Dr. Anne Eacker of Kaiser Permanente Bernard J. Tyson School of Medicine: “Connect with others; Really connect and be present”

…Connect with others. During the COVID-19 outbreak, this may be by FaceTime or Zoom, a phone call, or with at least 6 feet of physical distance while walking one-on-one. Really connect and be present.

As a part of my series about the women in wellness, I had the pleasure of interviewing Dr. Anne Eacker, Senior Associate Dean for Student Affairs at the Kaiser Permanente Bernard J. Tyson School of Medicine.

Dr. Anne Eacker joined Kaiser Permanente Bernard J. Tyson School of Medicine as Senior Associate Dean for Student Affairs after serving from 2013 to 2018 as the Associate Dean for Student Affairs at the University of Washington School of Medicine, where she also was an Associate Professor of Medicine in the Division of General Internal Medicine. As the student affairs dean, she had oversight of all medical student support services and student progress issues at the University of Washington, a medical school for the five states of Washington, Wyoming, Alaska, Montana, and Idaho (WWAMI). She also co-chaired the Learning Environment Committee, which was responsible for ensuring a positive, supportive learning environment for students and managing any incidents of mistreatment and co-chaired the inaugural Anti-Racism Action Committee. She has had numerous teaching roles with medical students and residents, including serving as a site director for the internal medicine clerkship.

Thank you so much for doing this with us! Our readers would love to “get to know you” better. Can you share your “backstory” with us?

I decided to go to medical school at 25 years old, after a terrible interaction with a physician. I have a psychology degree, and I thought “I can do better than that” around communicating with patients. I had not been a pre-med student, so had to take all the pre-requisites and didn’t start medical school until 28 and finished training at 35, but I would have been 35 with or without completing medical training! At that point I was ready to jump into academic medicine. I knew I wanted to teach.

Now, I serve as the Senior Associate Dean for Student Affairs at the soon-to-be-opened Kaiser Permanente Bernard J. Tyson School of Medicine, after having a similar role at the University of Washington. I’m responsible for student engagement & well-being, student support and leadership experiences, and equity, inclusion and diversity (EI & D). I took this role because of the intentional commitment to student health and well-being within the curriculum, not just outside of the curriculum, and also to issues of equity, inclusion and diversity, also imbedded in the curriculum, and beyond.

Right now I am helping launch our school’s REACH course (Reflection, Education, Assessment, Coaching, and Health and well-being), where four times a year for a week, students will focus on these areas, and spend time with their dedicated physician-coach, and in small groups with each other. Coaching is a key aspect of our program, where students are the expert on themselves, and their coach is there to help them self-assess and develop action plans to achieve their hopes and dreams. Our goal is to teach resilience skills and mental health self-care that our students can apply throughout their careers.

Can you share the most interesting story that happened to you since you started your career? What were the main lessons or takeaways from that story?

As a student affairs dean I am entrusted with all kinds of fascinating, but confidential, student life experiences, so I actually can’t disclose many of my most interesting stories! Protecting students’ privacy and confidentiality is of the utmost importance to protect them in their future careers, and it is also just the right thing to do.

However, I can say I have learned a lot from my patients over the years as a general internal medicine physician. Older patients, which I will be myself shortly, are the best. They impart all kinds of life wisdom that I have put to good use. Also, the “nadir of happiness” is at 47 years of age or so, and then just keeps increasing with age, so taking care of the elderly is a very good way to have others’ happiness rub off on you as a physician.

“Don’t borrow trouble” is one adage an elderly patient shared with me. She was waiting on a breast biopsy and was smiling from ear to ear when I asked how she was. I took this as a reminder to stay in the present moment since it is the only one we really have, anyway. This is useful advice right now as we face a global pandemic. We don’t really know what’s coming tomorrow or the next day. We never did — but it was easier to maintain the illusion before COVID-19!

Can you share a story about the biggest mistake you made when you were first starting? Can you tell us what lesson you learned from that?

Learn to trust your intuition and speak up when something just doesn’t seem quite right. This applies to taking care of patients, and also advocating for students.

We all have many examples of this. A patient of mine had advanced breast cancer at diagnosis. She also had some joint pain which her oncologist dismissed as arthritis, but it turned out to be evidence of spread of her breast cancer, meaning it was more advanced than we initially thought. I lament that I did not push harder for additional testing earlier. It would have given her more time to get used to her terminal diagnosis and to have a better death, both for the patient and her family. My experience caring for her showed me that as the experts, we’re only able to provide the best care when we listen closely to both our patients and our own instinct.

None of us are able to achieve success without some help along the way. Is there a particular person who you are grateful towards who helped get you to where you are? Can you share a story about that?

My mom died by suicide when I was ten, and life was challenging for a time, but my dad has always been in my corner. He’s 86 years old and fundamentally an optimist, which I try to carry with me every day. He always says “things work out,” and of course that is true! The evidence is that 85% of the things we worry about never come to pass, and in the 15% of cases where they do come to pass, they are generally not as awful as we had anticipated. I think this is useful information right now as worries around COVID-19 abound.

Ok perfect. Now let’s jump to our main focus. When it comes to health and wellness, how is the work you are doing helping to make a bigger impact in the world?

Physicians have high rates of burnout, and this ultimately impacts the quality of patient care, resulting in 2-fold increased odds for unsafe care, unprofessional behaviors, and low patient satisfaction, according to research published in JAMA. Physician burnout also contributes to the cost of care, and is estimated to cost $4.6 billion per year nationally.

Finding meaning and purpose helps with resilience. Medical students need space and opportunity for reflection so they can engage in meaning-making and healthy professional identity formation. In our curriculum this will occur regularly, but consistently in the REACH course and with their coaches.

We want to determine: Can we use medical school to help students develop skills of resilience, but also skills of leadership and advocacy, and inclusion, so that they can transform the health care system to provide better care not only for patients, but also better care of the health care workers within it?

Can you share your top five “lifestyle tweaks” that you believe will help support people’s journey towards better wellbeing? Please give an example or story for each.

1. Go outside even if the weather isn’t perfect. You may hear the birds, get caught in a torrential down pour, feel the sun on your skin, smell the blooming hyacinth, see the light through the clouds.
2. Move in whatever way works for you. If you are really distressed, get your heart rate up as high as you can tolerate, even just for a few minutes. It will help you feel better.
3. Connect with others. During the COVID-19 outbreak, this may be by FaceTime or Zoom, a phone call, or with at least 6 feet of physical distance while walking one-on-one. Really connect and be present.
4. Notice your breathing. A long exhale will calm you down physically as it activates your parasympathetic nervous system. Your breath is always with you and is a tool you can put to good use.
5. Practice gratitude if that works for you. Think of small things that you can appreciate right now in the moment — drinking a cup of hot coffee, noticing the sunrise, appreciating the laughter of a friend. Doing this daily for a couple of weeks as a regular practice can have persistent impact on your well-being, even after you stop!

If you could start a movement that would bring the most amount of wellness to the most amount of people, what would that be?

To me well-being is fundamentally a spiritual practice. Generally, you can ask yourself if in the present moment you are okay or not, and generally the answer will be that you ARE okay, maybe not great, or fabulous, but fundamentally okay, in this very moment. Reminding yourself “I’m all right, right now” is a good place to start (this comes from Dr. Rick Hanson’s work) Maybe over time this evolves to asking yourself whether you are at ease in this moment, and if not, are there things you can do to create a sense of ease if you are NOT at ease? For example, three deep breaths, a walk around the block, relaxing your shoulders, slowing down for a moment. Surely you can slow down for just a moment. Then over time you may be able to appreciate all the abundance in your life, rather than the areas of scarcity — not the things you didn’t get done, but the things that you did accomplish. I don’t mean abundance like wealth or possessions but rather what matters most to you — such as your relationships, your general health, your sense of meaning and purpose.

What are your “5 Things I Wish Someone Told Me Before I Started” and why?

What a great question. I’m not sure if this is “before I started med school, or doctoring, or being a dean…” but I think these apply in any setting!

• Learn how to just be. I’m still learning this as it is not a lesson that comes easily to me.
• Listen well ….
• …. And its corollary — ask a lot of questions.
• Being fully oneself is so much better than trying to be perfect, which is impossible!
• Practice bravery.

Sustainability, veganism, mental health and environmental changes are big topics at the moment. Which one of these causes is dearest to you, and why?

Mental health is the cause dearest to me. I first decided to go into primary care because primary care physicians are on the front lines of detecting potential mental health issues in patients. After my mother’s death, I wanted to try and help others in this way. On the other side, ensuring the health and mental well-being of doctors (and future doctors in medical school) is crucial to ensuring they’re capable of serving patients in need.

What is the best way our readers can follow you on social media?

You can follow me on Twitter at @EackerAnne.