You can't fatten a cow by weighing it, and other stories we tell ourselves with Dr. Ellie Vogt!
Interview with Dr. Eleanor Vogt, PhD, RPh
Eleanor Vogt, PhD, RPh, is a faculty member in the UCSF School of Pharmacy. She has been named the president of the board of directors for the American Pharmacists Association Foundation (APhAF).
Vogt has had a distinguished career working in clinical pharmacy practice, the pharmaceutical industry, health policy and planning, regulatory affairs, and patient safety and advocacy, and even as a TV pharmacist, answering questions for the public in the 1970s.
She was the first consumer representative on an FDA technical review committee, and served as Senior Fellow for the AMA’s National Patient Safety Foundation, testifying before Congress on this issue.
Vogt joined the faculty of the UCSF School of Pharmacy’s Department of Clinical Pharmacy in 2004 and was awarded the UCSF Presidential Chair for 2004-2005.
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L: Hi everyone and welcome to Two Pills Podcast. We have Dr. Eleanor Ellie Vogt as our guest today. To get started, can you tell us a little about yourself and your teaching style?
E: Absolutely I'm delighted to be here. My teaching style is a learning style. I consider myself a learner and that's what it's all about. Someone asked me in the classroom who should learn the most? The teacher. If the teacher is not learning, then learning isn't happening. That's the process. I really try to live that. It's a community of learners, not a classroom. We're all learning together. It's a dialogue. Learning is an internal active change process. That's my philosophy and that's where I'm coming from.
L: Fantastic! Can you tell us when you knew you wanted to be a teacher?
E: My parents tell me I was already telling people what to do by the age of eight. Literally, I was designing neighborhood programs. Teaching comes naturally for me and I enjoy it. I get feedback that I'm good at it, so why not do it?
L: Throughout your time in teaching, can you tell us about a time where a teaching strategy went well and then can you also tell us about a time or when did not go well?
E: Why can tell you what doesn't go well at all is lecture. I don't enjoy it and the students don't enjoy it. I don't like racing through material. I really believe in the quote from the British poet WB Yeats: teaching is not filling a bucket, it's lighting a fire!
That's the approach I take. When we have real dialogue, the real excitement and learning takes place. The answer is in the room. Having people share their experiences is what it's all about. The dynamic that goes really well for me is when everyone is involved. Sometimes that takes physical movement. I like to have people get up and move.
Sitting is the new smoking. Your listeners may be familiar with Amy Cuddy's work from Harvard who has her students get up and do the Super Woman move with hands on the hips and strut around. They have actually measure testosterone levels after 2 minutes of doing this. Immune levels and levels of self-confidence increase within just those two minutes.
Do the virtual high five for social engagement. Something that we see not only in Pharmacy students but in students in general is the feeling that they are all alone. The feeling that no one is going through what they are going through. And that is the opening to major disease. Mental and physical.
L: Can you talk about your role with students and the issues that they face while they are in pharmacy school?
E: Number one, they feel all alone. The first thing we do is get them to share. What is your story? What is your story? So that they realize that they are not all alone. I literally have them walk around and give virtual high five.
I do a lot with basic life skills. You know, the stuff we should have learned in kindergarten. One of the basic skills that I use all the time is heart appreciation. Let yourself literally feel appreciation in your heart. Imagine that you're breathing through your heart space. How lovely is that? Let yourself actually feel appreciation. Levels are rising, your blood pressure is falling, your cortisol levels are falling, there's more blood flow to the brain and you problem-solve better. I remind my students that they are paying big money to sit in those seats. So, why not take advantage? Why wouldn't you be as optimal as you can be? This is the easiest and fastest way. You can literally get to this learning mode in a heartbeat.
Some people are so out of touch with appreciation, I literally just focus on them feeling that. I saw an interview of Oprah Winfrey when she said that her grandmother told her every night before she went to sleep to identify three things that she was grateful for. Oprah says that she has never not done that. I think by anyone's measure, Oprah is a successful and happy woman. It works for her!
There is an abundance of research that shows that when you move into positive thoughts, you generate positive feelings. Your body responds to that. Your body hears every word you say. Your thoughts predict your feelings. Your feelings are just shadows of your thoughts. So, wherever you put your thought is where you're putting your attention. That's the feeling you're going to generate. Science tells us that we generate between 58,000 and 78,000 thoughts per day. So, where are you putting your attention? I love this analogy. Do you remember that children's game in which there would be a picture of a house? You could then take your little cursor and put it on the door and the door was open. Then you could put your cursor on the cupboard and mice would come out. Or you put it on a flowerpot and a flower would come out. It's the same thing! Wherever you put your attention, your whole mind and body is responding. That's how you generate your feelings. That's how you generate your behavior and the outcomes. So, that can be both positive and negative.
When looking at the kinds of thoughts that medical students generate, such as imposter syndrome and thinking why did I get here. I'm not good enough. I shouldn't be here. That leads to shame, which leads to anxiety and depression. So, if we turn it around and we say that our thoughts are going to be of appreciation and gratitude and positive stories, that leads to my feelings of I am good enough. I feel Confident, I am focused, I'm centered, and that leads to resiliency. This helps with the ability to deal with life. What we are talking about are basic life skills.
I certainly believe that professional intervention is appropriate when it is appropriate. Medicine is also appropriate when appropriate. How did we get here? How can we prevent these disastrous results from upstream? Let's get more of the science into the core curriculum. The science has been there for years. 40 years ago, quantum physicists documented that the observer affects the observed. It is not even time relevant. How we see things is a reflection of what is going on in our own heads. It’s an inside job. In a sense, it's a hallucination. We're all hallucinating positively or negatively. The neurocognitive science coming out on this issue is so fascinating. Major universities are demonstrating that what happens on the outside is a reflection of what is happening on the inside. These include our perceptions and our filters that are transparent to us. We just see right through them. The exciting thing is that you can change! You can change your perception and you can change your thinking.
L: I think what is so great about what you’re saying is that we as faculty need to know how to respond to a student who is sharing with us. Maybe they do feel really down, maybe they just failed a course, and they don't know if they should be a pharmacist or be a physician anymore. We need to be helping students through those filters and getting them through what is going on.
E: To your point, what I say to students is “I am doing anxious” or “I am doing scared.” It changes the power here. Let's tell it from that point of view. If you still need professional help, great, but let's evaluate it that way. It is all about the stories we tell ourselves.
L: Is there a student experience or student question that has left a lasting memory?
E: This is a story that a student told me, which I love. He was a 26-year-old male and he said that he lived in a transitional neighborhood; it's a little rough. Sometimes when I go home at night, I feel vulnerable. He said I feel like I'm wearing a skirt. I realized that I needed to change my story. I pay rent on this street and probably more than anyone does, I'm a good citizen, and I’m a good renter. He said he realized that he was a victim of his own mind. That has stayed with me for a very long time.
I give all my students, everyone, a prescription. I've had people come back to me years later saying they still have that prescription. It's so neat and there is no co-pay with this prescription.
L: Can you talk about Still point breathing and how that has helped people?
E: This is so marvelous. We know so much about the benefits of breathing. In school, we teach students about inhalers and treatment for respiratory diseases. But the respiratory system is so fascinating. When you breathe in, and I invite your listeners to take a breath, be aware at the top of your in breath. And then especially at the bottom of your out-breath. There is a point at which nothing happens. Don't hold your breath, just be aware. Put your awareness when it happens. At that point, your body is in perfect balance. Both systems are in perfect balance. We call it a rest and restore point. It's potent healing. It costs nothing. It's readily available every few seconds. Not only is it physiologically healing, but it can change your perception. If you are talking to someone who is upset, you can put your focus on your own Still Point, you will find that you will become more relaxed. You'll be surprised what comes out of your mouth when you're in this more relaxed and focused state. You're no longer just reacting to the situation. You are speaking from your authentic self. It's really a mind-altering technique. And it's so simple.
L: So if you had a new faculty member who came to you, what kind of insight would you give them that you wish you had on your first day?
E: That I am learning from my students and we are in this together. We are going to create something together. I may have a little more information, but if we are not in dialogue, then nothing is happening. Plus, you will burn out so fast. I was doing CE for pharmacy and there were about 200 pharmacists in the room. At the end, a young man asked me, when I come in in the morning and see all the work in the pharmacy that hasn't been done and the phone calls that haven't been made, you want me to take a breath and appreciate this? A woman in the back of the room said when I come in the morning and see all the work that hasn't been done oh, I remind myself that I have been specially trained to do the specialty work. I have a license to do this kind of work. When I see that bus from the senior home pull up, I am so thankful that I have skills that can help them. I found out later that both of these people work in the same pharmacy. So, I ask you, who is going to burn out faster and sour on the profession faster? And more importantly, who would you want to work with? It's the same thing about teaching. If you are not getting a personal return, being authentic, being present, and being engaged, Then you are not lighting your own fire. If your own fire isn't lit, there is no way that you can spread your fire to your students. That's the advice I give to young faculty when I train them.
L: Who inspires you?
E: I am lucky to be the graduate assistant of Malcolm Knowles. He is considered the father of adult education. When I got out of pharmacy school, worked for a few years, and decided to go into this program, he gave me a list. This is a list of competencies that I think teachers should have. I want you to grade yourself on this list. This was so foreign to me after coming out of pharmacy school where you are supposed to know the answer to everything. There was no self-assessment or reflection. I had to learn that and then I saw how he taught and interacted with students. I saw how he pulled the learning from the group. He was an incredible inspiration. We would discuss how the student and the teacher were partners. We have to decide together how we are going to move forward and how we are going to assess if it is going well.
L: Are there any books, podcasts, or resources that you would recommend?
E: Anything by Parker Palmer. “The Courage to Teach”. I find books like that more helpful than those that are more formulaic. Just because it can be counted, doesn't mean it needs to be counted. When I was very involved with quality standards while working in Washington, we were talking about assessment. A gentleman stood up and said that every farmer knows that you can't fatten a cow by weighing it. That should be the motto of every assessment committee. We need to also pay attention to the science. We need to be teaching about Still point and cardiac coherence. We should be teaching homeostasis and the Mind Body Connection.
L: It amazes me as an advisor, since I had a pretty smooth sailing trip in pharmacy school, some of the things that students are dealing with in their personal lives are just amazing. Diagnoses, concerns about immigration, concerns about all kinds of things. There are so many things, whether mental or physical, going on.
E: There are and so the story you tell yourself is very important. I advise everyone not to watch the evening news. That's a way to really put yourself in a bad place. I love this TED Talk of an established Magician. He makes the point that there is one word that every magician uses when he pulls the rabbit out of the Hat- Abracadabra. Abracadabra really means, “with my words I create.” So, I have some colleagues and some students now where we catch each other and say abracadabra. What are you saying to yourself? That is where you are putting your cursor on your attention. Pay attention to the story that you are telling yourself.
L: My last question for you is what is your overall prescription for success and happiness in this job and in general?
E: The prescription I give everyone, which is choose to feel good. We have the ability to change what we think. There are some wonderful simple techniques if you need them like The Still Point, like moving into appreciation, and just be so aware of the story you're telling yourself. Ask your friends for help and reach out! Because we’re all in this together. There is this wonderful analogy from Carl Jung that says as you go deeper into the well of yourself; you realize that we are all connected by the same stream. We are all connected.
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