Dr. Ali Zreik arrives at patient rooms with an unusual tool—a rolling whiteboard. While most physicians carry stethoscopes and tablets, this internal medicine attending physician and associate program director brings something more transformative: a visual bridge between complex medical science and human understanding.
"Bring me the whiteboard," he tells residents when faced with a challenging patient case. What follows is nothing short of medical storytelling at its finest. Drawing hearts, explaining physiologies, and breaking down medical jargon into clear visuals, Dr. Zreik transforms the clinical encounter for everyone involved – the frustrated patient suddenly understands their condition, burned-out residents rediscover purpose, and healing begins in earnest.
Drawing inspiration from Dr. Lisa Sanders (the physician behind the New York Times' "Diagnosis" column and TV's "House"), Dr. Zreik brings a Sherlockian approach to medicine. Yet his true innovation lies in combining analytical precision with profound compassion. "Medicine has changed from being patient-oriented to goal and task-oriented," he observes, pinpointing a shift that has left many patients feeling unheard despite technological advances.
His philosophy centers on creating "happiness at the point of care"—a radical concept in today's efficiency-focused healthcare environment. This approach not only improves patient outcomes but serves as a powerful antidote to burnout among medical professionals. By finding meaning in the work and intentionally fostering connection, Dr. Zreik demonstrates how medicine can remain both scientifically rigorous and deeply human.
For pre-health students uncertain about their path, his advice resonates beyond medicine: "Create a sense of why for yourself... it's in the art of asking questions that identity gets created." This perspective shifts focus from merely accumulating knowledge to developing purpose – a lesson valuable for anyone in healthcare or beyond.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Ashley (00:00):
Hello and welcome to Shadow Me Next, a podcast where
I take you into and behind thescenes of the medical world to
provide you with a deeperunderstanding of the human side
of medicine.
I'm Ashley, a physicianassistant, medical editor,
clinical preceptor and thecreator of Shadow Me Next.
It is my pleasure to introduceyou to incredible members of the
(00:22):
healthcare field and uncovertheir unique stories, the joys
and challenges they face andwhat drives them in their
careers.
It's access you want andstories you need, whether you're
a pre-health student or simplycurious about the healthcare
field.
I invite you to join me as wetake a conversational and
personal look into the lives andminds of leaders in medicine.
(00:44):
I don't want you to miss asingle one of these
conversations, so make sure thatyou subscribe to this podcast,
which will automatically notifyyou when new episodes are
dropped, and follow us onInstagram and Facebook at shadow
me next, where we will reviewhighlights from this
conversation and where I'll giveyou sneak previews of our
upcoming guests.
What happens when you combinethe curiosity of Sherlock Holmes
(01:07):
, the heart of a mentor and awhiteboard on wheels?
You get Dr Ali Zarik, aphysician educator, who's
redefining how we teach,practice and experience medicine
Today.
On Shadow Me Next.
I am so excited to introduceyou to Dr Zarareek, an internal
medicine attending physician andassociate program director at a
(01:29):
prestigious hospital.
But this conversation is aboutmore than titles.
It's about purpose.
From his early inspirationdrawn from Dr Lisa Sanders in
the TV show House, to his ownbring me the whiteboard moments
during rounds Dr Zareek brings arefreshing blend of intellect,
compassion and vision to medicaleducation.
(01:52):
We explore how he's buildingmore than clinical competency.
He's creating happiness at thepoint of care.
And, yes, we dive into howsomething as simple as a dry
erase marker can completelychange the dynamic between a
frustrated patient and a burnedout medical team.
In this episode you'll learnwhy the most difficult patients
(02:13):
can become your greatestteachers, how bridging the gap
between science and humanitytransforms learners and lives,
why curiosity and askingquestions aren't just encouraged
they're essential todiscovering your why in medicine
.
And how Dr Zareek is buildingnew tools and texts to reshape
(02:34):
the future of healthcare.
Whether you're a pre-healthstudent, a resident or someone
who's felt the tension betweenbureaucracy and bedside care,
this conversation is for you.
Please keep in mind that thecontent of this podcast is
intended for informational andentertainment purposes only and
should not be considered asprofessional medical advice.
(02:56):
The views and opinionsexpressed in this podcast are
those of the host and guests anddo not necessarily reflect the
official policy or position ofany other agency, organization,
employer or company.
This is Shadow Me Next with DrAli Zarik.
Hi Dr Z, thank you so much forjoining me today on Shadow Me
(03:16):
Next.
I am just so thrilled that youhave made time for us, thank you
.
Dr. Zreik (03:21):
It's absolutely my privilege, ashley.
I'm always here to help and Ido appreciate how you've offered
a light to the compassion ofmedicine and guiding people in
ways that are actually veryhelpful.
So whatever I can do, I'd loveto share with that today, with
you.
Ashley (03:37):
I appreciate that and you know that's actually we met
on LinkedIn and that's actuallywhat drew me so much to your
profile was how you are ineducation and yet you're not
just teaching the science andyou're not just teaching the
diagnoses and the treatment, butyou're really revitalizing this
whole approach to medicine andyou're encouraging people to see
(03:57):
the whole person and to perhapsconsider, oh, I don't know, the
patient maybe as opposed to thediagnosis first.
So thank you.
I think that we will learn somuch about how to approach a
patient, and not just how towork in medicine, from our
conversation.
So, dr Z, tell us a little bitabout your beginnings.
Dr. Zreik (04:18):
You know, ashley.
Thank you for that introduction, by the way, I hope I deserve
it.
You know, to begin with I'vealways been very Sherlockian in
my approach to everything inlife and medicine was the best
vessel to that.
You know, internal medicine initself has been somewhat of a
Sherlockian methodology for meand to be able to deliver
(04:40):
information in an algorithmicfashion, intertwine with some
you know, poetry, passion,purpose, medicine's kind of come
to light for me that way.
I joke around a lot with mycolleagues sometimes and I say
I'm secretly a narcissistbecause I love seeing people
learning and it gives me truegratification.
So seeing the future of doctorsgrow, being able to deliver
(05:04):
information in this Sherlockian,algorithmic sense, it's really
become a big milestone in mylife.
A little bit about what inspiredme, I would say, is a physician
named Lisa Sanders.
She's an American author,physician and a journalist.
She was the forefront ofinternal medicine and professor
(05:25):
at Yale.
She began writing in 2002 atthe New York Times column called
Diagnosis, where she basicallycovered medical mystery cases
and later founding the conceptbehind our very own television
series, house.
So she kind of brought a senseof medicine, what I want to
practice medicine like, and shereally says something very
(05:49):
amazing in one of her books.
It's called Every Patient Tellsa Story and I actually wrote it
down here just so we can allhave a good reference, you know.
She says the basic sciences ofanatomy, physiology, biology and
chemistry are linked to apatient at the bedside through
very specific stories thatdoctors learn and eventually
create.
It's the story that everydoctor puts together for herself
(06:12):
with the knowledge she gainsfrom books and patients.
The more experience a doctorhas with any of these illnesses,
the richer and more detailedthe illness script she has as
the disease becomes.
So it's reveling in theSherlockian process itself and
being a detective and takingthat plus compassion towards
patients and bringing the bestexperience to light at the
(06:32):
bedside and that's really kindof driven my whole expertise, I
think, in medicine.
Ashley (06:37):
That's incredible.
I love that.
Thank you, dr Sanders, forcreating such a beautiful
resource for people.
I love hearing where people gottheir inspiration from, and you
know, of course, a lot ofpeople will say a family member
encouraged them, or perhaps afamily friend, something like
that.
For you it was reading, youknow reading stories on a page
(06:57):
by Dr Sanders.
That's just, you know findinginspiration, and in every little
corner of our lives it can bereally motivating.
Every patient does tell a storyand this is where experience
comes in, right, I think sooften people find that a
physician or a PA or an NP thathas a lot of experience.
It means they know a bunch ofthings, right?
(07:20):
Well, perhaps, but it alsomeans they've seen and
experienced and lived and loveda bunch of patients through a
bunch of things.
Dr. Zreik (07:28):
Absolutely Well said, Ashley, and you know it is
unfortunate and we have tosometimes, as even though we're
so passionate in this regard, wedo have to see the unfortunate
reality unfolding sometimes inhealth care institutions.
Reality unfolding sometimes inhealthcare institutions.
Medicine has really changed.
It was once this paradox offascination, science, an
(07:50):
experience of awe, and somewherealong the road, length of stay,
hospital bureaucracy, advancesin healthcare technology.
That perspective changed.
We went from beingpatient-oriented to goal and
task-oriented.
So, despite all our trillionsof dollars from, you know, 1990
to 2020 and our advances in thestate-of-the-art diagnostic
(08:13):
tools, studies still show asignificant number of patients
they're unhappy about theirmedical providers and they feel
unhappy because that lack ofcompassion and they feel unhappy
because that lack of compassion.
So the paradigm shift I feelthat we need to illustrate to
our listeners and to our futurehealthcare professionals is that
we have to bridge the socialand the science and that's the
(08:35):
most important thing I think wecan offer as healthcare
professionals.
Ashley (08:40):
And that's why I love so much the phrase that you used,
sherlockian, because I think alot of people really resonate
with that right.
They resonate with theobsession with the problem and
the desire to solve the mystery,and those problems are the ones
that our patients areexperiencing.
You know, our patients are theones with the mystery, so you
(09:01):
really have to partner with themin order to get the whole
picture right.
Dr. Zreik (09:06):
Exactly.
Ashley (09:06):
Dr Z, tell me, you know, you mentioned, of course you
mentioned the fantastic medicalshow house and there's been many
more even since then.
And I think of course we do.
We are God, as cliniciansespecially, but even as
pre-health students.
I think we're so drawn to thesestories and these shows because
, well, number one, they're justincredible.
Number two we do end uplearning a bunch of things.
(09:28):
Obviously it's a drama, right,but there's good.
So what would you tell?
Let's say, what would you tella pre-health student who's come
to you and said hey, dr Zeke, Iwatched this really awesome show
.
It's this medical show.
Is this real life?
Tell me, is this what you do ona daily basis?
How do you, how does your storyresonate with that?
Dr. Zreik (09:45):
Sure, and you know, ashley, I've been asked this
question before because of thenumerous references I have to
Lisa Sanders, and I will say myanswer has been consistently
about the same.
I usually tell them to reallyfocus on the moments of
inspiration in these kinds ofshows.
You know, it's obviously Idon't want them to learn all the
(10:07):
personality issues that comewith certain personas, but I do
want them to focus that thereare going to be moments in
medicine where you're going tohave that connection, where
you're going to feel that formof inspiration.
I mean, even now I have somepivotal moments with patients
and I'd love to share with youone or two of those where you
(10:27):
know I have a problematicpatient with it which in a show
would come off, as you know, aclimactic moment, and then at
the end of it I find some sortof peace and art with my patient
, and so I would focus on themerit behind delivering care,
but also creating and tailoringyour own persona and your own
(10:49):
medical knowledge to reallydeliver that care.
So to some extent it's good tohave some inspiration from
whatever source you can find,but it's really bringing that to
life in your own profession, Ithink.
Ashley (11:04):
That is so perfect.
Thank you so much.
I'm going to I'm totally goingto steal that, because I too
have received this question veryoften and, of course, our like
our cut and dry, our cut and dryresponses.
Well, well, all medicine is notGrey's Anatomy, you know and
that's true, but focusing on themoments of inspiration and the
merit behind delivering care,that's perfect.
(11:25):
That's exactly the whole pointDr Z tell us about.
What does a day in your lifelook like right now?
Dr. Zreik (11:29):
Sure.
So I'm an associate programdirector at a residency program,
internal medicine.
I work at a level one, trauma.
I have about 15 residents perclass.
I have I tell people all thetime I have about seven or eight
tentacles and what I mean bythat is I really take on a lot
(11:51):
of roles and that's because Ilove doing it.
A day to day for me would be,you know, waking up in the
morning, coming to round.
I will say I'm very notoriousfor having a rolling whiteboard
at rounds.
I'm very notorious for having arolling whiteboard at rounds.
So what I do with this thing isI every single patient room
after we've discussed the caseme and the residents and the
students I explain, I go throughall the physiology, the
(12:17):
guidelines, the diagnosis andthe treatments on this
whiteboard and I really try totie together the medical school
physiology all the way to thestuff being discussed really at
like guidelines andconference-based level.
So that's like a typicalrounding for me.
I also hold these noonconferences in this residency
program where I work onhigh-yield internal medicine
topics and delivering that atlike kind of a patient case
(12:41):
scenario and other timeslectures where I go over the
pathologies and physiologies.
I also am part of the academiccurriculum on quality and
research too.
So you know it's a very longlist of things that I do.
But, to be quite honest withyou, the most important thing
for me is seeing that theresidents are happy, the
(13:03):
students are learning and ourquality of care is delivered in
the most optimal fashion.
So I always make and I tell myresidents and my students that,
at the end of the day, no matterwhat we do, whatever guideline
we follow, whatever milestone wereach with our requirements, we
always have to make you knowhappiness at the point of care
(13:25):
requirements.
We always have to make you knowhappiness at the point of care,
and that's ultimately whatmotivates me, inspires me to
come and do all of this everysingle day.
Ashley (13:30):
That's incredible.
Now I have a picture of youwith seven or eight tentacles
and it's just fantasticHappiness at the point of care.
You know you are the associateprogram director, you are the
attending.
In this case, how do you makesure that your residents are
truly understanding this concept?
I mean, I can only imagine howmany different things a resident
is worrying about on theday-to-day, you know.
(13:51):
I mean they're trying to learn,they're trying to hone their
skills, and then you tell them,you know, happiness at the point
of care for everybody involved.
This is our goal and they, theymust look at you and go wait,
what I thought our goal issomething different.
How do you convey that and makesure that the well-being of not
just your patient but also yourresident is really being looked
(14:13):
after?
Dr. Zreik (14:14):
Absolutely, and there's a real art to this more
than it is a science, and I willsay with much humility that
that's the one great thing I'velearned as an attending is how
to bridge that gap.
It's difficult, that you know,without a doubt, bridging the
academics of residency topatient care, personability, the
(14:35):
wellness of the health careprofessionals.
It really takes a lot ofexperience, I think, and
learning about yourself and yourown shortcomings too, I think,
and learning about yourself andyour own shortcomings too.
My way of handling this is toremind myself the reason, the
very reason I'm here on thisearth between these residents,
that I'm here as a mentor.
I'm here to bridge the gapbetween what's real and what's
(14:57):
in their books and to reallymake the point of care come to
light for them.
So the point behind using thiswhiteboard, for example, is
really to show them how we cantake so much information and
really tie it together like apuzzle, and when you see that
and when they experience that,even burnout, we're able to make
(15:17):
their experience a whole lotbetter.
So it's really within justtaking a nice marker and drawing
a picture for them, you reallybring that to light and it
becomes more moral andintellectual and happy to work
humanely, with gentleness,concern and being able to
(15:37):
deliver information in a waythat is interesting rather than
disciplinary.
That's the most important wayto keep their experience light
and going.
Ashley (15:48):
Yes, yes, and thank you so much for providing this
incredible mentorship to theseresidents and literally
everybody else who is watchingyou teach them.
I mean, it could be you knowany of the other medical staff
on the floor that you're workingor perhaps just a patient's
family member that's sitting inthe room or listening outside
the door.
The mentorship you're providinghas been such a key element for
(16:12):
so many clinicians that I havetalked to.
I would imagine that you havehad fantastic mentorship that
has shaped you and shaped yourcareer.
Is that your story?
Dr. Zreik (16:24):
You know what?
I've had so many ups and downs,ashley.
When I was in residency I had aprogram director who was.
You know, when you first meethim, at a glance you think he's
really tough.
But I've really learned thatcompassion comes in so many
different forms and really it'sthe point of care where you
(16:45):
really get to see people'spersonas and you learn from.
So what may appear as a toughattending in certain lights may
actually be the mostcompassionate person at the
bedside.
And it's all these, thisculmination of experiences I've
gained from great doctors, harddoctors, easier doctors, people
with so many different personasin medicine, plus all the
(17:09):
passion and the education I'velearned and chased myself.
I've kind of tailored it intomy own type of mentality.
You know, it's reallyinteresting to me because the
time I've learned the most andthe time I've been able to
exhibit this at the highestlevel has really been with my
most difficult and what mostpeople would call problematic
(17:31):
patients.
You know, I'd love to share anexperience, for example, with
you where I had a patient in theICU a couple of weeks ago with
heart failure and aorticstenosis.
I remember my team of residentscoming to me and telling me Dr
Zareek, we have a veryproblematic patient.
The staff is really frustrated.
(17:53):
He doesn't want any of themedicines we're giving him and I
welcome the chaos.
That type of darkness is wherelight really comes in right.
So my colleagues were signingout to me this difficult patient
who needed a TAVR, who neededall these medical therapies for
heart failure.
I remember looking at theresidents, nurses and the team
members.
(18:14):
You see, now we're kind ofinspiring the institution,
everyone within the ICU, and Itold them bring me the rolling
whiteboard.
And everyone laughed initially,right, but what initially
appeared to be an exhaustedpatient who was extremely
frustrated, first thing Iremember doing is walking in the
room.
I fist pumped the patient and Iremember saying brother, I'm
(18:38):
here to help, I know there's alot going on and I don't want to
do anything except providemyself to you today.
So, one line to the next, oneheartfelt reply to the next,
drawing a heart, explaining thephysiology, what appears to be a
patient for years who requiredall these therapies, who's been
led by cardiologists andmultiple specialists.
(18:58):
He broke down in tears and thesame patient ended up deciding
to all of us and it was alearning experience to everyone
in the room the nurses, me, theresidents.
You can see a patient who wasfinally inspired, and it's in
moments like this where we cancultivate an environment between
(19:19):
ourselves, nurses, patientswhere we can provide the highest
quality of care.
All it requires is going backto the drawing board and
inspiring people.
Ashley (19:29):
Quite literally the drawing board right.
I love that.
Bring me the rolling whiteboard.
And it benefited your team,your medical team that was in
there, but it benefited thatpatient.
I mean, when has that patientever had somebody illustrate a
heart in front of him?
You know, probably never.
Dr. Zreik (19:45):
Yeah, and that's what he said.
He said never.
And this is not my opportunityto showcase myself and I'm so
sorry if I sound egotistical.
I just want to illustrate oneconcept is that sometimes, by
caring a little bit more, it cango a long way.
Ashley (20:03):
No, absolutely.
But no, it's just lessonslearned, right?
Because I'm sure that you, muchlike me, have walked into these
difficult, quote, unquote,problematic patients, the
patients that you really justwant to go.
Oh, you know, and we've hadexperiences where where perhaps
we have been frustrated.
It kind of reminds me ofparenting, you know, like with
my girls.
There are moments when you knowI behave in a way that I'm not
(20:27):
proud of my children and and Itake that lesson and I take that
moment.
This is the same with patientstoo.
And then you grow from it andyou move on, and you've probably
had that opportunity, and nowyou can approach a patient like
this and, instead of going, youcan give them a fist bump and
say, listen, I've got you,You've got me now and we're
(20:50):
going to figure this outtogether, you know, and I think
that patients just want to feellike we are on their team.
They want to be standing nextto you at the whiteboard trying
to figure this out witheverybody else.
And no, I think, I think that's, I think that's really great.
Dr Z, what are you doingdifferently in medical education
(21:11):
today that you wish had existedwhen you yourself were a
resident?
How about that?
Dr. Zreik (21:16):
Right.
So for me, when I was inresidency, actually I really
cared more about, to be honest,the science.
I wanted to deliver as muchinformation, a plethora of
information, to showcase theamount of information and
knowledge that we can actuallyprovide to our patients, and I
(21:37):
really took pride in being ableto explain everything to a T to
my patients.
Growing into becoming anattending, I've learned that
it's more than that.
It's kind of like I'm not sureif you've ever heard of Atul
Gawande.
He's this American author andsurgeon who wrote this book
called being Mortal.
But he says you go into thiswork thinking it's all a matter
(21:58):
of a canny diagnosis, sometechnical prowess and some
ability to empathize with people.
But it's not Soon.
You find out.
We have to grapple with systems, resources, circumstances and
our own shortcomings.
And he puts it really well andI feel that in the last couple
of years especially, I've kindof learned that it's more than
just having that technicalprowess to be able to deliver
(22:21):
that care, but really reallyfocusing on connecting people to
the information and also to thequality of care beyond the
scope of the science.
I mean patients or somecommunities of patients.
They're genetically born intodisparity and there are things
we can control, things that wecan't.
But what we're here for and I'mgoing to continue to emphasize
(22:44):
is everything that we can offerhas to come from a
multifactorial perspective.
Knowledge is great, compassionis great.
Tying it all together andtrying to understand where these
people are coming from, I thinkthat's something I feel that
I've really acclimated a littlebit better to in the last couple
of years.
Ashley (23:01):
Amazing experience, right?
I mean it just comes from somuch experience.
Dr Z, tell me about how youcare for your residents, because
I can tell that you, obviouslyyou care for their medical
education residents, because Ican tell that you, obviously you
care for their medicaleducation, you care for their
perception on where they standin these patients' lives, is
that it?
I mean outside of this, they'rein residency with you for a
(23:23):
little while.
Dr. Zreik (23:24):
What does that?
Ashley (23:24):
relationship look like.
Dr. Zreik (23:27):
You know, as a mentor and, more importantly, as a
friend, I like to take a stepback from expectations sometimes
to figure out what's exactlyhappening to the residents or
the students.
Sometimes it's not really thebest day of the week or the best
day of their life and it couldbe a matter of personal issues
(23:49):
or it can be just maybe thedelivery information.
So sometimes a resident couldbe overwhelmed and everybody
works at different paces andit's best to access that data
bank of information beforeassuming.
Guidance is always the answer.
So I try my best to tailoreveryone's academic plans, their
learning and really how theyapproach patient care and their
(24:11):
journey in medical education toeach resident on their own.
I have the privilege of workingwith these residents and
students and they come from allacross the world here at Hurley,
I mean I've worked withstudents and residents from all
across the world and with muchhumility.
I also need to learn my ownshortcomings and that it's not
(24:33):
always as perfect as a machineor some sort of educational
curriculum.
You have to really understandpeople, just like we're trying
to understand patients.
So really instilling some sortof pride and inspiration in them
is the best way about going anddoing this and really teaching
them by example.
(24:54):
But nothing's perfect and thisis a process that requires
learning every day.
Ashley (25:02):
Imagine so with every new group of residents, because
you get a new group every year,right.
So with every new group ofresidents, it's new
personalities, new people, whichis just amazing.
Speaking of which, do theyoften remain in contact with you
after this, I mean, oncethey've moved on, do they still
reach out?
Dr. Zreik (25:23):
Absolutely.
That's my metric of success formyself is when I know a
resident has graduated and theyreach out to me.
A lot of times they do reachout to kind of just say hello.
I've really developed a strongfriendship with so many of them
and sometimes they reach out tome to kind of elaborate on their
(25:45):
own experiences and tell meabout their patients, and it's
really a proud moment for me tohear that the education I was
able to provide to them hasreally made an impact on them
later in their own personalcareers.
Ashley (26:01):
I think that's a perfect metric.
I think that's the best metric,right.
Are they reaching out?
Do they want to update you ontheir lives?
Do they want to tell you abouta patient, about a patient or
just, you know, commiserateabout perhaps a memory in
residency Before we transition?
I want to start talking to someof our pre-health students here
(26:22):
in just a minute, but before wetransition to that.
you briefly mentioned a wordthat is just such a.
It's a hot topic right now.
It has been for a while, butit's burnout.
It's burnout in medicine.
Everybody experiences this atsome point.
But I'm just so curious to knowhow you protect your passion
from this awful thing calledburnout.
(26:42):
You've mentioned poetry andyou've mentioned art, and I
would just love to hear a littlebit of advice from you on how
to stay so passionate of advicefrom you on how to stay so
passionate Absolutely.
Dr. Zreik (26:57):
You know there's a lot of evidence base and
literature that's actually beingprovided in so many different
TED Talks on this.
I've learned, especially frommy personal experience and the
literature, that when I enjoywhat I do, I gain a sense of
responsibility and purpose andwith that purpose making my
happiness at the point of careI'm actually less likely to burn
(27:18):
out.
You know, even data suggeststhat if we optimize our language
and our quality of care,burnout burden becomes actually
less.
That's not to say that youshouldn't be detaching, but
doing that plus really creatinga sense of purpose, I feel
really helps mitigate the riskof burnout.
I can't really speak on thisall the time because I'm a
(27:43):
workaholic.
Sometimes I just got off a fiveweek straight rounding, but
that's that's me.
But I do qualify it by sayingto everyone that it's good to
have balance.
But when we try to reallyexperience the happiness of what
we do, I do think we mitigatethe burnout.
Ashley (28:00):
That's great, Just being intentional.
Being intentional about makinghappiness at the point of care.
It's not just something thathappens.
I mean sometimes it is.
Those are really great moments.
Dr. Zreik (28:10):
Yeah, absolutely.
Ashley (28:11):
Thank you so much, dr Z.
We have a segment on the showit is called quality questions
and this is where you and Idiscuss an interview type
question that you have eitherheard or you like to ask.
That is just memorable, forwhatever reason, this helps
pre-health students develop acache of interview questions for
them to practice and it alsoactually spurs really great
(28:31):
conversation.
Do you have one of thesequality questions for us?
Keep in mind that there's moreinterview prep, such as mock
interviews and personalstatement review over on
shadowmenextcom.
There you'll find amazingresources to help you as you
prepare to answer your ownquality questions.
Dr. Zreik (28:49):
Absolutely.
I have a lot of them actually.
But what I would like to kindof showcase and ask would be,
when you're interviewing to workat institutions, whether you're
applying to residency or goingto a medical school that serves
a certain community, becausedoing your rotations, you still
have a sense of autonomy andresponsibility towards that
(29:09):
community, towards thatcommunity.
What I tend to ask my studentsand a lot of the applicants
applying is what inspires youabout the community that you're
going to serve, because a lot ofthe education that we typically
learn about in medicine reallyrevolves around curriculums and
(29:29):
milestones and exams and thingslike that.
But what we really care so muchabout especially people who are
very compassionate about thecommunities that they serve is
ultimately what brings you toour community and why do you
want to serve our patientpopulation.
You know, sometimes you can bethe most intelligent individual,
(29:49):
have so much science behindyour name, but what really
matters is how you can deliverthat information and how much
you care about the people thatyou're serving.
I work here in Flint and Flintto kind of showcase what it's
like.
I mean, we've been published bythe NIH regarding the opioid
crisis.
Our patients are living withadvanced heart failure and they
(30:11):
don't even know what heartfailure means.
So when I interview people,what I care more about is how
hard do you want to work for acommunity that's underserved?
And that's ultimately what Iwant to relay to people.
Ashley (30:24):
That is one of the best quality questions I have ever
heard.
What a fantastic, fantasticthing, and I'm sure you've
gotten some pretty impressiveresponses from that when you've
asked that in interviews.
Dr. Zreik (30:36):
Absolutely, absolutely.
I've gotten responses wheresome students may even reference
the water crisis in the past.
I don't always want to know allthe details of what they're
doing, but I want to know thatthey're putting forth a real
effort and due diligence toreally care about a community
that's not as privileged as weare.
Ashley (30:57):
And it's a great reminder to anyone interviewing
for a job anywhere you know,unless it's a remote position,
and even then there's a certainculture.
But you know, reallyinvestigate not just the role
but the community that you'restepping into you know, and
you're going to be there for alittle bit.
You might as well make bigchanges and big differences in
the people's lives who are alsothere, so that's fantastic.
Dr. Zreik (31:21):
Well said, Ashley.
It's exactly right.
Ashley (31:23):
For pre-med or pre-health students, either one
that are perhaps unsure aboutwhere they belong in medicine.
In your opinion, what shouldthey be paying attention to,
like during shadowingexperiences or really any time
they have exposure to medicine?
What would you encourage themto look for?
And these are students thatperhaps might not have an exact
(31:47):
idea of where they want to endup in this career.
Dr. Zreik (31:50):
Absolutely.
I hope this can be beneficial.
My advice to every futuredoctor professional because
that's what they are is tocreate a sense of why for
yourself, why do you care formedicine, why do you want to be
in health care and then to usethat to drive your presence.
So when you're on a rotationthen you can move on to ask the
(32:11):
how It'll make it flow well.
So you'll need to ask questions.
Understand that you're notsupposed to really know all the
information yet, but it's in theart of asking that really
identity gets created inmedicine.
So show up, ask questions, gohome.
It gets created in medicine, soshow up, ask questions, go home
(32:33):
.
Read.
The best students I worked withare the ones who had been
really curious when they roundedwith me and they really
expressed a genuine interest tolearn and, by the way, us
attendings and directors andeven residents, they can feel
that, by the way, intuitionexists in all of us and that
extends into the very systemthat we have here in medical
education.
So really caring and asking alot of questions, that's the
(32:55):
most beautiful thing you can doas a student builds on the merit
behind delivering care right Ifyou're practicing that before
you even begin to deliver care.
Ashley (33:11):
Once you're actually caring for these patients and
chatting with them and doing allof these things, it makes that
so much easier.
Dr. Zreik (33:19):
Exactly.
Ashley (33:21):
Well, dr Zarik, thank you so much for joining us today
.
Before we go, I read one ofyour interviews that you are
working on some texts and guidesto revitalize the approach to
medicine, and you're doing thiswith up-to-date studies and in
clinical practice.
Tell me a little bit more aboutthis.
How do you hope to change theface of healthcare during your
(33:42):
career?
Dr. Zreik (33:43):
Absolutely.
You know I've been working onthese texts since I was a second
year resident in residency.
I've been trying to compile allthis information tying the.
You know there's so manyresources out there.
You have UpToDate, you haveAMBOSS, you have MixApp, you
have UWorlds.
You have all this informationand sometimes it's so fragmented
(34:04):
what you may learn in medicalschool may not perfectly
translate into residency andwhat you've learned in residency
may not actually translateperfectly at specialty levels.
So I've been working on thesetexts to revitalize medicine and
kind of bridge that gap andteach all that information and
hopefully in a video series oneday.
(34:24):
It's a work in progress but Idon't like to just emphasize
that because, again, you know Iwant people to be inspired by
the quality of care and not justthe information behind it.
So hopefully I can take allthese ambitions that I have and
really turn it into something alittle bit more formidable one
day.
Ashley (34:44):
And then the product is going to just be beautiful.
I know it.
We cannot wait to see what youdo.
Thank you so much for the carethat you've provided, for the
education that you give, and forjoining us and sharing it all
with us today.
On Shatter Me Next.
I am so grateful.
Dr. Zreik (35:02):
Thank you so much, ashley, and thank you for
everything that you do.
We're all very lucky to havesomeone like you who's
showcasing all this and reallybringing medicine to a whole
different light.
We appreciate you, thank you.
Ashley (35:13):
You make it easy, thanks .
Thank you so very much forlistening to this episode of
Shadow Me Next.
If you liked this episode or ifyou think it could be useful
for a friend, please subscribeand invite them to join us next
Monday, as always.
If you have any questions, letme know on Facebook or Instagram
Access.
You want stories you need.
You're always invited to shadowme next.
Hello and welcome to Shadow Me Next, a podcast where
I take you into and behind thescenes of the medical world to
provide you with a deeperunderstanding of the human side
of medicine.
I'm Ashley, a physicianassistant, medical editor,
clinical preceptor and thecreator of Shadow Me Next.
It is my pleasure to introduceyou to incredible members of the
(00:22):
healthcare field and uncovertheir unique stories, the joys
and challenges they face andwhat drives them in their
careers.
It's access you want andstories you need, whether you're
a pre-health student or simplycurious about the healthcare
field.
I invite you to join me as wetake a conversational and
personal look into the lives andminds of leaders in medicine.
(00:44):
I don't want you to miss asingle one of these
conversations, so make sure thatyou subscribe to this podcast,
which will automatically notifyyou when new episodes are
dropped, and follow us onInstagram and Facebook at shadow
me next, where we will reviewhighlights from this
conversation and where I'll giveyou sneak previews of our
upcoming guests.
What happens when you combinethe curiosity of Sherlock Holmes
(01:07):
, the heart of a mentor and awhiteboard on wheels?
You get Dr Ali Zarik, aphysician educator, who's
redefining how we teach,practice and experience medicine
Today.
On Shadow Me Next.
I am so excited to introduceyou to Dr Zarareek, an internal
medicine attending physician andassociate program director at a
(01:29):
prestigious hospital.
But this conversation is aboutmore than titles.
It's about purpose.
From his early inspirationdrawn from Dr Lisa Sanders in
the TV show House, to his ownbring me the whiteboard moments
during rounds Dr Zareek brings arefreshing blend of intellect,
compassion and vision to medicaleducation.
(01:52):
We explore how he's buildingmore than clinical competency.
He's creating happiness at thepoint of care.
And, yes, we dive into howsomething as simple as a dry
erase marker can completelychange the dynamic between a
frustrated patient and a burnedout medical team.
In this episode you'll learnwhy the most difficult patients
(02:13):
can become your greatestteachers, how bridging the gap
between science and humanitytransforms learners and lives,
why curiosity and askingquestions aren't just encouraged
they're essential todiscovering your why in medicine
.
And how Dr Zareek is buildingnew tools and texts to reshape
(02:34):
the future of healthcare.
Whether you're a pre-healthstudent, a resident or someone
who's felt the tension betweenbureaucracy and bedside care,
this conversation is for you.
Please keep in mind that thecontent of this podcast is
intended for informational andentertainment purposes only and
should not be considered asprofessional medical advice.
(02:56):
The views and opinionsexpressed in this podcast are
those of the host and guests anddo not necessarily reflect the
official policy or position ofany other agency, organization,
employer or company.
This is Shadow Me Next with DrAli Zarik.
Hi Dr Z, thank you so much forjoining me today on Shadow Me
(03:16):
Next.
I am just so thrilled that youhave made time for us, thank you
.
Dr. Zreik (03:21):
It's absolutely my privilege, ashley.
I'm always here to help and Ido appreciate how you've offered
a light to the compassion ofmedicine and guiding people in
ways that are actually veryhelpful.
So whatever I can do, I'd loveto share with that today, with
you.
Ashley (03:37):
I appreciate that and you know that's actually we met
on LinkedIn and that's actuallywhat drew me so much to your
profile was how you are ineducation and yet you're not
just teaching the science andyou're not just teaching the
diagnoses and the treatment, butyou're really revitalizing this
whole approach to medicine andyou're encouraging people to see
(03:57):
the whole person and to perhapsconsider, oh, I don't know, the
patient maybe as opposed to thediagnosis first.
So thank you.
I think that we will learn somuch about how to approach a
patient, and not just how towork in medicine, from our
conversation.
So, dr Z, tell us a little bitabout your beginnings.
Dr. Zreik (04:18):
You know, ashley.
Thank you for that introduction, by the way, I hope I deserve
it.
You know, to begin with I'vealways been very Sherlockian in
my approach to everything inlife and medicine was the best
vessel to that.
You know, internal medicine initself has been somewhat of a
Sherlockian methodology for meand to be able to deliver
(04:40):
information in an algorithmicfashion, intertwine with some
you know, poetry, passion,purpose, medicine's kind of come
to light for me that way.
I joke around a lot with mycolleagues sometimes and I say
I'm secretly a narcissistbecause I love seeing people
learning and it gives me truegratification.
So seeing the future of doctorsgrow, being able to deliver
(05:04):
information in this Sherlockian,algorithmic sense, it's really
become a big milestone in mylife.
A little bit about what inspiredme, I would say, is a physician
named Lisa Sanders.
She's an American author,physician and a journalist.
She was the forefront ofinternal medicine and professor
(05:25):
at Yale.
She began writing in 2002 atthe New York Times column called
Diagnosis, where she basicallycovered medical mystery cases
and later founding the conceptbehind our very own television
series, house.
So she kind of brought a senseof medicine, what I want to
practice medicine like, and shereally says something very
(05:49):
amazing in one of her books.
It's called Every Patient Tellsa Story and I actually wrote it
down here just so we can allhave a good reference, you know.
She says the basic sciences ofanatomy, physiology, biology and
chemistry are linked to apatient at the bedside through
very specific stories thatdoctors learn and eventually
create.
It's the story that everydoctor puts together for herself
(06:12):
with the knowledge she gainsfrom books and patients.
The more experience a doctorhas with any of these illnesses,
the richer and more detailedthe illness script she has as
the disease becomes.
So it's reveling in theSherlockian process itself and
being a detective and takingthat plus compassion towards
patients and bringing the bestexperience to light at the
(06:32):
bedside and that's really kindof driven my whole expertise, I
think, in medicine.
Ashley (06:37):
That's incredible.
I love that.
Thank you, dr Sanders, forcreating such a beautiful
resource for people.
I love hearing where people gottheir inspiration from, and you
know, of course, a lot ofpeople will say a family member
encouraged them, or perhaps afamily friend, something like
that.
For you it was reading, youknow reading stories on a page
(06:57):
by Dr Sanders.
That's just, you know findinginspiration, and in every little
corner of our lives it can bereally motivating.
Every patient does tell a storyand this is where experience
comes in, right, I think sooften people find that a
physician or a PA or an NP thathas a lot of experience.
It means they know a bunch ofthings, right?
(07:20):
Well, perhaps, but it alsomeans they've seen and
experienced and lived and loveda bunch of patients through a
bunch of things.
Dr. Zreik (07:28):
Absolutely Well said, Ashley, and you know it is
unfortunate and we have tosometimes, as even though we're
so passionate in this regard, wedo have to see the unfortunate
reality unfolding sometimes inhealth care institutions.
Reality unfolding sometimes inhealthcare institutions.
Medicine has really changed.
It was once this paradox offascination, science, an
(07:50):
experience of awe, and somewherealong the road, length of stay,
hospital bureaucracy, advancesin healthcare technology.
That perspective changed.
We went from beingpatient-oriented to goal and
task-oriented.
So, despite all our trillionsof dollars from, you know, 1990
to 2020 and our advances in thestate-of-the-art diagnostic
(08:13):
tools, studies still show asignificant number of patients
they're unhappy about theirmedical providers and they feel
unhappy because that lack ofcompassion and they feel unhappy
because that lack of compassion.
So the paradigm shift I feelthat we need to illustrate to
our listeners and to our futurehealthcare professionals is that
we have to bridge the socialand the science and that's the
(08:35):
most important thing I think wecan offer as healthcare
professionals.
Ashley (08:40):
And that's why I love so much the phrase that you used,
sherlockian, because I think alot of people really resonate
with that right.
They resonate with theobsession with the problem and
the desire to solve the mystery,and those problems are the ones
that our patients areexperiencing.
You know, our patients are theones with the mystery, so you
(09:01):
really have to partner with themin order to get the whole
picture right.
Dr. Zreik (09:06):
Exactly.
Ashley (09:06):
Dr Z, tell me, you know, you mentioned, of course you
mentioned the fantastic medicalshow house and there's been many
more even since then.
And I think of course we do.
We are God, as cliniciansespecially, but even as
pre-health students.
I think we're so drawn to thesestories and these shows because
, well, number one, they're justincredible.
Number two we do end uplearning a bunch of things.
(09:28):
Obviously it's a drama, right,but there's good.
So what would you tell?
Let's say, what would you tella pre-health student who's come
to you and said hey, dr Zeke, Iwatched this really awesome show
.
It's this medical show.
Is this real life?
Tell me, is this what you do ona daily basis?
How do you, how does your storyresonate with that?
Dr. Zreik (09:45):
Sure, and you know, ashley, I've been asked this
question before because of thenumerous references I have to
Lisa Sanders, and I will say myanswer has been consistently
about the same.
I usually tell them to reallyfocus on the moments of
inspiration in these kinds ofshows.
You know, it's obviously Idon't want them to learn all the
(10:07):
personality issues that comewith certain personas, but I do
want them to focus that thereare going to be moments in
medicine where you're going tohave that connection, where
you're going to feel that formof inspiration.
I mean, even now I have somepivotal moments with patients
and I'd love to share with youone or two of those where you
(10:27):
know I have a problematicpatient with it which in a show
would come off, as you know, aclimactic moment, and then at
the end of it I find some sortof peace and art with my patient
, and so I would focus on themerit behind delivering care,
but also creating and tailoringyour own persona and your own
(10:49):
medical knowledge to reallydeliver that care.
So to some extent it's good tohave some inspiration from
whatever source you can find,but it's really bringing that to
life in your own profession, Ithink.
Ashley (11:04):
That is so perfect.
Thank you so much.
I'm going to I'm totally goingto steal that, because I too
have received this question veryoften and, of course, our like
our cut and dry, our cut and dryresponses.
Well, well, all medicine is notGrey's Anatomy, you know and
that's true, but focusing on themoments of inspiration and the
merit behind delivering care,that's perfect.
(11:25):
That's exactly the whole pointDr Z tell us about.
What does a day in your lifelook like right now?
Dr. Zreik (11:29):
Sure.
So I'm an associate programdirector at a residency program,
internal medicine.
I work at a level one, trauma.
I have about 15 residents perclass.
I have I tell people all thetime I have about seven or eight
tentacles and what I mean bythat is I really take on a lot
(11:51):
of roles and that's because Ilove doing it.
A day to day for me would be,you know, waking up in the
morning, coming to round.
I will say I'm very notoriousfor having a rolling whiteboard
at rounds.
I'm very notorious for having arolling whiteboard at rounds.
So what I do with this thing isI every single patient room
after we've discussed the caseme and the residents and the
students I explain, I go throughall the physiology, the
(12:17):
guidelines, the diagnosis andthe treatments on this
whiteboard and I really try totie together the medical school
physiology all the way to thestuff being discussed really at
like guidelines andconference-based level.
So that's like a typicalrounding for me.
I also hold these noonconferences in this residency
program where I work onhigh-yield internal medicine
topics and delivering that atlike kind of a patient case
(12:41):
scenario and other timeslectures where I go over the
pathologies and physiologies.
I also am part of the academiccurriculum on quality and
research too.
So you know it's a very longlist of things that I do.
But, to be quite honest withyou, the most important thing
for me is seeing that theresidents are happy, the
(13:03):
students are learning and ourquality of care is delivered in
the most optimal fashion.
So I always make and I tell myresidents and my students that,
at the end of the day, no matterwhat we do, whatever guideline
we follow, whatever milestone wereach with our requirements, we
always have to make you knowhappiness at the point of care
(13:25):
requirements.
We always have to make you knowhappiness at the point of care,
and that's ultimately whatmotivates me, inspires me to
come and do all of this everysingle day.
Ashley (13:30):
That's incredible.
Now I have a picture of youwith seven or eight tentacles
and it's just fantasticHappiness at the point of care.
You know you are the associateprogram director, you are the
attending.
In this case, how do you makesure that your residents are
truly understanding this concept?
I mean, I can only imagine howmany different things a resident
is worrying about on theday-to-day, you know.
(13:51):
I mean they're trying to learn,they're trying to hone their
skills, and then you tell them,you know, happiness at the point
of care for everybody involved.
This is our goal and they, theymust look at you and go wait,
what I thought our goal issomething different.
How do you convey that and makesure that the well-being of not
just your patient but also yourresident is really being looked
(14:13):
after?
Dr. Zreik (14:14):
Absolutely, and there's a real art to this more
than it is a science, and I willsay with much humility that
that's the one great thing I'velearned as an attending is how
to bridge that gap.
It's difficult, that you know,without a doubt, bridging the
academics of residency topatient care, personability, the
(14:35):
wellness of the health careprofessionals.
It really takes a lot ofexperience, I think, and
learning about yourself and yourown shortcomings too, I think,
and learning about yourself andyour own shortcomings too.
My way of handling this is toremind myself the reason, the
very reason I'm here on thisearth between these residents,
that I'm here as a mentor.
I'm here to bridge the gapbetween what's real and what's
(14:57):
in their books and to reallymake the point of care come to
light for them.
So the point behind using thiswhiteboard, for example, is
really to show them how we cantake so much information and
really tie it together like apuzzle, and when you see that
and when they experience that,even burnout, we're able to make
(15:17):
their experience a whole lotbetter.
So it's really within justtaking a nice marker and drawing
a picture for them, you reallybring that to light and it
becomes more moral andintellectual and happy to work
humanely, with gentleness,concern and being able to
(15:37):
deliver information in a waythat is interesting rather than
disciplinary.
That's the most important wayto keep their experience light
and going.
Ashley (15:48):
Yes, yes, and thank you so much for providing this
incredible mentorship to theseresidents and literally
everybody else who is watchingyou teach them.
I mean, it could be you knowany of the other medical staff
on the floor that you're workingor perhaps just a patient's
family member that's sitting inthe room or listening outside
the door.
The mentorship you're providinghas been such a key element for
(16:12):
so many clinicians that I havetalked to.
I would imagine that you havehad fantastic mentorship that
has shaped you and shaped yourcareer.
Is that your story?
Dr. Zreik (16:24):
You know what?
I've had so many ups and downs,ashley.
When I was in residency I had aprogram director who was.
You know, when you first meethim, at a glance you think he's
really tough.
But I've really learned thatcompassion comes in so many
different forms and really it'sthe point of care where you
(16:45):
really get to see people'spersonas and you learn from.
So what may appear as a toughattending in certain lights may
actually be the mostcompassionate person at the
bedside.
And it's all these, thisculmination of experiences I've
gained from great doctors, harddoctors, easier doctors, people
with so many different personasin medicine, plus all the
(17:09):
passion and the education I'velearned and chased myself.
I've kind of tailored it intomy own type of mentality.
You know, it's reallyinteresting to me because the
time I've learned the most andthe time I've been able to
exhibit this at the highestlevel has really been with my
most difficult and what mostpeople would call problematic
(17:31):
patients.
You know, I'd love to share anexperience, for example, with
you where I had a patient in theICU a couple of weeks ago with
heart failure and aorticstenosis.
I remember my team of residentscoming to me and telling me Dr
Zareek, we have a veryproblematic patient.
The staff is really frustrated.
(17:53):
He doesn't want any of themedicines we're giving him and I
welcome the chaos.
That type of darkness is wherelight really comes in right.
So my colleagues were signingout to me this difficult patient
who needed a TAVR, who neededall these medical therapies for
heart failure.
I remember looking at theresidents, nurses and the team
members.
(18:14):
You see, now we're kind ofinspiring the institution,
everyone within the ICU, and Itold them bring me the rolling
whiteboard.
And everyone laughed initially,right, but what initially
appeared to be an exhaustedpatient who was extremely
frustrated, first thing Iremember doing is walking in the
room.
I fist pumped the patient and Iremember saying brother, I'm
(18:38):
here to help, I know there's alot going on and I don't want to
do anything except providemyself to you today.
So, one line to the next, oneheartfelt reply to the next,
drawing a heart, explaining thephysiology, what appears to be a
patient for years who requiredall these therapies, who's been
led by cardiologists andmultiple specialists.
(18:58):
He broke down in tears and thesame patient ended up deciding
to all of us and it was alearning experience to everyone
in the room the nurses, me, theresidents.
You can see a patient who wasfinally inspired, and it's in
moments like this where we cancultivate an environment between
(19:19):
ourselves, nurses, patientswhere we can provide the highest
quality of care.
All it requires is going backto the drawing board and
inspiring people.
Ashley (19:29):
Quite literally the drawing board right.
I love that.
Bring me the rolling whiteboard.
And it benefited your team,your medical team that was in
there, but it benefited thatpatient.
I mean, when has that patientever had somebody illustrate a
heart in front of him?
You know, probably never.
Dr. Zreik (19:45):
Yeah, and that's what he said.
He said never.
And this is not my opportunityto showcase myself and I'm so
sorry if I sound egotistical.
I just want to illustrate oneconcept is that sometimes, by
caring a little bit more, it cango a long way.
Ashley (20:03):
No, absolutely.
But no, it's just lessonslearned, right?
Because I'm sure that you, muchlike me, have walked into these
difficult, quote, unquote,problematic patients, the
patients that you really justwant to go.
Oh, you know, and we've hadexperiences where where perhaps
we have been frustrated.
It kind of reminds me ofparenting, you know, like with
my girls.
There are moments when you knowI behave in a way that I'm not
(20:27):
proud of my children and and Itake that lesson and I take that
moment.
This is the same with patientstoo.
And then you grow from it andyou move on, and you've probably
had that opportunity, and nowyou can approach a patient like
this and, instead of going, youcan give them a fist bump and
say, listen, I've got you,You've got me now and we're
(20:50):
going to figure this outtogether, you know, and I think
that patients just want to feellike we are on their team.
They want to be standing nextto you at the whiteboard trying
to figure this out witheverybody else.
And no, I think, I think that's, I think that's really great.
Dr Z, what are you doingdifferently in medical education
(21:11):
today that you wish had existedwhen you yourself were a
resident?
How about that?
Dr. Zreik (21:16):
Right.
So for me, when I was inresidency, actually I really
cared more about, to be honest,the science.
I wanted to deliver as muchinformation, a plethora of
information, to showcase theamount of information and
knowledge that we can actuallyprovide to our patients, and I
(21:37):
really took pride in being ableto explain everything to a T to
my patients.
Growing into becoming anattending, I've learned that
it's more than that.
It's kind of like I'm not sureif you've ever heard of Atul
Gawande.
He's this American author andsurgeon who wrote this book
called being Mortal.
But he says you go into thiswork thinking it's all a matter
(21:58):
of a canny diagnosis, sometechnical prowess and some
ability to empathize with people.
But it's not Soon.
You find out.
We have to grapple with systems, resources, circumstances and
our own shortcomings.
And he puts it really well andI feel that in the last couple
of years especially, I've kindof learned that it's more than
just having that technicalprowess to be able to deliver
(22:21):
that care, but really reallyfocusing on connecting people to
the information and also to thequality of care beyond the
scope of the science.
I mean patients or somecommunities of patients.
They're genetically born intodisparity and there are things
we can control, things that wecan't.
But what we're here for and I'mgoing to continue to emphasize
(22:44):
is everything that we can offerhas to come from a
multifactorial perspective.
Knowledge is great, compassionis great.
Tying it all together andtrying to understand where these
people are coming from, I thinkthat's something I feel that
I've really acclimated a littlebit better to in the last couple
of years.
Ashley (23:01):
Amazing experience, right?
I mean it just comes from somuch experience.
Dr Z, tell me about how youcare for your residents, because
I can tell that you, obviouslyyou care for their medical
education residents, because Ican tell that you, obviously you
care for their medicaleducation, you care for their
perception on where they standin these patients' lives, is
that it?
I mean outside of this, they'rein residency with you for a
(23:23):
little while.
Dr. Zreik (23:24):
What does that?
Ashley (23:24):
relationship look like.
Dr. Zreik (23:27):
You know, as a mentor and, more importantly, as a
friend, I like to take a stepback from expectations sometimes
to figure out what's exactlyhappening to the residents or
the students.
Sometimes it's not really thebest day of the week or the best
day of their life and it couldbe a matter of personal issues
(23:49):
or it can be just maybe thedelivery information.
So sometimes a resident couldbe overwhelmed and everybody
works at different paces andit's best to access that data
bank of information beforeassuming.
Guidance is always the answer.
So I try my best to tailoreveryone's academic plans, their
learning and really how theyapproach patient care and their
(24:11):
journey in medical education toeach resident on their own.
I have the privilege of workingwith these residents and
students and they come from allacross the world here at Hurley,
I mean I've worked withstudents and residents from all
across the world and with muchhumility.
I also need to learn my ownshortcomings and that it's not
(24:33):
always as perfect as a machineor some sort of educational
curriculum.
You have to really understandpeople, just like we're trying
to understand patients.
So really instilling some sortof pride and inspiration in them
is the best way about going anddoing this and really teaching
them by example.
(24:54):
But nothing's perfect and thisis a process that requires
learning every day.
Ashley (25:02):
Imagine so with every new group of residents, because
you get a new group every year,right.
So with every new group ofresidents, it's new
personalities, new people, whichis just amazing.
Speaking of which, do theyoften remain in contact with you
after this, I mean, oncethey've moved on, do they still
reach out?
Dr. Zreik (25:23):
Absolutely.
That's my metric of success formyself is when I know a
resident has graduated and theyreach out to me.
A lot of times they do reachout to kind of just say hello.
I've really developed a strongfriendship with so many of them
and sometimes they reach out tome to kind of elaborate on their
(25:45):
own experiences and tell meabout their patients, and it's
really a proud moment for me tohear that the education I was
able to provide to them hasreally made an impact on them
later in their own personalcareers.
Ashley (26:01):
I think that's a perfect metric.
I think that's the best metric,right.
Are they reaching out?
Do they want to update you ontheir lives?
Do they want to tell you abouta patient, about a patient or
just, you know, commiserateabout perhaps a memory in
residency Before we transition?
I want to start talking to someof our pre-health students here
(26:22):
in just a minute, but before wetransition to that.
you briefly mentioned a wordthat is just such a.
It's a hot topic right now.
It has been for a while, butit's burnout.
It's burnout in medicine.
Everybody experiences this atsome point.
But I'm just so curious to knowhow you protect your passion
from this awful thing calledburnout.
(26:42):
You've mentioned poetry andyou've mentioned art, and I
would just love to hear a littlebit of advice from you on how
to stay so passionate of advicefrom you on how to stay so
passionate Absolutely.
Dr. Zreik (26:57):
You know there's a lot of evidence base and
literature that's actually beingprovided in so many different
TED Talks on this.
I've learned, especially frommy personal experience and the
literature, that when I enjoywhat I do, I gain a sense of
responsibility and purpose andwith that purpose making my
happiness at the point of careI'm actually less likely to burn
(27:18):
out.
You know, even data suggeststhat if we optimize our language
and our quality of care,burnout burden becomes actually
less.
That's not to say that youshouldn't be detaching, but
doing that plus really creatinga sense of purpose, I feel
really helps mitigate the riskof burnout.
I can't really speak on thisall the time because I'm a
(27:43):
workaholic.
Sometimes I just got off a fiveweek straight rounding, but
that's that's me.
But I do qualify it by sayingto everyone that it's good to
have balance.
But when we try to reallyexperience the happiness of what
we do, I do think we mitigatethe burnout.
Ashley (28:00):
That's great, Just being intentional.
Being intentional about makinghappiness at the point of care.
It's not just something thathappens.
I mean sometimes it is.
Those are really great moments.
Dr. Zreik (28:10):
Yeah, absolutely.
Ashley (28:11):
Thank you so much, dr Z.
We have a segment on the showit is called quality questions
and this is where you and Idiscuss an interview type
question that you have eitherheard or you like to ask.
That is just memorable, forwhatever reason, this helps
pre-health students develop acache of interview questions for
them to practice and it alsoactually spurs really great
(28:31):
conversation.
Do you have one of thesequality questions for us?
Keep in mind that there's moreinterview prep, such as mock
interviews and personalstatement review over on
shadowmenextcom.
There you'll find amazingresources to help you as you
prepare to answer your ownquality questions.
Dr. Zreik (28:49):
Absolutely.
I have a lot of them actually.
But what I would like to kindof showcase and ask would be,
when you're interviewing to workat institutions, whether you're
applying to residency or goingto a medical school that serves
a certain community, becausedoing your rotations, you still
have a sense of autonomy andresponsibility towards that
(29:09):
community, towards thatcommunity.
What I tend to ask my studentsand a lot of the applicants
applying is what inspires youabout the community that you're
going to serve, because a lot ofthe education that we typically
learn about in medicine reallyrevolves around curriculums and
(29:29):
milestones and exams and thingslike that.
But what we really care so muchabout especially people who are
very compassionate about thecommunities that they serve is
ultimately what brings you toour community and why do you
want to serve our patientpopulation.
You know, sometimes you can bethe most intelligent individual,
(29:49):
have so much science behindyour name, but what really
matters is how you can deliverthat information and how much
you care about the people thatyou're serving.
I work here in Flint and Flintto kind of showcase what it's
like.
I mean, we've been published bythe NIH regarding the opioid
crisis.
Our patients are living withadvanced heart failure and they
(30:11):
don't even know what heartfailure means.
So when I interview people,what I care more about is how
hard do you want to work for acommunity that's underserved?
And that's ultimately what Iwant to relay to people.
Ashley (30:24):
That is one of the best quality questions I have ever
heard.
What a fantastic, fantasticthing, and I'm sure you've
gotten some pretty impressiveresponses from that when you've
asked that in interviews.
Dr. Zreik (30:36):
Absolutely, absolutely.
I've gotten responses wheresome students may even reference
the water crisis in the past.
I don't always want to know allthe details of what they're
doing, but I want to know thatthey're putting forth a real
effort and due diligence toreally care about a community
that's not as privileged as weare.
Ashley (30:57):
And it's a great reminder to anyone interviewing
for a job anywhere you know,unless it's a remote position,
and even then there's a certainculture.
But you know, reallyinvestigate not just the role
but the community that you'restepping into you know, and
you're going to be there for alittle bit.
You might as well make bigchanges and big differences in
the people's lives who are alsothere, so that's fantastic.
Dr. Zreik (31:21):
Well said, Ashley.
It's exactly right.
Ashley (31:23):
For pre-med or pre-health students, either one
that are perhaps unsure aboutwhere they belong in medicine.
In your opinion, what shouldthey be paying attention to,
like during shadowingexperiences or really any time
they have exposure to medicine?
What would you encourage themto look for?
And these are students thatperhaps might not have an exact
(31:47):
idea of where they want to endup in this career.
Dr. Zreik (31:50):
Absolutely.
I hope this can be beneficial.
My advice to every futuredoctor professional because
that's what they are is tocreate a sense of why for
yourself, why do you care formedicine, why do you want to be
in health care and then to usethat to drive your presence.
So when you're on a rotationthen you can move on to ask the
(32:11):
how It'll make it flow well.
So you'll need to ask questions.
Understand that you're notsupposed to really know all the
information yet, but it's in theart of asking that really
identity gets created inmedicine.
So show up, ask questions, gohome.
It gets created in medicine, soshow up, ask questions, go home
(32:33):
.
Read.
The best students I worked withare the ones who had been
really curious when they roundedwith me and they really
expressed a genuine interest tolearn and, by the way, us
attendings and directors andeven residents, they can feel
that, by the way, intuitionexists in all of us and that
extends into the very systemthat we have here in medical
education.
So really caring and asking alot of questions, that's the
(32:55):
most beautiful thing you can doas a student builds on the merit
behind delivering care right Ifyou're practicing that before
you even begin to deliver care.
Ashley (33:11):
Once you're actually caring for these patients and
chatting with them and doing allof these things, it makes that
so much easier.
Dr. Zreik (33:19):
Exactly.
Ashley (33:21):
Well, dr Zarik, thank you so much for joining us today
.
Before we go, I read one ofyour interviews that you are
working on some texts and guidesto revitalize the approach to
medicine, and you're doing thiswith up-to-date studies and in
clinical practice.
Tell me a little bit more aboutthis.
How do you hope to change theface of healthcare during your
(33:42):
career?
Dr. Zreik (33:43):
Absolutely.
You know I've been working onthese texts since I was a second
year resident in residency.
I've been trying to compile allthis information tying the.
You know there's so manyresources out there.
You have UpToDate, you haveAMBOSS, you have MixApp, you
have UWorlds.
You have all this informationand sometimes it's so fragmented
(34:04):
what you may learn in medicalschool may not perfectly
translate into residency andwhat you've learned in residency
may not actually translateperfectly at specialty levels.
So I've been working on thesetexts to revitalize medicine and
kind of bridge that gap andteach all that information and
hopefully in a video series oneday.
(34:24):
It's a work in progress but Idon't like to just emphasize
that because, again, you know Iwant people to be inspired by
the quality of care and not justthe information behind it.
So hopefully I can take allthese ambitions that I have and
really turn it into something alittle bit more formidable one
day.
Ashley (34:44):
And then the product is going to just be beautiful.
I know it.
We cannot wait to see what youdo.
Thank you so much for the carethat you've provided, for the
education that you give, and forjoining us and sharing it all
with us today.
On Shatter Me Next.
I am so grateful.
Dr. Zreik (35:02):
Thank you so much, ashley, and thank you for
everything that you do.
We're all very lucky to havesomeone like you who's
showcasing all this and reallybringing medicine to a whole
different light.
We appreciate you, thank you.
Ashley (35:13):
You make it easy, thanks .
Thank you so very much forlistening to this episode of
Shadow Me Next.
If you liked this episode or ifyou think it could be useful
for a friend, please subscribeand invite them to join us next
Monday, as always.
If you have any questions, letme know on Facebook or Instagram
Access.
You want stories you need.
You're always invited to shadowme next.
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