December 9, 2024 • 49 mins
What if the very challenges that seem to hold us back are actually the keys to our success? Join us as we uncover this possibility with Dr. Rachel A. Davis, a psychiatrist and medical director who turns her personal journey with obsessive-compulsive disorder (OCD) into a source of strength and empathy in her professional life. Rachel shares the transformative experience of becoming a living organ donor, a milestone that marks her triumph over childhood health anxieties and her unwavering dedication to the medical field.
Rachel's story is one of resilience, from her early years marked by religious scrupulosity and health anxiety to her pursuit of a medical career despite these challenges. With candid reflections, she reveals how a tough-love upbringing and specialized OCD treatment helped her navigate these anxieties, ultimately leading her to thrive in high-pressure environments. Her experiences as both a medical student and now a practicing physician highlight the nuanced ways OCD has shaped her approach to patient care, making her a compassionate and conscientious advocate for mental health within the medical profession.
As we explore the evolving culture in medical education, Rachel offers valuable insights into the importance of mental health support for future physicians. Her dedication to breaking down stigma and fostering open conversations about mental well-being stands as a beacon for change. From the pressures of medical school to the shifts in educational approaches aimed at reducing stress, Rachel's journey underscores the importance of supportive environments where medical professionals can excel, not just survive. Tune in to discover how Rachel's personal battles have fueled her passion to transform the landscape of mental health in medicine.
https://www.youtube.com/@TransplantTalks-Podcast
Conversations like the ones on this podcast can sometimes be hard, but they're always necessary. If you or someone you know is struggling, please consider visiting www.wannatalkaboutit.com. If you or someone you know is considering suicide, please call, text, or chat 988.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Gabe Nathan (00:01):
Hello, this is Recovery Diaries In-Depth.
I'm very excited to be talkingto our guest today.
Her name is Rachel A Davis.
She's a psychiatrist andmedical director in Aurora,
colorado.
She wrote an essay for us backin 2017 called how Does a Doctor
with OCD Navigate Life Careerand the.
Every Day We'll be talking toRachel about her essay about
(00:21):
managing her mental healthsymptoms as a physician and
where she is today.
Each week we'll bring you aRecovery Diaries contributor
folks who have shared theirmental health journey with us
through essay or video format.
We want to see where they arein their mental health journey
since initially being publishedon our website.
Our goal is to continuesupporting our diverse community
by having conversations here onour podcast to follow up and
(00:44):
see what has shifted, what haschanged and what new things have
emerged.
We're so happy to have youalong for this journey.
We want to remind you to followour show for new and back
episodes at recoverydiariesorg.
There, like the podcast, you'llfind stories of mental health,
empowerment and change.
You can also sign up for ourmailing list there so you never
miss a new podcast health,empowerment and change.
(01:05):
You can also sign up for ourmailing list there so you never
miss a new podcast episode,essay or film, and you can find
this podcast pretty muchanywhere.
You get your podcasts.
We appreciate your comments andfeedback about our show.
It helps us improve, makechanges and grow and, of course,
make sure to like, share andsubscribe.
Hi Rachel, hi there, thank youfor being on the show with me.
Rachel Davis (01:32):
Thanks for having me.
Gabe Nathan (01:33):
It is a pleasure, as it was a pleasure to edit
your essay all those years ago.
Do you remember when it was no?
Rachel Davis (01:43):
It was.
That sounds about right.
Yeah, it's been a while, though.
Gabe Nathan (01:46):
Part of the reason why we're doing this podcast is
because we as an editor and awriter have a comparatively
short time together.
When we work on a personalessay, we go back and forth,
there's a revision or two, theessay gets published and then
frequently I never hear from theperson again published and then
(02:08):
frequently I never hear fromthe person again.
And it's just such a wonderfulthing to be able to catch up and
see how you are.
What has changed since we werelast together, and it has been a
long time.
So how are you now?
Where are you now?
What's going on in your life?
How are you?
Rachel Davis (02:26):
now?
Where are you now?
What's going on in your life?
Catch us up.
Those are a lot of questions.
But how am I?
I am good I am still working atUniversity of Colorado on the
CU Anschutz campus.
I think that's where I was whenI wrote the article I am now.
I have several different roles,so my main role is Vice Chair
(02:46):
of Clinical Affairs in theDepartment of Psychiatry.
I'm also Medical Director ofour OCD program and Co-Director
of our OCD Surgical Program, sowe do deep brain stimulation for
severe and refractory OCDsevere and refractory OCD and
(03:08):
then I'm chief of all of ouroutpatient psychiatry practices,
and so I'm busy, but I likewhat I do.
I still have OCD, so stillmanage that every day.
And yeah, was there anythingelse you asked that I didn't?
Gabe Nathan (03:20):
I think that was a pretty good catch up, and you
have a podcast, correct?
Rachel Davis (03:24):
I do.
It's called Transplant Talksand it's about transplant organ
donation.
Gabe Nathan (03:32):
Are you an organ donor or a recipient?
Rachel Davis (03:36):
I'm a donor, so I donated the right lobe of my
liver in January of 2022.
January of 2022.
This is actually something Ilearned about in medical school,
22 plus years ago, and I wassitting in lecture and the
(03:59):
professor was talking about howyou could donate part of your
liver and it would regenerate.
I thought that was really cool.
I actually reached out to himafterwards and thought I was
interested in doing it and youknow, back then non-directed
donation wasn't really a thingyet or giving to an anonymous,
or giving anonymously.
But he took me seriously and hemet with me and at that point
he told me I would need to get apsychological evaluation as the
(04:20):
next step.
And I thought, oh no, I don'tthink I'm necessarily
psychologically okay, becausethis was before I got treatment
for OCD or anything and in allreality, I didn't have time to
donate part of my liver.
As a medical student, I meanit's too intensive a procedure
and recovery.
But it's always been there inthe back of my mind and you know
, fast forward 20 years.
(04:42):
I was doing my charting onlineand I came across an article
that UC Health had put out aboutsomeone who's a double donor.
So she had actually donated oneof her kidneys and part of her
liver to an infant and there wasa link to the form and, without
really even thinking, I justfilled it out and you have to
put in all your medical historyand all your medications and I
(05:03):
take a lot of medications and Ihave OCD and so I followed it up
with an email.
I said, hey, I just put in thisapplication.
You're going to see mymedication list and think, oh no
, but you know, actually Ifunction quite well, I'm on
faculty here and, yeah, I justgave him heads up.
And so a few months later I wasdonating the right lobe of my
(05:24):
liver to someone I didn't knowat the time, but I've met since
then and she's an important partof my life and for me.
You know, we haven't reallystarted talking about my OCD yet
, but this was very significantto me because as a child I was
afraid of my body and I hadhealth anxiety, what we used to
call hypochondriasis, and youknow I would stay up late
(05:49):
learning all the symptom flowcharts and anyway, to be able to
go from that to feelingconfident enough in my body to
undergo a major surgery was abig milestone, and also to be
someone with mental healthdiagnoses, who takes a lot of
medication, who could also befound to be healthy enough to
make a decision to donate partof her liver.
(06:10):
So that was a very long answerto your question.
Yes, I'm a liver donor.
Gabe Nathan (06:15):
Extraordinary one at that, and thank you so much
for sharing that.
And you also answered myfollow-up question, which, of
course, in preparation for thisinterview.
I went back to your essay and,as you were talking earlier, I
was thinking about Rachel thechild, and could she have
possibly envisioned that shewould be undergoing a procedure
(06:36):
like this?
What an unfathomableprogression.
And if she could see you now.
But of course she can.
Rachel Davis (06:48):
Right right.
Gabe Nathan (06:52):
In addition to asking about updates and things
like that.
Do you still have the sunconures?
Rachel Davis (06:58):
Well, I have.
No, I don't.
So one of them died of old ageand one of them died tragically,
got caught in his sleep hut.
But I have, I don't.
So one of them died of old ageand one of them died tragically,
got caught in his sleep hut,but I have.
I rescued her when she was19-year-old Sunday Conyer, so
she's a mix between a Sun Conyerand a Gen Day Conyer, and so
she's probably about 21 now.
She's a chronic plucker, whichis kind of like a bird version
(07:21):
of trichotillomania, so she'sbald.
She doesn't have feathers onanywhere she can reach, so she's
cute and bald.
Gabe Nathan (07:30):
Cute and bald what I someday aspire to.
You wrote in your essay.
I still do not often feel calmand you know, as I was listening
to you really talk about yourbio and your various
professional positions, inaddition to being an individual
(07:53):
who's living with OCD, I wasthinking to myself well, of
course she's not, of course sherarely feels calm, but that was
in 2017, feels calm, but thatwas in 2017, you wrote that and
I'm curious about now do youstill feel that way and what
helps you if you do?
What helps you attain thoserare moments of feeling calm?
Rachel Davis (08:17):
Yes, I still feel that way and that is, I think,
one of the reasons I stay sobusy, because it's easier to
manage real problems than tomanage the imaginary problems.
Your brain makes up with OCDand your brain has a lot more
time to make up problems ifyou're not doing things.
So, fortunately, I've been ableto find things that I really
enjoy doing.
I love my career.
(08:38):
I couldn't ask for a moreperfect job or positions and I
think I'm good at solving realproblems and I like kind of high
acuity situations and I likemanaging crises and really I
think it comes down to it's somuch better to actually be able
(08:59):
to do something about a problemthan with OCD, where you're like
thinking about these what ifsand there's absolutely nothing
you can do about it, but you'redoing all these compulsions
trying to do something about itand it doesn't actually change
anything.
Relaxing is hard for me.
I mean I don't do well athaving a lot of downtime.
I generally try to keep myselfbusy, but that's okay.
(09:23):
I mean it's the life I have andI like my life in general
Doesn't mean it's not hard still, but I like my life Does the
podcast help you feel calm.
Yeah, it does.
It gives me something to focuson.
So I get to use the creativepart of my mind.
I get nervous recording thingsand so I'm always a little bit
nervous when I'm talking toguests, but I enjoy it.
(09:50):
And then the editing part is alot of fun.
I do all the video editing andthat takes up a different part
of my brain and is a really gooddistraction.
Gabe Nathan (09:56):
So when you were talking about high acuity
situations and how you're kindof drawn to those and of course
I know you were an emergencymedical technician in your early
days this might be a weirdquestion Do you consider
yourself an action junkie?
Rachel Davis (10:16):
That is an interesting question, because
not, no, I don't tend to pursuethings just for, like the sake
of adrenaline, but I do like todo things that have a lot of
purpose, and often that involvesaction.
So I guess the closest thing tobeing an action or adrenaline
(10:36):
junkie would be maybe I likeclimbing but I'm terrified of
heights.
But I still do it and there'snot really a purposeful goal
there other than, like gettingto the top of something right.
So I enjoy that.
But I think the other thingsthat I've done in my life that
are kind of action-oriented allare driven by a purpose.
So you know, being an EMT, Ifelt I was helping people,
(10:58):
donating part of my liver.
I felt I was helping someone.
And I think one of the thingsabout having OCD at least for a
lot of us is we're hyper awareof all the bad things that could
happen and also hyper aware ofall the badness in this world,
and it is an awful feeling tofeel paralyzed and like you
can't do anything about it.
So I think I put myself insituations where I feel like I'm
(11:22):
doing something about it, evenif it's just for the person in
front of me, where I feel likethe badness isn't.
I'm not paralyzed by it becauseI'm doing something about it.
Gabe Nathan (11:34):
Yeah, that's so interesting and it's also so
interesting to me that when youwere talking about the various
things that may have seemedaction junkie oriented, you
mentioned the liver donation.
I never would have thought toput that in there, but in a way
it is A it's purpose-filled, itis also helping other people and
(11:57):
it is I don't know if the wordI'm looking for is dramatic, but
it's intense.
It's an intense situation toput one's body and mind and
being in, and I wonder if youfelt all of that at the time.
Rachel Davis (12:10):
Oh yeah, I mean, it definitely gave me something
to focus on.
It occupied all my thoughts forsome time.
I did a lot of research aboutit, learned what I was going
into, and then there was a wholeactual experience.
I was in the hospital for aboutsix days and then the recovery
was intense.
So, yeah, it was a meaningfulway to occupy my mind and also
(12:35):
do something in line with myvalues, Can you?
Gabe Nathan (12:39):
talk a little bit about how your OCD manifested in
your youth and the ways inwhich you responded to it, and
how those are different todayresponded to it and how those
(13:00):
are different today.
Rachel Davis (13:01):
Sure, so I'd say, as a kid, my OCD probably
started around the age of Idon't know, somewhere between
like nine and 12, but I hadprobably two main themes.
So one was like scrupulosity,or fear of doing something wrong
, and in my case it was going tohell.
I grew up Southern Baptist andso you know we had a lot of like
tent revivals and altar callsand things like that, and so
that drove my fears of going tohell.
(13:21):
And then the other area washealth anxiety, so worry that I
was going to get, you know,cancer was one of the main
concerns, but really any sort ofillness, but really any sort of
illness.
And so I guess, what did I do?
How did I manage the healthanxiety?
I mean, I would sneak upstairs,grab this AMA home journal
(13:44):
thing which had symptom charts,and I literally probably had
every symptom chart memorized.
And then I do a lot of checking, like look at my tongue, look
at my lymph nodes, I think onceI went to the doctor and I told
him I thought I had polycythemiavera, which is a disease that
mostly old men get.
(14:05):
And in terms of the religiousscrupulosity, I had a prayer
that I repeated over and over.
I did a lot of confessing.
I would always tell my mostlymy mom the things I thought I
had done wrong during the day,and at one point she told me you
know, rachel, you don't have totell us everything that you do
during the day, you don't haveto tell us all of your thoughts.
But I was often afraid I wasgoing to commit blasphemy.
(14:29):
So I was always trying tofigure out what blasphemy was,
because I didn't really knowwhat it was, but I was afraid I
was going to do it.
So that's kind of how it showedup as a kid.
Gabe Nathan (14:38):
So here's my question, and I don't know if
you covered this in your essayand of course you're going to
read it, which I'm very muchlooking forward to what was your
parents' response to issuesrelating to the scrupulosity,
issues relating to the healthanxiety?
(15:00):
I mean, did they know that thiswas going on?
Were you constantly asking themto take you to the doctor to
get examined for this, that andthe other thing?
Were there alarm bells thatwere going off?
Or was it just oh's, rachel, umor somewhere in between?
Rachel Davis (15:16):
I well, mental illness wasn't really a thing
either in our family, or atleast it wasn't talked about,
and I grew up in a really smalltown, too, where there was a lot
of stigma, so they knew I wasanxious.
Um, I think my mom describedthat even as a an infant.
I didn't like to be touched orheld, especially when I was
crying.
I just like to be let alone,and I didn't ever sleep very
(15:37):
much.
So they knew I was anxious.
Their way of dealing with it,though, wasn't necessarily to
seek out treatment.
They encouraged us to do thehard things anyway.
In fact, they kind of made us.
I had a lot of separationanxiety, and I went to music
camp because I was good at music.
I played French horn and piano,and I dreaded going and I would
(16:01):
get so homesick and I'd spendprobably the first four weeks
crying and then the second fourweeks crying because I was going
to miss everybody and having togo home.
But they, you know, they toldme I was going anyway.
I think a lot of people'sfamilies with OCD
over-accommodate.
They try to appease the anxiety, and, for better or worse, my
parents didn't do that at all.
They just were kind of likeyou're doing it.
(16:23):
Anyway, I don't care.
I do think, even though thatwas hard and hard, in many ways
it has served me well.
I mean, it has helped me pushforward in life.
I had a thought that I justforgot about.
Oh, I remember once.
So, yeah, I would often, Ithink, tell my parents I thought
(16:43):
I had something.
And I remember once I wasconvinced I had skin cancer and
I even took up pictures from thebook and I showed them.
And they're like no, and I'mlike no, you need to take me in.
And then the doctor also wasyou're like 15, you don't have
skin cancer.
And they biopsied it.
I had skin cancer.
Gabe Nathan (16:59):
So I felt like you see, I know what I'm talking
about.
Rachel Davis (17:03):
It was basal cell carcinoma, so it was the best
kind of skin cancer to have.
But I still needed to have itexcised with wide margins and I
was like I almost feltvindicated.
I'm like, see, I'm not justcrazy here, I'm.
You know, sometimes my fearsare true.
Gabe Nathan (17:18):
Did that add fuel to you at that point?
Did that make?
Did that make the healthanxiety worse?
Rachel Davis (17:25):
It didn't actually .
No, I mean no.
Gabe Nathan (17:39):
That's so interesting.
Rachel Davis (17:42):
Wow.
And so what is different today?
I mean, I'm sure, quite a bitin terms of managing the OCD and
how it manifests.
I also did.
I've been in therapy for a longtime now and some of that
therapy was OCD-specific therapy.
So exposure and response,prevention.
So I've learned a lot moreabout how to, you know, not do
(18:05):
rituals although you know Istill do rituals sometimes but I
think I have a betterunderstanding of what's going on
in my brain, which makes iteasier to, you know, keep moving
forward, and I also have abetter idea of how to respond to
it.
In college, before I gottreatment, I was miserable.
(18:31):
I studied all the time.
I couldn't study at homebecause I would cry and I
couldn't figure out how to stopcrying.
And so I finally realized if Iwent to like Barnes and Noble or
a coffee shop, there was enoughdistraction that I wouldn't
feel so sad.
I was crying and I wouldn'tfeel so anxious.
I was crying, I could actuallystudy.
So I spent all my spare time ateither Barnes and Noble or
Starbucks or whatever coffeeshop there was, and I just
(19:05):
wanted to be done with collegeso that, in my mind, then I can
go home or I can go to medicalschool.
I knew I wanted to go tomedical school, that I basically
got A pluses in every singleclass and I graduated in three
years just because I wanted tobe done.
I wasn't living life, I wassurviving.
And now I actually, even thoughmy OCD is still present, I am
(19:26):
doing things I like, I enjoy mylife, even in the presence of
things that are hard, versuseverything just being surviving.
Gabe Nathan (19:35):
You know, speaking of surviving, I'm curious about
the health anxiety just in termsof yourself, because as we get
older, things are going tohappen and I'm just curious
about how you're living withthat part of it now.
Rachel Davis (19:54):
You know that part of it isn't really a thing
anymore.
I don't know why, but I'm notreally anxious about my health,
but that part is just kind ofresolved, I think.
So as a kid I was hyper-focusedon anything medical, so it
wasn't only a fear, it was aninterest, like almost a
(20:14):
hyper-fixation.
So I loved my mom's ladies'magazines.
I would find all the medicalarticles and read them.
I was fascinated.
I think my favorite gift waswhen I got this anatomy model as
a kid that I got to puttogether and I was very proud of
Everything medical I loved, andso it was weird to have that
juxtaposition.
And now, if I have somethingmedical going on, like donating
(20:37):
part of my liver, I wasfascinated by it.
I found it interesting, I lovedresearching it, but I wasn't
afraid of it.
So that fear part has gone away.
I don't know exactly why.
Gabe Nathan (20:46):
And the scrupulosity.
Rachel Davis (20:48):
Scrupulosity is still there.
It's not religious scrupulosityanymore.
You know, I, like I mentioned,grew up in a very conservative
family, religious family.
I am also gay and for a whilein college and early in medical
school that caused a lot ofdistress in my head, trying to
reconcile how I grew up withwhat I knew about myself, and so
(21:11):
I spent a lot of time doingpartly what was useful but
partly what was also probablycompulsive reading the Bible and
comparing the Greektranslations and the Hebrew
translations.
And what does it really mean?
And all these passages peoplesay about why it's wrong to be
gay and ultimately landed on.
I don't actually think it'swrong.
This is just kind of rhetoricthat people have passed along
(21:33):
and I need to make my ownchoices and my own decisions.
And you know, I know what itmeans to me to be a good person,
to be a kind person, to be acompassionate person, and I can
do that.
So I'm not really focusedanymore on going to hell or, you
know, sinning per se, but I dostill.
I would say I may be kind of ahyper moral person.
(21:55):
I'm always worried about doingthe right thing.
I don't want to hurt people.
I'm often afraid I'm hurtingpeople, I often, you know, find
myself wanting to apologize,excessively, super conscientious
.
So I guess it's turned intomore sort of moral scrupulosity
as opposed to religiousscrupulosity, but that part's
still there.
Gabe Nathan (22:14):
The part in your essay which we're going to get
to after this bit that reallyresonated with me, just as a
person and a human being andalso someone who lives with
mental illness, when you wroteabout how I think it was a
supervisor who turned to you andsaid you know, you always come
(22:36):
into work looking like you'vedone something wrong.
And I used to work at a lockedinpatient psychiatric hospital
and my supervisor said to me onemorning you always look like
you're coming in about to befired, like this is your last
day here, and for five years,every single day, that was how I
(22:59):
lived my life and my shiftstarted at 7 am.
I would be in the parking lotat 5.15 in the morning.
I would come in.
The overnight nurses wouldstill be there.
They were never supposed to seeme because the shifts changed
at seven.
But I got to know all theovernight nurses very, very well
because I would come downstairs, clean up all of the messes
(23:21):
from the night before, do all ofthe paperwork for my supervisor
in the morning that I wasn'teven supposed to be doing, get
all the schedules ready, learneverything about the patients
who had been admitted overnight.
I could not stop myself and Icould not stop myself from
waking up at four o'clock in themorning, three o'clock in the
morning, obsessing about who hadbeen admitted overnight, who
(23:44):
had gotten assaulted the nightbefore, what was the acuity on
the unit, and even still I wasterrified that I was going to be
fired that day, that I had donesomething wrong, that I was
going to say something wrong,that they knew I was an imposter
, that I had no business workingthere.
Just such empathy for you inthat moment of just knowing what
(24:15):
that feels like and what ashitty way it is to go through
each day with all of that noisein your brain.
I don't believe I'm a competentprofessional at your level, but
I know I did the job that I hadto the very best of my
abilities and yet you're stillhijacked by that internal
(24:36):
monologue that's so abusive andharmful.
So I just wanted to tell youthat.
Rachel Davis (24:42):
Yeah, I mean totally.
That's the thing about OCD isit doesn't matter how well
you're doing or how thorough youare or how competent you are,
you just don't feel that you are.
And part of the problem is wewant to feel that way.
Right, that's what most peopleget to do.
They get to do a good job andthey get to feel like they did.
But we don't feel like they did, but we don't.
(25:07):
And I always tell my patientstoo, like that's not really fair
, it's kind of a.
It's a very difficult way to goabout life.
It's almost like going aboutlife with chronic pain, except
this is chronic pain in yourbrain, and you have to learn how
to move forward, even withoutfeeling that things are okay,
without feeling that you're goodenough, without feeling that
things are, you know, going tobe fine.
You just have to move forwardanyway.
Gabe Nathan (25:27):
Yeah, because that just may never come.
Rachel Davis (25:30):
Right.
Gabe Nathan (25:31):
Well, with that, I would love it if you would turn
to your essay in your hymnal,written for us in around 2017.
And it is called how Does aDoctor with OCD Navigate Life
Career and the Everyday by DrRachel Davis, whenever you're
ready.
Rachel Davis (25:53):
In medical school, my peers described me as a
mousy person who just kept toherself.
Not long ago I heard throughthe grapevine that a former
classmate remembers me as a nota nice person.
I immediately felt angry, sadand defensive, but I know why I
was perceived that way.
I kept to myself and seemed toonly care about grades.
I know that people didn'treally like me.
(26:14):
I seemed standoffish and cold,but I didn't mean to be.
I wasn't trying to honoreverything.
I was just trying not to fail.
I was trying to managedebilitating anxiety so I could
become a doctor.
As I think back about my timein medical school, I'm sad about
how I was trying to managedebilitating anxiety so I could
become a doctor.
As I think back about my timein medical school, I'm sad about
how I was perceived and howmuch I struggled.
I feel compassion for myselfnow, as something was going on,
(26:35):
something that even I didn'tfully understand, something I'd
wish I'd known when I was that22-year-old medical student.
I grew up in a religious familyin rural southeastern Colorado
and, for reasons I still don'tentirely understand, I always
wanted to be a doctor.
For that desire I am eternallygrateful.
It is a gift that has given mepurpose and direction.
(26:56):
When I was three so legend hasit I wanted to be a brain
surgeon.
When I was 11 or 12, I wouldsneak upstairs after my parents
had gone to bed, grab theAmerican Medical Association
family medical guide and stay uplate memorizing symptom flow
charts.
By the time I was 13, Idetermined I had polycythemia
vera and possibly Hodgkin'slymphoma.
(27:17):
One night I stayed up late intothe early morning hours sitting
on my bathroom sink trying tomake sure I wouldn't
accidentally swallow my tongue.
The thought consumed me.
The human body fascinated meand it terrified me.
I was a creative child andcreativity in my mind fostered
boundless worries.
When we'd drive by a caraccident, I would perseverate on
(27:38):
gruesome images and horriblethoughts about what must have
happened to the people inside.
Weekly Sunday school Biblestudies and Southern Baptist
revivals fueled my fear of goingto hell, and I would attempt to
prevent this outcome byhabitually reciting Dear God,
please forgive me, I love youvery, very much.
In Jesus' name, I pray Amen.
For as long as I can remember,I have lived with a constant
(28:00):
sense of dread and a fear thatsomething was and is terribly
wrong.
I took an emergency medicaltechnician EMT class when I was
15 and started volunteering withour rural ambulance squad.
I worked as a certified nursingassistant at our local nursing
home.
I exposed myself to blood anddeath.
I comforted a 19-year-old boyas he died in a ditch, crushed
(28:22):
beneath a van.
I prayed that a beautiful,blue-eyed, blonde little girl
would live, as a police officerdragged her lifeless body out
beneath a van.
I prayed that a beautiful,blue-eyed, blonde little girl
would live, as a police officerdragged her lifeless body out of
a lake.
She did not live and instead Isat with my hand on her mother's
shoulder as she screamed.
I comforted a woman withdementia as I dried her after a
bath.
I remember her timid, beautifulvoice as she started singing
(28:43):
when peace, like a river,attendeth my way.
I joked with a 73-year-old manas I cleaned the pus from around
his catheter, trying to helphim preserve some sense of
dignity.
I washed glass out of a man'shair sullenly and quietly.
A couple of hours after wepicked up the body parts of his
friend off the highway.
This is how I began to learn tolive.
(29:05):
Helping others during the worsttimes in their lives gave
meaning to my life.
Now I understand that thismeaning was also helping me move
beyond the horrible noise in myhead.
I was tortured during my firstyear of medical school.
I barely slept.
I learned it was easier to getup in the morning if I drank a
lot of coffee before going tobed at 2 am.
I snuck away between eachlecture to be by myself for a
(29:28):
few minutes.
Attempting to calm my mind, Irecited the Lord's prayer over
and over and over and over.
My preceptor asked if I was allright because I was so thin,
not so thin, too thin.
I was too thin partly because Ididn't make enough time to eat
and partly because I was soworried about money that I
didn't buy enough food.
I was so ashamed that mypreceptor had noticed.
(29:50):
I couldn't let go of the imagesI had seen during my time as an
EMT.
Things were unraveling 9-11happened during first-year
anatomy and I couldn't stopthinking about death.
My experiences as an EMT werenecessary and critical in
helping me move past my anxietyand actually live life.
It was less painful to dealwith real trauma than to be
(30:12):
helpless against my fears.
I could actually do somethingabout real-life disasters, even
if it was just being with peopleas they died.
But these experiences as anadolescent and early adult did
add another layer of traumaticexperience to the primary trauma
of living in my brain.
My time on the ambulance was adouble-edged sword, but I don't
know that I could havedisentangled myself from my
(30:33):
anxiety without this exposureand without my overarching goal
of becoming a doctor.
A classmate of mine wrote in ourschool's humanities journal
about his struggle withdepression.
I reached out to him.
He was kind and this gave methe courage to ask for help, but
not right away.
I told my parents that Ithought I might be depressed and
(30:54):
they told me I probably wasn't.
They would not, or perhapscould not, accept that their
daughter was struggling.
When I did finally allow myselfto see a therapist, I only felt
comfortable seeing a Christiantherapist.
This therapist asked me to sitand listen to God, so I spent
hour after hour sitting insilence wondering what was wrong
with me, because God certainlywasn't speaking to me.
This only made things worse.
(31:16):
So I eventually surrendered andsaw a secular psychiatrist.
She prescribed medication andwe met weekly for therapy.
This was the beginning of a newlife.
I began to have room to breatheand the strength and space to
interact with other people.
It was also when I wasdiagnosed with obsessive
compulsive disorder, or OCD.
Fortunately, despite OCD andthanks to meds and therapy, I
(31:38):
enjoyed my clinical rotations.
I provided good care and mypatients, residents and
attending liked me.
It was nice to be liked, sinceI didn't have to direct all my
energy towards survival.
I had more room for the nuancesof human interaction.
I felt more normal and a littleless alienated from the
category of human.
However, even with treatment, Istill had religious and other
(32:00):
obsessions.
On the obstetrics gynecologyservice, I couldn't bring myself
to participate in abortions andsome other procedures, not
because I wanted or needed tomake a political statement, nor
because I felt judgmental.
Rather, it was because I wasstill afraid of going to hell, a
remnant of scrupulosity carriedover from growing up as a child
with OCD in a very conservativeSouthern Baptist family in
(32:22):
rural Colorado.
It was because, while I hadfigured out how to do well in
medical school, I still hadsevere OCD, a diagnosis I wish I
had known sooner.
I have compassion for myselfnow.
Back then I just felt shame.
Now, a doctor for 13 years, I amprivileged to serve as the
medical director of student andresident mental health on a
(32:43):
health professions campus.
I am passionate about helpingmy student and resident patients
discover how to thrive, notjust survive.
I am moved when I have theopportunity to help someone
change their perspective fromdesperately avoiding failure to
pursuing meaning and joy.
It is my mission to help mypatients remember they are
indeed resilient.
I strive to reduce stigma andcombat the fear that seeking
(33:04):
help for mental health issueswill interfere with being a
physician.
Last year, as president of theColorado Psychiatric Society, I
collaborated with keystakeholders to work with the
Colorado Department ofRegulatory Agencies to eliminate
the mental illness screeningquestions that stigmatize and
marginalize mental healthproblems and discourage students
, residents and practicingphysicians from seeking the
(33:24):
treatment they need.
I still have OCD.
I'm a doctor with OCD.
A couple of years ago one of mysupervisors remarked you come
in here every week looking likeyou've done something wrong.
I was embarrassed that hepicked up on that, but he was
right.
I still live with the perpetualfeeling that I have done or
will soon do something terriblywrong.
I have learned to live andpractice effectively despite
that feeling, but I guess Idon't soon do something terribly
(33:45):
wrong.
I have learned to live andpractice effectively despite
that feeling, but I guess Idon't always succeed at hiding
it.
It resonated with me one timewhen a particularly articulate
patient with OCD shared howexasperated she is of being told
she has a resting bitch face.
She said an OCD sufferer isfighting a war with a brain that
randomly gets hijacked byhorrifying images and thoughts,
(34:07):
and sometimes this secret warmakes its way out of our
tortured brains and furrows ourbrows, making us look bitchy.
I'm aware I still sometimescome off as standoffish and
overachieving.
This is because I'm trying notto let my OCD show through and
I'm doing my best to make surebad things don't happen.
(34:27):
My desire to be a doctor is whathelped me overcome my extreme
anxiety, and my desire tocontinue to be the best possible
doctor helps me navigate eachday.
I feel very fortunate that Iseem to have been born with a
purpose.
I have also come to realize itis not only in spite of my OCD
that I am a physician, but alsobecause of it.
I was driven to do hard thingsat a young age, in part because
(34:53):
I needed a distraction and asense of meaning outside of the
chaos in my brain.
My OCD leads me to be extremelyconscientious, very honest,
empathetic and perfectionisticcharacteristics that, when
reined in, contribute to being agood physician.
I like working with very illpatients, especially in the
emergency department, becausebad things are expected to
happen and I am prepared tomanage bad things.
(35:14):
I feel comfortable working withsuicidal patients and panicked
patients and desperate patientsbecause I am good at managing
crises and bringing calm tochaos.
I've learned how to take alifelong struggle and utilize
certain aspects of it for good.
This doesn't mean everything isperfect.
I still do not often feel calm.
I have learned that my brain israrely capable of feeling
(35:36):
capable, so I just move forward.
I still take medication and Isee a cognitive behavioral
therapist.
I incorporate exposure andresponse, prevention, erp
principles into my daily lifeAll day, every day, I make
conscious decisions to resistthe OCD and make choices that
lead to effective functioningboth for me and my patients.
I have learned to set aside, onmost days, the constant feeling
(35:59):
that something is dreadfullywrong, but sometimes I still
listen to my fears, like when mypatient misses an appointment
and I find myself on Googletrying to find her obituary.
I see so many students andresidents afraid to be seen as
weak, afraid to be human, sofull of shame that they might
need help or possibly even havean illness.
The classmate of mine who wroteabout depression, gave me a
(36:22):
gift in his story and thisallowed a sliver of light to
penetrate the suffocating shame.
I hope my story offers the sameto other students, residents
and practicing physicians.
I also hope my experiences helpfaculty and other educators
consider that it may beexquisitely difficult for
high-functioning students andresidents to seek help because
they are able to hide behindtheir performance.
(36:44):
Yet they can have mentalillness, receive treatment and
be successful physicians.
Gabe Nathan (36:50):
Thank you, Rachel.
Thank you for reading that, Ofcourse.
Rachel Davis (36:55):
What was it like to look back at the essay, I'm
assuming as you were preparingfor the show and probably for
the first time in a while as Iwas preparing for this show, but
(37:17):
I have had many students andresidents and practicing
physicians actually from acrossthe world reach out to me after
finding this article, and so Ihave been brought back to it
fairly often, actually becausepeople find it and reach out,
which has been very meaningfuland made me.
It's really helped me continueto be transparent about what
goes on in my brain as aphysician with OCD, because of
(37:41):
the feedback I've gotten frompeople about how much hope it's
given them, and so you know it'sinteresting to read it out loud
.
It is often hard for me toexpress my emotions or feelings
and so it's easier for me towrite it, so sometimes reading
what I've written always feels alittle awkward.
Gabe Nathan (38:02):
Well, I think you did it beautifully and I want to
say I wasn't expecting thereply about you receiving
contact from people all over theworld, and I just want to tell
you, as executive director ofthis organization that puts
stories out there you never knowhow or where they're going to
(38:26):
land and it's incrediblygratifying to me to know that
people are reaching out to youwith affection and gratitude and
shared experience, so thank youfor sharing that with me.
Rachel Davis (38:45):
Yeah, yeah.
I've even been able to mentorsome of them as they've gone
through residency or as they'reapplying to medical school and
whatnot.
Gabe Nathan (38:53):
That's wonderful.
I'm curious about something Inyour piece.
You wrote about being thepresident of the Colorado
Psychiatric Society andeliminating these screening
questions, helping make iteasier for physicians and
physicians in training to seekhelp without negative
(39:14):
repercussions.
And we did this film seriesabout first responder mental
health, police, fire, emsdispatch and of course, as I'm
sure you know and can imagine,there's myriad issues that
prevent first responders fromseeking help, particularly law
enforcement, this fear that I'mgoing to lose my gun and my
(39:36):
badge and they're going to takeme off the street and destroy my
career and all of that.
And I think there's also a fairamount of paranoia about that.
Are confidential sources reallyconfidential and is my
commanding officer going to knowand all of that.
And I'm very curious in themedical profession.
I mean, I know approximately400 physicians die by suicide in
(39:57):
America every year and that'sprobably underreported, as most
suicide stats are, I think.
Can you talk to me about thelandscape now in 2024, about
being a physician or a physicianin training and seeking help?
What is that like about being aphysician or a physician in
training?
Rachel Davis (40:15):
and seeking help.
What is that like?
I mean, there's still a lot ofstigma, I do think, compared to
other professions.
So, for example, pilots or, asyou mentioned, law enforcement,
we've come a long way.
I've certainly had patients whoare law enforcement or pilots,
and the options they have are solimited I mean, I could go off
(40:36):
on a tangent about that.
It makes zero sense why youwouldn't want a pilot or a law
enforcement person to gettreatment and obviously, if
they're not allowed to havemental illness, they're just
going to hide it right and notget treatment.
So it's not quite that way inmedical school.
You know, in Colorado, at least, we did get rid of the
(40:57):
stigmatizing questions.
That said, there are stillstates that ask people if
they've ever had a history ofmental illness and you know,
unfortunately that does dissuadepeople from seeking help,
because then they have to talkto the board about what this was
and does the board thinkthey're competent?
Because then they have to talkto the board about what this was
and does the board thinkthey're competent?
And just a lot of things thatpeople shouldn't have to go
(41:18):
through if they're functioningwell and practicing well.
I was medical director ofstudent and resident mental
health from 2013 to 2021.
And even over the course ofthose few years, I saw that
students were able to talk moreopenly about mental illness and
mental health and we have done alot of outreach, at least at
(41:40):
University of Colorado, andbeing proactive about
encouraging people to come ineven before there's a problem.
But there's still people whocome from families where there's
stigma and it's not okay tohave mental illness.
People come from cultures ortowns.
So it's definitely still thereand it still is there in
medicine too, and a lot ofstates have what are called peer
(42:05):
monitoring agencies where youcan self-refer if you know that
you have any sort of diagnosisit could be a mental diagnosis
or a physical diagnosis that hasthe potential of ever
interfering and then, as long asyou follow their
recommendations which usually ifyou're doing well, it just
means you're staying engaged intreatment you don't have to
(42:26):
self-report to the board.
You only have to self-report tothe board if you are impaired
or if you face some sort ofconsequence because of an
illness, and that can be mentalillness or physical illness.
There's just a lot of stigmaaround mental illness.
So that's a very long-windedanswer of saying stigma is there
, but it's not as bad as someother professions.
Definitely still there, though,okay.
Gabe Nathan (42:48):
And I guess related to that.
What changes would you like tosee in medical schools
nationwide to address that?
Rachel Davis (42:59):
Which part.
Gabe Nathan (43:02):
I guess what I'm asking is culture change in
terms of you know you have to bethe leader in all situations
and you have to have your shittogether 24 hours a day because
everybody's looking to you.
And I guess, changing that kindof culture how?
Rachel Davis (43:27):
do you go about?
Gabe Nathan (43:28):
that.
Rachel Davis (43:29):
Well, this is interesting.
I was actually just talking toa Medscape reporter about this
yesterday because there was theannual report in Medscape about
medical student lifestyle inmedical school and really
highlighted that depression andsuicidal ideation and
maladaptive coping skills arestill very prevalent, very
(43:57):
prevalent.
But schools have done somethings and there are some things
nationally.
So, as a medical student, youhave to take three steps of the
board.
You take step one, which isbasic sciences, and it's a full
day exam.
You take step two, which ismore clinical, and then step
three, which is entirelyclinical, and they have changed
step one to pass-fail, whereasit used to get a score and
people weighed those scores veryheavily in considering you for
(44:18):
residency.
So now that's pass-fail, so allyou have to do is pass.
Many medical schools, includinghere at University of Colorado,
have changed to a pass-failsystem instead of a graded
system, which I think is huge,instead of a graded system,
which I think is huge, becausein medical school you know we're
all a bunch of high-achievingpeople who are used to being at
(44:39):
the top of everything, and thenyou come in and like you're kind
of in the middle or at thebottom because everybody's super
smart.
That's really difficult, and soI think changing to pass-fail
is a huge improvement.
They've also changed thecurriculum.
So when I was in medical school, we basically had lecture all
(45:01):
day long, five days a week, andthen I had to go find time to
like memorize everything afterhours or on the weekend, which
meant zero free time.
And so now they've incorporateda lot more clinical stuff in
the early years, which I thinkgives people more of a sense of
what they're doing for a purpose.
You know, learning biochemistryin my first year of medical
school, it's like this hasnothing to do with being a
doctor.
So now there's hopefully moresense of purpose, but I think
(45:24):
also just maybe moreacknowledgement about.
You know, being a doctor is hard.
It's really hard, and we dealwith very difficult situations
and it's normal for people tohave a hard time with that.
So I think normalizing that youknow what we do is hard.
You're going to struggle, andthat's normal, and you should
(45:46):
seek support and you know havingavenues of talking about that
more rather than just oh, thisis what you signed up for, you
just need to suck it up and deal.
You need to be.
You know it's hard, it's hard.
Gabe Nathan (45:58):
Yeah, and that at the end of the day, you're a
human being and you know if youdon't like it.
I think actually one of thefirst responder mental health
films there was a paramedic whowas talking about how it used to
be in the old days.
If someone was having a hardtime, we would say well, you
know, this probably isn't foryou, cupcake, and it's like no,
(46:20):
this can still be for you andyou can still be having a hard
time.
The two are not mutuallyexclusive and I think just
understanding that that's hugetoo.
Rachel Davis (46:31):
Right, Like I want my own doctor to be human and
to care if something bad happensto me, I don't want them to be
robotic and not you know, careat all.
Gabe Nathan (46:41):
Same with your pilot, same with your law
enforcement officer.
Rachel Davis (46:44):
Yes.
Gabe Nathan (46:44):
Same down the line.
Um, rachel Davis, I'm so, sograteful to you for making time.
I can't fathom the fact thatyou had an hour to sit and talk
with me, but here we are and Ijust I'm very grateful for you.
Thank you.
Rachel Davis (47:00):
Well, I appreciate this opportunity.
Thank you for inviting me.
Gabe Nathan (47:04):
Before you go.
Where can people find yourpodcast and perhaps other
writing of yours?
Rachel Davis (47:10):
Oh, thank you.
So it's Transplant Talks.
So it's on YouTube and ApplePodcasts and Spotify, but the
YouTube channel is TransplantTalks-Podcast and yeah, it's all
about has a strong focus onliving donation, but it's about
(47:31):
many aspects of transplant.
We interview a lot of peoplewho've had transplants.
We interview living donors,things like that.
I mean, I've written academicarticles.
You can go to PubMed and justput in my name although Rachel
Davis is kind of a common name,I think if you put in Rachel
Davis MD into Google, you canfind stuff I've written.
Gabe Nathan (47:50):
Yeah, awesome.
Well, thank you again forspending some time with us,
really appreciate it.
Rachel Davis (47:56):
Of course.
Thank you so much.
Gabe Nathan (48:01):
Thank you again for joining us in conversation
today.
It's beautiful to see theprogression of our contributors.
Thank you so much to our guest,dr Rachel A Davis.
She's a psychiatrist andmedical director in Aurora,
colorado.
She's doing so much to helpdiminish the stigma of mental
health challenges amongphysicians and physicians in
training.
I'm so grateful to her forhelping us learn all about how
(48:25):
she manages her OCD as asurviving and thriving physician
.
Before we leave you, we want toremind you to check out our
website, recoverydiariesorg.
There, like this podcast,you'll find additional stories,
videos and content about mentalhealth, empowerment and change.
We look forward to continuingto grow our community.
(48:48):
Thank you so much for being apart of it.
We wouldn't be here without you.
Be sure to join our mailinglist so you never miss a podcast
episode, essay or film.
I'm Gabe Nathan.
Until next time, take good care.
Hello, this is Recovery Diaries In-Depth.
I'm very excited to be talkingto our guest today.
Her name is Rachel A Davis.
She's a psychiatrist andmedical director in Aurora,
colorado.
She wrote an essay for us backin 2017 called how Does a Doctor
with OCD Navigate Life Careerand the.
Every Day We'll be talking toRachel about her essay about
(00:21):
managing her mental healthsymptoms as a physician and
where she is today.
Each week we'll bring you aRecovery Diaries contributor
folks who have shared theirmental health journey with us
through essay or video format.
We want to see where they arein their mental health journey
since initially being publishedon our website.
Our goal is to continuesupporting our diverse community
by having conversations here onour podcast to follow up and
(00:44):
see what has shifted, what haschanged and what new things have
emerged.
We're so happy to have youalong for this journey.
We want to remind you to followour show for new and back
episodes at recoverydiariesorg.
There, like the podcast, you'llfind stories of mental health,
empowerment and change.
You can also sign up for ourmailing list there so you never
miss a new podcast health,empowerment and change.
(01:05):
You can also sign up for ourmailing list there so you never
miss a new podcast episode,essay or film, and you can find
this podcast pretty muchanywhere.
You get your podcasts.
We appreciate your comments andfeedback about our show.
It helps us improve, makechanges and grow and, of course,
make sure to like, share andsubscribe.
Hi Rachel, hi there, thank youfor being on the show with me.
Rachel Davis (01:32):
Thanks for having me.
Gabe Nathan (01:33):
It is a pleasure, as it was a pleasure to edit
your essay all those years ago.
Do you remember when it was no?
Rachel Davis (01:43):
It was.
That sounds about right.
Yeah, it's been a while, though.
Gabe Nathan (01:46):
Part of the reason why we're doing this podcast is
because we as an editor and awriter have a comparatively
short time together.
When we work on a personalessay, we go back and forth,
there's a revision or two, theessay gets published and then
frequently I never hear from theperson again published and then
(02:08):
frequently I never hear fromthe person again.
And it's just such a wonderfulthing to be able to catch up and
see how you are.
What has changed since we werelast together, and it has been a
long time.
So how are you now?
Where are you now?
What's going on in your life?
How are you?
Rachel Davis (02:26):
now?
Where are you now?
What's going on in your life?
Catch us up.
Those are a lot of questions.
But how am I?
I am good I am still working atUniversity of Colorado on the
CU Anschutz campus.
I think that's where I was whenI wrote the article I am now.
I have several different roles,so my main role is Vice Chair
(02:46):
of Clinical Affairs in theDepartment of Psychiatry.
I'm also Medical Director ofour OCD program and Co-Director
of our OCD Surgical Program, sowe do deep brain stimulation for
severe and refractory OCDsevere and refractory OCD and
(03:08):
then I'm chief of all of ouroutpatient psychiatry practices,
and so I'm busy, but I likewhat I do.
I still have OCD, so stillmanage that every day.
And yeah, was there anythingelse you asked that I didn't?
Gabe Nathan (03:20):
I think that was a pretty good catch up, and you
have a podcast, correct?
Rachel Davis (03:24):
I do.
It's called Transplant Talksand it's about transplant organ
donation.
Gabe Nathan (03:32):
Are you an organ donor or a recipient?
Rachel Davis (03:36):
I'm a donor, so I donated the right lobe of my
liver in January of 2022.
January of 2022.
This is actually something Ilearned about in medical school,
22 plus years ago, and I wassitting in lecture and the
(03:59):
professor was talking about howyou could donate part of your
liver and it would regenerate.
I thought that was really cool.
I actually reached out to himafterwards and thought I was
interested in doing it and youknow, back then non-directed
donation wasn't really a thingyet or giving to an anonymous,
or giving anonymously.
But he took me seriously and hemet with me and at that point
he told me I would need to get apsychological evaluation as the
(04:20):
next step.
And I thought, oh no, I don'tthink I'm necessarily
psychologically okay, becausethis was before I got treatment
for OCD or anything and in allreality, I didn't have time to
donate part of my liver.
As a medical student, I meanit's too intensive a procedure
and recovery.
But it's always been there inthe back of my mind and you know
, fast forward 20 years.
(04:42):
I was doing my charting onlineand I came across an article
that UC Health had put out aboutsomeone who's a double donor.
So she had actually donated oneof her kidneys and part of her
liver to an infant and there wasa link to the form and, without
really even thinking, I justfilled it out and you have to
put in all your medical historyand all your medications and I
(05:03):
take a lot of medications and Ihave OCD and so I followed it up
with an email.
I said, hey, I just put in thisapplication.
You're going to see mymedication list and think, oh no
, but you know, actually Ifunction quite well, I'm on
faculty here and, yeah, I justgave him heads up.
And so a few months later I wasdonating the right lobe of my
(05:24):
liver to someone I didn't knowat the time, but I've met since
then and she's an important partof my life and for me.
You know, we haven't reallystarted talking about my OCD yet
, but this was very significantto me because as a child I was
afraid of my body and I hadhealth anxiety, what we used to
call hypochondriasis, and youknow I would stay up late
(05:49):
learning all the symptom flowcharts and anyway, to be able to
go from that to feelingconfident enough in my body to
undergo a major surgery was abig milestone, and also to be
someone with mental healthdiagnoses, who takes a lot of
medication, who could also befound to be healthy enough to
make a decision to donate partof her liver.
(06:10):
So that was a very long answerto your question.
Yes, I'm a liver donor.
Gabe Nathan (06:15):
Extraordinary one at that, and thank you so much
for sharing that.
And you also answered myfollow-up question, which, of
course, in preparation for thisinterview.
I went back to your essay and,as you were talking earlier, I
was thinking about Rachel thechild, and could she have
possibly envisioned that shewould be undergoing a procedure
(06:36):
like this?
What an unfathomableprogression.
And if she could see you now.
But of course she can.
Rachel Davis (06:48):
Right right.
Gabe Nathan (06:52):
In addition to asking about updates and things
like that.
Do you still have the sunconures?
Rachel Davis (06:58):
Well, I have.
No, I don't.
So one of them died of old ageand one of them died tragically,
got caught in his sleep hut.
But I have, I don't.
So one of them died of old ageand one of them died tragically,
got caught in his sleep hut,but I have.
I rescued her when she was19-year-old Sunday Conyer, so
she's a mix between a Sun Conyerand a Gen Day Conyer, and so
she's probably about 21 now.
She's a chronic plucker, whichis kind of like a bird version
(07:21):
of trichotillomania, so she'sbald.
She doesn't have feathers onanywhere she can reach, so she's
cute and bald.
Gabe Nathan (07:30):
Cute and bald what I someday aspire to.
You wrote in your essay.
I still do not often feel calmand you know, as I was listening
to you really talk about yourbio and your various
professional positions, inaddition to being an individual
(07:53):
who's living with OCD, I wasthinking to myself well, of
course she's not, of course sherarely feels calm, but that was
in 2017, feels calm, but thatwas in 2017, you wrote that and
I'm curious about now do youstill feel that way and what
helps you if you do?
What helps you attain thoserare moments of feeling calm?
Rachel Davis (08:17):
Yes, I still feel that way and that is, I think,
one of the reasons I stay sobusy, because it's easier to
manage real problems than tomanage the imaginary problems.
Your brain makes up with OCDand your brain has a lot more
time to make up problems ifyou're not doing things.
So, fortunately, I've been ableto find things that I really
enjoy doing.
I love my career.
(08:38):
I couldn't ask for a moreperfect job or positions and I
think I'm good at solving realproblems and I like kind of high
acuity situations and I likemanaging crises and really I
think it comes down to it's somuch better to actually be able
(08:59):
to do something about a problemthan with OCD, where you're like
thinking about these what ifsand there's absolutely nothing
you can do about it, but you'redoing all these compulsions
trying to do something about itand it doesn't actually change
anything.
Relaxing is hard for me.
I mean I don't do well athaving a lot of downtime.
I generally try to keep myselfbusy, but that's okay.
(09:23):
I mean it's the life I have andI like my life in general
Doesn't mean it's not hard still, but I like my life Does the
podcast help you feel calm.
Yeah, it does.
It gives me something to focuson.
So I get to use the creativepart of my mind.
I get nervous recording thingsand so I'm always a little bit
nervous when I'm talking toguests, but I enjoy it.
(09:50):
And then the editing part is alot of fun.
I do all the video editing andthat takes up a different part
of my brain and is a really gooddistraction.
Gabe Nathan (09:56):
So when you were talking about high acuity
situations and how you're kindof drawn to those and of course
I know you were an emergencymedical technician in your early
days this might be a weirdquestion Do you consider
yourself an action junkie?
Rachel Davis (10:16):
That is an interesting question, because
not, no, I don't tend to pursuethings just for, like the sake
of adrenaline, but I do like todo things that have a lot of
purpose, and often that involvesaction.
So I guess the closest thing tobeing an action or adrenaline
(10:36):
junkie would be maybe I likeclimbing but I'm terrified of
heights.
But I still do it and there'snot really a purposeful goal
there other than, like gettingto the top of something right.
So I enjoy that.
But I think the other thingsthat I've done in my life that
are kind of action-oriented allare driven by a purpose.
So you know, being an EMT, Ifelt I was helping people,
(10:58):
donating part of my liver.
I felt I was helping someone.
And I think one of the thingsabout having OCD at least for a
lot of us is we're hyper awareof all the bad things that could
happen and also hyper aware ofall the badness in this world,
and it is an awful feeling tofeel paralyzed and like you
can't do anything about it.
So I think I put myself insituations where I feel like I'm
(11:22):
doing something about it, evenif it's just for the person in
front of me, where I feel likethe badness isn't.
I'm not paralyzed by it becauseI'm doing something about it.
Gabe Nathan (11:34):
Yeah, that's so interesting and it's also so
interesting to me that when youwere talking about the various
things that may have seemedaction junkie oriented, you
mentioned the liver donation.
I never would have thought toput that in there, but in a way
it is A it's purpose-filled, itis also helping other people and
(11:57):
it is I don't know if the wordI'm looking for is dramatic, but
it's intense.
It's an intense situation toput one's body and mind and
being in, and I wonder if youfelt all of that at the time.
Rachel Davis (12:10):
Oh yeah, I mean, it definitely gave me something
to focus on.
It occupied all my thoughts forsome time.
I did a lot of research aboutit, learned what I was going
into, and then there was a wholeactual experience.
I was in the hospital for aboutsix days and then the recovery
was intense.
So, yeah, it was a meaningfulway to occupy my mind and also
(12:35):
do something in line with myvalues, Can you?
Gabe Nathan (12:39):
talk a little bit about how your OCD manifested in
your youth and the ways inwhich you responded to it, and
how those are different todayresponded to it and how those
(13:00):
are different today.
Rachel Davis (13:01):
Sure, so I'd say, as a kid, my OCD probably
started around the age of Idon't know, somewhere between
like nine and 12, but I hadprobably two main themes.
So one was like scrupulosity,or fear of doing something wrong
, and in my case it was going tohell.
I grew up Southern Baptist andso you know we had a lot of like
tent revivals and altar callsand things like that, and so
that drove my fears of going tohell.
(13:21):
And then the other area washealth anxiety, so worry that I
was going to get, you know,cancer was one of the main
concerns, but really any sort ofillness, but really any sort of
illness.
And so I guess, what did I do?
How did I manage the healthanxiety?
I mean, I would sneak upstairs,grab this AMA home journal
(13:44):
thing which had symptom charts,and I literally probably had
every symptom chart memorized.
And then I do a lot of checking, like look at my tongue, look
at my lymph nodes, I think onceI went to the doctor and I told
him I thought I had polycythemiavera, which is a disease that
mostly old men get.
(14:05):
And in terms of the religiousscrupulosity, I had a prayer
that I repeated over and over.
I did a lot of confessing.
I would always tell my mostlymy mom the things I thought I
had done wrong during the day,and at one point she told me you
know, rachel, you don't have totell us everything that you do
during the day, you don't haveto tell us all of your thoughts.
But I was often afraid I wasgoing to commit blasphemy.
(14:29):
So I was always trying tofigure out what blasphemy was,
because I didn't really knowwhat it was, but I was afraid I
was going to do it.
So that's kind of how it showedup as a kid.
Gabe Nathan (14:38):
So here's my question, and I don't know if
you covered this in your essayand of course you're going to
read it, which I'm very muchlooking forward to what was your
parents' response to issuesrelating to the scrupulosity,
issues relating to the healthanxiety?
(15:00):
I mean, did they know that thiswas going on?
Were you constantly asking themto take you to the doctor to
get examined for this, that andthe other thing?
Were there alarm bells thatwere going off?
Or was it just oh's, rachel, umor somewhere in between?
Rachel Davis (15:16):
I well, mental illness wasn't really a thing
either in our family, or atleast it wasn't talked about,
and I grew up in a really smalltown, too, where there was a lot
of stigma, so they knew I wasanxious.
Um, I think my mom describedthat even as a an infant.
I didn't like to be touched orheld, especially when I was
crying.
I just like to be let alone,and I didn't ever sleep very
(15:37):
much.
So they knew I was anxious.
Their way of dealing with it,though, wasn't necessarily to
seek out treatment.
They encouraged us to do thehard things anyway.
In fact, they kind of made us.
I had a lot of separationanxiety, and I went to music
camp because I was good at music.
I played French horn and piano,and I dreaded going and I would
(16:01):
get so homesick and I'd spendprobably the first four weeks
crying and then the second fourweeks crying because I was going
to miss everybody and having togo home.
But they, you know, they toldme I was going anyway.
I think a lot of people'sfamilies with OCD
over-accommodate.
They try to appease the anxiety, and, for better or worse, my
parents didn't do that at all.
They just were kind of likeyou're doing it.
(16:23):
Anyway, I don't care.
I do think, even though thatwas hard and hard, in many ways
it has served me well.
I mean, it has helped me pushforward in life.
I had a thought that I justforgot about.
Oh, I remember once.
So, yeah, I would often, Ithink, tell my parents I thought
(16:43):
I had something.
And I remember once I wasconvinced I had skin cancer and
I even took up pictures from thebook and I showed them.
And they're like no, and I'mlike no, you need to take me in.
And then the doctor also wasyou're like 15, you don't have
skin cancer.
And they biopsied it.
I had skin cancer.
Gabe Nathan (16:59):
So I felt like you see, I know what I'm talking
about.
Rachel Davis (17:03):
It was basal cell carcinoma, so it was the best
kind of skin cancer to have.
But I still needed to have itexcised with wide margins and I
was like I almost feltvindicated.
I'm like, see, I'm not justcrazy here, I'm.
You know, sometimes my fearsare true.
Gabe Nathan (17:18):
Did that add fuel to you at that point?
Did that make?
Did that make the healthanxiety worse?
Rachel Davis (17:25):
It didn't actually .
No, I mean no.
Gabe Nathan (17:39):
That's so interesting.
Rachel Davis (17:42):
Wow.
And so what is different today?
I mean, I'm sure, quite a bitin terms of managing the OCD and
how it manifests.
I also did.
I've been in therapy for a longtime now and some of that
therapy was OCD-specific therapy.
So exposure and response,prevention.
So I've learned a lot moreabout how to, you know, not do
(18:05):
rituals although you know Istill do rituals sometimes but I
think I have a betterunderstanding of what's going on
in my brain, which makes iteasier to, you know, keep moving
forward, and I also have abetter idea of how to respond to
it.
In college, before I gottreatment, I was miserable.
(18:31):
I studied all the time.
I couldn't study at homebecause I would cry and I
couldn't figure out how to stopcrying.
And so I finally realized if Iwent to like Barnes and Noble or
a coffee shop, there was enoughdistraction that I wouldn't
feel so sad.
I was crying and I wouldn'tfeel so anxious.
I was crying, I could actuallystudy.
So I spent all my spare time ateither Barnes and Noble or
Starbucks or whatever coffeeshop there was, and I just
(19:05):
wanted to be done with collegeso that, in my mind, then I can
go home or I can go to medicalschool.
I knew I wanted to go tomedical school, that I basically
got A pluses in every singleclass and I graduated in three
years just because I wanted tobe done.
I wasn't living life, I wassurviving.
And now I actually, even thoughmy OCD is still present, I am
(19:26):
doing things I like, I enjoy mylife, even in the presence of
things that are hard, versuseverything just being surviving.
Gabe Nathan (19:35):
You know, speaking of surviving, I'm curious about
the health anxiety just in termsof yourself, because as we get
older, things are going tohappen and I'm just curious
about how you're living withthat part of it now.
Rachel Davis (19:54):
You know that part of it isn't really a thing
anymore.
I don't know why, but I'm notreally anxious about my health,
but that part is just kind ofresolved, I think.
So as a kid I was hyper-focusedon anything medical, so it
wasn't only a fear, it was aninterest, like almost a
(20:14):
hyper-fixation.
So I loved my mom's ladies'magazines.
I would find all the medicalarticles and read them.
I was fascinated.
I think my favorite gift waswhen I got this anatomy model as
a kid that I got to puttogether and I was very proud of
Everything medical I loved, andso it was weird to have that
juxtaposition.
And now, if I have somethingmedical going on, like donating
(20:37):
part of my liver, I wasfascinated by it.
I found it interesting, I lovedresearching it, but I wasn't
afraid of it.
So that fear part has gone away.
I don't know exactly why.
Gabe Nathan (20:46):
And the scrupulosity.
Rachel Davis (20:48):
Scrupulosity is still there.
It's not religious scrupulosityanymore.
You know, I, like I mentioned,grew up in a very conservative
family, religious family.
I am also gay and for a whilein college and early in medical
school that caused a lot ofdistress in my head, trying to
reconcile how I grew up withwhat I knew about myself, and so
(21:11):
I spent a lot of time doingpartly what was useful but
partly what was also probablycompulsive reading the Bible and
comparing the Greektranslations and the Hebrew
translations.
And what does it really mean?
And all these passages peoplesay about why it's wrong to be
gay and ultimately landed on.
I don't actually think it'swrong.
This is just kind of rhetoricthat people have passed along
(21:33):
and I need to make my ownchoices and my own decisions.
And you know, I know what itmeans to me to be a good person,
to be a kind person, to be acompassionate person, and I can
do that.
So I'm not really focusedanymore on going to hell or, you
know, sinning per se, but I dostill.
I would say I may be kind of ahyper moral person.
(21:55):
I'm always worried about doingthe right thing.
I don't want to hurt people.
I'm often afraid I'm hurtingpeople, I often, you know, find
myself wanting to apologize,excessively, super conscientious
.
So I guess it's turned intomore sort of moral scrupulosity
as opposed to religiousscrupulosity, but that part's
still there.
Gabe Nathan (22:14):
The part in your essay which we're going to get
to after this bit that reallyresonated with me, just as a
person and a human being andalso someone who lives with
mental illness, when you wroteabout how I think it was a
supervisor who turned to you andsaid you know, you always come
(22:36):
into work looking like you'vedone something wrong.
And I used to work at a lockedinpatient psychiatric hospital
and my supervisor said to me onemorning you always look like
you're coming in about to befired, like this is your last
day here, and for five years,every single day, that was how I
(22:59):
lived my life and my shiftstarted at 7 am.
I would be in the parking lotat 5.15 in the morning.
I would come in.
The overnight nurses wouldstill be there.
They were never supposed to seeme because the shifts changed
at seven.
But I got to know all theovernight nurses very, very well
because I would come downstairs, clean up all of the messes
(23:21):
from the night before, do all ofthe paperwork for my supervisor
in the morning that I wasn'teven supposed to be doing, get
all the schedules ready, learneverything about the patients
who had been admitted overnight.
I could not stop myself and Icould not stop myself from
waking up at four o'clock in themorning, three o'clock in the
morning, obsessing about who hadbeen admitted overnight, who
(23:44):
had gotten assaulted the nightbefore, what was the acuity on
the unit, and even still I wasterrified that I was going to be
fired that day, that I had donesomething wrong, that I was
going to say something wrong,that they knew I was an imposter
, that I had no business workingthere.
Just such empathy for you inthat moment of just knowing what
(24:15):
that feels like and what ashitty way it is to go through
each day with all of that noisein your brain.
I don't believe I'm a competentprofessional at your level, but
I know I did the job that I hadto the very best of my
abilities and yet you're stillhijacked by that internal
(24:36):
monologue that's so abusive andharmful.
So I just wanted to tell youthat.
Rachel Davis (24:42):
Yeah, I mean totally.
That's the thing about OCD isit doesn't matter how well
you're doing or how thorough youare or how competent you are,
you just don't feel that you are.
And part of the problem is wewant to feel that way.
Right, that's what most peopleget to do.
They get to do a good job andthey get to feel like they did.
But we don't feel like they did, but we don't.
(25:07):
And I always tell my patientstoo, like that's not really fair
, it's kind of a.
It's a very difficult way to goabout life.
It's almost like going aboutlife with chronic pain, except
this is chronic pain in yourbrain, and you have to learn how
to move forward, even withoutfeeling that things are okay,
without feeling that you're goodenough, without feeling that
things are, you know, going tobe fine.
You just have to move forwardanyway.
Gabe Nathan (25:27):
Yeah, because that just may never come.
Rachel Davis (25:30):
Right.
Gabe Nathan (25:31):
Well, with that, I would love it if you would turn
to your essay in your hymnal,written for us in around 2017.
And it is called how Does aDoctor with OCD Navigate Life
Career and the Everyday by DrRachel Davis, whenever you're
ready.
Rachel Davis (25:53):
In medical school, my peers described me as a
mousy person who just kept toherself.
Not long ago I heard throughthe grapevine that a former
classmate remembers me as a nota nice person.
I immediately felt angry, sadand defensive, but I know why I
was perceived that way.
I kept to myself and seemed toonly care about grades.
I know that people didn'treally like me.
(26:14):
I seemed standoffish and cold,but I didn't mean to be.
I wasn't trying to honoreverything.
I was just trying not to fail.
I was trying to managedebilitating anxiety so I could
become a doctor.
As I think back about my timein medical school, I'm sad about
how I was trying to managedebilitating anxiety so I could
become a doctor.
As I think back about my timein medical school, I'm sad about
how I was perceived and howmuch I struggled.
I feel compassion for myselfnow, as something was going on,
(26:35):
something that even I didn'tfully understand, something I'd
wish I'd known when I was that22-year-old medical student.
I grew up in a religious familyin rural southeastern Colorado
and, for reasons I still don'tentirely understand, I always
wanted to be a doctor.
For that desire I am eternallygrateful.
It is a gift that has given mepurpose and direction.
(26:56):
When I was three so legend hasit I wanted to be a brain
surgeon.
When I was 11 or 12, I wouldsneak upstairs after my parents
had gone to bed, grab theAmerican Medical Association
family medical guide and stay uplate memorizing symptom flow
charts.
By the time I was 13, Idetermined I had polycythemia
vera and possibly Hodgkin'slymphoma.
(27:17):
One night I stayed up late intothe early morning hours sitting
on my bathroom sink trying tomake sure I wouldn't
accidentally swallow my tongue.
The thought consumed me.
The human body fascinated meand it terrified me.
I was a creative child andcreativity in my mind fostered
boundless worries.
When we'd drive by a caraccident, I would perseverate on
(27:38):
gruesome images and horriblethoughts about what must have
happened to the people inside.
Weekly Sunday school Biblestudies and Southern Baptist
revivals fueled my fear of goingto hell, and I would attempt to
prevent this outcome byhabitually reciting Dear God,
please forgive me, I love youvery, very much.
In Jesus' name, I pray Amen.
For as long as I can remember,I have lived with a constant
(28:00):
sense of dread and a fear thatsomething was and is terribly
wrong.
I took an emergency medicaltechnician EMT class when I was
15 and started volunteering withour rural ambulance squad.
I worked as a certified nursingassistant at our local nursing
home.
I exposed myself to blood anddeath.
I comforted a 19-year-old boyas he died in a ditch, crushed
(28:22):
beneath a van.
I prayed that a beautiful,blue-eyed, blonde little girl
would live, as a police officerdragged her lifeless body out
beneath a van.
I prayed that a beautiful,blue-eyed, blonde little girl
would live, as a police officerdragged her lifeless body out of
a lake.
She did not live and instead Isat with my hand on her mother's
shoulder as she screamed.
I comforted a woman withdementia as I dried her after a
bath.
I remember her timid, beautifulvoice as she started singing
(28:43):
when peace, like a river,attendeth my way.
I joked with a 73-year-old manas I cleaned the pus from around
his catheter, trying to helphim preserve some sense of
dignity.
I washed glass out of a man'shair sullenly and quietly.
A couple of hours after wepicked up the body parts of his
friend off the highway.
This is how I began to learn tolive.
(29:05):
Helping others during the worsttimes in their lives gave
meaning to my life.
Now I understand that thismeaning was also helping me move
beyond the horrible noise in myhead.
I was tortured during my firstyear of medical school.
I barely slept.
I learned it was easier to getup in the morning if I drank a
lot of coffee before going tobed at 2 am.
I snuck away between eachlecture to be by myself for a
(29:28):
few minutes.
Attempting to calm my mind, Irecited the Lord's prayer over
and over and over and over.
My preceptor asked if I was allright because I was so thin,
not so thin, too thin.
I was too thin partly because Ididn't make enough time to eat
and partly because I was soworried about money that I
didn't buy enough food.
I was so ashamed that mypreceptor had noticed.
(29:50):
I couldn't let go of the imagesI had seen during my time as an
EMT.
Things were unraveling 9-11happened during first-year
anatomy and I couldn't stopthinking about death.
My experiences as an EMT werenecessary and critical in
helping me move past my anxietyand actually live life.
It was less painful to dealwith real trauma than to be
(30:12):
helpless against my fears.
I could actually do somethingabout real-life disasters, even
if it was just being with peopleas they died.
But these experiences as anadolescent and early adult did
add another layer of traumaticexperience to the primary trauma
of living in my brain.
My time on the ambulance was adouble-edged sword, but I don't
know that I could havedisentangled myself from my
(30:33):
anxiety without this exposureand without my overarching goal
of becoming a doctor.
A classmate of mine wrote in ourschool's humanities journal
about his struggle withdepression.
I reached out to him.
He was kind and this gave methe courage to ask for help, but
not right away.
I told my parents that Ithought I might be depressed and
(30:54):
they told me I probably wasn't.
They would not, or perhapscould not, accept that their
daughter was struggling.
When I did finally allow myselfto see a therapist, I only felt
comfortable seeing a Christiantherapist.
This therapist asked me to sitand listen to God, so I spent
hour after hour sitting insilence wondering what was wrong
with me, because God certainlywasn't speaking to me.
This only made things worse.
(31:16):
So I eventually surrendered andsaw a secular psychiatrist.
She prescribed medication andwe met weekly for therapy.
This was the beginning of a newlife.
I began to have room to breatheand the strength and space to
interact with other people.
It was also when I wasdiagnosed with obsessive
compulsive disorder, or OCD.
Fortunately, despite OCD andthanks to meds and therapy, I
(31:38):
enjoyed my clinical rotations.
I provided good care and mypatients, residents and
attending liked me.
It was nice to be liked, sinceI didn't have to direct all my
energy towards survival.
I had more room for the nuancesof human interaction.
I felt more normal and a littleless alienated from the
category of human.
However, even with treatment, Istill had religious and other
(32:00):
obsessions.
On the obstetrics gynecologyservice, I couldn't bring myself
to participate in abortions andsome other procedures, not
because I wanted or needed tomake a political statement, nor
because I felt judgmental.
Rather, it was because I wasstill afraid of going to hell, a
remnant of scrupulosity carriedover from growing up as a child
with OCD in a very conservativeSouthern Baptist family in
(32:22):
rural Colorado.
It was because, while I hadfigured out how to do well in
medical school, I still hadsevere OCD, a diagnosis I wish I
had known sooner.
I have compassion for myselfnow.
Back then I just felt shame.
Now, a doctor for 13 years, I amprivileged to serve as the
medical director of student andresident mental health on a
(32:43):
health professions campus.
I am passionate about helpingmy student and resident patients
discover how to thrive, notjust survive.
I am moved when I have theopportunity to help someone
change their perspective fromdesperately avoiding failure to
pursuing meaning and joy.
It is my mission to help mypatients remember they are
indeed resilient.
I strive to reduce stigma andcombat the fear that seeking
(33:04):
help for mental health issueswill interfere with being a
physician.
Last year, as president of theColorado Psychiatric Society, I
collaborated with keystakeholders to work with the
Colorado Department ofRegulatory Agencies to eliminate
the mental illness screeningquestions that stigmatize and
marginalize mental healthproblems and discourage students
, residents and practicingphysicians from seeking the
(33:24):
treatment they need.
I still have OCD.
I'm a doctor with OCD.
A couple of years ago one of mysupervisors remarked you come
in here every week looking likeyou've done something wrong.
I was embarrassed that hepicked up on that, but he was
right.
I still live with the perpetualfeeling that I have done or
will soon do something terriblywrong.
I have learned to live andpractice effectively despite
that feeling, but I guess Idon't soon do something terribly
(33:45):
wrong.
I have learned to live andpractice effectively despite
that feeling, but I guess Idon't always succeed at hiding
it.
It resonated with me one timewhen a particularly articulate
patient with OCD shared howexasperated she is of being told
she has a resting bitch face.
She said an OCD sufferer isfighting a war with a brain that
randomly gets hijacked byhorrifying images and thoughts,
(34:07):
and sometimes this secret warmakes its way out of our
tortured brains and furrows ourbrows, making us look bitchy.
I'm aware I still sometimescome off as standoffish and
overachieving.
This is because I'm trying notto let my OCD show through and
I'm doing my best to make surebad things don't happen.
(34:27):
My desire to be a doctor is whathelped me overcome my extreme
anxiety, and my desire tocontinue to be the best possible
doctor helps me navigate eachday.
I feel very fortunate that Iseem to have been born with a
purpose.
I have also come to realize itis not only in spite of my OCD
that I am a physician, but alsobecause of it.
I was driven to do hard thingsat a young age, in part because
(34:53):
I needed a distraction and asense of meaning outside of the
chaos in my brain.
My OCD leads me to be extremelyconscientious, very honest,
empathetic and perfectionisticcharacteristics that, when
reined in, contribute to being agood physician.
I like working with very illpatients, especially in the
emergency department, becausebad things are expected to
happen and I am prepared tomanage bad things.
(35:14):
I feel comfortable working withsuicidal patients and panicked
patients and desperate patientsbecause I am good at managing
crises and bringing calm tochaos.
I've learned how to take alifelong struggle and utilize
certain aspects of it for good.
This doesn't mean everything isperfect.
I still do not often feel calm.
I have learned that my brain israrely capable of feeling
(35:36):
capable, so I just move forward.
I still take medication and Isee a cognitive behavioral
therapist.
I incorporate exposure andresponse, prevention, erp
principles into my daily lifeAll day, every day, I make
conscious decisions to resistthe OCD and make choices that
lead to effective functioningboth for me and my patients.
I have learned to set aside, onmost days, the constant feeling
(35:59):
that something is dreadfullywrong, but sometimes I still
listen to my fears, like when mypatient misses an appointment
and I find myself on Googletrying to find her obituary.
I see so many students andresidents afraid to be seen as
weak, afraid to be human, sofull of shame that they might
need help or possibly even havean illness.
The classmate of mine who wroteabout depression, gave me a
(36:22):
gift in his story and thisallowed a sliver of light to
penetrate the suffocating shame.
I hope my story offers the sameto other students, residents
and practicing physicians.
I also hope my experiences helpfaculty and other educators
consider that it may beexquisitely difficult for
high-functioning students andresidents to seek help because
they are able to hide behindtheir performance.
(36:44):
Yet they can have mentalillness, receive treatment and
be successful physicians.
Gabe Nathan (36:50):
Thank you, Rachel.
Thank you for reading that, Ofcourse.
Rachel Davis (36:55):
What was it like to look back at the essay, I'm
assuming as you were preparingfor the show and probably for
the first time in a while as Iwas preparing for this show, but
(37:17):
I have had many students andresidents and practicing
physicians actually from acrossthe world reach out to me after
finding this article, and so Ihave been brought back to it
fairly often, actually becausepeople find it and reach out,
which has been very meaningfuland made me.
It's really helped me continueto be transparent about what
goes on in my brain as aphysician with OCD, because of
(37:41):
the feedback I've gotten frompeople about how much hope it's
given them, and so you know it'sinteresting to read it out loud
.
It is often hard for me toexpress my emotions or feelings
and so it's easier for me towrite it, so sometimes reading
what I've written always feels alittle awkward.
Gabe Nathan (38:02):
Well, I think you did it beautifully and I want to
say I wasn't expecting thereply about you receiving
contact from people all over theworld, and I just want to tell
you, as executive director ofthis organization that puts
stories out there you never knowhow or where they're going to
(38:26):
land and it's incrediblygratifying to me to know that
people are reaching out to youwith affection and gratitude and
shared experience, so thank youfor sharing that with me.
Rachel Davis (38:45):
Yeah, yeah.
I've even been able to mentorsome of them as they've gone
through residency or as they'reapplying to medical school and
whatnot.
Gabe Nathan (38:53):
That's wonderful.
I'm curious about something Inyour piece.
You wrote about being thepresident of the Colorado
Psychiatric Society andeliminating these screening
questions, helping make iteasier for physicians and
physicians in training to seekhelp without negative
(39:14):
repercussions.
And we did this film seriesabout first responder mental
health, police, fire, emsdispatch and of course, as I'm
sure you know and can imagine,there's myriad issues that
prevent first responders fromseeking help, particularly law
enforcement, this fear that I'mgoing to lose my gun and my
(39:36):
badge and they're going to takeme off the street and destroy my
career and all of that.
And I think there's also a fairamount of paranoia about that.
Are confidential sources reallyconfidential and is my
commanding officer going to knowand all of that.
And I'm very curious in themedical profession.
I mean, I know approximately400 physicians die by suicide in
(39:57):
America every year and that'sprobably underreported, as most
suicide stats are, I think.
Can you talk to me about thelandscape now in 2024, about
being a physician or a physicianin training and seeking help?
What is that like about being aphysician or a physician in
training?
Rachel Davis (40:15):
and seeking help.
What is that like?
I mean, there's still a lot ofstigma, I do think, compared to
other professions.
So, for example, pilots or, asyou mentioned, law enforcement,
we've come a long way.
I've certainly had patients whoare law enforcement or pilots,
and the options they have are solimited I mean, I could go off
(40:36):
on a tangent about that.
It makes zero sense why youwouldn't want a pilot or a law
enforcement person to gettreatment and obviously, if
they're not allowed to havemental illness, they're just
going to hide it right and notget treatment.
So it's not quite that way inmedical school.
You know, in Colorado, at least, we did get rid of the
(40:57):
stigmatizing questions.
That said, there are stillstates that ask people if
they've ever had a history ofmental illness and you know,
unfortunately that does dissuadepeople from seeking help,
because then they have to talkto the board about what this was
and does the board thinkthey're competent?
Because then they have to talkto the board about what this was
and does the board thinkthey're competent?
And just a lot of things thatpeople shouldn't have to go
(41:18):
through if they're functioningwell and practicing well.
I was medical director ofstudent and resident mental
health from 2013 to 2021.
And even over the course ofthose few years, I saw that
students were able to talk moreopenly about mental illness and
mental health and we have done alot of outreach, at least at
(41:40):
University of Colorado, andbeing proactive about
encouraging people to come ineven before there's a problem.
But there's still people whocome from families where there's
stigma and it's not okay tohave mental illness.
People come from cultures ortowns.
So it's definitely still thereand it still is there in
medicine too, and a lot ofstates have what are called peer
(42:05):
monitoring agencies where youcan self-refer if you know that
you have any sort of diagnosisit could be a mental diagnosis
or a physical diagnosis that hasthe potential of ever
interfering and then, as long asyou follow their
recommendations which usually ifyou're doing well, it just
means you're staying engaged intreatment you don't have to
(42:26):
self-report to the board.
You only have to self-report tothe board if you are impaired
or if you face some sort ofconsequence because of an
illness, and that can be mentalillness or physical illness.
There's just a lot of stigmaaround mental illness.
So that's a very long-windedanswer of saying stigma is there
, but it's not as bad as someother professions.
Definitely still there, though,okay.
Gabe Nathan (42:48):
And I guess related to that.
What changes would you like tosee in medical schools
nationwide to address that?
Rachel Davis (42:59):
Which part.
Gabe Nathan (43:02):
I guess what I'm asking is culture change in
terms of you know you have to bethe leader in all situations
and you have to have your shittogether 24 hours a day because
everybody's looking to you.
And I guess, changing that kindof culture how?
Rachel Davis (43:27):
do you go about?
Gabe Nathan (43:28):
that.
Rachel Davis (43:29):
Well, this is interesting.
I was actually just talking toa Medscape reporter about this
yesterday because there was theannual report in Medscape about
medical student lifestyle inmedical school and really
highlighted that depression andsuicidal ideation and
maladaptive coping skills arestill very prevalent, very
(43:57):
prevalent.
But schools have done somethings and there are some things
nationally.
So, as a medical student, youhave to take three steps of the
board.
You take step one, which isbasic sciences, and it's a full
day exam.
You take step two, which ismore clinical, and then step
three, which is entirelyclinical, and they have changed
step one to pass-fail, whereasit used to get a score and
people weighed those scores veryheavily in considering you for
(44:18):
residency.
So now that's pass-fail, so allyou have to do is pass.
Many medical schools, includinghere at University of Colorado,
have changed to a pass-failsystem instead of a graded
system, which I think is huge,instead of a graded system,
which I think is huge, becausein medical school you know we're
all a bunch of high-achievingpeople who are used to being at
(44:39):
the top of everything, and thenyou come in and like you're kind
of in the middle or at thebottom because everybody's super
smart.
That's really difficult, and soI think changing to pass-fail
is a huge improvement.
They've also changed thecurriculum.
So when I was in medical school, we basically had lecture all
(45:01):
day long, five days a week, andthen I had to go find time to
like memorize everything afterhours or on the weekend, which
meant zero free time.
And so now they've incorporateda lot more clinical stuff in
the early years, which I thinkgives people more of a sense of
what they're doing for a purpose.
You know, learning biochemistryin my first year of medical
school, it's like this hasnothing to do with being a
doctor.
So now there's hopefully moresense of purpose, but I think
(45:24):
also just maybe moreacknowledgement about.
You know, being a doctor is hard.
It's really hard, and we dealwith very difficult situations
and it's normal for people tohave a hard time with that.
So I think normalizing that youknow what we do is hard.
You're going to struggle, andthat's normal, and you should
(45:46):
seek support and you know havingavenues of talking about that
more rather than just oh, thisis what you signed up for, you
just need to suck it up and deal.
You need to be.
You know it's hard, it's hard.
Gabe Nathan (45:58):
Yeah, and that at the end of the day, you're a
human being and you know if youdon't like it.
I think actually one of thefirst responder mental health
films there was a paramedic whowas talking about how it used to
be in the old days.
If someone was having a hardtime, we would say well, you
know, this probably isn't foryou, cupcake, and it's like no,
(46:20):
this can still be for you andyou can still be having a hard
time.
The two are not mutuallyexclusive and I think just
understanding that that's hugetoo.
Rachel Davis (46:31):
Right, Like I want my own doctor to be human and
to care if something bad happensto me, I don't want them to be
robotic and not you know, careat all.
Gabe Nathan (46:41):
Same with your pilot, same with your law
enforcement officer.
Rachel Davis (46:44):
Yes.
Gabe Nathan (46:44):
Same down the line.
Um, rachel Davis, I'm so, sograteful to you for making time.
I can't fathom the fact thatyou had an hour to sit and talk
with me, but here we are and Ijust I'm very grateful for you.
Thank you.
Rachel Davis (47:00):
Well, I appreciate this opportunity.
Thank you for inviting me.
Gabe Nathan (47:04):
Before you go.
Where can people find yourpodcast and perhaps other
writing of yours?
Rachel Davis (47:10):
Oh, thank you.
So it's Transplant Talks.
So it's on YouTube and ApplePodcasts and Spotify, but the
YouTube channel is TransplantTalks-Podcast and yeah, it's all
about has a strong focus onliving donation, but it's about
(47:31):
many aspects of transplant.
We interview a lot of peoplewho've had transplants.
We interview living donors,things like that.
I mean, I've written academicarticles.
You can go to PubMed and justput in my name although Rachel
Davis is kind of a common name,I think if you put in Rachel
Davis MD into Google, you canfind stuff I've written.
Gabe Nathan (47:50):
Yeah, awesome.
Well, thank you again forspending some time with us,
really appreciate it.
Rachel Davis (47:56):
Of course.
Thank you so much.
Gabe Nathan (48:01):
Thank you again for joining us in conversation
today.
It's beautiful to see theprogression of our contributors.
Thank you so much to our guest,dr Rachel A Davis.
She's a psychiatrist andmedical director in Aurora,
colorado.
She's doing so much to helpdiminish the stigma of mental
health challenges amongphysicians and physicians in
training.
I'm so grateful to her forhelping us learn all about how
(48:25):
she manages her OCD as asurviving and thriving physician
.
Before we leave you, we want toremind you to check out our
website, recoverydiariesorg.
There, like this podcast,you'll find additional stories,
videos and content about mentalhealth, empowerment and change.
We look forward to continuingto grow our community.
(48:48):
Thank you so much for being apart of it.
We wouldn't be here without you.
Be sure to join our mailinglist so you never miss a podcast
episode, essay or film.
I'm Gabe Nathan.
Until next time, take good care.
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