From San Francisco, A Conversation With Valerie Jarrett

Drew Ramsey, MD


June 06, 2019

Portions of this interview have been edited for clarity.

The 175th Annual Conference of the American Psychiatric Association, held in San Francisco this May, featured an opening-night session with Valerie Jarrett, the longest-serving senior adviser to President Barack Obama. Before addressing the conference-goers, Jarrett sat down with Medscape's Drew Ramsey, MD, to discuss the importance of leadership and how learning to follow her own voice put her on the path toward an esteemed career.

Leading by Listening

Valerie Jarrett, former senior advisor to President Obama, speaks during the National Action Network convention in New York, Wednesday, April 3, 2019. Photo courtesy of AP Photo/Seth Wenig

You are about to address the largest group of psychiatrists ever gathered in the world. What does mental health mean to you?

Being both psychological and emotional, I think it's how we respond to other people and to stress in our own lives, how we balance the enormous challenges that so many working families have today. All of that wraps up into what I consider mental health.

You've been a leader in both the public and private sectors. So many physicians are in leadership roles, yet we don't have a lot of leadership training in medicine. Can you share with us some of your tips on what has made you successful as a leader and how we in medicine can do a better job leading?

My dad was a physician, a pathologist. He taught me that what is most important is simply to listen.

Part of what I learned working in local government, being a lawyer, running a company, and certainly working in the White House, is that you have to listen and you have to make informed decisions. The best way to do that is to do your due diligence, and make people comfortable enough to open up and tell you what they think. Oftentimes I've noticed when I go to the doctor, it's the last question he or she asks me that's actually what was bothering me all along. You've got to give patients space to really open up.

That's applicable to physicians, as well as anybody else, no matter what you're doing: Listen to the people whom you're there to serve.

Listening is something we psychiatrists definitely believe in and advocate for.

I'm also wondering, given that you have been in stressful situations that I think few of us can imagine, are there things in your personal wellness routine that you do to keep yourself...?

Sane? I try, yes.

So many physicians are facing risk for burnout, and as a profession, physicians have a very high rate of mental illness and struggle with things like suicide. Do you have wellness tips for all the healthcare providers out there who are on the front lines providing care?

As they say on the airplane, put the oxygen mask on yourself first, which means you have to take care of yourself. I exercise, which gives me peace of mind and gets my endorphins going. I also spend time with my family.

I think everybody has to figure out what it is that keeps you grounded and allows you to feel this sense of balance. Nothing is ever perfectly in balance, but whatever you do should allow you to rejuvenate yourself. Life is a marathon, not a sprint.

I think you showed us that as President Obama's longest-serving senior advisor.

It never would have occurred to me to leave, because I did try to pace myself. I also laugh a lot, mostly at myself, and I surround myself with people who wish me well. I think we have to have circles in our lives that are supportive, and physicians need those just as much as anybody else.

Finding Your Voice

You have a wonderful new book, Finding My Voice: My Journey to the West Wing and the Path Forward. I think finding your voice is something with which so many physicians struggle. Medicine is a field that has a lot of challenges and, increasingly, a lot of diversities.

What can you share from your book with all of the physicians and medical students reading this, who have been inspired by your service and your career, on how you have found your voice and how you use it so effectively?

First, I had to learn to trust my voice. There are a lot of people who are telling you what to do, and I'm sure that's also the case for people who are early in their career in medicine. You have to find what your passion is, what you're going to do that makes you excited when you get up in the morning, where you feel as though you're making a difference in the lives of other people.

I didn't trust my voice early in my life, which I address very openly in my book. I did that to speak to people who feel as though they're going in one direction, and maybe not really the one that they want to go in, but it might be comfortable because it's the direction that everybody around them thinks they should go. My adventure really began when I swerved outside of my comfort zone and started doing something that spoke to my quiet voice. I encourage everybody in their profession to do that gut check pretty often and say, "Is this really what I want to do?" If it's not, swerve.

In this day and time, we are hesitant to have uncomfortable conversations, even with ourselves. We should. The adventure is in the zig-zag, it's in the swerve. I think straight lines can be kind of boring. Back when I was pre-med, I was focusing on that straight line, and it wasn't for me. I swerved out if it, and the rest is history.

But I'm certainly grateful to all of you who do go into the medical profession. It's an honorable one, particularly in this day of so many challenges, where mental health is a real issue, and we need as much support as we can get. It's why in the Affordable Care Act (ACA), we treated mental and physical health as being on par, as it should be. I value what you do, and I'm just delighted for all of the healthcare providers out there who are serving so many around the country.

Seeing mental and physical health have that parity in the ACA, and for the nation to view us as completely equal, was such a great moment for us in mental health. Thank you so much for that.

You have thousands of psychiatrists from all over the world here to listen to you, so thank you so much for spending some time with us, and for your leadership. It's been such a pleasure to have you here.

I'm happy to be with you today.

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