Katrina Armstrong, MD: Leading with Empathy

Q: Today with us on the podcast we have Katrina Armstrong, who is the physician-in-chief here at Mass General. So thank you for joining us, Katrina, and I personally had never heard of a physician-in-chief, so I’m wondering if you can start by telling us what does that mean?

A: Well, I’d be delighted. So, I’m not sure I’d heard of it until I came here about five years ago, I will say, but now I’m incredibly attached to the title. It’s, I think, my favorite title. And so, a physician-in-chief really comes from the history of Mass General. It’s this institution that was 200 years old, and was a hospital before there was really an attached medical school.

And so, there used to be, believe it or not, one physician, and one surgeon, who were essentially in charge of the hospital. And so, the physician, of course, was a man, a man named James Jackson, and so, it’s a role that means from my perspective that you get to oversee all of the medical side of the hospital.

And I love it, because I have decided it allows me to have opinions about essentially anything in the hospital. So, not just the medical services, which I run, as Chief of Medicine, but anything that makes the hospital a better place for our patients, or the people taking care of our patients.

Q: What do you mean by medical services? Because to me, as a lay person, I think, well, everything at the hospital is a medical service.

A: Well, so the way we organize these days in most big hospitals is really around a number of different services that come together to make a hospital work. Right? So, some of those, just to be clear, are things like nursing, and the way that we deliver food, or the way that we think about taking on our marketing aspects.

But a lot of them are actually about the direct delivery of care by docs – by doctors – and how they do it. And so, medicine is essentially all of the adult care services that don’t involve surgery, or other types of major interventions. And also, things like radiology, and pathology have become different services.

So, 200 years ago, like go back to that, it was just medicine and surgery, and now we’ve become specialized that those things have gotten different, and there are multiple services. The medicine includes most of the things that you would probably think about that people go to the hospital for, so, heart disease, cancer, diabetes, all of that comes under the medical services.

We have over 1,000 doctors that take care of patients through the medical services. We see over a million patients every year, and really focus both on taking care of people when they’re sick, but I think a special part of the medical service is we really think about how to keep people healthy. Primary care is a huge part of what we do in prevention.

Q: Can you talk a little bit more about that? How do you think about primary care and prevention?

A: Well, so from my perspective, and this has been written about a lot – right? – that so many of us got into medicine, because we’re trying to keep people healthy, to keep them out of the hospital. And I think, traditionally, there’s been this really interesting tension, between the focus on sickness as what health care does, and trying to move it, as we say, from kind of a sick care system to a health care system.

And so, we have been focusing – I’ve been a primary care doc – I went into primary care, gosh, oh, maybe 25 years ago, and when nobody was really doing it. And so, I think we’ve now hit a time of really being able to understand how do we take those same tools that we’re thinking about treating cancer, about curing a certain disease, and actually moving them upstream, so that we’re using the same advances in biology, and immunology, and gene therapy, all that stuff you hear about.

But instead of just focusing at the time that somebody gets sick, actually being able to apply them to keep people healthy, keep them out of the hospital. And there’s all sorts of reasons that we have an opportunity there now, that we never had before. It’s really an incredible time to be able to do that.

Q: How did you find your way into primary care? Do you see yourself as a generalist, or is that also a specialization?

A: Well, so, I think that’s a really interesting question. And so many of these things are dynamic. I usually will try to point out, and somebody said, actually, that organization that I just told you about, about medical care, so having a cardiology, a heart group, and a cancer group, much of that is only 50 years old.

So, if you go back even 100 years, maybe 60 years, even, there weren’t those subspecialties. You just had internal medicine. And in fact, what I often say is that Mass General actually created a number of those subspecialties. So, we are the place that created cardiology. We created infectious diseases.

Q: Really?

A: Absolutely. There’s amazing stories, actually, about this crazy guy named Paul Dudley White, who actually came back from London understanding about how measure some of the electricity in the heart and had patients in the bottom of the Bulfinch with part of them in buckets of salt water. And he had them hooked up to other things to figure out the heart rhythm.

I will just say, luckily, we don’t put anybody in buckets of salt water in the basement of Bulfinch anymore. But it’s a really dynamic part of medicine, and I think a lot of people don’t understand that we’re constantly trying to sort out what is the best way to organize, and think of this?

So, primary care really became a field that was defined into itself, largely because we were missing people who are out in the communities, taking care of individuals to keep them healthy. And so, the federal government decided to fund programs to train primary care providers. Here, and in lots of places, we tend to actually bring those things together.

So, we have people who are general internists, kind of like we go all the way back to James Jackson, the physician-in-chief, who really spanned primary care, so their outpatient setting, but then they’re still working in the hospital. So, they’re doing all of internal medicine.

Q: Wow. So, James Jackson was here at Mass General?

A: In 1811. So, he’s famous, and I think this is so important about Mass General, because he was one of the people that created a hospital that was founded on the belief that when in distress, every man, or I will say every woman, is our neighbor, and I think that’s still fundamental to why primary care is such a big part of Mass General is that we are here to serve our community.

And I think that is such a critical theme for what brought me here, really. And it’s a very special thing to keep at the front of what we’re doing.

Q: So, how do you do that? How do you keep our neighbor, or the patient at the center of everything?

A: Well, so it’s something that we wake up every day, and work towards, so, so many of us who went into medicine. So, I went into medicine – it’s probably better not to count the years in some ways – but let’s say almost 30 years ago, and I think that when you go into medicine, it really is all about those patients.

I still remember the stories of the people who I took care of as a medical student, the experiences I had, when first going into medicine. I went into medicine at a time where HIV had just started, and was really ravaging a lot of the communities, right? So, this concept of how do you care for your community?

And for me, I think it was such an instructive moment, because what you learned was that not only are we focusing on an individual patient in front of us to make an impact, right, so understanding their story, thinking about how to make sure they get the best possible treatment, the best chance, as we often say, of a cure of making that disease go away.

But you’re also working to try to fix the bigger problems, and so, it’s both taking care of that patient, and understanding that story, and that option, but for HIV, a lot of those advances came because actually Mass General had scientists working on the disease, and understanding how to move forward to make new treatments.

So, what’s great about my job is that I get to go both from how do we listen, and take care of an individual patient to how do we think about what are the biggest problems that we could take on that affect a whole group of patients? And what can we bring tools to that way, also?

Q: When you think back over – I’m sure you’ve cared for thousands of patients over all these year – are there particular patient who have stood out, or who’ve kind of changed your course in a certain way?

A: Absolutely. You know, it’s so funny, I’m thousands, and I can even imagine there’s – I’m sure there’s been tens and tens of thousands, but you carry some people forward with you. I’m sure we all do in our world. I remember when I was a resident, I had one patient, and I’ll never forget this. It was a woman who had worked as a housekeeper in the institution when I was training for that whole time, and she came in, and had a cough, and it turns out we ended up finding that she had lung cancer.

And it was interesting, because there wasn’t much we could do for her lung cancer at the time, but the biggest stress she had, actually, was from the financial impact of her disease, was actually not being able to pay those bills. She was a very proud woman, grown up very poor, but had always paid her bills, and it was this incredibly impactful thing for me to walk that journey with her, and understand sometimes it’s not just the treatment we’re giving, but it’s our ability to really think holistically about what that patient is experiencing while they’re sick.

And I think that was part of probably what got me so engaged in thinking about taking on more and more leadership roles in medicine. So, an opportunity not to both think about how we deliver better care, but to understand that being ill comes with so many different pieces of stress, and that as a health care institution, we can do so much more.

So, I think about her a lot, actually. I have to say, it was my first experience in really advocating for a patient in terms of how to think about that financial impact upon the family. And we do that so much here now to try to understand, particularly if a woman is sick, right? The implications for their family go way beyond their own illness.

The caregiving aspect is so much of what that means to a family. And so, that’s been just an incredibly important thing for me, and I still think about her.

Q: Going back to empathy, can you talk a little bit more about what are the questions you ask? How do you think about it?

I think people often say, “What is the piece of why MGH gels so well?” And I think one of the things I’ve discovered is that we’re actually all about people’s stories here. And one of the things I love is that I’ve learned that every time when I meet anybody, and I bet I did this when I met you, the first thing I ask is, “Can you tell me where you grew up?”

“Or tell me about you. Tell me your story.” And it’s amazing, I think, that by being able to put that narrative together, you learn so much, and your assumptions about people change so much, right? It’s amazing. So, I used to have this thing when I was a kid, so, my mother is Australian. My father was actually – grew up in China. His parents were in the State Department, so he’s American.

And I moved all over, a lot. And so, one of my favorite things was that I used to go to county fairs, and there was this competition where they would try to guess where you were from, and I forget exactly what I would win. It was probably like a dollar, but to me that was a lot. And I always won, because nobody could guess that I was actually from Tuscaloosa, Alabama.

Like there wasn’t a soul that could guess that. And so, it didn’t really turn into a long-term business model for me. [Laughter] But as a child it was like an extraordinarily positive thing. And so, I think what we don’t understand so often is that what we assume about somebody else, and how we see them on the outside is so different than who they are, and what they’re carrying with them.

And so, I think, one of the very special things about Mass General is that you’ll discover that people know each other’s stories. They know. When I got here people would ask me about my children. They’d ask me about each of these pieces. And so, I think empathy for all of us goes beyond looking at that surface, assuming – making assumptions based upon what we see. And really understanding the story, where the person came from.

We have this thing in the medical services that we talk about, which is that we’re often comparing our insides to other people’s outsides. And this idea that actually that can lead us to all sorts of both personal insecurities, but also judgments about other people that just don’t make sense a lot.

So, we spend a lot of time trying to understand those insides to hear the stories. And I wish, and I hope that as we build our country moving forward that we really focus on understanding how much we are so alike, and how those stories end up being so similar about what we care about – our families, our friends, our children, our work, making a difference.

Q: I think something I’ve been really surprised in in coming here is the impact that those little things can have, and it can be something really simple, like helping someone figure out how to pay their bill that doesn’t seem like a big deal, but the ripple effects downstream can really change the course.

A: One of the things I think that I love about the way that Mass General operates, and I often say this is that we really are – we’re run out of values not rules. And so, if you look at – an example would be if we have a patient – if I have a doctor who’s taking care of a cancer patient in the department, and if there’s something they believe they need to get done for that cancer patient, they move heaven and earth to get that done.

And there are some incredible stories about that, and I think that is because in the fundamental end, the relationship that you have with an individual patient is this unbelievable gift. And so, we place an extraordinary value on that. And so, you’ll see docs around here doing crazy stuff, flying all sorts of things.

So, I think in every other system they would be like, “Why are they doing this? You know, why are we driving a patient?” I had a doctor in my Cardiology Division who flew with a patient out to the West Coast, a young woman, to help her get the type of treatment she needed for her arrhythmia that we didn’t have here, but she was petrified.

Sometimes the most important thing you can do for a patient is really be there, and be part of their team, as they take something on, whether or not it’s being scared of going to California, or a bill that we can help with.

Q: It sounds very Mass General, and kind of, “I have this idea, and I’m going to follow through, and I’m going to make it happen.” It seems to me that empathy is a big part of what you’ve been talking about. How do you learn that, and how do you teach that to the people you’re training?

A: Well, I think, you know, we talk a lot about how you learn to walk in somebody else’s shoes in our world, and I think if you could think about that skill, it’s something I think about with my children all the time, like what is it about them that can learn to put them in somebody else’s place? And I think that that is such a critical part of medicine, but honestly, it’s such a critical part of being part of our society, and being the type of people I want my kids to be, and the type of people we all want to be.

You know, my sense is that a lot of what the gift is of being in medicine is that you do get to really connect with the patient, and understand their perspective, understand their story, and really have the opportunity to put yourself in somebody else’s shoes that I think is so different than a lot of other professions. And I think we’re really lucky with that.

What we’ve tried to do in the training side is just make sure that we create plenty of time for them, right? So, in the rush of whatever we’re doing, the ability to really listen to somebody’s story, to get to actually know their family, to really spend time. We’re doing a lot actually with our trainees going out to people’s homes doing home visits, really being able to walk in the shoes of somebody, and understand, well, they can’t take their medicines, or they don’t have any place to put their medicines.

Maybe we need to really understand what people are experiencing. So, we’ve tried to create time, and then allow different people to kind of walk in different pieces of that patient’s life. So often we see – and I’m sure you know this from going to the doctor – I do this, right? I get myself all geared up for the doctor’s appointment. I have my list, and I’m going to be very well-behaved.

Q: I have to be nice. I’m going to drink a glass of water.

A: And then the reality is the patients are very different than that, and so, having people be able to kind of understand it’s not just the person you see in your exam room, but what are they bringing to that?

So, I think that piece of empathy, of being able to see things from another person’s perspective is just fundamental to medicine, and any part of medicine. And we’re really very lucky to be able to support that in the ways that we do here.

I also think it’s fundamental to leadership. I so often spend my time talking to young physicians about being able to understand the perspective of older people, you know, of just being able to say, “Well, you know, I’m sure that – let’s just say he didn’t really mean it that way. Let’s kind of put yourself in his shoes, and think about it.” So, those skill sets go way beyond medicine.

Q: Are there particular techniques that you train or teach into them to learn how to do that?

A: Well, one of the things we’re doing more and more, but I think anytime – it’s almost like this old adage of having dinner with your children. So, I have three kids. They’re now 22 to 17, but one of the things I’ve tried all the way along was to be home for dinner. And we used to play a game called “High Low.” I don’t know if you’ve grown up with that game, but everybody goes around the table, and says their best of their day, and their worst part of their day.

And so, basically what that is, is actually a reflection session. And we don’t think about it, because we call it “dinner.” But actually, it’s an ability to kind of reflect on the experiences that you had, and learn from those experiences.

So, one of the things we’re really focusing on to try to build empathy, and resilience is this ability to carve out time to reflect with others, to talk, and think, and process. Sometimes that reflection is done in person, so we’ll sit around, and talk. Sometimes there’s a lot of value for people who write, and writing that type of narrative of experience. But I often say an enormous amount of what I do are things that I learned in trying to raise children. And the scales cross all those different sectors the same way.

Q: Yeah. So, it’s kind of like every year you get this new set of –

A: Exactly.

Q: – children that you’re going to shepherd through. Is it getting harder, that empathy piece? I think we’re in a world that’s speeding up, and things are getting difficult, and outside of these walls, scary things are happening. Do you see that affecting sort of the way people are relating?

A: Well, you know, I think I would say that probably some of the changes in the country over the last year and a half have meant that we’re having much more open conversations about issues than I ever thought I might see in my lifetime. And I think those are hard. I’ve spent time, actually, working with Harvard and us on issues around diversity, inclusion, and belonging.

And I think, as we recognize our diversity it means that sometimes there’s more – the belonging stuff gets stressed, so that we have to work hard to understand the other person’s perspective. When things were all the same – at the beginning of MGH, even though there was a physician, and a surgeon, they were kind of the same, let’s just say. They came from the same background.

Now, we are committed, and we bring people from all over to Mass General to be able to take on these incredibly important problems. We have to be able to begin those types of dialogues of understanding difference, and celebrating, and moving that forward.

I’m always uncertain how to bring in the tech piece that you’re probably implying; you know, it’s such an interesting time in medicine, whether technology is going to be a huge force for good in medicine. Are we going to connect more over social media or other media? Or is it taking us away from that human connection?

I would say I think that we’re at a time when more and more people are working to harness it, to build connection. I don’t know that we’re there yet. I think that a lot of people in the end really want to sit down with a doctor, you know, just side by side, and be able to see them, and be able to know that they’re listening, and that they understand, and that they’re respected and heard. And that’s sometimes hard to do over an app.

Q: There’s a lot of value in being able to text your doctor, or send him a question whenever you have it, but there is still so much value in that face time.

A: Yeah. And I do get a lot of pictures of rashes, and I’m never sure of what to do with those, I will say. [Laughter] More and more patients will send me a picture of like, “I did this to myself. What should I do?”

Q: One thing I was wondering if you could tell me a little more about. I know you’ve been instrumental in the formation of the Pathways Service, which – what does that do?

A: Well, so I think that one of the pieces is that – and it probably gets back so much to my roots, if you think about what we experienced with HIV and AIDS in those days is that as we were taking on a problem that a patient was facing that we were not only trying to solve that problem, and work with a patient to take on all the aspects – the financial, the treatment – but we really, I think, have a social responsibility at academic centers, like MGH, to take on the question of how can we actually bring science to this problem?

How can we create new treatments, new understanding? And so, that has become much more fragile, just because people are busy, and actually the science – this is kind of a paradox – because so much of the scientific advances that happened in molecular biology, and certainly kind of the fundamental understanding of genes, and molecules, they ended up being in labs that were way away from the medical, from the actual patients.

So, we had all this incredible science being done, but it was nowhere near the patients. And so, one of the things we’ve done over the last three years with the leadership of residents, of Victor Fedorov, and Lauren Zeitels, who were two of our residents who started this, and Mark Fishman, is to really reconnect those pieces.

We essentially created a service where patients are referred in when nobody understands what to do. So, a patient that really – we’re – Mass General is all about those patients. We have patients come from all over the country, the globe. Plus, I will tell you, so many of our patients on the medical service right now – I will tell you, there’s at least four or five people who flew to Logan, because they didn’t know what was going on; got in a cab, and came to MGH, and that’s all they knew to do.

And so, we’ve connected those individuals, not only to the trainees, to our residents so they can learn how to think, and how to push something forward, but to the scientific enterprise around those. My hope is that someday we’ve got a story – right? – that a patient came in with this type of problem. A resident, a young person got engaged in that story, figured out that this lab, this particular technology they could use to study it.

And then brought it all the way full circle, back to understanding that patient, and others. And we’ve already got a lot of those going on, but I think each one that we take on not only changes the story for that individual patient, but changes the trainee, and then changes that overall disease. And so, it’s been an incredible collaboration so far.

Q: How do you see it changing the trainee?

A: Well, I think one of the challenges we have in any training program, but particularly in medicine is that you get rewarded for saying what you know. I’m going through this with my kids right now. I have a daughter who’s trying to take the SAT, and she’s like quite stressed about it. This is just about so much the concept that the more you know, the better you will do.

The incredible thing about medicine, actually, is that sometimes the greatest advances come from us being willing to say what we don’t know, and actually recognizing that it’s not always about being able to say, “I know this, and I know that.” It’s about saying, “Look, this is what we know. This is what we don’t understand, and this is where we can go.”

So, by creating a training program that celebrates and recognizes their ability to say, “I don’t understand this,” I think it has the longest-term impact in terms of who they will be in asking those questions, feeling comfortable in certain rooms. It’s an incredibly important leadership skill, also. And so, we’ve seen it already change them from feeling uncomfortable saying, “I don’t know,” to really embracing that as a part of what we should be doing, and how we should move forward.

Q: I love that. That is just comforting, and I don’t know, it’s so tempting to just make it up, or –

A: Absolutely.

Q: – skip steps, but instead just saying, “This is where I am, and where do we go from here?”

Q: I’m really curious of something you just said about kind of your own insecurities, and having those be sort of drawn out. What do you do when that happens?

Well, I think we all live in a land of impostor complex. I don’t think there’s a person that doesn’t. I experience it very strongly now talking to young people , and I do think that there is an enormous amount of understanding how to go forward, even when you’re not completely sure. Maybe it gets back to the being willing to say what I don’t know.

And understanding how we often say here, “Never worry alone.” So, making sure that you have others that you’ve connected with in that setting. But I also think recognizing that the person across the table from you, no matter what title they have – I can call myself physician-in-chief –but it turns out that they are just so much more like you, thinking about the same things.

I often try to get that message through to people when they’re trying to speak in public. We have lots of people who go talk to either patient groups, or students, and they’re always so worried about what people are thinking about them. And I usually try to remind them that almost everybody in that audience is just thinking about what other people are thinking about them.

And actually, that’s really all that’s going on. It’s like those cartoons of what dogs are thinking. [Laughter] Like if you were to put the little blurbs up, everybody in that audience is just thinking about, “What are thinking about me?” And so, it’s very freeing, when you can recognize how human that is, and that’s such a big part of medicine, right?

And I think we’re so lucky to be in medicine, and to be able to do that. So, we all have our insecurities, but finding the commonality in that, I think, is what really brings us together.

Q: Yeah. And kind of getting out of our own heads, and I love that – seeing the other people around us, and recognizing, whether you’re at the top or the bottom, we all kind of have the same –

A: Absolutely.

Q: – inherent human instincts. So, you’re the physician-in-chief, and as you said, it goes all the way back to the beginning of this hospital, when there were just a couple of doctors in charge. if you could hop on a time machine, and go back to the very beginning, and talk with James Jackson, the first physician-in-chief, are there things that you would want to ask him, or things you would want to tell him?

A: Well, you know, there’s always these things where you’d love to know maybe this gets back to my insecurities. I would love to know if he’s proud of us, if this is what he hoped, if when he started a hospital that was supposed to be there for the Boston community at its times of need is this something that, as we look at ourselves today, I just hope that he has a sense of the unbelievable thing he accomplished, not just for Boston, but really for the world.

Q: Yeah. And talking about times of need, I think something notable about you in your career here at Mass General, your very first day, a very memorable day in Boston was the 2013 Marathon Bombing. What was that like?

A: Well, so, I have to say moving to a place as big, and complex as Mass General, I always explain was a little bit like moving to a foreign country, anyway. I’d never lived in Boston. It gets back to my Alabama roots. I mostly thought that I was mostly scared of the sports teams. I’d been in Philadelphia a very long time, and so, let’s just say I had some biases about our sports teams here in Boston.

And so, I already felt like I had been – I don’t know – moved somehow to Czechoslovakia. So, it was already, and so, we were actually having meetings that day. I was trying to learn the MGH, and we were having a meeting, and somebody came in, and said, “There’s been a bombing.” And this is going to sound crazy, but it seemed to me, like, maybe that’s what happens in Czechoslovakia. [Laughter] Like ever so often on Mondays there’s bombings.

And so, they must have thought I was like the coolest character you’ve ever seen in the world. Because I was like, “Okay. Let me know how that goes, like report back in a half an hour.” But of course, it was just so out of my range of normal already –

Q: And all of our range of normal. I think it’s –

A: Yeah. But I think other people were more surprised. Because I was already surprised by everything that day. I couldn’t even find the bathroom, let alone – so, what was so incredible, though, and I often say this. I feel so fortunate that I didn’t come a week or two after that, because it was a time, and I know that people know this now across the country, where our community came together in just an unparalleled way.

What happened at the hospital levels to put those patients first, to change everything was just, I think, something I will never experience again. And it was the best that I think you could be. And some of the stories were incredible. They essentially, and I sometimes try to not let this out, because it turns out that probably means we probably could do it any day.

But it turns out the medical doctors in the hospital went down to the emergency room, simply based upon the Twitter feed, really, checked in with the emergency room, and they decided to clear the emergency room of patients, so they could take everybody who came.

Q: So, that was kind of before we officially knew what was happening, people just –

A: Before anybody hit the ED. And so, we took every patient we could out of the emergency room in case they needed the space for people coming in. And so, it was voluntary. It just went across the system instantly that people knew to do that. It was coordinated. They got people where they needed to go. We actually moved people from – patients out of some of the ambulatory practices onsite, in case they needed to become triage stations.

This is when at the time – I don’t know how much you remember – but we had no idea, initially how many causalities there were going to be. And so, it was this incredible example of people just pulling together around a clear sense of what we mean to that community. And not competing, right? There was no sense of this hospital, that hospital.

It was really just about what it means to be part of Boston, what it means to be in this country, what it means to stand up at that time. I will say the thing that was the most remarkable for me, also, about it was that in the aftermath of that, I think it was such a reaffirming time to be part of the medical profession. You know, the medical professions are often under a lot of stress, but so many people wanted to help at that moment.

And we had had and continue to have this opportunity to be part of the healing, that I think almost no other group got to do. And so, to be able to heal both patients and a community that way, it was an incredible time to start. I can’t imagine in many ways that I wouldn’t have gone through that with this community. It really is one of the times that I think I will remember, obviously, forever.

Q: Do you feel like – do you feel that it’s changed the way you approach your job, or approach medicine since then?

A: Well, I think it set an ideal for us, right? And I think that that ideal has been there, honestly, if you were going to say what I would ask James Jackson, the ideal of how we do always put our patients, and our communities first. So, I don’t think it changes it. I think it is a touchstone here.

You’ve probably noticed that we know what we’re capable of, and we aspire to that at all times. And I think that having those moments where you’re reminded just so unbelievably vividly of what it means to be at the Mass General, what it means to be a physician, I think are incredibly powerful touchstones.

I think they’re deep in us already, but having that I do think is something that keeps us really facing forward about what we can do.

Q: Yeah. It’s kind of like that confidence that we had sort of the worst day put in front of us, and how we performed through it.

A: Yeah, absolutely.

Q: Great. Well, thank you so much, Katrina. This has been really wonderful talking with you, but before you go, I have my fast five questions for you.

A: Excellent, hit me.

Q: First question: What do you think the best piece of advice you’ve ever gotten is?

A: The best piece of advice by any means has been to just be myself. There’s never a time that you don’t think maybe if I’ll go do this job, or I’ll do this podcast that I’ll be somebody else. Maybe I’ll try this, but the reality is that we are all who we are, and by far the best piece of advice I got was, “Even if you wanted to be somebody else, you’ll fail. So, you might as well stick with it.”

Q: So, the name of this podcast is “Charged.” So, I’m curious, in the context of what you do, what does that word mean to you?

A: Well, I think for me the word “charged” really is this idea that we fundamentally do carry a social mission for – we’re carrying the charge of the people we serve, right? So, we’ve really been charged in academic medicine at the Mass General to think about how we care for patients now; how we create cures for the future.

And I think that charge is an unbelievably powerful thing, and we owe it to our country to do everything we can to actually deliver on the charge that they’ve given us.

Q: Great. So, everyone at some point needs to recharge, so what is your best recommendation for how to recharge?

A: So, I’m a huge believer in vacation. So, I both sleep, and I vacation a lot. In fact, I’m apparently famous that at some medical grand rounds I got up, and told everybody to take a vacation. So, I believe – one of the things in medicine is that the heart works in some two phases. They call it systole and diastole. So, we squeeze the heart, and then we relax.

And if you don’t relax the heart, you don’t squeeze the heart. And so, I am a – I couldn’t believe more in vacation. So, I think that was also raising three children. I discovered that if you are raising three children, and you didn’t have some real downtime, you spent a lot of time screaming at them about putting on their shoes, and other things.

So, we go away in the summer. I go away. Spending time at the ocean is really important to me. We just went fishing in Florida for five days, which was absolutely beautiful, and we caught not a single fish, not one. But apparently that was – at least according to my husband, not his fault. But it was a wonderful time. So, I would tell everybody that you’ve got to have diastole. It is time to relax that allows you to do the rest of the work.

Q: I love that. When and where are you happiest?

A: Well, as you can probably tell there’s not – other than winter, there’s not a lot that I struggle with in terms of being unhappy. I will tell you, and I know that anybody – the times that we cherish are the times that we are with people who we’re closest to – with your family, with the people I’ve trained. I relish the times that I get to connect with people like that.

But I love my work. There is an incredible gift to be able to be part of the Mass General, and to do this work. And sometimes there’s nothing greater than being able to see us pull all those pieces together to make an impact for somebody.

Q: That is a perfectly lead into the last one: Do you have any particular rituals that help you have a successful day?

A: Well, so I am adamant about what coffee I drink. So, I will say my husband and I have these ongoing arguments. So, it turns out that I really don’t want him to change the type of coffee in the morning. So, my favorites – I’m willing to change eventually, so I was in Philadelphia we drank Starbuck’s House Blend. I have at least one cup of coffee before I’m functional in the morning.

And he decides every so often that we should branch out, we should try something from this country, or that country, but I can tell in like 7 seconds – right? – that that is not my coffee. So, we have these ongoing debates about coffee as a ritual in my house, and whether or not I’m willing to try the Sumatran, or whatever.

But I have to say for me, and maybe it’s part of it that there is something unbelievably reassuring about having certain parts of your day that just play out the same. I love my cup of coffee in the morning. I love knowing how it’s going to go. And I think that he’s been unbelievably nice now about just sticking with Major Dickinson’s Blend. And we have Major Dickinson’s Blend every morning, no matter what he wants to do.

Q: I have one follow-up question I have to know: How do you brew your coffee? And kind of what device do you use?

A: Well, this is probably an aging issue. It’s a coffeemaker. I don’t know. [Laughter] You’re probably showing that you know a whole lot more about this than I do.

Q: I’m no pro, but I live with four people, and we have four different coffee devices. [Laughter] So, I’ve learned that everyone has a preference, and I was curious.

A: As long as we’re all Major Dickinson’s Blend, I’m fine.

Q: So, thank you so much, Katrina, for being here to talk with us. It’s been a pleasure hearing more about you.

A: It’s been wonderful to be here.