The PLA Podcast

Ep 6 - Part 2: Boundaries, Community & the Practice of Presence

• Physicians Leadership Academy (PLA) • Season 1 • Episode 6

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In part two of this heartfelt conversation, host Dr. Stephanie Costa and PLA founder Phil Cass continue their dialogue with contemplative forester and longtime meditation teacher Jim Dresher.

Together, they explore the essential role of community in physicians’ well-being, the deeper meaning of boundaries, and how solitude and self-care expand our capacity to serve. Listeners will gain thoughtful insight on cultivating agency, balance, and connection—practical wisdom to restore both personal and professional vitality.

Produced by the Columbus Medical Association

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Speaker 01:

Welcome to the Physicians Leadership Academy podcast, hosted by me, Stephanie Costa, and Phil Cass. Join us as we dive deep into the world of physician leadership, mindfulness, and rediscovering your purpose. Each episode features insightful interviews with inspiring guests who share their expertise and experiences, helping you become a more effective and fulfilled leader in healthcare. Tune in to reignite your passion and transform your practice.

Speaker 00:

Welcome back to part two of Dr. Stephanie Costa's conversation with Jim Drechler and Phil Cass.

Speaker 01:

One of the things that I notice locally in in Ohio and nationally is this effect that that um or this state that physicians are in where they're experiencing a lot of loneliness and isolation or depression or anxiety. And we're realizing more and more how important community is specifically for physicians and specifically at this time. And unfortunately, a lot of times physicians are so busy or so depleted that they don't really have the energy or even the awareness of the need to cultivate that sense of community. Phil, we've talked just a little bit ago about how important community is within PLA and maintaining connection to that community. But specifically with regard to the physicians that are going through the Leadership Academy, can you speak to the importance of community and what that community means to the docs?

Speaker 03:

Every year I'm a little shocked. I can't believe it. After 12 years, I'm still shocked at how hungry people are for that for community. We do, as you know, Steph, we do a fall retreat every year. And that retreat, people come in as participants and they leave at the at the beginning, they're beginning to have a community. Most of them actually never, uh, my experience has been they never imagined that they could have a community. They didn't even realize that they needed a community. And so there's this hung that shows up that they don't even really realize at the beginning how hungry they are for community. And it lasts the whole 10 months, and we're seeing it last beyond that. Um yeah, it's an aspect of their lives as a desert. And um and when it starts to be cultivated, and as Jim said, we don't do stuff, we create the conditions, or we create the container, if you will, for the community to arise. Um again, looking at this coming year, one of my intentions is to help people start to be clear about how they can initiate community. I don't think we've done enough of that. And uh because I think that's the agency part of it, where you don't have to sit around and wait for somebody else to create a container that's a community. You can do it. Uh, and here's and learning about how to do it. Um it's really about conditions, setting conditions, um, as Jim said. So I um it's been, and when we look retrospectively at the interviews we've done with physicians who've been through the academy, uh this comes out all the time as one of the top two um aspects of the of the PLA that people value is community. It always does. I've looked at there are 40 interviews lately, and uh and that's always one of the two. So we've that's it just tells me this is this is our work, this is the work, right? It's a big part of our work. Um, and people don't even know, they don't even know that they're that hungry. And when they start to get a taste of it, wow. Yeah. To me, that's that's one of the most gratifying parts of what we're doing is to see that happen.

Speaker 01:

Yeah, well, and Jim demonstrated so beautifully how generous a community can be. And and so I think it's just you know, having this awareness of giving and receiving, but also being able to have the discernment of like what what you need from the two. One of the things that we talk about with with people working in healthcare is the depletion that can occur if you're always giving, giving, giving. And um it's hard to receive when you've um committed yourself to a career in healthcare where you're you're always giving of yourself and you're putting others' needs before your own. And so we talk a little bit about setting boundaries um with physicians. And as I pointed out, it can be difficult for physicians to to set boundaries because it feels a little bit selfish. And Jim, when I hear about you taking five days to be in solitary retreat, um, you're carving out time for yourself. And in doing so, when you come out of retreat, you're probably even more generous to Margaret and to your community. But you mentioned something to me in our conversation a couple weeks ago about how you're not necessarily initiating things with people in your community, yet you make yourself available to your community. And I'm wondering if that whole concept might resonate with physicians a little bit. Could you speak to that for us?

Speaker 02:

Yeah, thank you. This whole question of uh uh boundary is an important one when we talk about retreat, because actually, in some languages, if you translate retreat, it actually translates as boundary. And so boundaries are really important, but what are boundaries for? Boundaries can be to separate, but boundaries ideally be should be to connect. So in a sense, we could all imagine that we are in retreat if we're talking about, and then it's up to us to design that retreat in terms of boundary, physical boundary, um verbal boundary, mental boundary, psychological boundary, however, we think about boundaries, I think it's important to think about those things and to then think how is the boundary that I'm setting separating me from others, and how is it connecting me with others? So I think of this as a positive boundary or a negative boundary. Negative boundaries separate and positive boundaries connect, but they're all boundaries because they're saying, How would I like to live my life? I mean, it's what Phil is talking about in terms of agency. So I don't know exactly how to connect all these things, but I'm feeling a connection.

Speaker 03:

Can I take a shot at this?

Speaker 02:

Yes, please.

Speaker 03:

Jim, I've known you all these years. And every time I'm with you now, there's another level of generosity, of peace, of calm, abiding that's reaching uh even greater and greater levels. That impacts me. Your practice impacts me. I go down to the Abbey of Gethsemane with twenty-five Cistercian monks who sit in solitude to practice peace. What would this world be like if we didn't have people who were sitting in solitude practicing peace? To me, that's the boundary or the boundarylessness of what you do and what the monks at Gethsemane do. I hope it's what I do when I'm in retreat, is continue to develop my capacity to be love and to be peace. We gotta have people that are are willing to walk the walk and do the talk. So to me, this is where the boundaries not, there's no boundaries here. I know when I'm in your presence, and I know for 25 years how that's changed as you've changed and as I've changed. I know when I go down to the Abbey every year, I have you know, I have people that say, How do these guys monastic monastic lives? And increasingly I'm like, thank you because I suck up your peace when I'm down there. That's to me why we have to be doing what we do.

Speaker 01:

And having a sense of agency position and to realize that perhaps setting some limitations on how much we give or when we give it or how we give it, and being able to create that sense of peace within ourselves, we're gonna show up for our patients and our colleagues in a better way.

Speaker 02:

Absolutely.

Speaker 01:

And in a sense, you are able to better serve because you're tending to yourself.

Speaker 02:

Yeah, I think Dev. And I was thinking, well, this word retreat, this comes up a lot in this conversation, and for a physician, uh let's just imagine that uh the physicians that come out of the PLA are going to go into retreat for the rest of their lives? What are they going to retreat from? Well, what if they retreat from bias? What if they retreat from um self-centered love? What if they retreat from anger and irritation? What if they retreat from closed-mindedness? These are the kinds of boundaries that we can all draw in our retreat in our everyday life. And we can wish that for ourselves and for others.

Speaker 03:

And what if we what if we what if we what if we gave up the idea that I'm doing my best when I'm laying on the ground completely depleted? Can I give up that concept that that's actually what's required of me and start to acquire the reality that is what Steph said a minute ago, if I take care of myself, I'm here for you. Laying on the floor depleted, not so much. That's something that that's a thing that has to be given up. Yeah.

Speaker 01:

Retreating from the conditioning that happens to you.

Speaker 02:

Thank you.

Speaker 03:

Thank you.

Speaker 02:

Yeah. Retreating from our bad habits. Um but I I told this to Phil Steph that uh that I have a teacher that's uh actually guiding this retreat for me. By that I just mean I ask him, you know, if when kind of confusion comes up, I I ask. But basically what he has said to me is uh um that you're not retreating from uh the needs of your family and your neighbors and your community, you're not out there stirring things up, but you're available and you're responsive. And I think that's you know, if we take this now not from an 82-year-old meditation retreatment, but a uh young, vibrant physician, I think that's the kinds of questions to ask. What does agency mean? What does caring for myself mean? What does what am I what would I like to withdraw from? And what would I like to offer into? Just as a contemplation without uh saying what those things should be, but I think an interesting question. What would I like less of in my life? What would I like more of in my life? And I have a feeling that everyone knows, but maybe they haven't articulated it to themselves, and then maybe they haven't figured out how to act on that motivation, and give themselves permission to do so, yeah.

Speaker 01:

So, what I'm hearing is a gentle reminder to our alumni and listeners to be intentional about carving out some time to slow down, see what you notice, not just around you, but within you. Get curious, open your eyes, and really see what's out there, what's in here. And Jim and Phil, both of you, give such wonderful example to all of us of what it is to be observant of ourselves and who and what are around us. Um Bill, it's so wonderful to hear about the love that you have for Jim and Windhorse, um, and the physicians that come through PLA and and in the future will come through PLA. Um, so thank you both for for all of that. As we start to wrap things up, any last comments from either of you?

Speaker 02:

Well, I I have two things I'd like to say, Steph. One is that uh uh Phil got to wax on about uh his relationship with me, but I didn't get to reciprocate. I I don't have to go through all the details because all of you know Phil, but uh I could say that I am in love with Phil Cass and have been for a long time, and I don't have to go through all the reasons because you probably all share them. The other thing that I wanted to say is that I was recently with a group of children, um maybe six to 15 years old, a whole posse of them. And we were walking along, and uh I I had suggested to them that that we go slowly. And uh after oh 15 or 20 minutes, I asked them, um what are you noticing about going slowly? Because you know, kids often are not going very slowly, and uh one of them said uh, well, I'm noticing a lot more. And another one said, I'm noticing that I'm noticing a lot more, which I that was quite profound. So thank you, Steph, for uh for this uh offering this opportunity to be in this podcast, my first ever.

Speaker 01:

It's wonderful, Bill?

Speaker 03:

Yeah, I just uh thank you, Steph, for the opportunity. Um as you can see, um Jim and I and you as well could do this for a long time. And I'm grateful when I've gotten to Windorf that we do do it for a long time. Um I just went through a pretty uh significant health or lack of health experience um in which um I was not even aware of who I was for a while. And um as I've come out of that and I'm getting better and getting wealth, um I don't let I don't let the opportunity pass to not tell people I love them. And so I've said that to Jim. I always say that to Jim. I love him, and then you do stuff. You know, I hope you know that. So um, yeah, my wrap-up is simply I've had yet another experience of there ain't no time to fool around with questions about that. So thank you.

Speaker 01:

Well, it's so good to see both of you and to see the smiles on your face and the health in your cheeks and uh bodies. I'm I'm glad you're all uh doing better. And uh we'll express much gratitude and love for our listeners uh who are part of this wonderful and unique and special community that we call the Physicians Leadership Academy. Thanks so much for joining us this time, and we'll catch you on the next PLA podcast.

Speaker 04:

Thank you for tuning in to the Physicians Leadership Academy podcast. This podcast is produced by the Columbus Medical Association. We hope today's conversation has inspired and equipped you on your journey as a physician leader. For more resources and to learn about applying to the PLA, visit us at Physicians Leadership Academy.org.