences, what’s my body telling me about how I’m feeling after certain experiences? Those can be really good navigational tools as how I would use it for discovering what some of these factors are that are driving you in to that stuck place. So, when you do stop and pay attention and notice that “Hey, I’m moving in this direction and it feels out of alignment.” I talk a lot with my coaching clients about life being a game of warmer and colder. Is this warmer or is this colder, right? So, when you’re getting those clues that this isn’t right, how do you make changes or how do you dare to do something differently? Especially, I think, I can hear the voices of many of my clients, “But what am I supposed to do, the schedule is set? The expectations are there? How am I supposed to make changes when I’m feeling in that stuck place?” What are your thoughts on that?

 

Dr. Inga: One of the things that I really like doing is trying to figure out how I can show up differently even for the same obligations. So, it’s not about slashing the calendar and looking at all the things that I can cancel, but I will sometimes deliberately say, “I feel a lot of friction in this meeting. I’m trying to move in one direction, somebody else is trying to move in another. I may not agree completely with some of the decisions that are being made, or I may feel ineffective, or I’m not communicating well. I’m letting you know some of the things that make me feel slumpy.” So, those are some of the things that when I noticed myself feeling that way, I get really unenthusiastic about showing up at work or to things that I have to do. 

 

One of the techniques that I found is really useful is to say, “I’m going to show up in this meeting, but instead of the regular stance that I have or the position that I have historically taken in this particular situation, I’m going to find a way that I can really support or be valuable to the group as a whole.” Sometimes that is being a great team member, not a leader. Sometimes, it means being deliberately kind and welcoming. I’d like to think that I’m kind and welcoming all the time, but sometimes I’m really focused on the job at hands. The things that I have to move through and get done and sometimes my way of making myself feel unstuck is showing up at the same things, but instead of getting into the same discussion that leaves me feeling a little depleted, I’m going to ask myself, “How can I show up in this meeting and be really valuable to the group, but not necessarily take the same stances or have the same conversations that I’ve had in the past? Can I find somebody else to support? Can I find somebody else to amplify, to lift up, to make sure that they’re being heard?” 

 

Sometimes taking a step back and doing something like that, number one, I think it shows your value. You’re showing not just your skills, but your value to the people that you work with, it shows your flexibility, the ability that you know, sometimes if you feel stuck that you’re not going to stop showing up, but you’re going to try and show up in a different way. Then lastly, I would say that, I find that those acts of being very purposefully generous and inclusive, they leave me feeling like I’m a good person that I’m doing good for other people, my colleagues, the world, and it creates at the end of the slump, goodwill. Because you will come out of a slump. It will happen. What I always think is, once I’m finished with this slump and I’m feeling energized again and ready to get back on top of my game, I want to come back from wherever it is that I’ve been, and I want people to still really appreciate me, and maybe even more than they did before, and have even better relationships than before. So, I think one place that I found where I can be useful is to just focus my attention. So, the goal of this meeting is to create collegiality and to lift someone else up. If I don’t get my way in other ways, if I don’t move my agenda forward, that’s my agenda for this meeting and then I feel better over time because I have let go of the things that I was trying to accomplish.

 

Jill: Oh, my gosh, you’ve said so many good things in just those couple of minutes. So, I might suggest everyone pause and rewind, and listen to that again because there’s so much good stuff. Just the idea that you said that kind of just pausing for a second and thinking about how do I want to show up into this, what’s the energy I want to bring into the room? Jill Bolte Taylor, the neuroscientist, who famously had a stroke that rendered part of her brain not working as it had before and she became really aware during her time of recovery of when she didn’t have language of the energy that people bring into the room, and I think sometimes when we’re feeling like we’re in a slump, it can just make us more negative. It doesn’t mean we’re bad people. It is a human experience, a feeling there. 

 

Taking a second not to be fake or false, but to think what’s the energy I want to bring into the room? And another friend, Margaret Webb, who’s a parenting coach, and somebody that we’ve had on the podcast as well a couple of times talks about “Intention, Attention, No Tension.” So, it’s this idea of paying attention to how you want to show up, of setting an intention for the kind of interactions you want to have, and what kind of a listener you want to be, what kind of a communicator you want to be, and then allowing yourself in that space of awareness to not be tense, right? Because a lot of times when we come into it without really thinking about it, we bring that tension inadvertently into the space. So, I think a lot of what you said really resonates with her words as well. 

 

I also love what you said at the end here. The human experience requires some ebb and flow. I think really, really highly capable, highly successful people, sometimes who are extremely internally driven, and I’m talking to you, all my doctor friends, [laughs] who are here, forget that this is a natural part of the human experience, and they tend to be extremely self-critical and sometimes even a little scared when they experience some of that ebb and flow of how they’re feeling, how much motivation there is, how much drive there is. So, recognizing that you know the resilience or research tells us that it’s important to recognize that some of these ebbs are part of the zest of life which means they don’t feel great, but they’re part of the whole experience. Is that what you meant by that last part or am I going in a different direction there? [laughs] 

 

Dr. Inga: No, absolutely. I agree with you 100%. I think that physicians especially can feel like a failure if they’re not at speed hundred at all times and leading the charge. The fact is, I have found in my life is that sometimes in those moments where you intentionally get a little quieter, get a little bit more generous, focus on how you’re going to lift someone else up, how you’re going to support someone who’s working with you ask a curious question, those are the times when we find another spark, and there’s something else that interests you, that moves you in a different direction. I have found when I’ve felt most stuck when I can get into that place where I’m really thinking about, you know what, I’m going to intentionally make sure that my job is to be a great team member. I’m going to spend some time listening, and I’m going to try and put somebody else first forward, make sure that they are amplified, and those types of times where I have been very intentional about that have paid dividends. Either because you’re demonstrating your value. I love thinking about the difference between showing your skills and demonstrating your value. 

 

I think physicians sometimes get really caught up in demonstrating skills, and showing your value is different, and you can have a lot of value by those skills that aren’t so loud. You know, that bring people together, that make teams work better, and some of those skills you have to work at. And part of the work is to be quiet, and to listen, and to do things a little differently. So, when I feel like I am stuck, one of the best things that has helped is to say, “You know what, I’m not going to focus on what I feel like I can’t accomplish right now and I’m going to try and move the ball forward in a different way.” It can be surprising to coworkers who might not always experience us that way. The loyalty, the camaraderie, the collaboration, those things, they get amplified tremendously when we take a step back and start to focus inward a little bit. 

 

Again, the focus of the slump or getting out of the slump is setting the stage for your next big rise. The thing that you’re going to do. The best advice I’ve gotten is we want to take those times in life to be quiet, to set the stage for the next big rise, the next big thing that’s going to happen in your life, what you’re going to lead, what you’re going to think of, what new direction you’re going to go, and the best thing we can do for our future selves is to spend a little time tilling the soil of our relationships, because those are the things that are going to grow us the best success in the future.

 

Jill: I think that’s beautifully said. I do think that leads to another point that I think we would be remiss if we left out of this conversation. As you said, nurturing relationships, sometimes when we’re in a slump, it requires us to get a little bit vulnerable with somebody who has earned our vulnerability as Brené Brown would say, “Not all the world has earned our vulnerability,” but for those who have a slump can be a really good time for you to reach out and say, “Hey, I’m feeling this way or I’m experiencing this,” and just in the act of kind of saying it out loud and having somebody else who has earned our vulnerability in a way that we know that they can hold the space, and listen, and know without trying to fix, or argue, or encourage us to wallow in it, any of the things that we know aren’t helpful, but that kind of willingness to get even just a little bit vulnerable, which again, I know is not always easy for physicians to do, it’s encouraged necessarily in various parts of the practice of medicine or in medical education. But it can be a really meaningful way when you’re feeling stuck to move forward is to have somebody that you can share that with. What are your thoughts on that? 

 

Dr. Inga: Absolutely. I love what you said about earning that vulnerability. If you don’t have someone who has earned your vulnerability, I think that is something to pay attention to. I do think that the relationships that we have, especially, around work are so important and there’s great research that shows that those relationships in being able to be vulnerable with at least a few people are what ‘A,’ keep us loyal to the jobs that we have, ‘B,’ make us happy in the work that we’re doing, and ‘C,’ help propel us to the next level of achievement in the things that we’re hoping to achieve. We have to find those people that we can be vulnerable with and even sharing some of what’s going on, some of the slump that you’re having, and trying to think together about ways not just to make the slump stop, but to address any causes of where you are, why you’re stuck in the first place. 

 

Again, what I would say is it’s an opportunity to be a bit creative to say, “What can I think about that’s a little different, what would I like to be doing that I’m not doing, what’s that meaning that gives me the most anxiety on my schedule, and what are some creative ways that I could try to change it?” In the meantime, again, I’m going to shift into neutral and I’m going to focus on lifting other people up like really making great relationships, showing my value, but that can be a resting place. I say that, that should be your neutral. If you need to downshift, you’re neutral is that place of being a fantastic team member and that’s okay. It’s all right to be in neutral, being a great team member for a little while, as you think about what’s next, and what gives you joy, what sparks your curiosity, what questions do you have, it’s fine to hang out there for a little while. 

 

Sometimes, just being there and being able to talk about it with someone who can help you strategize, and also support you through being in neutral, as I say, that can be somebody who can really help make your next pivot and propel you out of the slump, get you excited again about what’s happening. 

 

Jill: Beautifully said, again. I think, you’ve invited us into something that can be a little bit counterintuitive if we haven’t practiced it, which is some introspection, some creative ways to think about doing things differently instead of just pushing our nose to the grindstone and trying to do it harder and harder and harder in a way that doesn’t necessarily take us in any different direction other than digging a deeper hole for ourselves so to speak in where we’re stuck. So, sometimes that introspection and that willingness to look at things creatively and to put ourselves in neutral, which I think another way is kind of slowing down in order to look at things from a different perspective and to get a different lens on the vista if you will of what it is it’s going on. 

 

A lot of times then that leads us to a place where we need to communicate, maybe. Not always, but maybe we need to ask for what we need in a different way or have a conversation with someone and I had this great session recently with a physician client, and we ended up laughing really hard at the end, because what the physician was doing in this session changed all factors. We’ll call him Frank. He kept saying, “Well, I’m going to do this, and he was having all these ideas wanting to do because I think then, my leader is going to be thinking this and I think then he’ll want to do this.” I said, we just have a conversation with this person instead of all of this dancing around trying to figure out what he might think or not think in these settings. 

 

I think sometimes it’s like, there’s a lot of dancing around whatever the cause of the slump is, instead of sometimes having just a meaningful direct honest, authentic conversation, where you exercise just a little bit of agency by saying, “I think this is what I need in order for me to move forward.” Thoughts on that as a leader?

 

Dr. Inga: I find that those types of conversations are really refreshing, honestly and I want to actually say that because I do think that there’s a lot of swirl sometimes that physicians get into thinking about what if I say this and then they say that, and then working down what I call the algorithm of all the possible responses. As a leader who people have come to saying, “I just don’t feel energized in this work anymore” or I feel like, “I’m in a slump or I just can’t quite get past this barrier.” I will say that a great boss wants to help you. I like it when people come to me and are honest about some things like that because I say there’s so much I don’t know every day about what’s going on, but I feel like my job is to reduce challenges. My job is to hire great and then to break down barriers so that you can be the best employee that you can be. That is my entire job as leader. So, if I never know what challenges you’re feeling, I can help.

 

I think that there’s a lot of leaders out there that want to help. I want my team to feel like they are running on all cylinders that they’re really fulfilled, that they’re making meaningful change, and doing great work, but if you feel like you hit a slump, I can’t help. So, first of all, I want to encourage people. If you feel like you have the right relationship with your leader or boss to go ahead and say something, because I think there’s a lot of people out there really eager to help to reduce the things that might cause the slump. 

 

The second is, that you might find that there’s a different perspective that you haven’t even seen yet. I’ll speak now from my own experience. When I feel really stuck, especially at work, some of the most valuable advice I’ve gotten is from my leaders. They have a view of vista that I don’t have and so oftentimes I think that have me really jazzed up or just really feeling stuck, I may not appreciate some other nuance to the view that I can’t see yet and I have had so many conversations, where I started a conversation, explained a little bit about how I was feeling stuck in something, and then got a piece of information that made it evaporate because I just didn’t know that piece of information. They didn’t know that I didn’t know it. 

 

Again, this is so basic but that constant, respectful, and open channels of communication before you start feeling really bad about things are really important. Sometimes, we have to manage up a little bit to teach the people who manage us about that great communication, but now that you see the value in that and you can experience it, that’s something that we can affect around us by eliciting some of that communication and helping us not feel stuck at someplace where just a little bit of information and discussion could make that feeling evaporate.

 

Jill: Absolutely. Final thoughts that you want to leave our listeners with when it comes to that idea of being in a slump and how to move through it?

 

Dr. Inga: I would say in summary, number one, treat yourself as well as you would treat the people that you take care of every day. Attend to the things that are important. Are you getting enough sleep, are you eating well, are you drinking water, are you doing those things that make you happy and feel healthy? Number one. 

 

Number two, it’s okay to shift into neutral to say, you don’t have to lead this project, you don’t have to force your agenda, you don’t have to be recognized as a leader all the time. Sometimes demonstrating your value is about the relationships that you create, and the other people that you’re able to lift up, and the work that you do together. Shifting into a neutral spot where you can focus on those things instead of moving, for instance, your agenda through, can be a really generative place for you that will pay dividends in the long run. 

 

Then, lastly, I would say, communicate, communicate, communicate. You can’t communicate enough with not only the people that you manage, if they are in slumps to make sure that you’re giving that piece of information that helps them move through it and breaking down barriers, but also having good conversations with the people who are your leaders as well. Letting them know about the places that you might feel stuck because they can be really useful in helping you move through that too, if you feel comfortable in sharing that vulnerability with them.

 

Jill: We are so fortunate to have been able to tap into your really infinite wisdom. Dr. Inga Lennes, Senior Vice President at Mass General Hospital, leader as well as a practicing oncologist, thank you so much. It’s been inspiring and really meaningful and I know a lot of your wisdom here will be one of those things that our listeners go back to time and time again. I think listening to this is my final piece of advice every time you feel like you’re in a slump because I think there’s just a lot of really meaningful and impactful information. So, thank you so much for being here. 

 

Dr. Inga: Thanks, Jill. 

 

[DocWorking theme]

 

Jill: Thanks to all of you for joining us. Tell your friends, we love having these conversations. Until next time, I’m Jill Farmer and this is DocWorking: The Whole Physician Podcast. 

 

Life as a physician can be packed with pressure. Let’s face it, it’s stressful. When everyone says, you should manage your stress, but how do you do that? Everyone needs to be less stressed, but it could be a mystery how to get there. The good news is there are proven ideas and techniques that you can put into action today that can lower your stress. You just need the right coach to help you put those tactical-practical tools into action. And you need an experienced coach who’s worked with physicians and helped countless doctors put these ideas into play in their daily life to see big results.

 

Amanda: I’m Amanda Taran, producer of DocWorking: The Whole Physician Podcast. Thank you for being here. Please check us out at docworking.com and please don’t forget to like and subscribe. Thank you for listening.

 

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