GSACEP Government Services ACEP

GSACEP Lecture Series: Camo Chameleon: Capitalizing on Adaptability in Your Military Career

December 07, 2021 GSACEP Season 1 Episode 11
GSACEP Government Services ACEP
GSACEP Lecture Series: Camo Chameleon: Capitalizing on Adaptability in Your Military Career
Show Notes Transcript

COL (Ret) Missy Givens shares her surprising journey through the Army over her career, and insights into how to take advantages of opportunities to create a full and rewarding career in military emergency medicine.

For access to the slides and to view the whole lecture, visit:
https://pheedloop.com/GSS21/virtual/?page=sessions&section=SESYRISFRH6ESP95O

This lecture qualifies for 1.0 Category I Continuing Education Credits.  How to claim CME for this podcast:
Use this link to access the certificate process, you will need to complete the entire evaluation in order to receive credit. Please note in the evaluation comments that you are claiming credits for the podcast sessions, as we also have video & live session options available. A 30 minute Podcast episode may be claimed as 0.5 CME credits, 1 hour can be claimed for 1.0 CME credits.

Support the show

Missy Givens:

But I'm also an incredible living example of what not to do sometimes. And so I think it's just as important to share challenges and backward steps as it is to share forward steps. So I'm going to go through kind of some things very quickly and ask some questions, and you can answer them in your mind. And then I'm going to walk through kind of a timeline for me quickly, and then I'm really going to open it up to questions and discussion. And because there are so many senior very experienced people kind of lurking in the background there, if they want to chime in, I would kind of love that as well. Because I think these sessions are very helpful when we have dialogue about different ways we problem solve in our careers. All right, so let's kick it off. Um, so you know, the, when you are like young, everybody kind of points out to there's these things you're supposed to do in your career, this kind of like stepwise approach to, like career progression, I will tell you, that's me in the sand trap. I don't think I ever went in the right order of anything the entire way. Somehow it worked out for me, I'm, I wouldn't change a thing about my career. But I will tell you, when somebody is like, Okay, you need to do this, and then you need to do this, and then you need to do this. Those are good guidelines. Um, but I, in my experience, you have to do what fits right in your life at the time. And I think, probably some sensitivities to that as a woman who was also you know, if you're looking at being a parent, or maybe if you have something going on with family members, where you need to care for elderly parents, or you know, anything where life just doesn't fit with the linear approach to the military career. You know, I always like to encourage people, that's okay, like, there's still a very fulfilling way to navigate your career that doesn't always have to be in a linear direction. And sometimes the sand traps are more fun than the path. So I kind of like this visual. And so I'm just gonna ask these questions. And and unfortunately, I can't see faces, and I can't see answers as I would anything. But But answer them in your head. So you know, from the time I graduated med school till I retired in 2020, I'm just curious how many times you think I was actually assigned to an emergency department? Or how many how many years? I was actually in a MTF, emergency department, and I'll, I'll come back to that. Um, how many times do you think I got my first choice of jobs? Or the location where I wanted to be? Um, how many times did I actually get training to do the job that I was supposed to do? Like, for example, the brigade surgeon course before being a brigade surgeon, or, you know, being getting any sort of training on how to be a residency director before I had an RRC visit? I'll talk about some of that stuff. Um, how many times did I screw up enough to get fired? Um, that'll be a fun one to talk about. How many jobs did I dislike? Asked me that when we get to the end? Um, how many of my own evaluations did I write in a, and I'll go all the way back, I'll go back to a 30 year career because I actually, you know, started in the military, before medical school with West Point, so I'll count that as well, because we had evaluations back then, too. And then, how far in advance do you think I plan my retirement? You know, they talked about 18 months out, start thinking about it kind of thing. So how long do you think I did to do that? And what what do I have to say about that? Alright, so here's the timeline, and I'm gonna fly through it, because when I get through it, I'm gonna, I'm going to talk about some principles I earned, but then I want I want to use this timeline as a chance to kind of open up the door for some questions. All right, so um, a lot of people don't know this. But um, so I went to military academy, but believe it or not, I was actually kicked out of the military academy for a year. So I started my career off stellar, I was kicked out and let back in and you know, still went out swinging 30 years later, so you can come back from something like that. Um, then I went to CES and I managed to get a get pregnant my the end of my third year, and if I did not lie about my daughter's age to get her into daycare, I would not have graduated on time. So there was another time where life just was not going on the timeline I plan. Um, then, during my fourth year, I decided I want to do emergency medicine, I'd already matched to family medicine. So I went and I did that internship. And when I left that to do em, they took my top block eval and decided to change it to a center of mass because I was abandoning this specialty. I saw Marco on the line. I would love for him to chime in because Marco was actually Fighting for me to be a resident at Darnell. And I was denied because I was over qualified because I'd already done an internship. And at that time, Darnell was just a one to three program. So that plan didn't work out for me. So I went, I went to the first cab, and when I got my orders, I was supposed to go to second brigade, which was a non deployed brigade, I had, you know, a baby at that time and thought I was going to be, you know, living in Fort Hood doing the brigade surgeon thing. When I signed into Fort Hood, they said, We reassigned you, you need to be on a plane to Bosnia in three days, so, so I had three days to find childcare and a house and, and get on a plane. And then when I came back, I, I then switched brigades and was a flight surgeon. And right after I found out, I was going to the flight surgeon course I found out I was pregnant again. So I hid my pregnancy while I'd now get a flight surgeon course. And, and then when I got to my unit, I couldn't do anything because I was I was pregnant, you know, I mean, obviously, I could still practice medicine, but I couldn't fly. So I didn't get to do any of the fun stuff. And then I did my year residency at BMC, which, as I mentioned, I was trying to go to Fort Hood, because I wanted to train with Marco and all this smart people there. So BMC was not my first choice, but I had a great residency there. Then I wanted to do critical care. And back then they were not allowing critical care, emergency medicine to get boarded and critical care. So at the time, David Ella, just you know, as a consultant, and he's like, he's like, that's not he's like, we're not going to support critical care. Why don't you go do toxicology wasn't what I wanted to do. I was kind of mad at him at the time, it ended up being the best thing that ever happened to me. So I owe him a thank you. But it really wasn't what I wanted to do. Because I was didn't didn't know anything about it, but it turned out to be a good thing. So then, um, and actually, oh, let me talk about fellowship, because when I was in fellowship, your contract says that you cannot volunteer or you cannot be paid. So technically, when I was in fellowship, I could not work in the ER, um, because it would either be volunteer work or paid work. I think they revised the contract since then. But I actually had to like go through all kinds of hoops to just be allowed to work in the ER while I was in fellowship. So that was a very interesting fight as well. Then I'm off I went to Madigan and I was supposed to deploy for OEF all excited about it. The week before I deployed I broke my leg. And I had to tell one of my very favorite colleagues that he was going in my place What an asshole I was. Fortunately, he took my 16 six month deployment and I took his 13 month or so it ended up being fair in the end, but boy did I feel like a piece of crap. When I had to tell him he had to leave his wife and kid in a week because of my bad decision making on a ski slope. Um, so then off I will after I came back from from Bosnia, I went to be a PD out Fort Hood probably one of my favorite jobs and there's several Fort Hood people on the call and and it's those people that that really made that a special assignment for me. Um, during that time, I went back over to Iraq and oh, by the way, got got divorce. So kind of figured, you know, out a new lifestyle for myself as a single parent at that time. Then I got my job at SOC AF and I will tell you how I got it. I happened to be in the room and somebody called Steve Tanksley to offer him the job and he didn't want it, um, because he didn't want to move overseas. And so I literally got that job because I overheard a conversation it was in the room and was like, Can I do that, and somebody really put their put their neck out for me, because there there wasn't room for women at the time in those jobs. And so it was actually the chief of staff that snuck out that was like, I don't know why we're not taken, you know, this person. Let's go ahead and open this up to the women. So that was, that was pretty cool. Um, I got into a lot of a little, a little bit of hot water there. I actually didn't find out about it until later, I bought some lab equipment to take to the continent with me. And it was kind of progressive point of care testing at the time. Well, if any of you have heard of that company, Toronto, so I'm now a I'm now a, a witness for Elizabeth Holmes probably going to jail someday for using bad lab equipment. So that's another story I can happily tell you about. When I left sock app, I did a sports medicine fellowship. I like Sports Med, but I realized I didn't want to do it full time. It's just it's very procedurally based. And I like it. But but I just found driving an ultrasound all day wasn't my thing. So I pursued something and then I realized, I'm not sure I like this very much. And then I went, I went back to USACE, which I loved. And there was the next time that I that I almost got fired from the military. They, I got picked to be the CENTCOM surgeon I don't want to do and I didn't want to move. And I said, No, I'm not going to do it. And they said, Okay, well then pay your ad so back and, and you can leave. So that, you know, here they were going to put me with however many years I had left on my ad so so that was an almost fired from the army kind of moment. Um, and then I left uses and went into the Special Operations world doing some kind of nuance jobs there. And just, you know, I loved every minute of that, but I will tell you, I was in a no four billet I was an O six and an O four billet. So I completely took a step backwards in my career to do a job I loved. And then, you know, they, they put the here fill this out for your, you know, general officer promotion packet, they put that on my desk, like three times and, and I and I managed to fill it out in the most sloppily manner, ever, because I knew that wasn't what I wanted to do. Then I was supposed to go to the UAE and I was over there for six months, TDY waiting for my orders. Military couldn't seem to pull it together to get my family over there with me. So I passed up on that job and, and they said, Well, if you're not going to do it in the timeline we want to do then you're welcome to get out. So three months after, I thought I was going to be moving to the UAE, I retired and was out of the army. And then COVID hit, and I was in New York running a field hospital. And that is that, you know, that's the blur of my career. Now, you don't care about my career, it doesn't matter. Every one of us has our own career and our pathway. The reason I walk through all of that is I don't know, if you paid attention, pretty much nothing along the way was planned. Other than my assignment to use this, you know, I always knew I wanted to get back to you someday. I really learned to Lawrence was was my mentor when I was a student and she was faculty there. And that always stuck in my head of like, Wow, what a big difference you can make in somebody's life that uses so that was an intentional assignment. But I wanted to point out to everybody that, that none of this was planned. But all of it was open doors that somehow I was fortunate enough to walk through and, and ended up having great experiences. So you know, when you saw that, that slide of how many jobs did I hate? Absolutely. Zero, I loved every single one of my jobs. Um, it's, uh, you know, surprisingly, so and most of it was was because of the people that I had the opportunity to work with. So what did I learn along the way, um, you know, Master Master the boondoggle, these are a couple fun things that that I got to do. And I'm just gonna throw them up there. If somebody wants to ask me about them. At the end, I'm happy to talk about them. One of the things I want to point out, that was probably the highlight of my career was doing medical coverage for the pow Mia recovery missions, if you've never heard of the defense accountability agency, they literally go around the world and look for remains of loss service members. And so I did one of those missions. And I will say, if you can ever get on one of those, make your way onto it, it is incredibly rewarding. And it's a great workout, because you just dig all day long. So you get to play in the dirt for fun. So, um, that was a whirlwind. I'm going to go through through the principles that I learned in my career, and then I'll and then I'll answer the questions. So one thing that I always know is you got to know the rules, you have to know what your job is, what the rules are, what the right and left boundaries are. But then sometimes you got to break them. Um, and, and you have to know why you're breaking them. And you have to be very deliberate when you're doing that. And you have to inform the right people that I'm going to break a rule. And I'll give you an example. There were times when I was operating in Africa, where I knew I was violating certain, you know, regulations. And I went to my commander, and I was like, I was like, This is what we need to do. And this is why and it's the only way to mitigate this risk. So, you know, I just I just really learned to communicate when you're breaking the rules and have a really good reason. But you have to know the rules before you know you're breaking them. And then in line with that, when you're trying to do something and somebody tells you no. Listen, why are they telling you? No? Is it because you just want something personally for yourself? Or if it's something that is for the good of the mission or good of other people, then you need to articulate that better. You need to write your justification better explain your justification better, because it's not getting across because I guarantee there are money and resources everywhere. You just need to go find them. So if What if you believe in what you're doing and somebody tells you no, then you just need to keep working on that justification to support what it is you're asking for. Um, that's in line with know your budget and where the money comes from. I will say that the thing that probably put me ahead of my career the most times is I really did learn where the money is. and where it hides and how, you know how to how to explain to a commander, which bucket of money I was using, and how we were going to get something donated from somewhere else. The best example of this was when I was in sock AF, um, you know, we didn't have any evacuation platforms. So I spread all over the continent with evacuation times that were upwards of 36 hours. And, you know, I got to the point where we would literally land in airfields, and I would walk around and look at all the aircraft and these random airports in Africa. And I'd go introduce myself to whoever owned that plane just to make friends just in case I ever needed them. And I was in the chair and happen to come across a plane that was parked on the runway, and I started asking questions of, like, who's playing? It's that, um, and it turned out, I was at a department of state plane that nobody was using, and then you're like, Well, why aren't they using it, and then I found out that nobody had ever purchased the maintenance package for the plane. So literally, it was like a plane sitting on a runway in Africa that was brand new, that somebody just didn't fill out the right paperwork to use. So of course, I'm like, Can I have it and you know, figured out the process to do that. So you know, filled out probably a stack of paperwork, this big, to have this plane donated from the Department of State to the country of Niger, and we built an E back platform around it. And it was very doable, you just had to fill out the paper and write the justification. Um, but it comes with like, opening your eyes and seeing what your resources are. And knowing that there's all these various pots of money out there, and you have to like, you have to be willing to stick your hand in the pot and grab it, or else somebody else will. Um, so the other piece I like to point out is, is you are a cog in the machine. And so when you are asking for things, everything you're asking for, should be, you know, for the good of the machine, or, you know, someone in there, we all have our personal needs and our personal interests, but at the end of the day, we're in the military, and it's this big, you know, machine that keeps moving forward with or without us. And that may sound very, very heartless, but it's, it's the reality of the situation, you know, the the day I got out of the military, it didn't miss me, you know, it kept on moving just like it did when I was in it and, and still doing stuff. And I think the earlier you embrace that in your career is that there, you're a replaceable part, and there's somebody that's gonna come along and do great things, they might not look exactly like you did, but but there's really great people always come in. And that's, that's what we should be building, we should be building a self sustaining self building machine all the time. And so be very careful about you know, personal interests versus organizational interests. Now, on the flip side of that look out for each other, because the machine is not looking out for you. So you know, as peers, as colleagues, as mentors, as mentees, we all have to look out for each other because the machine doesn't care. And we're the only ones who really can take care of each other. Um, the next kind of thing I wanted to kind of point out is sometimes you really got to know when you have to put yourself out there as a leader, kind of, you know, take that big, bold step and step forward and say I got it, and then and then when are the times when you just need to get in line and do what you're being told and be a follower. I struggled with that a lot. I mean, anybody who knows me knows I'm not very good at keeping my mouth shut. And, and doing as I'm told, and I had to learn I had, you know, I kind of got put in my place a couple times along the way. And, you know, I would say whichever end of the spectrum you fall on, you know, if you're like me and far on the right side, and always the one kind of being, you know, Problem Child in the front, check yourself back a little bit. If you're on the other end of that spectrum, and you like to just kind of fall in line and not not be the standout one, you know, every once in a while, dip your toe out, see what it feels like out there. And I would say just try and, you know, try and auto correct to which end of the spectrum you live on, we need both. We need we need both types of people but but you know, leaders need to learn to operate in their discomfort zone as well. And I just felt like I had to throw this in here because this is something that I saw at the very end of my career that really just made me check myself. So this is generally gada. He's some look at his chest like I don't have to say any more than look at his chest. But he's he retired as a three star out of Special Operations Command. And I did his retirement physical for him and he doesn't mind me sharing this at all when he was getting ready to retire for his retirement ceremony. He wanted His Command Sergeant Major to deliver a ceremony and in the great big, you know, World of the army and protocol. The protocol office for the Army refused to host it ceremony if he had an enlisted person deliver his ceremony and you know, for the general officers when they retire, it's like this big deal with a Protocol Office. And it's, you know, it's funded, and there's, there's all this fanfare that goes along with it. And they literally were going to deny this three star, his promotion ceremony, um, because he insisted on having an enlisted member be his keynote speaker at his ceremony. And he, you know, he stuck with it, he ended up not having a sponsored retirement. But I thought that was just such a shining example of, you know, like, nobody in this system is special, you know, and there's these rules, and all of us fall victim to the rules sometimes that are just nonsensical. And so, you know, we just try and leave it a little better than what we found it. Um, but But yeah, I really made me check myself when you kind of are get that sense of entitlement of like, you know, I'm a colonel, I get this, or I'm a doctor, I get this, and I'm, like, you know, here's this three star who couldn't even get his retirement ceremony after 30, I think 37 or 38 years of service, you know, couldn't even get what he wanted at his retirement ceremony. So really was an entitlement check for me. Um, and this is kind of kind of jump in, jump in topics a little bit, but I think, you know, one of the things that, that we all struggle with, is trying to find that balance between being a doctor and being a military officer. But I think it's a really natural fit to be the link between the operational world and the clinical world, you know, like, like, I think those two things are naturally married, you know, if you really care about your, about your guys that are in the operational world, that is, that is where, you know, being a physician comes alive, because you get to care for them, you don't just do medicine, you actually get to care for them. And so I really encourage everybody to explore those linkages, which I think it's as er, Doc's, you know, like, if they're not sticking in a chest tube, or starting a central line, what am I doing, I think there's a lot of value in being, you know, the person that looks out for them, and then also does the operational planning to make sure that that everything is well prepared to do the best we can for them in any circumstance. So in this, this comes to, like, my next point is that, you know, practicing medicine is, is just not the, it doesn't always equal, you know, caring for people. And I would say, you know, really check yourself sometimes and say is, am, am I carrying medicine, I don't like where it's going, you know, I am starting a company, because I don't like where it's going, and I want to do something to change it. And I find, sometimes medicine asks us to do things that that, um, they don't feel right, they don't feel right and caring for the person, kind of thing. And, and, you know, I just kind of encourage everyone to, to examine, like, why they're in medicine, why they're in the military, what their beliefs are on taking care of people and really, you know, really continue to challenge where the system tries to take us. Because I think we have to own this as physicians, I think, you know, it's easy to get into protocols and rules, and finances and billing, and, you know, all these things that just move us further and further away from compassionate care. And so, you know, I just have to put that plug in, because it's really, it's really an important part of my life right now of trying to go back to actually caring for people. And in doing that, throughout your military career, nothing, you know, nothing will serve you better than developing people around you, and then growing this very deep network, because as you saw, you know, throughout my career, it was really was really the people that that make your career, you know, the jobs come and go, but, but the people really matter and, and, you know, I mean, I, I can go down the list of attendees in this actual lecture and tell you how, probably, I think 80% of them have touched my career in a way that was so meaningful, and I'm so grateful for him. So please, all of you, thank you for being part of my career, because it would have been the same without you. But that will continue post career. I mean, I'm really, you know, we're tapping into our networks now for my current company, and it's just fun, it's fun to have these people you trust that you can, like move on to a different phase of your life with and be able to connect and do great things with them. So develop that now. I'm in this, you know, this is just a little little bit of me of like, you know, you're in the military, you know, and but I think all of us like to be unique, you know, we all like to like to stand out in our own ways. And so, I think it's really important to understand yourself and understand where you fit in with the organization and then what it is about you that is unique, that truly makes the organization better. And so in order to do that, you have to understand the uniformity piece be able to to be uniform when you need to And then be able to be unique when, when the situation calls for a unique skill. And then I already addressed this careers don't always go in a linear manner, you can go down, you can go up, you can go sideways, it's all okay. It'll work itself out. And then probably I think this is my last one is most of your growth is going to occur when you're uncomfortable if there's a job that scares you, or if you think you're going to go to a place where there's a lot of uncertainty, you really grow professionally, when you take on the hard stuff and do the things that are unfamiliar. But you don't have a support network when you do that. And like I said, the people that are kind of attending this lecture, a lot of them were mine. So and then the last, the last one is retirements, really nice stand until retirement, it's really nice to wake up and go, I took a breath, and I got paid today. So that was kind of my last take home point is if anybody's considering getting out. Everybody has their own life goals, but it really is nice to get paid to breathe. And now that was my whirlwind. And I really want to take take questions. So I guess grace, your you've been kind of monitoring the chat board. So I will be happy to feel questions. I tried to kind of fly through that and and open it up and say, you know, what are people's thoughts?

Unknown:

Absolutely, ma'am. And thank you very much for that presentation. I had several of my own personal questions, but I guess those are probably best accomplished over a beer telling a couple of those stories. So the first question comes from major lion. How did you know when it was time to get out? And what really was your cue?

Missy Givens:

Um, so that's a great question. So as I mentioned, you know, I had planned to go to the UAE and was going to send stand up the trauma center there love my team love the job was over there TDY for six months, my I was supposed to get to your PCs orders with my daughter accompanied, and in the military couldn't get out of its own way and get my daughter, her passport in time to start school. And I had kind of reached that point in my career where I had sacrificed my family over and over and over and over again. And I and I finally just just said, today's the day, I'm going to say no. And, and also it was also my commitment was up so and so you know, I can't I don't know what I would have done if I didn't have a you know, I was blessed with a commitment that didn't give me choices. So I think it's much harder for people that don't have a commitment. Um, you know, my commitment took me all the way up to my retirement. So I think my choices were easier on but I will say, you know, that was a line in the sand moment for me because it was just so ridiculous that that I was kind of done, I think you, you get to a point where you feel you've done, you've you've given and you've served and you've done good things. And I also started to feel old I didn't as I taught people, I couldn't relate as well. And I felt like it was time for me to go to pasture and let somebody that was fresher and closer to the issues. Step in so so it's kind of a combination of those two things of feeling like it's time you know, it was it was time for me to to let more talented and more you know, folks that are closer to the fight step into the some of the things I was doing.

Unknown:

Thank you for that humble opinion there, ma'am. The next question comes from Colonel Lee. And he specifically says thank you for your perspective and an amazing career and experiences. His question is what non medical experience or training has unexpectedly served you well in your life?

Missy Givens:

Whoo, Max, leave throw it out in the fire with some questions here. Um, wow. Um, so I will say and this is it's actually in every thing I ever write. You know, when you go places you have to write your leadership philosophy. And when I was at uses, I had to write my educational philosophy. And it's always founded on the words of my powerlifting coach in college. Coach Paul Christopher, he told me one day I was being a little whiny, whiny punk, and he's like, he's like, you know, Missy if you're not sore every day for the rest of your life you're not working hard enough. And obviously that was about weightlifting and working a little harder but I I really took that to heart in terms of being you know, tackling the the intellectually hard things emotionally hard things and being uncomfortable because that's where growth occurs. And you know, I still credit him to this day. I adore this man because he was a He was a philosophy professor at West Point. And I never forgot that quote. And so, so yeah, I learned it in the squat rack. And anybody who knows me in my, in my weightlifting, you know, life knows, the best lessons are learned in the weight room.

Unknown:

Absolutely. And a comment here from major Kailyn, who's currently deployed, that they, she appreciates your amazing career and your rule breaking has made a huge difference. And she also would like to mention that they are very proud of the plane.

Missy Givens:

Yay. Yeah, you know, so I have to give a thank you to a lot of people. So there were several people in the Air Force, actually, who built the program. Um, you know, so Alvin was probably, you know, he's the co author on the papers I wrote for that for that program. And so I definitely have to give him credit because they really built the metabolic program around the plane. And so again, back to, you know, forming a team of people that that are able to do the things you're not able to really, you know, prove to work well, for me have an understanding the joint world, you know, like so back to kind of Max Lee's question, I think what non medical thing of the more you use is really set set us up for this, of understanding the other services and what their capabilities are and what they're good at, versus what your service might not focus on as much allowed me to tap into the other services and and capitalize on Oh, they know how to do this really well. So I'll ask them to help me so we get a better end product. And I think, I think we're getting better at that now. JTS, you know, has really set the example for that. And there's a lot of more inner service collaboration. So that that would be I guess, something that's a little bit more sophisticated than my weight room example. But use this really helps with that of building these, you know, cross service awareness so that you can tap into other resources.

Unknown:

MSC, so I just want to let you know, so Linda Lawrence is on the call. Also, she's watching with Andrea. So she says Hi, as well and Marco, posted to everyone that you did a fantastic job, but really not not a no brainer for you to do something like this for us. So there's a couple more questions that we were gonna ask you. So looking back at your illustrious career and your timeline for everything, is there anything that you can think of that you could have done or may have done to help you transition to your civilian now job and career.

Missy Givens:

Um, while I'm still I'm actually still in the phase of learning to be a civilian, I will, I've found, you know, so it's just funny, I just actually got off the phone with a bunch of venture capitalists, um, I, I've, I know nothing about the business and finance world and this year has been like this, you know, I feel like I'm a resident again, trying to like learn a new language, I would have paid a lot more attention to like the health care business side of things like I really wish I would have learned a lot a lot more along the way because I'm taking a crash course in it right now. The The other thing is, is like being aware of how culturally indoctrinated you are in the military, you do not realize your language and your mannerisms. And some of the phrases you use are so military and then when you get in a non military setting, it can be really, some people find it charming, other people find it off putting, but I think you have to be very self aware of, you know, for me, it's how aggressive I come across or how like, you know, structured when I really like I just don't see myself as that at all. But I really had to add you know, some emotional intelligence on how you come across to others having that military background and just just the words we choose and some of the lingo and stuff like that so I think that's that's been the steepest learning curve for me as a civilian

Unknown:

so that's really great advice for all of us thinking about like, as far as the transition and knowing you know, that it's in the future somewhere whether it be you know, one year for some of us five years for the 10 year plan first for some other people so

Missy Givens:

add something else to that though No, I would I would say you know, embrace embrace your military culture because I will say like in this latest, you know, venture that I'm doing with home for and help people love it, they love they kind of find it Interesting in it, and it, you forget how small the military presence is in the greater American, you know, in, in the whole us like, like, we're a very small thing to the big wide world out there. And so you know, I'm certainly a lot I used to always kind of be like, I'm not gonna wear my uniform, you know, but but actually now in this new world, it's like people really like to hear about it, they like some of the strengths we bring. So on the flip side, while you have to be aware and allow for it, be proud of it and wear it, you know, wear it well.

Unknown:

Thanks. And so you also want to know when to hold them know when to fold him kind of thing. And so, there's, this year has been extremely stressful, you know, during the COVID situation, and you know, and you have been out in the civilian world on this and transitioning to all of this, um, knowing all of like stress management techniques, other than the physical portion of it, and bodybuilding and all that stuff, is there anything else that you suggest just to keep yourself focused, as an emergency medicine physician through all of these changes, and military career opportunities?

Missy Givens:

Um, I don't think I'm gonna say anything different that isn't said in every forum on this is outsource what you can and, and it's okay to not, you know, it's sometimes 50% is okay. And I think giving yourself the grace, to be able to say, I can't be good at everything, I'm going to pick what I want to be good at, I'm going to outsource what I can. And then, you know, your, again, your support network, whatever that looks like, um, keep a close, keep a really close.

Unknown:

Eye. All right. And so there anybody else in the chat? So either type your question in the chat, or if you want to say hi, to Missy, and then we have a question and answer box, just on the bottom, just to let anybody knew they want to ask a question about here. Ma'am, I do have a question. You specifically said several times, how you have recovered from difficult points in your career. You spoke about some grit and some resiliency in there. What would you say would be the most important piece of that moving forward? Because a lot of us now feel like we are in a one shot, one failed kind of military. So what would you say would be the one thing or the one trait that you've really found to be able to move forward out of out of those difficult circumstances?

Missy Givens:

Mmm, that's a really good question. And I you know, there's, there's, there's several, like very discreet instances where, you know, I was, I was either in trouble or I was told I was not as good as I thought I was. And I, you know, so I'm going to call out. Colonel John Lammy was my DCCs when I was in, in Baghdad, during the surge, and, you know, I'll never forget this, like I was, you know, I've I was crushing it there. I mean, we were, we were doing 60 to 80 traumas a day, you know, run in that room, you're just, you know, like, insanely working, doing a great job, we had great outcomes. You know, I had all the surgeons like, Stan, where I wanted him to stand and like, you know, like, things were going in my head amazing. And I felt like and master that. And I'll never forget this. When I got my evaluation, I sat down with Colonel amihan He gave me you know, center mass in the army. That's like a, that's like a you're good, but you're not great thing. And I was pissed. Oh, my gosh, I was so like, What are you talking about? This is like the pinnacle of like emergency medicine, and I'm crushing it, you know, and I was so hurt by that. And he's like, he's like, and he, he, I love this man. Because he was the first person in my career who was brave enough to tell me I had room for improvement. And, you know, and I, he really said, he's like, here's the thing, you don't have to be all that all the time. Um, and at the time, it was kind of hard to hear. But he really was trying to get the point across of like, there's a time to dial it up. And then there's a time to kind of, you know, run it, let it just kind of run on its own and not be always pushing, pushing, pushing, pushing, you know, now obviously, this was a high tempo environment. So you know, it, it's hard to turn it off, but his advice was really well taken. And, and I remembered that because sometimes as a leader, it's very hard to look your, you know, subordinate in the face and go this is what you need to do better on and it's often a very soft skill. It's not like a Do your charts on time or, you know, show up for work on time, it's, uh, you have this character trait that's getting in the way of you being more of you. And I think as a developmental leader to be able to identify that and help the person see it and self actualize it and move on to be a greater version of themselves, is a is a huge challenge as a leader, so and I know I'm straying away from the grit and resilience. But it comes back to the point of if you know, yourself, and you know, where your strengths and weaknesses are, and you authentically know them, like you're not faking it, you know, like, I mean, I probably spent a good 10 years of my career faking it until I really did figure out what my strengths and weaknesses are. And I felt like once I personally got to the point where where I embraced those and capitalize on the strengths, and then found good people to carry my weaknesses, that was kind of really when my resiliency blossomed, and I was able to, like, take on things that were scarier and more challenging, because I knew if I failed, you know, I kind of would know the context and how to grow from that. And so failure became less scary. My worry about what it would look like on the outside became less scary. And it really just came down for me of knowing I'm doing the right thing that's authentically me. And if this doesn't work out, then I just have to go be authentically me someplace else. So that's not really grit resilience, but I think, in a way it was for me.

Unknown:

No, and I think you speak to a very good point, ma'am. That we don't traditionally do very well as physicians, which is learning how to take a knee, right and not being running constantly. And it's even something that we brought up in the operator panel that commander chick and Commander stone emphasized as well have been able, I guess, to refill your tank, in some ways, and not always having to push, push, push. And so I appreciate that. Because I think a lot of us and especially a lot of women as well, we always feel the need to prove ourselves. And so we don't necessarily step forward with the confidence that it's okay to recharge our batteries. And it's hard to pour from an empty cup. Thank you for that. And so, Dr. Gibbons along the same lines, especially in light of all the things that have happened for in the political realm, and diversity inclusion has been a big push for the military this past year. What sorts of things that you had to deal with through your military career, and now civilian career as a female physician, in dealing with different kinds of issues.

Missy Givens:

Um, I mean, you heard some of them and it and, you know, I mean, a lot of them have gone away, you know, I mean, duct tape in my belly during during flight surgery course, I still anymore. Um, but, you know, it was all of it, it was like I was, you know, I was gonna get kicked out of a course, if I chose to go Pom, but, um, you know, like, just being denied jobs, because you might get pregnant. You know, though, I think some of those things we still have to advocate for, I will say, when I was in the soft community, there were a couple of organizations that did a really great job of career planning with their women. And so they were, you know, these were women that, uh, that a lot of money had been invested into training them in very specific areas. And so it wasn't like, they were just gonna throw them aside because they were expensive. They're expensive toys at this point. And so they did a really good job with trying to map out some career planning for them of like, well, if you if you are going to have a family, here's some good times to do it. Here's a school to do while you're doing that. And it's not perfect, but at least it's something that's at least it's trying and there will never be a right answer. That's right for everybody. But I think the more we can acknowledge that life happens, and now let's figure out how to make the most of what is happening in life. That is That doesn't have anything to do with whether you're a man or woman it has to do with you're a human being that has life issues, and we as leaders owe it to those, you know, around us to be able to adapt to life and make it fit within our organization. I think now in a civilian world, what I'm, you know, like there's so a lot of things that bother me, like, you know, for example, it's like as, as co founder of, of this, you know, company, we're getting preferential look from, you know, venture capitalists because of having a female, you know, founder, you know, like, there's these things and I'm like, No, well, it should be because I'm a good company knocks girl you know, so there's still things that frustrate me about positive, positive You know, pushing the female agenda a little bit, I still am a real believer in in do a good job and select based on that. So I'm all over the place on this answer, I'm sorry, it um, it really is kind of I still am always not about empower women, I'm gonna, like empower people to be their best self. And I'll stand by that,

Unknown:

ya know, at you know, personally, and I know, there's lots of questions and I'm, you know, interested in knowing more especially about somebody with such a long career, and lots of stuff that you've done. So we do have one more question for me, for you. This is from an anonymous, or somebody in the group here, the people. So thank you so much for speaking, ma'am. How do you recommend finding that balance, especially early on in a career between walking the quote unquote, party line in the Medical Corps, and making waves when something isn't right? Additional? Do you have any advice for the folks just starting their careers for balancing career advancement with building and supporting your family?

Missy Givens:

So I'll split those into two. So the first one of like, knowing when to rock the boat goes back to my like, no, the money, no, the resources, know the rules, and know them better than everybody else that you're going to go to and try and push whatever agenda it is that you're pushing. Because Because within that lies the beauty of what it is you're trying to do, you're trying to show them Yes, I understand all the reasons that, you know, I shouldn't do this, but here's the reasons why. And there's the tipping of the scale. And, and honestly, what will happen is you're gonna have leaders who, first of all don't have the energy for it. Second of all have other things that are more important. And in you might have to acknowledge that and go sit down and shut up. But if it truly is something that you feel needs to be forward, sometimes you have to come at it from another direction. And that's not saying, you know, jump your chain of command, I really did try and inform my chain of command when I was going another direction. Because it doesn't, it doesn't work to burn bridges. It really doesn't like don't light the house on fire and then walk out, you know, really try and come from several angles and help get various perspectives involved in that will that will serve you well, when you're trying to challenge the status quo. Balance for family life, I'm probably a horrible advisor on this. Yeah, it's, it's, it's hard, you know, and it is a it's a different answer for everybody on what's okay with you. I mean, in life definitely was different for me, you know, once I became a single parent, I did make sure I negotiated I write the schedule, that's, that's the number one advice I can give you is if you can be the owner of the schedule, and everybody hates making schedules, it's a lot of work. But I found if I wrote the schedule, I you know, and I gave myself the crappiest shifts, but I gave myself the crappiest shifts so I could have what I needed otherwise that that's a tactical skill that worked very well for me. And I kind of use that moving forward of of make myself the boss so I could decide when work was important or when it wasn't important, and that that requires taking on some administrative burdens that actually increase your workload, but give you more control of your environment. If that makes any sense.