Interview with Dr. Barbara Loeb
Dr. Barbara Loeb shares the healing power of poetry in this interview. She is an author, speaker, mentor, facilitator, and physician leader. And she is committed to promoting well-being, especially for people working within healthcare.
She believes that individuals devoted to caring for others often fail to take care of themselves. Her work is now focused on inspiring caregivers to do just that.
Dr. Loeb started her 40-year career in health care as a primary care physician growing an internal medicine group practice. To have a larger impact, she expanded her work into medical staff leadership roles as department chairman and medical staff president at Advocate Good Samaritan Hospital, part of Advocate Aurora Health.
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Consultant and Chief Medical Officer
After transitioning her practice to become part of Advocate Aurora Health, she moved into a number of chief medical officer roles for other health systems, hospitals, physician networks, and health plans. She also served as an independent consultant for the Studer Group, improving physician communication and leadership skills.
During her career, she became highly aware of the balance she had to maintain between her work and her personal life. From all these vantage points, she observed the fatigue, lack of self-care, and burnout that many peers experienced.
The Healing Power of Poetry
In her first book “How to Save a Life: Healing Power of Poetry,” Dr. Loeb utilizes the principles of presence, reflection, self-awareness, and self-compassion to create poetry that displays the personal healer’s journey. She inspires the reader to reflect on their own individual path to well-being. By sharing her poems and introspective travels, she reveals the great strength one can build by engaging in this process.
To cultivate her own well-being, she developed her own restorative ritual. It combines mindfulness, writing, and building deeper connections with patients and colleagues. She intensified this practice during the challenges of the pandemic.
Today, Dr. Loeb shares this knowledge with colleagues through speaking, writing, mentoring, and facilitating groups. Her focus is on building mindfulness and promoting narrative medicine and related initiatives. She notes that the healing power of poetry is a metaphor for it's effect on her professional and personal journeys.
Summary
Dr. Barbara Loeb describes her transition to the most recent chapter in her life. Some might call it retirement. However, Barb feels as productive as ever. And she is having a positive impact on those around her while doing what she finds meaningful.
NOTE: Look below for a transcript of today's episode.
Links for Today's Episode:
- Dr. Barbara Loeb's Website
- How to Save a Life: Healing Power of Poetry on Amazon [this is an affiliate link]
- Mindful Practice in Medicine at the University of Rochester
- Narrative Medicine: An Opportunity for Empathy, Reflection, Profession, and Trust. Rita Charon, MD, PhD
- Maven Project
- NewScr!pt
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Transcription PNC Podcast Episode 228
How the Healing Power of Poetry Saved My Life
John: Dr. Barbara Loeb.
Dr. Barbara Loeb: Hi, John. I'm glad to be here today.
John: It's good to see you again. We're doing a video just so we can do the interview. I remember talking to Barb very clearly because she was doing something at the time that was near and dear to my heart because I had been in hospital administration for a while. But today's interview can go in a little different direction. I think you'll all enjoy this.
With that though, tell us a little bit about yourself, the thumbnail version, and your background. What's been going on since we talked to you over two years ago?
Dr. Barbara Loeb: Well, John, two years ago when we talked, we talked a lot about how I prepared myself to take the plunge into executive physician leadership and gave some advice, but I didn't really realize at that time that I was beginning to go in another direction. There was an undercurrent there even long before the world changed for all of us, that something was sort of peaking. And I wasn't really aware until a few months later, things sort of started to happen.
John: Yeah, looking back there was nothing. I think there had been a little bit of a transition, there was a gap there, but I hadn't really heard that you said anything related to what we are talking about today based on what I know. I really want to see what's changed and learn more about what you've been up to. So, tell me more about that.
Dr. Barbara Loeb: Well, first of all, I had a change in my career path, which was the first thing that happened, but simultaneously I actually had a little bit of change in my physical health. I had a back problem. I've had spinal stenosis surgery several years back. Actually, it's been almost eight, nine years now. But I started to have some relapse. And I realized at that time that I had spent my life really in a cycle of constant doing. First, as a young doctor, running with my kids to daycare, then to the office and writing prescriptions, seeing patients, and making a lot of critical decisions that were life and death and had to be done right now. And when I transitioned into a physician leader, I did the same thing just with a different focus. And at this time, right after we talked, I realized that it was time to take a pause. That I had spent my life focused on others and I needed to turn a little bit more towards what I needed to have my own well-being improved.
John: Okay. It seems like it's a common thing that comes up for physicians, obviously because we have this kind of shared pathway we go through during our careers and our lives. And for some of us, it comes earlier than others, but it sounds like a common thing. It'll be interesting to see what you've learned and share with others that are listening today. So, when you notice that, what kind of steps did you take to change or to do something different?
Dr. Barbara Loeb: Well, the first thing I decided to do was to move away from my administrative role and I decided to focus more on promoting wellbeing for myself and wellbeing for others in healthcare who were like me, who had not really attended to their own needs. I wanted to find a way to become more grounded and present and connected with myself. I turned back to the practice of mindfulness.
John: Okay. Now back to the practice, was that something you had done before or was this a new thing?
Dr. Barbara Loeb: When I was young, I had done a lot of mindfulness and my mother actually was a Buddhist. And I used to meditate and I used to do a lot of very creative things as well. They had all fallen by the wayside with this career of producing and the pressures and stress of the healthcare profession. And so, I thought, well, maybe one way would be to go to a retreat. And I signed up for a Zen retreat in California, a place called Deer Park Monastery that was founded by a very famous monastic Zen master Thich Nhat Hanh which many of you may have heard of.
And I also simultaneously started looking at ways that people were using mindfulness for healthcare people. There's a program out of the University of Rochester school of medicine, where they use mindfulness techniques in training to help physicians and connect with their patients and their colleagues and prove their resilience as well as their care. Those were two paths I started on simultaneously.
John: Okay. So that reminds me, I've had other guests that have been involved heavily with meditation. Some of them teach meditation. These are physicians. There's something about, I don't know, being so focused on intellectuality or concrete things and science and that some of us abandon the softer parts of our learning. And boy, that's pretty interesting though, that your mother was a Buddhist because there's a lot of knowledge there about how to approach this.
Dr. Barbara Loeb: Yeah, she was. And my husband said that my mother's name was Judy, and he said, "Well, the Judy in you is coming out now, you're interested in art and poetry and meditation". I guess the Judy was coming out of me. I know it was the genetics or the background, but one of the things that I'd like to turn back to for a moment, as you mentioned about science, and this is a softer side. Yes and no, because there's a lot of science now about mindfulness. And if you study the works of Daniel Goldman or Richie Davidson, the neuroscience shows that cultivating mindfulness actually has a physiologic neurologic effect on your brain. And that our brain has neuroplasticity, the ability to grow and change.
We used to think the brain was like a fixed organ and that nothing would change, but there's been a lot of scientific evidence that the brain does change. And that long time meditators have thickening of their neocortex frontal lobe, which is our center of executive function. There's a lot of science now that shows that this can help us and also suppress some of our lower brain functions, a fight-flight-freeze, and the emotional overload that we have in these terribly difficult times and difficult challenging careers that we have in medicine.
John: Okay. I'm going to ask a little more about this because I want to get your perspective on it. Of course, meditation and mindfulness are not exactly the same thing. Is it? Maybe mindfulness is a form of meditation. What is your take on that? Explain that to some of us who are novices.
Dr. Barbara Loeb: I think meditation is a form of mindfulness. I think mindfulness is sort of an act of paying attention on purpose, being aware, being present, and allowing yourself to connect to what is actually here in the present moment, sensations, even thoughts. It's not eliminating any of those things, and it's not going up to the Himalayas and saying, "Oh, it's actually just focusing your mind and attention back onto the present moment, the things around you".
John: I know little about it, but I did read about it for a while. I've read several books about Buddhism and so forth. And the one time I decided to use it, I'm just giving my own example, this was 20 years ago, but I was very depressed, I was burnt out. I was going through a divorce. It was a lot of anxiety, a lot of thoughts that were out of my control seemingly. My approach to mindfulness was simply, if I was driving, I would focus on the license plate in front of me, focus my hands on the wheel. I'd go home and I earned a shirt and I would focus on that or I would chew a French fry and I would do it very slowly and I'd feel the crunch and the oil come out. Everything was focused on exactly what's happening right now. That's my take on my own personal use of mindfulness.
Dr. Barbara Loeb: Well, I wouldn't necessarily recommend it while you're driving, maybe at a stoplight when you're waiting for it to turn green. There's a common exercise about noticing when you're at a stoplight or waiting in a line, but I was wondering, well, how was that for you?
John: Definitely, it would just push all the other thoughts out of my mind. And then I would relieve a lot of those physiologic responses. And I've thought about in the past trying to meditate or to take a course or something, and I haven't, but that's the closest I've come to it. I know a lot of people though, that have used it extensively and have been very pleased and have physically and emotionally, and mentally felt better.
Dr. Barbara Loeb: Well, yeah, one of the things that you can do, or that is part of mindfulness is within your daily activities, as you mentioned. But sometimes as for instance, if you're a nurse and you're working in a COVID unit and you're very overwhelmed and you're just continuously doing things, taking care of patients. If in a moment, as you're walking from room to room, you begin to notice the sensation of your feet on the ground, or when you wash your hands, you feel the sensation of the water and the soap.
That gives a moment of you becoming back present in your own body, and also gives you a chance to decompress from this constant, "What do I have to do next?" And there's a lot of stress. Bringing yourself back into your body with sensations has a very calming effect and helps you build your resilience to face difficult times. So you can do things in your daily activities, such as some of the ones you did, some of the ones nurses and doctors and others caretakers can do. People find a very positive effect of doing that.
And then also when you're in a situation, you are able to notice what the sensations are of your body. Like, for instance, if you're in a conflict or you're in a situation where someone has died, your grief of loss, when you notice what's coming up in your body, you can actually sort of lean into it and ease some of that and give yourself a moment. You don't just have automatic tightening and clenching and different things that don't help your wellbeing. There's a lot of benefits to it in just daily life.
John: All right. I want to pause for a minute now, only because I know that you have a website. Do you address some of this on the website? Do you have some of the articles you've written?
Dr. Barbara Loeb: My website right now is more focused on my poetry. But I would like to expand into some of these other areas, neuroscience, et cetera. I would recommend if someone's interested in neuroscience to look into the Healthy Minds program from the University of Wisconsin in medicine because Dr. Richie Davidson is in charge of that. And then there's also for caregivers and doctors, and the healthcare people, there's the mindful practice program in the University of Rochester that talks about healthcare. There are a lot of things out there and you can certainly contact me if you want to hear more information about what programs are out there.
John: Excellent. Well, you did just mention the poetry. So let me just give the website, first of all, mind2heal.com. We'll do it again at the end. Somewhere in this process that you've described now, you did get into writing specifically writing poetry, which will be described on that site. Tell us how that happened and what was that process like?
Dr. Barbara Loeb: Well, it was interesting. There actually were three phases and I've turned it into what the three intentions for my book are because in mindfulness, we talk about beginning with what your intention is. Really the first writing came about at that retreat I mentioned. And the monastic was talking about in a hundred years from now, your name, your face, your voice, no one will know your identity that we all think is so important. Our name up in lights, it's so critical. No one will know who Barbara Loeb is, or John Jurica is. No one will know us.
So that actually freaked me out a little bit. And I thought, well, my great-great-grandchildren will be asking their parents who this Barbara person is. And I decided I needed to send them a message. I wrote my first poem, which was called "To All Generations with Love". And it was basically sending a message into the future that I'm with them, even if they can no longer know who I am. So that was the beginning of writing poetry. But I didn't know at that time that it was going to be a book.
John: Ah, so then you kept writing, right? Apparently.
Dr. Barbara Loeb: Well, what happened then was the pandemic hit. Not a good time. Like many of you, I was already trying to figure out what my next life was. They always say in your previous life you figure out your next life. And I already told you about the first two lives and I was in my third life. And then the pandemic hit and all the plans I had, like everyone else, were destroyed. And in addition, unfortunately, I had some really significant losses. My father passed away of COVID in the first month of COVID on his 90th birthday in isolation. I couldn't be with him. He was in the hospital. They didn't have anything to treat him at that time. And then my mother-in-law, my husband's mom got COVID and she survived the COVID, but then it was downhill and she passed.
And in the middle of all that, my two-year-old grandson got hit by a car. And my husband and I had to rush to Colorado before vaccines were available and take care of the other four kids. They are five siblings. He luckily survived, but it was pretty stressful. It was a spinal cord injury. I realized I really needed to look at how to heal myself. And poetry, mindfully sitting, reflecting, and writing was very healing for me. And it opened the time that I hadn't spent in all those 40 years in healthcare to actually attend to my own self-care.
John: Okay. That kind of tells me that the title is very similar to what you just said. The healing that occurred because the title is "How to Save a Life: Healing Power of Poetry", right?
Dr. Barbara Loeb: That's right. And I always thought that I would write something or do something that would help healthcare people and their healing process was always healing others. And I realized that this poetry writing in a sense saved my life from going into a downward spiral in these really difficult times because it energized me and gave me a feeling of uplifting and hope. That was actually the second intention of the book. It was saving my own life with the healing power of poetry.
And also, it sorts of brought me to what I call the third phase or third intention when I realized that there were other people will like me, many, many, many thousands and thousands of doctors, nurses, and others that had spent so much time caring about other people, caring for other people that they had left themselves not attendant. And I thought, well maybe if they see my journey, this can help save their life metaphorically speaking, by connecting them with their inner wisdom and inspiring them to write or paint or do whatever it is, or even just sit and reflect and release their own ability for creativity and healing. The third intention was to share the methodology with others, for promoting their self-healing.
John: I don't want to get into too much detail, but how was that? What was it like? Was it difficult to turn those that you had written into a book to get the book published or self-published? Just a couple of sentences on that.
Dr. Barbara Loeb: It was a journey and I'm glad to connect with anyone who needs advice on that. I first published it through Amazon Self-Publishing. By the time I decided to make the book in my phase three, the third intention, I had a lot of poems already that I had written. In part, I had the material, but I had to do the editing and I used an independent vendor called Fiverr to edit and to format, which was very helpful. And I used my mother's artwork as an illustration. So that was really fun because it was a journey into the legacy of my family and I put it all together. It took a little bit, but there were a lot of good YouTube videos out there and webcasts that helped me and gave me advice on how to do it. I was able to accomplish it. I actually put the whole book together in less than six months.
John: Nice, nice. But you had already written a lot of it before that, right?
Dr. Barbara Loeb: Yeah. I had written the poems. I had to do the prolog and the introduction. And then at the end of the book, I actually have an appendix that explains
every poem, just a few sentences saying where I was when I wrote it, what I was thinking, what my intention for that particular poem was. And a lot of people have found that very helpful. Although the poems are not abstract, they're pretty clear. A lot of people like that little extra background.
John: Nice. Okay. So, I've interviewed many people that have written books, some self-published, some published by national companies, and things in between, but I don't usually have people read from their books. But I thought, wait a second, if you've got a book of poems, we should be able to have you read one of them for us and really give us an example of your poetry.
Dr. Barbara Loeb: I would love to.
John: All right, let's do it.
Dr. Barbara Loeb: Yeah. I picked out one that is relatively short and it's about how we're driven from one thing to another. And I realize that the ability to change anything or do anything is to first become aware of the cycle of doing that I was in and that I'm in. So, it's called "Shiny objects".
"I'm floating in a sea of uncertainty, beneath the surface among shiny objects. Reaching for one I'm distracted by another. Turning back the first one disappears. Dazzled by yet another and another. I try to scoop them up, they slipped through my looped arms, gracefully dancing in slow motion just out of reach. I turn and search. My goggles are clouded. I swim to the surface gasping for air with one deep breath and one deep pause. I dive down again and again."
John: Thank you for doing that. I don't read a lot of poetry, but I always imagine that I'm not reading it necessarily the way the poet wrote it and with the inflection and the timing. And it's nice to hear someone actually read their own poetry and get the feeling and how it was. Because poetry has a certain rhythm to it.
Dr. Barbara Loeb: Yeah. Well, I like reading it to myself because it reminds me of what I was thinking and what my intention was. And I hope that it inspires that in someone else to think, "Gee, I've been there".
John: Right. Now did you write poetry when you were younger? Was that part of growing up? Because it's sort of like, well, someone just starts writing poetry? Tell me about that just as an aside.
Dr. Barbara Loeb: When I was a teenager, I wrote a number of poems, including one that was like your epitaph. My teacher said, write your epitaph. But in the front of the book, I actually have a poem that I wrote when I was like 14 or 15 years old. I did write poetry then, but then there was a big gap. I journal from time to time over the years, but then life got in the way of anything creative and all I did was work, work, work, and raise my children and take care of my patients and become the executive and all those things. And there was no space.
John: Right. This has been quite a journey so far that you've described, but I know from briefly talking to you before we actually set up the interview today that it's kind of led into some other things. And we do have time here, so maybe you can tell us some of the other things that you're involved with that my listeners might find interesting.
Dr. Barbara Loeb: I definitely would love to. The first thing that came about was when I was talking about mindful practice. I originally was looking into how we can help other healthcare folks through mindfulness. I got involved with a program called Mindful Practice out of the University of Rochester school of medicine and dentistry. It's started by two physicians that are general physicians, Dr. Ron Epstein and Dr. Michael Krasner.
And basically, it talks about bringing mindfulness narrative, like the stories and dialogue into healthcare so you can connect better with yourself, your patients, and your colleagues. And I trained as a facilitator of this program. I would recommend it as something to check out. There are retreats and remote programs that people can attend. So that's the first thing I've been involved in. And also at the same time, I got involved with a narrative medicine program. I'm sure you're going to ask me what narrative medicine is.
John: Yeah, exactly.
Dr. Barbara Loeb: Narrative medicine focuses on bringing what is called narrative competence into healthcare. Narrative competence means the ability for a person to acknowledge, absorb and interpret the accent stories and the plight of others around them, whether it be themselves, their patients, or their colleagues. That philosophy, that discipline was started at Columbia University with Rita Sharon. And she's really sort of the person who coined narrative medicine, but now it's quite spread throughout the country. And a lot of medical students and medical centers have courses in narrative medicine, which focus on close reading and reflective writing.
The program I've been involved with is through Advocate Aurora Health. We have a narrative medicine group that meets twice a month. And what we do in that group is we start with a meditation, a mindfulness reflection of some sort, and then we have a writing prompt. It's something that inspires us to write. And then we share in breakout rooms and then we have a closing reflection or meditation. And that has been very helpful in sort of stimulating me to write and bonding with a community of people. Just like the mindful practice, also a community of people that have like minds, that want to cultivate mindfulness. And this group created creativity and writing and humanities in healthcare.
John: Okay. Now you said two phrases that I'm not sure I know what they mean. Closed reading and reflexive writing. What was that?
Dr. Barbara Loeb: Okay. Close reading means when you read something more in a mindful fashion. In the very classic narrative medicine groups, they actually do a little more disciplined work around reading pieces whereas in an advocate auroras group we're a little bit more informal. But in classic narrative medicine, they have a particular way they read from the literature and then they write reflectively, meaning what comes up after the reading is a reflection in a way. And they do that in a more disciplined way. In our group, it's a little bit more open.
And we actually also have people in our group that are not directly healthcare workers, because everyone is part of the healthcare system on one side of the stethoscope or the other. It really helps by actually duplicating the relationship that you would have with the patients. We have to be able to relate to people regardless of what our role is and diminish that hierarchy of doctor-patient because that actually sometimes gets in the way of good communication and understanding of each other's stories.
John: That makes sense. If you're doing narrative medicine and are following the principles and you're not including the patient, it makes sense to be involved with people. Of course, we could all be patients too, but we have a different jargon than the average patient. It would be nice to do that together.
Dr. Barbara Loeb: Yeah. I don't know if you have time to share this, but there are two things clinically that have been done that have been very helpful related to this type of discipline. Our narrative medicine group's founders, his name is Dr. David Thoele, and also Marjorie Getz. They're the two founders of that group. Dr. Foley is a pediatric cardiologist and he's created a three-minute mental makeover where what he does is he works with the patient and the patient's family and they write three things they're grateful for, summarize our life in six words and three wishes if they had Aladdin's lamp. And that process of writing and reflecting with patients changes the dynamics between the caregiver and the patient and creates a synergy, a relationship, a communication that really helps care.
And then the other one I wanted to mention is Dr. Joshua Houser, who is out of the Jesse Brown VA and Northwestern Memorial Hospital. He has a program called Poetry for Veterans. And what they do there is they read poetry with veterans. Particularly, he's in palliative care, so some of them have very severe diseases. And they've witnessed a change in the patient's perspective about their own life story and how they relate to their caregiver, how they relate to each other, not just as in a medical way, but as humans. And they also do that kind of thing with their staff. Those are two examples of reading and writing together that have introduced a different level of human connection into healthcare.
John: All right. Well, that's a lot to get my brain around, but it's very helpful. Thanks. Because I can look those things up and I will actually include some links to those as well for listeners that are interested.
Dr. Barbara Loeb: There was one more thing that I'm doing if you have time.
John: Sure.
Dr. Barbara Loeb: It's called the Maven project and it's a non-for-profit telehealth organization that supports free and charitable clinics and federally funded clinics. And we have peer consults, specialists can give peer-to-peer consults on difficult cases for these providers in these clinics of need. We do mentoring for healthcare folks, doctors, nurses, others, and we do medical education including a weekly or biweekly COVID education. So that's a group of seasoned physicians. And actually, we've engaged them now in our writing narrative medicine program as well. But their main program has focused on helping these free and charitable clinics by supporting their providers, their clinicians working there.
John: What would the mentoring most commonly be related to if somebody needed some help with something?
Dr. Barbara Loeb: There are two types of mentoring that I do. The first one is leadership mentoring. I use my background as a CMO and medical director for other physicians that are in these clinics that don't have the funds for professional mentors. They can't hire an agency or firm to do that. I use my professional background and I've mentored for my professional organization and others organizations. I use that background to mentor them, to help them reveal for themselves what their leadership path might be. And like in episode 93, if they're trying to make transitions, how they might do it.
And then we also do clinical mentoring. I mentor nurse practitioners that are in areas where they may have simpler clinical questions, but they don't have access to a clinical mentor right there. So, they'll present me with cases. I'm an internist for those who might not know. So, they present me with basic internal medicine cases and we just talk about what they might do. And if they need a specialty referral, I can refer them to one of our Maven project specialists, and then they can have a more in-depth conversation about the patient's issues.
John: Awesome. I will definitely put a link to the Maven project in the show notes as well. It's a lot to be doing, a lot on your plate, but it sounds like it's not stressing you out. You're feeling pretty good about
it all.
Dr. Barbara Loeb: I feel good. I think one of the things we all have in common, whether we're still pursuing a clinical career, a leadership career or other careers, because I know that's been the topic of conversation for you and other podcasts, we all have this deep desire to help other people and to share what we've learned. And these are just other pathways that I've used that I'm using to continue to do that because that also energizes me, not just the self-reflection, but what I could inspire someone else to feel or do or heal. It's very uplifting for me. Although sometimes it seems like a lot to me too, it's still very helpful in my own personal journey.
John: Very nice. I guess I wouldn't say that you're retired because you're doing so many different things. I'm supposedly retired now. I did my last clinical shift a month ago. But everyone that I've ever talked to, particularly physicians that are so-called "retired", they're as busy as they ever were. It's just how it goes.
Dr. Barbara Loeb: Yeah. I always wonder what the word "retired" means. Does that mean we all went to sleep suddenly?
John: Hopefully not. Well, it might be a good sleep.
Dr. Barbara Loeb: We need the fairy dust for the prince charming to come and kiss me and wake me up.
John: Yeah. Well, before I let you go, though, we are getting to the end. I just want you to maybe think about my listeners. They're basically physicians for the most part who sometimes are frustrated, they're burnt out, they're looking for other options. Not that I really want every physician to not take care of patients because we all need physicians. But anyway, if you have any advice and basically what you've learned over the years, including the last four or five years, what advice would you have for them if they're feeling kind of frustrated and not really good?
Dr. Barbara Loeb: Well, my advice is sort of simple. I think the first step is to just take one breath and because we've been holding our breath for at least 20 months. And I also like to share this quote that sometimes is attributed to Victor Frankel. Although I hear that his family says he didn't say it, I still love the quote. "Between stimulus and response, there is a space. And in that space, we have the power to choose our response. In our response lies our growth and our freedom."
What I would suggest to people is to find a moment to pause, notice, and reflect and go into that space so you can uncover really the wisdom that you most likely already have, but just haven't had the time to connect with it. And whatever it is, whether it's creativity or other things, you will be energized and move forward by that. Maybe doctors like to have a 1, 2, 3 plan of what to do, but I think we just have to stop first and allow ourselves to find what we already know. So, one breath.
John: All right, good advice. Slow down, take a breath and pay attention. Excellent. Well, Barb, I think I've taken up enough of your day so far, but we've learned a lot. I'm going to put links to everything. I would definitely say that listeners, you should visit the website. www.mind2heal.com and go to Amazon and look for the book. Again, there'll be a link to that. At mind2heal.com there are several different things that people can learn and see about the book. I think you've got some video deals where you're talking about different things related to what we've discussed today. Does that sound good? Did I miss anything?
Dr. Barbara Loeb: No, that's perfect. I really appreciate the opportunity. And it's been a lot of fun being with you again. I haven't seen you in so long. I haven't talked to you in so long. Thank you so much for allowing me to share this with the listeners. Thank you.
John: It's been my pleasure.
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Transcription PNC Podcast Episode 228
How the Healing Power of Poetry Saved My Life
John: Dr. Barbara Loeb.
Dr. Barbara Loeb: Hi, John. I'm glad to be here today.
John: It's good to see you again. We're doing a video just so we can do the interview. I remember talking to Barb very clearly because she was doing something at the time that was near and dear to my heart because I had been in hospital administration for a while. But today's interview can go in a little different direction. I think you'll all enjoy this.
With that though, tell us a little bit about yourself, the thumbnail version, and your background. What's been going on since we talked to you over two years ago?
Dr. Barbara Loeb: Well, John, two years ago when we talked, we talked a lot about how I prepared myself to take the plunge into executive physician leadership and gave some advice, but I didn't really realize at that time that I was beginning to go in another direction. There was an undercurrent there even long before the world changed for all of us, that something was sort of peaking. And I wasn't really aware until a few months later, things sort of started to happen.
John: Yeah, looking back there was nothing. I think there had been a little bit of a transition, there was a gap there, but I hadn't really heard that you said anything related to what we are talking about today based on what I know. I really want to see what's changed and learn more about what you've been up to. So, tell me more about that.
Dr. Barbara Loeb: Well, first of all, I had a change in my career path, which was the first thing that happened, but simultaneously I actually had a little bit of change in my physical health. I had a back problem. I've had spinal stenosis surgery several years back. Actually, it's been almost eight, nine years now. But I started to have some relapse. And I realized at that time that I had spent my life really in a cycle of constant doing. First, as a young doctor, running with my kids to daycare, then to the office and writing prescriptions, seeing patients, and making a lot of critical decisions that were life and death and had to be done right now. And when I transitioned into a physician leader, I did the same thing just with a different focus. And at this time, right after we talked, I realized that it was time to take a pause. That I had spent my life focused on others and I needed to turn a little bit more towards what I needed to have my own well-being improved.
John: Okay. It seems like it's a common thing that comes up for physicians, obviously because we have this kind of shared pathway we go through during our careers and our lives. And for some of us, it comes earlier than others, but it sounds like a common thing. It'll be interesting to see what you've learned and share with others that are listening today. So, when you notice that, what kind of steps did you take to change or to do something different?
Dr. Barbara Loeb: Well, the first thing I decided to do was to move away from my administrative role and I decided to focus more on promoting wellbeing for myself and wellbeing for others in healthcare who were like me, who had not really attended to their own needs. I wanted to find a way to become more grounded and present and connected with myself. I turned back to the practice of mindfulness.
John: Okay. Now back to the practice, was that something you had done before or was this a new thing?
Dr. Barbara Loeb: When I was young, I had done a lot of mindfulness and my mother actually was a Buddhist. And I used to meditate and I used to do a lot of very creative things as well. They had all fallen by the wayside with this career of producing and the pressures and stress of the healthcare profession. And so, I thought, well, maybe one way would be to go to a retreat. And I signed up for a Zen retreat in California, a place called Deer Park Monastery that was founded by a very famous monastic Zen master Thich Nhat Hanh which many of you may have heard of.
And I also simultaneously started looking at ways that people were using mindfulness for healthcare people. There's a program out of the University of Rochester school of medicine, where they use mindfulness techniques in training to help physicians and connect with their patients and their colleagues and prove their resilience as well as their care. Those were two paths I started on simultaneously.
John: Okay. So that reminds me, I've had other guests that have been involved heavily with meditation. Some of them teach meditation. These are physicians. There's something about, I don't know, being so focused on intellectuality or concrete things and science and that some of us abandon the softer parts of our learning. And boy, that's pretty interesting though, that your mother was a Buddhist because there's a lot of knowledge there about how to approach this.
Dr. Barbara Loeb: Yeah, she was. And my husband said that my mother's name was Judy, and he said, "Well, the Judy in you is coming out now, you're interested in art and poetry and meditation". I guess the Judy was coming out of me. I know it was the genetics or the background, but one of the things that I'd like to turn back to for a moment, as you mentioned about science, and this is a softer side. Yes and no, because there's a lot of science now about mindfulness. And if you study the works of Daniel Goldman or Richie Davidson, the neuroscience shows that cultivating mindfulness actually has a physiologic neurologic effect on your brain. And that our brain has neuroplasticity, the ability to grow and change.
We used to think the brain was like a fixed organ and that nothing would change, but there's been a lot of scientific evidence that the brain does change. And that long time meditators have thickening of their neocortex frontal lobe, which is our center of executive function. There's a lot of science now that shows that this can help us and also suppress some of our lower brain functions, a fight-flight-freeze, and the emotional overload that we have in these terribly difficult times and difficult challenging careers that we have in medicine.
John: Okay. I'm going to ask a little more about this because I want to get your perspective on it. Of course, meditation and mindfulness are not exactly the same thing. Is it? Maybe mindfulness is a form of meditation. What is your take on that? Explain that to some of us who are novices.
Dr. Barbara Loeb: I think meditation is a form of mindfulness. I think mindfulness is sort of an act of paying attention on purpose, being aware, being present, and allowing yourself to connect to what is actually here in the present moment, sensations, even thoughts. It's not eliminating any of those things, and it's not going up to the Himalayas and saying, "Oh, it's actually just focusing your mind and attention back onto the present moment, the things around you".
John: I know little about it, but I did read about it for a while. I've read several books about Buddhism and so forth. And the one time I decided to use it, I'm just giving my own example, this was 20 years ago, but I was very depressed, I was burnt out. I was going through a divorce. It was a lot of anxiety, a lot of thoughts that were out of my control seemingly. My approach to mindfulness was simply, if I was driving, I would focus on the license plate in front of me, focus my hands on the wheel. I'd go home and I earned a shirt and I would focus on that or I would chew a French fry and I would do it very slowly and I'd feel the crunch and the oil come out. Everything was focused on exactly what's happening right now. That's my take on my own personal use of mindfulness.
Dr. Barbara Loeb: Well, I wouldn't necessarily recommend it while you're driving, maybe at a stoplight when you're waiting for it to turn green. There's a common exercise about noticing when you're at a stoplight or waiting in a line, but I was wondering, well, how was that for you?
John: Definitely, it would just push all the other thoughts out of my mind. And then I would relieve a lot of those physiologic responses. And I've thought about in the past trying to meditate or to take a course or something, and I haven't, but that's the closest I've come to it. I know a lot of people though, that have used it extensively and have been very pleased and have physically and emotionally, and mentally felt better.
Dr. Barbara Loeb: Well, yeah, one of the things that you can do, or that is part of mindfulness is within your daily activities, as you mentioned. But sometimes as for instance, if you're a nurse and you're working in a COVID unit and you're very overwhelmed and you're just continuously doing things, taking care of patients. If in a moment, as you're walking from room to room, you begin to notice the sensation of your feet on the ground, or when you wash your hands, you feel the sensation of the water and the soap.
That gives a moment of you becoming back present in your own body, and also gives you a chance to decompress from this constant, "What do I have to do next?" And there's a lot of stress. Bringing yourself back into your body with sensations has a very calming effect and helps you build your resilience to face difficult times. So you can do things in your daily activities, such as some of the ones you did, some of the ones nurses and doctors and others caretakers can do. People find a very positive effect of doing that.
And then also when you're in a situation, you are able to notice what the sensations are of your body. Like, for instance, if you're in a conflict or you're in a situation where someone has died, your grief of loss, when you notice what's coming up in your body, you can actually sort of lean into it and ease some of that and give yourself a moment. You don't just have automatic tightening and clenching and different things that don't help your wellbeing. There's a lot of benefits to it in just daily life.
John: All right. I want to pause for a minute now, only because I know that you have a website. Do you address some of this on the website? Do you have some of the articles you've written?
Dr. Barbara Loeb: My website right now is more focused on my poetry. But I would like to expand into some of these other areas, neuroscience, et cetera. I would recommend if someone's interested in neuroscience to look into the Healthy Minds program from the University of Wisconsin in medicine because Dr. Richie Davidson is in charge of that. And then there's also for caregivers and doctors, and the healthcare people, there's the mindful practice program in the University of Rochester that talks about healthcare. There are a lot of things out there and you can certainly contact me if you want to hear more information about what programs are out there.
John: Excellent. Well, you did just mention the poetry. So let me just give the website, first of all, mind2heal.com. We'll do it again at the end. Somewhere in this process that you've described now, you did get into writing specifically writing poetry, which will be described on that site. Tell us how that happened and what was that process like?
Dr. Barbara Loeb: Well, it was interesting. There actually were three phases and I've turned it into what the three intentions for my book are because in mindfulness, we talk about beginning with what your intention is. Really the first writing came about at that retreat I mentioned. And the monastic was talking about in a hundred years from now, your name, your face, your voice, no one will know your identity that we all think is so important. Our name up in lights, it's so critical. No one will know who Barbara Loeb is, or John Jurica is. No one will know us.
So that actually freaked me out a little bit. And I thought, well, my great-great-grandchildren will be asking their parents who this Barbara person is. And I decided I needed to send them a message. I wrote my first poem, which was called "To All Generations with Love". And it was basically sending a message into the future that I'm with them, even if they can no longer know who I am. So that was the beginning of writing poetry. But I didn't know at that time that it was going to be a book.
John: Ah, so then you kept writing, right? Apparently.
Dr. Barbara Loeb: Well, what happened then was the pandemic hit. Not a good time. Like many of you, I was already trying to figure out what my next life was. They always say in your previous life you figure out your next life. And I already told you about the first two lives and I was in my third life. And then the pandemic hit and all the plans I had, like everyone else, were destroyed. And in addition, unfortunately, I had some really significant losses. My father passed away of COVID in the first month of COVID on his 90th birthday in isolation. I couldn't be with him. He was in the hospital. They didn't have anything to treat him at that time. And then my mother-in-law, my husband's mom got COVID and she survived the COVID, but then it was downhill and she passed.
And in the middle of all that, my two-year-old grandson got hit by a car. And my husband and I had to rush to Colorado before vaccines were available and take care of the other four kids. They are five siblings. He luckily survived, but it was pretty stressful. It was a spinal cord injury. I realized I really needed to look at how to heal myself. And poetry, mindfully sitting, reflecting, and writing was very healing for me. And it opened the time that I hadn't spent in all those 40 years in healthcare to actually attend to my own self-care.
John: Okay. That kind of tells me that the title is very similar to what you just said. The healing that occurred because the title is "How to Save a Life: Healing Power of Poetry", right?
Dr. Barbara Loeb: That's right. And I always thought that I would write something or do something that would help healthcare people and their healing process was always healing others. And I realized that this poetry writing in a sense saved my life from going into a downward spiral in these really difficult times because it energized me and gave me a feeling of uplifting and hope. That was actually the second intention of the book. It was saving my own life with the healing power of poetry.
And also, it sorts of brought me to what I call the third phase or third intention when I realized that there were other people will like me, many, many, many thousands and thousands of doctors, nurses, and others that had spent so much time caring about other people, caring for other people that they had left themselves not attendant. And I thought, well maybe if they see my journey, this can help save their life metaphorically speaking, by connecting them with their inner wisdom and inspiring them to write or paint or do whatever it is, or even just sit and reflect and release their own ability for creativity and healing. The third intention was to share the methodology with others, for promoting their self-healing.
John: I don't want to get into too much detail, but how was that? What was it like? Was it difficult to turn those that you had written into a book to get the book published or self-published? Just a couple of sentences on that.
Dr. Barbara Loeb: It was a journey and I'm glad to connect with anyone who needs advice on that. I first published it through Amazon Self-Publishing. By the time I decided to make the book in my phase three, the third intention, I had a lot of poems already that I had written. In part, I had the material, but I had to do the editing and I used an independent vendor called Fiverr to edit and to format, which was very helpful. And I used my mother's artwork as an illustration. So that was really fun because it was a journey into the legacy of my family and I put it all together. It took a little bit, but there were a lot of good YouTube videos out there and webcasts that helped me and gave me advice on how to do it. I was able to accomplish it. I actually put the whole book together in less than six months.
John: Nice, nice. But you had already written a lot of it before that, right?
Dr. Barbara Loeb: Yeah. I had written the poems. I had to do the prolog and the introduction. And then at the end of the book, I actually have an appendix that explains
every poem, just a few sentences saying where I was when I wrote it, what I was thinking, what my intention for that particular poem was. And a lot of people have found that very helpful. Although the poems are not abstract, they're pretty clear. A lot of people like that little extra background.
John: Nice. Okay. So, I've interviewed many people that have written books, some self-published, some published by national companies, and things in between, but I don't usually have people read from their books. But I thought, wait a second, if you've got a book of poems, we should be able to have you read one of them for us and really give us an example of your poetry.
Dr. Barbara Loeb: I would love to.
John: All right, let's do it.
Dr. Barbara Loeb: Yeah. I picked out one that is relatively short and it's about how we're driven from one thing to another. And I realize that the ability to change anything or do anything is to first become aware of the cycle of doing that I was in and that I'm in. So, it's called "Shiny objects".
"I'm floating in a sea of uncertainty, beneath the surface among shiny objects. Reaching for one I'm distracted by another. Turning back the first one disappears. Dazzled by yet another and another. I try to scoop them up, they slipped through my looped arms, gracefully dancing in slow motion just out of reach. I turn and search. My goggles are clouded. I swim to the surface gasping for air with one deep breath and one deep pause. I dive down again and again."
John: Thank you for doing that. I don't read a lot of poetry, but I always imagine that I'm not reading it necessarily the way the poet wrote it and with the inflection and the timing. And it's nice to hear someone actually read their own poetry and get the feeling and how it was. Because poetry has a certain rhythm to it.
Dr. Barbara Loeb: Yeah. Well, I like reading it to myself because it reminds me of what I was thinking and what my intention was. And I hope that it inspires that in someone else to think, "Gee, I've been there".
John: Right. Now did you write poetry when you were younger? Was that part of growing up? Because it's sort of like, well, someone just starts writing poetry? Tell me about that just as an aside.
Dr. Barbara Loeb: When I was a teenager, I wrote a number of poems, including one that was like your epitaph. My teacher said, write your epitaph. But in the front of the book, I actually have a poem that I wrote when I was like 14 or 15 years old. I did write poetry then, but then there was a big gap. I journal from time to time over the years, but then life got in the way of anything creative and all I did was work, work, work, and raise my children and take care of my patients and become the executive and all those things. And there was no space.
John: Right. This has been quite a journey so far that you've described, but I know from briefly talking to you before we actually set up the interview today that it's kind of led into some other things. And we do have time here, so maybe you can tell us some of the other things that you're involved with that my listeners might find interesting.
Dr. Barbara Loeb: I definitely would love to. The first thing that came about was when I was talking about mindful practice. I originally was looking into how we can help other healthcare folks through mindfulness. I got involved with a program called Mindful Practice out of the University of Rochester school of medicine and dentistry. It's started by two physicians that are general physicians, Dr. Ron Epstein and Dr. Michael Krasner.
And basically, it talks about bringing mindfulness narrative, like the stories and dialogue into healthcare so you can connect better with yourself, your patients, and your colleagues. And I trained as a facilitator of this program. I would recommend it as something to check out. There are retreats and remote programs that people can attend. So that's the first thing I've been involved in. And also at the same time, I got involved with a narrative medicine program. I'm sure you're going to ask me what narrative medicine is.
John: Yeah, exactly.
Dr. Barbara Loeb: Narrative medicine focuses on bringing what is called narrative competence into healthcare. Narrative competence means the ability for a person to acknowledge, absorb and interpret the accent stories and the plight of others around them, whether it be themselves, their patients, or their colleagues. That philosophy, that discipline was started at Columbia University with Rita Sharon. And she's really sort of the person who coined narrative medicine, but now it's quite spread throughout the country. And a lot of medical students and medical centers have courses in narrative medicine, which focus on close reading and reflective writing.
The program I've been involved with is through Advocate Aurora Health. We have a narrative medicine group that meets twice a month. And what we do in that group is we start with a meditation, a mindfulness reflection of some sort, and then we have a writing prompt. It's something that inspires us to write. And then we share in breakout rooms and then we have a closing reflection or meditation. And that has been very helpful in sort of stimulating me to write and bonding with a community of people. Just like the mindful practice, also a community of people that have like minds, that want to cultivate mindfulness. And this group created creativity and writing and humanities in healthcare.
John: Okay. Now you said two phrases that I'm not sure I know what they mean. Closed reading and reflexive writing. What was that?
Dr. Barbara Loeb: Okay. Close reading means when you read something more in a mindful fashion. In the very classic narrative medicine groups, they actually do a little more disciplined work around reading pieces whereas in an advocate auroras group we're a little bit more informal. But in classic narrative medicine, they have a particular way they read from the literature and then they write reflectively, meaning what comes up after the reading is a reflection in a way. And they do that in a more disciplined way. In our group, it's a little bit more open.
And we actually also have people in our group that are not directly healthcare workers, because everyone is part of the healthcare system on one side of the stethoscope or the other. It really helps by actually duplicating the relationship that you would have with the patients. We have to be able to relate to people regardless of what our role is and diminish that hierarchy of doctor-patient because that actually sometimes gets in the way of good communication and understanding of each other's stories.
John: That makes sense. If you're doing narrative medicine and are following the principles and you're not including the patient, it makes sense to be involved with people. Of course, we could all be patients too, but we have a different jargon than the average patient. It would be nice to do that together.
Dr. Barbara Loeb: Yeah. I don't know if you have time to share this, but there are two things clinically that have been done that have been very helpful related to this type of discipline. Our narrative medicine group's founders, his name is Dr. David Thoele, and also Marjorie Getz. They're the two founders of that group. Dr. Foley is a pediatric cardiologist and he's created a three-minute mental makeover where what he does is he works with the patient and the patient's family and they write three things they're grateful for, summarize our life in six words and three wishes if they had Aladdin's lamp. And that process of writing and reflecting with patients changes the dynamics between the caregiver and the patient and creates a synergy, a relationship, a communication that really helps care.
And then the other one I wanted to mention is Dr. Joshua Houser, who is out of the Jesse Brown VA and Northwestern Memorial Hospital. He has a program called Poetry for Veterans. And what they do there is they read poetry with veterans. Particularly, he's in palliative care, so some of them have very severe diseases. And they've witnessed a change in the patient's perspective about their own life story and how they relate to their caregiver, how they relate to each other, not just as in a medical way, but as humans. And they also do that kind of thing with their staff. Those are two examples of reading and writing together that have introduced a different level of human connection into healthcare.
John: All right. Well, that's a lot to get my brain around, but it's very helpful. Thanks. Because I can look those things up and I will actually include some links to those as well for listeners that are interested.
Dr. Barbara Loeb: There was one more thing that I'm doing if you have time.
John: Sure.
Dr. Barbara Loeb: It's called the Maven project and it's a non-for-profit telehealth organization that supports free and charitable clinics and federally funded clinics. And we have peer consults, specialists can give peer-to-peer consults on difficult cases for these providers in these clinics of need. We do mentoring for healthcare folks, doctors, nurses, others, and we do medical education including a weekly or biweekly COVID education. So that's a group of seasoned physicians. And actually, we've engaged them now in our writing narrative medicine program as well. But their main program has focused on helping these free and charitable clinics by supporting their providers, their clinicians working there.
John: What would the mentoring most commonly be related to if somebody needed some help with something?
Dr. Barbara Loeb: There are two types of mentoring that I do. The first one is leadership mentoring. I use my background as a CMO and medical director for other physicians that are in these clinics that don't have the funds for professional mentors. They can't hire an agency or firm to do that. I use my professional background and I've mentored for my professional organization and others organizations. I use that background to mentor them, to help them reveal for themselves what their leadership path might be. And like in episode 93, if they're trying to make transitions, how they might do it.
And then we also do clinical mentoring. I mentor nurse practitioners that are in areas where they may have simpler clinical questions, but they don't have access to a clinical mentor right there. So, they'll present me with cases. I'm an internist for those who might not know. So, they present me with basic internal medicine cases and we just talk about what they might do. And if they need a specialty referral, I can refer them to one of our Maven project specialists, and then they can have a more in-depth conversation about the patient's issues.
John: Awesome. I will definitely put a link to the Maven project in the show notes as well. It's a lot to be doing, a lot on your plate, but it sounds like it's not stressing you out. You're feeling pretty good about
it all.
Dr. Barbara Loeb: I feel good. I think one of the things we all have in common, whether we're still pursuing a clinical career, a leadership career or other careers, because I know that's been the topic of conversation for you and other podcasts, we all have this deep desire to help other people and to share what we've learned. And these are just other pathways that I've used that I'm using to continue to do that because that also energizes me, not just the self-reflection, but what I could inspire someone else to feel or do or heal. It's very uplifting for me. Although sometimes it seems like a lot to me too, it's still very helpful in my own personal journey.
John: Very nice. I guess I wouldn't say that you're retired because you're doing so many different things. I'm supposedly retired now. I did my last clinical shift a month ago. But everyone that I've ever talked to, particularly physicians that are so-called "retired", they're as busy as they ever were. It's just how it goes.
Dr. Barbara Loeb: Yeah. I always wonder what the word "retired" means. Does that mean we all went to sleep suddenly?
John: Hopefully not. Well, it might be a good sleep.
Dr. Barbara Loeb: We need the fairy dust for the prince charming to come and kiss me and wake me up.
John: Yeah. Well, before I let you go, though, we are getting to the end. I just want you to maybe think about my listeners. They're basically physicians for the most part who sometimes are frustrated, they're burnt out, they're looking for other options. Not that I really want every physician to not take care of patients because we all need physicians. But anyway, if you have any advice and basically what you've learned over the years, including the last four or five years, what advice would you have for them if they're feeling kind of frustrated and not really good?
Dr. Barbara Loeb: Well, my advice is sort of simple. I think the first step is to just take one breath and because we've been holding our breath for at least 20 months. And I also like to share this quote that sometimes is attributed to Victor Frankel. Although I hear that his family says he didn't say it, I still love the quote. "Between stimulus and response, there is a space. And in that space, we have the power to choose our response. In our response lies our growth and our freedom."
What I would suggest to people is to find a moment to pause, notice, and reflect and go into that space so you can uncover really the wisdom that you most likely already have, but just haven't had the time to connect with it. And whatever it is, whether it's creativity or other things, you will be energized and move forward by that. Maybe doctors like to have a 1, 2, 3 plan of what to do, but I think we just have to stop first and allow ourselves to find what we already know. So, one breath.
John: All right, good advice. Slow down, take a breath and pay attention. Excellent. Well, Barb, I think I've taken up enough of your day so far, but we've learned a lot. I'm going to put links to everything. I would definitely say that listeners, you should visit the website. www.mind2heal.com and go to Amazon and look for the book. Again, there'll be a link to that. At mind2heal.com there are several different things that people can learn and see about the book. I think you've got some video deals where you're talking about different things related to what we've discussed today. Does that sound good? Did I miss anything?
Dr. Barbara Loeb: No, that's perfect. I really appreciate the opportunity. And it's been a lot of fun being with you again. I haven't seen you in so long. I haven't talked to you in so long. Thank you so much for allowing me to share this with the listeners. Thank you.
John: It's been my pleasure.
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