December 3, 2025 • 34 mins
What if the most powerful tool you carry into patient care isn’t a device or a protocol, but the way your brain has been trained to pay attention? I sit down with one of my mentors, Dr. Cassie Ferguson, pediatric emergency physician, medical educator, and architect of The Good Doctor well‑being curricula, to unpack how neuroplasticity, mindfulness, and self‑compassion can make medicine more humane and more sustainable.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
SPEAKER_00 (03:36):
This Wellness Wednesday is brought to you by
CAA Matters, the firstcomprehensive wellness and
professionalism curriculumdesigned to truly support the AA
student experience.
We all know AA education isstreamlined to produce competent
providers in a fast-pacedprogram.
Meanwhile, wellness andprofessionalism often get
(03:58):
overlooked, lumped in withmedical students, or addressed
too late to help.
CAA Matters fills this gap,centering student
anesthesiologist assistance andequipping them with the tools,
resources, and mindset shifts tosucceed in school and build
long, fulfilling careers.
(04:18):
It's a turnkey curriculum, fullyprepared, facilitated, and
supported from planning todelivery.
Program leaders and AA educatorscan learn more, read reviews
from early adopters, and explorepiloting CAA Matters at
awakenedanesthetist.com or byclicking the link in the show
notes.
(04:52):
And I think I said this to youbefore, like like-minded people
in medicine who are on awellness journey are not
oftentimes at the front centerstage.
They are, you know, more pulledinward.
They're protecting their energy.
They have boundaries.
They're hard to find.
They're hard to haveconversations with.
SPEAKER_01 (05:08):
Yeah.
So yeah.
I totally understand that.
SPEAKER_00 (05:13):
Yes.
So uh I'm grateful for yourtime.
And yeah, so maybe just startoff with who you are, where you
are in medicine, and maybe yourwork with the good doctor would
be a great place to start.
SPEAKER_01 (05:24):
Sure.
Absolutely.
My name's Cassie Ferguson.
I am, I like to say that myevening job is uh pediatric
emergency medicine physician.
So I work in the emergencydepartment at our children's
hospital uh here in Milwaukee,Wisconsin.
So that's what I do clinically.
Uh during the daytime, I work ummostly with students.
(05:50):
So I do various things invarious capacities with
students.
My favorite thing to do,honestly, and in my entire job
is to teach.
So one of the courses that I ama part of and an instructor in
is called the Good Doctor.
Um I refer to it as the Good-ishDoctor, which sort of is just my
(06:10):
bent on how we view ourselvesand how that impacts our ability
to stay present and makemistakes.
But um the good doctor focuseson three different threads in
medicine that aren'ttraditionally taught or haven't
been traditionally taught.
The first is medical ethics,which certainly has made its way
(06:33):
into our curriculum in the past,um, but this is really focused
on making ethics a bit moreaccessible to people who are
learning medicine.
Uh, the second is professionaldevelopment.
And the third thread is thethread that I am in charge of,
and that is really focused onwell-being.
(06:54):
You know, well-being, I don'tknow, I don't think that that
really captures everything thatwe teach or that I that I talk
about in the course.
I'd say really we're focused onteaching students, medical
students, the skills, the verypractical, hands-on skills that
we need as um people who witnessand um are present for the
(07:22):
suffering of other human beings,really in order to be a
compassionate presence, butalso, you know, really to have a
sustainable career.
So that's that's what I what Imost like about my job is
teaching students about that.
I also direct one of the othercourses in our medical school,
(07:44):
which is called Health SystemScience.
And there's definitely a lot ofoverlap between health systems
and um sort of learning to bewhole within medicine.
Um, and so you know, I talkabout that a lot when I'm
talking about systems.
SPEAKER_00 (08:00):
And just for the CAAs, you know, my audience
obviously is wholly CAAs, Iimagine.
Um, and they maybe are assumingthat I found you because there
is an AA program at the MedicalCollege of Wisconsin, which is
where you work.
That's the medical school youteach with and for.
Um, but actually I found youbecause it what seems like
(08:23):
almost a decade ago now for you,you developed a longitudinal
professional wellness, you know,curriculum for the Medical
College of Wisconsin calledREACH, which is an acronym.
Maybe say what the acronym'sfor.
SPEAKER_01 (08:39):
REACH stands for recognize, empathize, allow,
care, and hold each other up,which I realize is probably
beyond that acronym, but uh, butthat's what it stands for.
SPEAKER_00 (08:54):
I like it.
It starts with an H.
I think it works.
So my listeners who know whatI'm passionate about know what
drew me then to you.
Because I found basically aresearch paper that you had
written in collaboration withsome others talking about this
new curriculum that you hadcreated and its effectiveness
and what the students werethinking about it.
(09:14):
And I was like, oh my gosh, Ijust found the first person ever
who's doing something that Iwant to do.
I need to talk to this person.
And I reached out to you and youwere so generous to, you know,
share a little bit of theexcitement I had to talk to you
to also be willing to speak withme.
And so now we kind of meet, youknow, monthly.
And I'm just so excited to haveyou in my circle now as a mentor
(09:36):
and as a friend.
Um, and you had invited me thento drop into one of your
classes.
Actually, I'm pretty sure Isaid, Can I come to one of your
classes?
Uh, and you were teaching onneuroplasticity, which is
something that has been hugelyimportant in my own personal
wellness journey, also hugelyimportant for the work that I'm
(09:58):
doing through CAA Matters, andhugely important to the work
you're trying to do through thegood doctor.
I would love to have you explainjust maybe as simply as you can
what neuroplasticity is.
And then we'll kind of get intoits importance.
SPEAKER_01 (10:13):
Sure, absolutely.
And thanks for that uh thatintroduction.
I mean, I I am always thrilledto find someone who is as
interested in talking aboutwell-being in this way as I am.
I don't think that that is verycommon, honestly.
Um, but you know, I think thethis lecture on neuroplasticity
(10:34):
is really an example of of how Ilike to approach teaching
well-being to medical studentsand really anyone who is in
healthcare, because I think allof us have this respect for
science, um, respect for, youknow, really robust research and
(10:54):
our ability as scientists tosort of change our mind over,
you know, years and decadesabout how our bodies work,
particularly how our brainworks, because I think that's
probably the organ in our bodythat we know the least about.
And neuroplasticity really sortof follows in that pattern.
So, neuroplasticity, the way Ithink about it is that it refers
(11:16):
to just it's a capacity of thebrain.
And this capacity is really tochange in response to what we
do, what we think about, what weexperience in any given day.
Now, that doesn't mean that ourbrain is constantly changing,
you know, to everything thathappens in a given day or a
(11:37):
given moment, but the capacityis there.
And I think what's reallyfascinating to me is I was an
undergraduate student at UCLA inthe sort of mid to late 90s,
dating myself a bit, but um, andI was a psychology major, and
uh, you know, a lot of theclasses I took were focused on
neuroscience because that'sreally what I liked the most
(11:59):
about psychology.
And even then we didn't believeor we weren't taught that the
brain had this capacity.
Um, it was really thought orbelieved that sort of all the
changes that our brain wascapable of of making would
happen early on in our life, youknow, in our childhood or young
adulthood.
(12:20):
And then that capacity like sortof dwindled to nothing.
And we just over the years wewould just sort of lose brain
cells.
And that was pretty much how ourbrain changed from then on.
And now we know through you knowseveral different people that
the mature brain is malleableand is actually capable even of
(12:43):
regeneration, um, and that itdoes so continuously throughout
life.
And you know, those are both umstructural changes.
So like we actually can seechanges in volume in certain
parts of the brain in responseto you know a brain injury.
Other areas of the brain willcompensate by literally changing
(13:06):
in size, formation of new neuralpathways, you know, for the same
reason.
And then there's also functionalchanges, so changes to like the
frequency of how much a certaingroup of neurons fires, or um,
you know, it changes the amountof chemicals or chemical signals
that are released betweenneurons, um, and so changes the
(13:28):
way they communicate.
So that changes the strength ofconnections between groups of
neurons.
And, you know, we sort of had anidea that that could happen in
response to injury, somethinglike stroke.
But I think more recently, andwhat I'm most excited about is
that we're learning that we can,as you know, sort of agents, um,
(13:49):
or you know, with our ownagency, practice or do practices
that will actually change ourbrain, either structurally or
functionally, um, things likemeditation and mindfulness.
And so that's really what I'mexcited about and why I teach it
in the well-being course isbecause these are practices that
(14:14):
can be used to impact ourwell-being.
And I feel like this isimportant both for you know
health professional students toknow so that they can actually
relay these to their patients,right?
Because that's like what anamazing thing to be able to talk
with your patients.
And you know, what I focus on ishow we can um change the way,
(14:39):
again, change the way that we'represent for the suffering of
other people so that medicinebecomes a more sustainable
career.
SPEAKER_00 (14:46):
I have a thousand follow-up questions, Cassie.
Yeah.
Um, but first, my headphones aredoing something weird.
One second.
My 11-year-old got to these.
I know you know what this islike.
So I'm I think he broke thisside, maybe or something,
because it won't stay in.
Okay, well then that's I'll I'lljust like be like this.
(15:07):
Oh, okay.
I get it.
Um I think I want to first askyou because the science changed
during the course of youreducation or you know, after
residency, how did you come tofind out that neuroplasticity
was real?
Was it a prof like a personaljourney?
(15:28):
Was it a professional journey?
Were you teaching on it?
SPEAKER_01 (15:31):
Yeah.
So there is a researcher nameduh Richie Davidson.
He is a researcher at uh theUniversity of Wisconsin-Madison,
so just down the street from us,or down the freeway from us.
Um, and he teaches or startedthe Center for Healthy Minds
there.
And he's written a ton.
And um I learned about him whenI took a class called
(15:55):
Mindfulness-based stressreduction, which is a course
that many people take.
Um, it was developed by JohnCabotzin many years ago, really
for patients who wereexperiencing chronic pain.
But um, I learned a lot aboutmindfulness and and the
practices um that can help us uhsort of train our brains, right,
(16:18):
around being more present, beingmore mindful.
And when I learned about RichieDavidson, I was really
fascinated by him because he hadso much research out there and
really, again, rigorous researchthat held itself to a very high
standard.
So, you know, as a scientist, Iwas very interested in that.
So I started reading more aboutwhat does meditation really do?
(16:44):
You know, like really what iswhat is it for?
How does it change um how weinteract with the world?
And um I just was convincedenough that I started practicing
myself.
Um, and you know, I've neverbeen one of those people that
could sit for an hour a day andmeditate because you know, who
(17:05):
has the time?
But I um am someone who fits in,you know, between you know 15
minutes of meditation, usuallywhen I'm in my car before a
shift.
Yep.
Yeah.
Or when I get home before mykids know that I've, you know,
pulled in the driveway, thosekinds of times, I will meditate
in my car.
And the other practice that hasgone along with that, that sort
(17:28):
of is in that same under thatsame umbrella, are um practices
related to self-compassion.
So loving-kindness meditation umis one of those practices,
really sort of how do you takeall of that compassion, all of
your capacity for compassionateaction that we have as
(17:48):
healthcare people, uh, and thatwe show our patients every day,
how do we take that and sort ofturn it back on ourselves?
And and what does that do to ourability to take care of other
people?
And and over months and thenyears um of just that amount of
practice, you know, maybe liketwo or three times a week, you
(18:09):
know, I've been to some retreatsum that focused on
self-compassion, but really not,you know, I don't have all kinds
of time, so like not that much,but even in that amount of
practice, I have noticed, I'venoticed most specifically um
this sort of ability to see whatit is that I'm feeling at any
(18:31):
given moment.
And when I notice that, I cansee how that feeling, how that
emotion, how that thought mightimpact, or so in some cases has
already impacted the way I'mbehaving in the world.
So, you know, if I'm grievingsomething that happened at work,
how does that show up when Icome home and am present, you
(18:55):
know, at dinner with my kids oror talking with my with my
husband?
And that I think the ability tosort of lengthen the time
between between my emotion andfeeling that emotion and my
response has been what I'venoticed the most clearly.
(19:17):
And so, you know, and I tell mystudents this all the time, I'm
never gonna talk to them about apractice or a concept that I
haven't tried myself, that Ihaven't sort of put to the test.
Even if it doesn't work for me,I will have tried it.
Um, and that is one thatpractice in particular has
(19:37):
really changed my life both inand outside of, you know,
clinical medicine.
Mm-hmm.
SPEAKER_00 (19:44):
Let me track back to what you what I heard you say,
which is how do you find yourway into mindfulness as like a
type A, high-functioning, um,you know, get it all done sort
of person who is still activelyworking in medicine.
And the answer is, you know,generally someone has some sort
of like life event that has themask a big question or turn to
(20:07):
something like MBSR,mindfulness-based stress
reduction, and then they see tobelieve it in their own life.
Like, wow, this actually workedfor me.
That was certainly my experienceas well.
But I'm wondering then how youtranslate that to your students
as well as to listeners now whoare like, okay, all well and
good.
We've got N of two.
(20:28):
It worked for Cassie and MaryJean, but how do you relay that
this small practice over timewill likely have a result like
you've had?
Um, is there buy-in there?
Is the are there is there a lotof skepticism that you found
like within medical students?
SPEAKER_01 (20:43):
Yeah, and you know, it's actually it's not
necessarily for all the samereasons.
I think part of teaching inhealthcare in general, really,
is being okay, being comfortablewith the fact that not everybody
is going to immediately buy intowhat you're teaching.
You know, I think healthyskepticism is important.
(21:07):
Um, and I I would never say thatmeditation or these practices
(22:08):
would work for every person in,you know, in my class.
I think there's a couple thingsthat make it more accessible to
students.
I think the first is probably abit more predictable, right?
Like, like you said, like thissort of I don't have time for
this, you know, like you'vegiven me all this other work to
do.
SPEAKER_00 (22:28):
Correct.
Exactly.
Yes.
SPEAKER_01 (22:30):
Um, how do you expect me to then take time to
do something that may or may notactually change how well I'm
doing in school or how good Ifeel?
Um and that, I mean, that's ait's a great question.
I think um, you know, I I umexplain just what I explained to
(22:50):
you, you know, how I fit it intomy life.
Um I like to be very clear aboutwhat it does and doesn't do, you
know, for me in particular andwhat the research says, right?
I mean, there are some thingsthat meditation is supposed to
change, um, you know, ourability to concentrate or focus
(23:13):
and and really you don't seethat realistically happen with
people unless you are like anOlympic meditator, right?
Unless you're spending 10,000hours meditating.
So I've never I'm I don't tryand sell something that's not um
true.
So I tell a lot of stories whenI'm trying to, well when I'm
(23:35):
teaching clinical stories,stories about taking care of
patients, times when you knowI've really struggled and
connect this practice with mysort of emotional recovery or
just recovery in general fromsome of those um stories.
But I think the other, inaddition to sort of the time
(23:57):
argument, I think that there'ssort of I think the problem that
that I've also run into is thatstudents know that, you know,
this is like meditation is we'reborrowing that this is an
ancient practice that we'reborrowing from many other
non-secular, right,religious-based um cultures, and
(24:21):
that it wasn't designed for likeall of us to like de-stress,
right?
Like meditation is not supposed,it's not there for us to sort of
use as a tool to um decrease ouranxiety.
It you know, the the idea behindmeditation is really to change
(24:44):
like how we are in the world sothat when we show up, you know,
in spaces um with other people,we are a compassionate presence,
right?
The goal really is to increasethe amount of compassion in the
world by recognizing how ummeditation changes the way we
(25:07):
show up.
And so I'm very clear about thatwith students because I don't
ever want them to think thatmeditation in the absence of its
you know, historical um andreligious context or spiritual
context, um, you know, is iswhat I'm trying, you know, is
(25:28):
what we're trying to sell.
Um and I think that's kind ofhow meditation and mindfulness
gets a bad name um out in theworld, is because it is sort of
stripped of that underlyingpurpose.
SPEAKER_00 (25:40):
Yeah.
And I think that just as we'vekind of started talking about
mindfulness and meditation, andwe started talking with
neuroplasticity, it's almostbeen gamified to in a sense.
Like, here's how this ancienttool is going to help 2025 CAA
students and medical students.
And I like to rewind it back andbe like, okay, well, what's
(26:03):
underlying this is this humancapacity, this neuroplastic
capacity that you can form newneural pathways on anything.
You do anything repeated, well,not anything, but you know, it
is it's just the fact thatyou're using that capability and
you're using that to um, youknow, develop a mindfulness
practice.
And the mindfulness practice,all that's doing is allowing you
(26:25):
to pick where you put yourattention, what you're gonna
notice.
And you're saying that what youteach your students is that,
okay, you're gonna notice thatyou've got time between stimulus
and response.
And I'm teaching you to choosecompassion in that moment.
Um, and it's so it's just um, Idon't know, I just really want
listeners to understand thatwhat we're saying is a lot of
(26:48):
just human capacity and uschoosing what how we use it.
And then also the fact thatthese this ancient wisdom, this
mindfulness and meditation haskind of like fallen into this
like self-care, well-beingcategory, not because it can't
be there, but because um, Idon't know, they want us to buy
(27:09):
things.
It's just like kind ofcommodified.
But there is, but but the thingis it's an amb.
There is truth to it.
There is something valuablethere for AA students and
medical students.
And it's just lovely to talk tosomeone who can piece that
apart.
You know, we're not talkingabout this oowe-goooey wellness,
well-being, like, no, let'sreally talk about what's going
on here.
(27:29):
So thank you.
I don't know if you have anycomments after that that I went
on a tangent.
SPEAKER_01 (27:34):
No, I I think that sums it up really nicely.
I mean, I think, you know, ourbrain is changing whether we are
intentional about it or not.
And so and most of the time wedon't notice how our brains are
changing.
Um, you know, whether it's likescrolling, you know, Instagram
(27:56):
or um binging Netflix or ummindlessly, you know, having a
cocktail when you get home fromwork, whatever it is, we're we
our brain is changing.
And so I think that this is justeven if nothing else, if if you
can sort of help studentsremember that that capacity
(28:18):
exists, our brain is going tochange in um in response to the
experiences that we have.
And so, to what extent do youwant to have agency in that?
SPEAKER_02 (28:29):
Yes.
SPEAKER_01 (28:30):
Um, and finding those, whether we call them
skills or practices that willsort of help you feel or
actually have some control overthe way your brain is changing.
Yes.
I think that that's amazing.
SPEAKER_00 (28:46):
Yes.
I think it's amazing too,Cassie.
I want everyone to have a voicelike yours to understand this.
I can't stress this enough.
Like we are both speaking to avery particular type of mind.
And the coming from the researchand the evidence and the science
of it does help us buy into thefact that we could have some
(29:06):
more control over this than wemaybe realize, um, which is all
a choice.
It's all about intention and achoice.
So here's my last question, um,so that I don't, we don't talk
for another hour on this, whichI could do with you.
But if you're speaking directlyto um let's say, let's say the
larger CAA community, which forthis podcast incorporates people
(29:29):
who want to become CAAs, AAstudents, which is like a
27-month master's program, andthen practicing CAAs, which I
know you're familiar with.
What would you want them tounderstand about
neuroplasticity, like as atake-home message, as like a
little plant a seed, and thenyou're you water this and grow
it yourself.
You have to take this where it'smeant to go for you.
(29:51):
What would that takeaway messagebe?
SPEAKER_01 (29:53):
So I say this a lot to my own students.
I think, you know, becoming anAA, you know, the I I would
imagine, just like sort ofbecoming a physician, our work
can begin to feel technical,right?
It can begin to feeltransactional.
Um but you know, I think CAstudents, you're present with
(30:17):
patients at perhaps one of themost vulnerable moments in their
lives, right?
You are going to bear witness topatients who have serious
illness, um, may be in severepain, worried about what's, you
know, what's to come on theother side of the procedure or
the surgery, worried maybe eventhat they won't wake up, you
(30:38):
know, and absolutely um I thinkthat in just like medical
students in the process oflearning these skills that will
help so many people, you'regoing to see your care team
members handle that, you know,that moment of vulnerability, of
witnessing that vulnerabilitywith varying levels of skill,
(31:00):
yes, with varying levels ofgrace, and just even starting
with like looking around andsaying, What how do I want to be
in the world?
You know, how do I want to be inthat moment and who's doing that
well, and who's maybe not doingthat well, um, and recognizing
(31:22):
that you know, nobody probablytaught the people who are
teaching you how to do this.
Um, so I think just even payingattention to that is just a a
place to start.
And then, you know, findingthose people, those mentors and
saying, hey, how do you, youknow, how do you bring that
(31:44):
level of calm or that compassionor that whatever it is that
really sort of made you stop andlook um and just ask, you know,
like these aren't the onlymeditation and mindfulness
aren't the only practices thatare, you know, help that can
help in those moments.
Those mentors can be incrediblygreat resources to learn all
(32:06):
those things that maybe you'renot learning in the classroom.
SPEAKER_00 (32:10):
Mm-hmm.
I love that.
And I just I get excitedthinking about the next
generation of CAAs from these AAstudents who are having people
teach them this and physiciansthat have you teaching this and
like what change could bepossible.
Um yeah, it feels like it's thebeginning of the world that I
(32:31):
want to be practicing in, that Iwant to be practicing medicine
in.
Um, yeah, so I'm just sograteful to have found you, Dr.
Ferguson, and I'm grateful tointroduce your voice to my CAA
community.
And I want to have you backbecause I know some behind the
scenes that you're writing abook and that um you are hoping
to kind of expand the reach ofthe good doctor to other
(32:54):
professions, to other medicalschools.
So I'm sure, well, I know I'mI'm gonna be emailing you,
wanting to talk to you again,but have you on the pod again as
well.
SPEAKER_01 (33:03):
Absolutely.
I'd love to, and I'm so honoredthat you asked me here.
So thank you.
SPEAKER_00 (33:18):
Thanks for listening to Awakened Anesthetist.
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You can always find more ways toconnect with me and this CAA
(33:40):
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(34:02):
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Talk soon.
This Wellness Wednesday is brought to you by
CAA Matters, the firstcomprehensive wellness and
professionalism curriculumdesigned to truly support the AA
student experience.
We all know AA education isstreamlined to produce competent
providers in a fast-pacedprogram.
Meanwhile, wellness andprofessionalism often get
(03:58):
overlooked, lumped in withmedical students, or addressed
too late to help.
CAA Matters fills this gap,centering student
anesthesiologist assistance andequipping them with the tools,
resources, and mindset shifts tosucceed in school and build
long, fulfilling careers.
(04:18):
It's a turnkey curriculum, fullyprepared, facilitated, and
supported from planning todelivery.
Program leaders and AA educatorscan learn more, read reviews
from early adopters, and explorepiloting CAA Matters at
awakenedanesthetist.com or byclicking the link in the show
notes.
(04:52):
And I think I said this to youbefore, like like-minded people
in medicine who are on awellness journey are not
oftentimes at the front centerstage.
They are, you know, more pulledinward.
They're protecting their energy.
They have boundaries.
They're hard to find.
They're hard to haveconversations with.
SPEAKER_01 (05:08):
Yeah.
So yeah.
I totally understand that.
SPEAKER_00 (05:13):
Yes.
So uh I'm grateful for yourtime.
And yeah, so maybe just startoff with who you are, where you
are in medicine, and maybe yourwork with the good doctor would
be a great place to start.
SPEAKER_01 (05:24):
Sure.
Absolutely.
My name's Cassie Ferguson.
I am, I like to say that myevening job is uh pediatric
emergency medicine physician.
So I work in the emergencydepartment at our children's
hospital uh here in Milwaukee,Wisconsin.
So that's what I do clinically.
Uh during the daytime, I work ummostly with students.
(05:50):
So I do various things invarious capacities with
students.
My favorite thing to do,honestly, and in my entire job
is to teach.
So one of the courses that I ama part of and an instructor in
is called the Good Doctor.
Um I refer to it as the Good-ishDoctor, which sort of is just my
(06:10):
bent on how we view ourselvesand how that impacts our ability
to stay present and makemistakes.
But um the good doctor focuseson three different threads in
medicine that aren'ttraditionally taught or haven't
been traditionally taught.
The first is medical ethics,which certainly has made its way
(06:33):
into our curriculum in the past,um, but this is really focused
on making ethics a bit moreaccessible to people who are
learning medicine.
Uh, the second is professionaldevelopment.
And the third thread is thethread that I am in charge of,
and that is really focused onwell-being.
(06:54):
You know, well-being, I don'tknow, I don't think that that
really captures everything thatwe teach or that I that I talk
about in the course.
I'd say really we're focused onteaching students, medical
students, the skills, the verypractical, hands-on skills that
we need as um people who witnessand um are present for the
(07:22):
suffering of other human beings,really in order to be a
compassionate presence, butalso, you know, really to have a
sustainable career.
So that's that's what I what Imost like about my job is
teaching students about that.
I also direct one of the othercourses in our medical school,
(07:44):
which is called Health SystemScience.
And there's definitely a lot ofoverlap between health systems
and um sort of learning to bewhole within medicine.
Um, and so you know, I talkabout that a lot when I'm
talking about systems.
SPEAKER_00 (08:00):
And just for the CAAs, you know, my audience
obviously is wholly CAAs, Iimagine.
Um, and they maybe are assumingthat I found you because there
is an AA program at the MedicalCollege of Wisconsin, which is
where you work.
That's the medical school youteach with and for.
Um, but actually I found youbecause it what seems like
(08:23):
almost a decade ago now for you,you developed a longitudinal
professional wellness, you know,curriculum for the Medical
College of Wisconsin calledREACH, which is an acronym.
Maybe say what the acronym'sfor.
SPEAKER_01 (08:39):
REACH stands for recognize, empathize, allow,
care, and hold each other up,which I realize is probably
beyond that acronym, but uh, butthat's what it stands for.
SPEAKER_00 (08:54):
I like it.
It starts with an H.
I think it works.
So my listeners who know whatI'm passionate about know what
drew me then to you.
Because I found basically aresearch paper that you had
written in collaboration withsome others talking about this
new curriculum that you hadcreated and its effectiveness
and what the students werethinking about it.
(09:14):
And I was like, oh my gosh, Ijust found the first person ever
who's doing something that Iwant to do.
I need to talk to this person.
And I reached out to you and youwere so generous to, you know,
share a little bit of theexcitement I had to talk to you
to also be willing to speak withme.
And so now we kind of meet, youknow, monthly.
And I'm just so excited to haveyou in my circle now as a mentor
(09:36):
and as a friend.
Um, and you had invited me thento drop into one of your
classes.
Actually, I'm pretty sure Isaid, Can I come to one of your
classes?
Uh, and you were teaching onneuroplasticity, which is
something that has been hugelyimportant in my own personal
wellness journey, also hugelyimportant for the work that I'm
(09:58):
doing through CAA Matters, andhugely important to the work
you're trying to do through thegood doctor.
I would love to have you explainjust maybe as simply as you can
what neuroplasticity is.
And then we'll kind of get intoits importance.
SPEAKER_01 (10:13):
Sure, absolutely.
And thanks for that uh thatintroduction.
I mean, I I am always thrilledto find someone who is as
interested in talking aboutwell-being in this way as I am.
I don't think that that is verycommon, honestly.
Um, but you know, I think thethis lecture on neuroplasticity
(10:34):
is really an example of of how Ilike to approach teaching
well-being to medical studentsand really anyone who is in
healthcare, because I think allof us have this respect for
science, um, respect for, youknow, really robust research and
(10:54):
our ability as scientists tosort of change our mind over,
you know, years and decadesabout how our bodies work,
particularly how our brainworks, because I think that's
probably the organ in our bodythat we know the least about.
And neuroplasticity really sortof follows in that pattern.
So, neuroplasticity, the way Ithink about it is that it refers
(11:16):
to just it's a capacity of thebrain.
And this capacity is really tochange in response to what we
do, what we think about, what weexperience in any given day.
Now, that doesn't mean that ourbrain is constantly changing,
you know, to everything thathappens in a given day or a
(11:37):
given moment, but the capacityis there.
And I think what's reallyfascinating to me is I was an
undergraduate student at UCLA inthe sort of mid to late 90s,
dating myself a bit, but um, andI was a psychology major, and
uh, you know, a lot of theclasses I took were focused on
neuroscience because that'sreally what I liked the most
(11:59):
about psychology.
And even then we didn't believeor we weren't taught that the
brain had this capacity.
Um, it was really thought orbelieved that sort of all the
changes that our brain wascapable of of making would
happen early on in our life, youknow, in our childhood or young
adulthood.
(12:20):
And then that capacity like sortof dwindled to nothing.
And we just over the years wewould just sort of lose brain
cells.
And that was pretty much how ourbrain changed from then on.
And now we know through you knowseveral different people that
the mature brain is malleableand is actually capable even of
(12:43):
regeneration, um, and that itdoes so continuously throughout
life.
And you know, those are both umstructural changes.
So like we actually can seechanges in volume in certain
parts of the brain in responseto you know a brain injury.
Other areas of the brain willcompensate by literally changing
(13:06):
in size, formation of new neuralpathways, you know, for the same
reason.
And then there's also functionalchanges, so changes to like the
frequency of how much a certaingroup of neurons fires, or um,
you know, it changes the amountof chemicals or chemical signals
that are released betweenneurons, um, and so changes the
(13:28):
way they communicate.
So that changes the strength ofconnections between groups of
neurons.
And, you know, we sort of had anidea that that could happen in
response to injury, somethinglike stroke.
But I think more recently, andwhat I'm most excited about is
that we're learning that we can,as you know, sort of agents, um,
(13:49):
or you know, with our ownagency, practice or do practices
that will actually change ourbrain, either structurally or
functionally, um, things likemeditation and mindfulness.
And so that's really what I'mexcited about and why I teach it
in the well-being course isbecause these are practices that
(14:14):
can be used to impact ourwell-being.
And I feel like this isimportant both for you know
health professional students toknow so that they can actually
relay these to their patients,right?
Because that's like what anamazing thing to be able to talk
with your patients.
And you know, what I focus on ishow we can um change the way,
(14:39):
again, change the way that we'represent for the suffering of
other people so that medicinebecomes a more sustainable
career.
SPEAKER_00 (14:46):
I have a thousand follow-up questions, Cassie.
Yeah.
Um, but first, my headphones aredoing something weird.
One second.
My 11-year-old got to these.
I know you know what this islike.
So I'm I think he broke thisside, maybe or something,
because it won't stay in.
Okay, well then that's I'll I'lljust like be like this.
(15:07):
Oh, okay.
I get it.
Um I think I want to first askyou because the science changed
during the course of youreducation or you know, after
residency, how did you come tofind out that neuroplasticity
was real?
Was it a prof like a personaljourney?
(15:28):
Was it a professional journey?
Were you teaching on it?
SPEAKER_01 (15:31):
Yeah.
So there is a researcher nameduh Richie Davidson.
He is a researcher at uh theUniversity of Wisconsin-Madison,
so just down the street from us,or down the freeway from us.
Um, and he teaches or startedthe Center for Healthy Minds
there.
And he's written a ton.
And um I learned about him whenI took a class called
(15:55):
Mindfulness-based stressreduction, which is a course
that many people take.
Um, it was developed by JohnCabotzin many years ago, really
for patients who wereexperiencing chronic pain.
But um, I learned a lot aboutmindfulness and and the
practices um that can help us uhsort of train our brains, right,
(16:18):
around being more present, beingmore mindful.
And when I learned about RichieDavidson, I was really
fascinated by him because he hadso much research out there and
really, again, rigorous researchthat held itself to a very high
standard.
So, you know, as a scientist, Iwas very interested in that.
So I started reading more aboutwhat does meditation really do?
(16:44):
You know, like really what iswhat is it for?
How does it change um how weinteract with the world?
And um I just was convincedenough that I started practicing
myself.
Um, and you know, I've neverbeen one of those people that
could sit for an hour a day andmeditate because you know, who
(17:05):
has the time?
But I um am someone who fits in,you know, between you know 15
minutes of meditation, usuallywhen I'm in my car before a
shift.
Yep.
Yeah.
Or when I get home before mykids know that I've, you know,
pulled in the driveway, thosekinds of times, I will meditate
in my car.
And the other practice that hasgone along with that, that sort
(17:28):
of is in that same under thatsame umbrella, are um practices
related to self-compassion.
So loving-kindness meditation umis one of those practices,
really sort of how do you takeall of that compassion, all of
your capacity for compassionateaction that we have as
(17:48):
healthcare people, uh, and thatwe show our patients every day,
how do we take that and sort ofturn it back on ourselves?
And and what does that do to ourability to take care of other
people?
And and over months and thenyears um of just that amount of
practice, you know, maybe liketwo or three times a week, you
(18:09):
know, I've been to some retreatsum that focused on
self-compassion, but really not,you know, I don't have all kinds
of time, so like not that much,but even in that amount of
practice, I have noticed, I'venoticed most specifically um
this sort of ability to see whatit is that I'm feeling at any
(18:31):
given moment.
And when I notice that, I cansee how that feeling, how that
emotion, how that thought mightimpact, or so in some cases has
already impacted the way I'mbehaving in the world.
So, you know, if I'm grievingsomething that happened at work,
how does that show up when Icome home and am present, you
(18:55):
know, at dinner with my kids oror talking with my with my
husband?
And that I think the ability tosort of lengthen the time
between between my emotion andfeeling that emotion and my
response has been what I'venoticed the most clearly.
(19:17):
And so, you know, and I tell mystudents this all the time, I'm
never gonna talk to them about apractice or a concept that I
haven't tried myself, that Ihaven't sort of put to the test.
Even if it doesn't work for me,I will have tried it.
Um, and that is one thatpractice in particular has
(19:37):
really changed my life both inand outside of, you know,
clinical medicine.
Mm-hmm.
SPEAKER_00 (19:44):
Let me track back to what you what I heard you say,
which is how do you find yourway into mindfulness as like a
type A, high-functioning, um,you know, get it all done sort
of person who is still activelyworking in medicine.
And the answer is, you know,generally someone has some sort
of like life event that has themask a big question or turn to
(20:07):
something like MBSR,mindfulness-based stress
reduction, and then they see tobelieve it in their own life.
Like, wow, this actually workedfor me.
That was certainly my experienceas well.
But I'm wondering then how youtranslate that to your students
as well as to listeners now whoare like, okay, all well and
good.
We've got N of two.
(20:28):
It worked for Cassie and MaryJean, but how do you relay that
this small practice over timewill likely have a result like
you've had?
Um, is there buy-in there?
Is the are there is there a lotof skepticism that you found
like within medical students?
SPEAKER_01 (20:43):
Yeah, and you know, it's actually it's not
necessarily for all the samereasons.
I think part of teaching inhealthcare in general, really,
is being okay, being comfortablewith the fact that not everybody
is going to immediately buy intowhat you're teaching.
You know, I think healthyskepticism is important.
(21:07):
Um, and I I would never say thatmeditation or these practices
(22:08):
would work for every person in,you know, in my class.
I think there's a couple thingsthat make it more accessible to
students.
I think the first is probably abit more predictable, right?
Like, like you said, like thissort of I don't have time for
this, you know, like you'vegiven me all this other work to
do.
SPEAKER_00 (22:28):
Correct.
Exactly.
Yes.
SPEAKER_01 (22:30):
Um, how do you expect me to then take time to
do something that may or may notactually change how well I'm
doing in school or how good Ifeel?
Um and that, I mean, that's ait's a great question.
I think um, you know, I I umexplain just what I explained to
(22:50):
you, you know, how I fit it intomy life.
Um I like to be very clear aboutwhat it does and doesn't do, you
know, for me in particular andwhat the research says, right?
I mean, there are some thingsthat meditation is supposed to
change, um, you know, ourability to concentrate or focus
(23:13):
and and really you don't seethat realistically happen with
people unless you are like anOlympic meditator, right?
Unless you're spending 10,000hours meditating.
So I've never I'm I don't tryand sell something that's not um
true.
So I tell a lot of stories whenI'm trying to, well when I'm
(23:35):
teaching clinical stories,stories about taking care of
patients, times when you knowI've really struggled and
connect this practice with mysort of emotional recovery or
just recovery in general fromsome of those um stories.
But I think the other, inaddition to sort of the time
(23:57):
argument, I think that there'ssort of I think the problem that
that I've also run into is thatstudents know that, you know,
this is like meditation is we'reborrowing that this is an
ancient practice that we'reborrowing from many other
non-secular, right,religious-based um cultures, and
(24:21):
that it wasn't designed for likeall of us to like de-stress,
right?
Like meditation is not supposed,it's not there for us to sort of
use as a tool to um decrease ouranxiety.
It you know, the the idea behindmeditation is really to change
(24:44):
like how we are in the world sothat when we show up, you know,
in spaces um with other people,we are a compassionate presence,
right?
The goal really is to increasethe amount of compassion in the
world by recognizing how ummeditation changes the way we
(25:07):
show up.
And so I'm very clear about thatwith students because I don't
ever want them to think thatmeditation in the absence of its
you know, historical um andreligious context or spiritual
context, um, you know, is iswhat I'm trying, you know, is
(25:28):
what we're trying to sell.
Um and I think that's kind ofhow meditation and mindfulness
gets a bad name um out in theworld, is because it is sort of
stripped of that underlyingpurpose.
SPEAKER_00 (25:40):
Yeah.
And I think that just as we'vekind of started talking about
mindfulness and meditation, andwe started talking with
neuroplasticity, it's almostbeen gamified to in a sense.
Like, here's how this ancienttool is going to help 2025 CAA
students and medical students.
And I like to rewind it back andbe like, okay, well, what's
(26:03):
underlying this is this humancapacity, this neuroplastic
capacity that you can form newneural pathways on anything.
You do anything repeated, well,not anything, but you know, it
is it's just the fact thatyou're using that capability and
you're using that to um, youknow, develop a mindfulness
practice.
And the mindfulness practice,all that's doing is allowing you
(26:25):
to pick where you put yourattention, what you're gonna
notice.
And you're saying that what youteach your students is that,
okay, you're gonna notice thatyou've got time between stimulus
and response.
And I'm teaching you to choosecompassion in that moment.
Um, and it's so it's just um, Idon't know, I just really want
listeners to understand thatwhat we're saying is a lot of
(26:48):
just human capacity and uschoosing what how we use it.
And then also the fact thatthese this ancient wisdom, this
mindfulness and meditation haskind of like fallen into this
like self-care, well-beingcategory, not because it can't
be there, but because um, Idon't know, they want us to buy
(27:09):
things.
It's just like kind ofcommodified.
But there is, but but the thingis it's an amb.
There is truth to it.
There is something valuablethere for AA students and
medical students.
And it's just lovely to talk tosomeone who can piece that
apart.
You know, we're not talkingabout this oowe-goooey wellness,
well-being, like, no, let'sreally talk about what's going
on here.
(27:29):
So thank you.
I don't know if you have anycomments after that that I went
on a tangent.
SPEAKER_01 (27:34):
No, I I think that sums it up really nicely.
I mean, I think, you know, ourbrain is changing whether we are
intentional about it or not.
And so and most of the time wedon't notice how our brains are
changing.
Um, you know, whether it's likescrolling, you know, Instagram
(27:56):
or um binging Netflix or ummindlessly, you know, having a
cocktail when you get home fromwork, whatever it is, we're we
our brain is changing.
And so I think that this is justeven if nothing else, if if you
can sort of help studentsremember that that capacity
(28:18):
exists, our brain is going tochange in um in response to the
experiences that we have.
And so, to what extent do youwant to have agency in that?
SPEAKER_02 (28:29):
Yes.
SPEAKER_01 (28:30):
Um, and finding those, whether we call them
skills or practices that willsort of help you feel or
actually have some control overthe way your brain is changing.
Yes.
I think that that's amazing.
SPEAKER_00 (28:46):
Yes.
I think it's amazing too,Cassie.
I want everyone to have a voicelike yours to understand this.
I can't stress this enough.
Like we are both speaking to avery particular type of mind.
And the coming from the researchand the evidence and the science
of it does help us buy into thefact that we could have some
(29:06):
more control over this than wemaybe realize, um, which is all
a choice.
It's all about intention and achoice.
So here's my last question, um,so that I don't, we don't talk
for another hour on this, whichI could do with you.
But if you're speaking directlyto um let's say, let's say the
larger CAA community, which forthis podcast incorporates people
(29:29):
who want to become CAAs, AAstudents, which is like a
27-month master's program, andthen practicing CAAs, which I
know you're familiar with.
What would you want them tounderstand about
neuroplasticity, like as atake-home message, as like a
little plant a seed, and thenyou're you water this and grow
it yourself.
You have to take this where it'smeant to go for you.
(29:51):
What would that takeaway messagebe?
SPEAKER_01 (29:53):
So I say this a lot to my own students.
I think, you know, becoming anAA, you know, the I I would
imagine, just like sort ofbecoming a physician, our work
can begin to feel technical,right?
It can begin to feeltransactional.
Um but you know, I think CAstudents, you're present with
(30:17):
patients at perhaps one of themost vulnerable moments in their
lives, right?
You are going to bear witness topatients who have serious
illness, um, may be in severepain, worried about what's, you
know, what's to come on theother side of the procedure or
the surgery, worried maybe eventhat they won't wake up, you
(30:38):
know, and absolutely um I thinkthat in just like medical
students in the process oflearning these skills that will
help so many people, you'regoing to see your care team
members handle that, you know,that moment of vulnerability, of
witnessing that vulnerabilitywith varying levels of skill,
(31:00):
yes, with varying levels ofgrace, and just even starting
with like looking around andsaying, What how do I want to be
in the world?
You know, how do I want to be inthat moment and who's doing that
well, and who's maybe not doingthat well, um, and recognizing
(31:22):
that you know, nobody probablytaught the people who are
teaching you how to do this.
Um, so I think just even payingattention to that is just a a
place to start.
And then, you know, findingthose people, those mentors and
saying, hey, how do you, youknow, how do you bring that
(31:44):
level of calm or that compassionor that whatever it is that
really sort of made you stop andlook um and just ask, you know,
like these aren't the onlymeditation and mindfulness
aren't the only practices thatare, you know, help that can
help in those moments.
Those mentors can be incrediblygreat resources to learn all
(32:06):
those things that maybe you'renot learning in the classroom.
SPEAKER_00 (32:10):
Mm-hmm.
I love that.
And I just I get excitedthinking about the next
generation of CAAs from these AAstudents who are having people
teach them this and physiciansthat have you teaching this and
like what change could bepossible.
Um yeah, it feels like it's thebeginning of the world that I
(32:31):
want to be practicing in, that Iwant to be practicing medicine
in.
Um, yeah, so I'm just sograteful to have found you, Dr.
Ferguson, and I'm grateful tointroduce your voice to my CAA
community.
And I want to have you backbecause I know some behind the
scenes that you're writing abook and that um you are hoping
to kind of expand the reach ofthe good doctor to other
(32:54):
professions, to other medicalschools.
So I'm sure, well, I know I'mI'm gonna be emailing you,
wanting to talk to you again,but have you on the pod again as
well.
SPEAKER_01 (33:03):
Absolutely.
I'd love to, and I'm so honoredthat you asked me here.
So thank you.
SPEAKER_00 (33:18):
Thanks for listening to Awakened Anesthetist.
If this episode resonated withyou, share it with a CAA friend,
an AA student in your life, or aperspective, and let them know
why you loved it.
It's the most important thingyou can do to support this
podcast and its mission.
You can always find more ways toconnect with me and this CAA
(33:40):
community atawakenedanesthetist.com,
including an invitation to joinseason five Mindful Connections.
These are free virtualgatherings open to anyone in our
Awakened Anesthetist community.
And while you're scrolling thewebsite, check out my trusted
CAA partners who make thispodcast possible with a special
(34:02):
thank you to my season fivesponsor, Harmony and Ashia
Staffing.
Talk soon.
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