Ep. 250 Just Cut It Out with Dr. Kimberly Brown

Episode Summary

Dr. Kim Brown is a surgical oncologist in Austin, Texas, and an educator. She has spent her career being the one to tell patients they have cancer, or that it has come back, and in the process she began asking big questions: what does this all mean, why me, and what does it mean to live a good life? She noticed that some patients came through their diagnosis as better versions of themselves, finding meaning and purpose even in impossibly hard things, and she got curious about what she could learn from them.

In this Episode 250 conversation with Dr. Amy Vertrees, she shares what she has learned: the difference between pain and suffering, why we have more choice between an event and our response than we think, and why it is not our family's job, or our job's job, to make us happy. She talks about learning to manage the stories she tells herself, about how much of her identity had been wrapped up in being a pancreas surgeon, and about the sense of being part of something bigger than herself that steadied her.

She also tells the story of Just Cut It Out, the podcast she launched while working full time: how a grateful patient funded the equipment and first episodes, how a church grant and a new producer kept it going, and why she is treating the first season as an experiment. Along the way, she shares practical tools, including time blocking instead of to-do lists, sleeping on a yes, and the hard lesson that to do what you love well, you sometimes have to cut out things you like.

Detailed Episode Notes

Part 1: Background and Why She Started a Podcast

• Surgical oncologist in Austin, Texas; an educator, with education as her academic niche
• Outside work she plays keyboard, enjoys Olympic power lifting, and travels for outdoor activities
• Her first reason for the podcast: noticing a lot of negative culture and the difference in energy between being against something and being for something; she wanted to put positive, creative energy into the world
• Her second reason: a personal development journey inspired by patients, since she is sometimes the one telling them they have cancer or that it has come back
• She wanted to show, through patients telling their own stories, how they found joy, meaning, and purpose in a hard experience, without preaching to the world

Part 2: What Patients Who Thrive Teach Us

• Theory: it comes down to where you believe your happiness comes from; you create joy for yourself, and you can have it even while going through something hard
• Pain is the hard things that happen to all of us; suffering is how we respond in a way that makes them harder, bigger, or longer-lasting
• Even when it feels like there is no time between an event and a reaction, there can be more time than we think; choosing your response is a muscle you can build
• Some people are natural Tiggers and some are Eeyores, but what you pay attention to shapes your response and your overall sense of joy
• In patients who do well, the attention beam is focused on what matters to them and what they are contributing, not on what is happening to them; she says this without judgment, because everyone arrives with their own history
• People hold different beliefs about how much agency they have; that can be learned or wired, and probably both

Part 3: It's Not Your Job's Job to Make You Happy

• In training, everything seems to be happening to you; she gradually learned she could create her own joy rather than expecting it from other people
• A comment from her youngest child, that she was making something about herself, showed her she was looking to her child to make her happy about being a parent, which is not that child's job
• During COVID, with the whole family home, she realized she was expecting her husband to make her happy and that he had never agreed to do the things she was frustrated he wasn't doing; she is glad he pushed back kindly and firmly
• By extension, it is not our job's job to make us happy either
• Her boss has made leadership training a priority in their department; she is convinced it is “sneaky therapy,” since surgeons will talk about EQ if it's framed as leadership, and the first part of leadership is understanding yourself

Part 4: Managing Your Emotions

• She listened to the audiobook Crucial Conversations somewhere between 2011 and 2015, a first step in realizing she could show up differently
• The concept: you see or hear something, tell yourself a story about what it means, the story drives how you feel, and how you feel drives your actions
• It wasn't a light switch; it started a journey of years to apply it in every patient encounter and with students, residents, colleagues, and in the OR
• If someone is unkind to her, she considers what hurt or modeling may be behind it; it doesn't make the behavior okay, but it makes it not about her
• That was liberating for someone who took everything personally and wanted people to indicate she was valuable
• Some words and actions still require a response, but an intentional one, not a wounded lash-out
• Amy shares a line she heard on The Mel Robbins Show: all feelings are welcome, but not all actions are

Part 5: Supporting Patients Who Are Suffering

• Anxiety can undo someone before they have a diagnosis, and she is curious about why
• On a first visit she may ask who the patient's support is and who knows about the diagnosis; the answer shows whether the door is open or closed
• She is not a therapist, but can connect patients with a licensed counselor on the social work team and with resources in Austin
• She mentions Wonders & Worries, an organization that helps children deal with a parent's cancer diagnosis

Part 6: Identity Beyond the Title

• Amy asks when she realized the identity assigned at graduation was not the whole of who she is
• It starts before medical school: you ask what you need to do to be good enough, and it is harder to ask what kind of doctor you want to be
• She went into surgical oncology because she loved taking care of cancer patients; early on she did a lot of pancreas and liver surgery and felt like someone when she talked about those cases
• When she began stepping away from pancreas surgery, she saw how much her identity was wrapped up in being a pancreas surgeon; it took about three years to wrestle with that loss
• She notes surgeons who practice into their 80s because that is their identity
• For her, the answer was a faith journey: her identity is not her role, but being created by a loving God; she acknowledges that won't be everyone's answer
• Whatever it is, she consistently sees the belief that you are part of something bigger than yourself as empowering, sustaining, and stabilizing through hard things
• Now she can do surgeries that don't involve the portal vein, be fulfilled, and thrive

Part 7: Starting the Podcast

• She kept reading authors who turned their expertise into something accessible: Shawn Achor, Brené Brown, and Annie Duke (Thinking in Bets)
• The tipping point was asking why she kept doubting she had something to say
• She uses the Bible's “what's in your hand?” question to Moses: she's an educator who knows how to share stories and who talks to patients for a living
• She felt she couldn't write a book and keep her day job, but a podcast was possible
• A grateful patient offered to buy the gear and pay a producer for the first four episodes; she then shopped those episodes for grant funding, wanting someone else to believe in it enough to pay
• About a year and a half from idea to launch, with each step answered by a yes, and a lot of not quitting
• Her real hesitation was whether she had something worthy that hadn't already been said
• She frames it as an experiment: a first season she can be proud of, like an album, after which she can choose whether to continue
• A recent music event made her feel she was at the table with other creatives, which was a new feeling

Part 8: Just Cut It Out

• A friend and colleague, a musician and learning scientist, suggested the name: when you find out what matters most, you cut out what doesn't
• She knew it would be about patients and had a handful of stories that kept resonating; every patient she asked said yes
• The launch episode features a patient who managed anxiety, advocated kindly for herself, and was proactive about her health, which created good outcomes because people wanted to help her
• A producer insisted on video, so she re-recorded the first episodes that way
• Her first interviewee passed away recently; her episode has just been released
• A church grant helped, and her new producer is a breast cancer survivor who is passionate about the mission
• They have recorded 11 episodes and launched; the challenge is coordinating a workflow where each episode is at a different stage
• Amy notes the title sounds like cancer on its surface but is really about cutting what you don't need; she says that was intentional from the start

Part 9: Cutting What You Like, and How

• The big realization: she has to cut out things she likes so that the things she loves can be done well
• Saying yes to one thing means saying no to another, whether you realize it or not
• It is easy to give up things you don't like and harder to give up things you do, especially with FOMO and identity pressures in academic medicine
• Telling the difference between like and love takes time to think and reflect; she suggests midlife is when many of these revelations arrive, because you aren't in survival mode, and she isn't sure she could apply it with young kids
• She tries never to say yes or no without sleeping on it
• To-do lists are her enemy; she time blocks her calendar and asks where a thing fits and what she would give up for it
• Amy agrees: if it's on the list, good luck; if it's on the calendar, you have a chance

Part 10: Defining Success and Where to Find Her

• She hasn't defined success yet: downloads, subscribers, or comments?
• Each guest has told her how meaningful it was to share their story, and shared comments from friends and family
• A partnership with the School of Social Work faculty in Austin will study who the audience is and what success looks like
• Amy shares that if you are enjoying yourself, that is success
• Find her at justcutitoutpod.com, YouTube Just Cut It Out Pod, and on Instagram and Facebook; a Substack is planned to build a patronage model for sustainability after her grant ends