Dr. Emelia Sam shares her perspectives on mindfulness and developing a foundation of compassion. As an oral surgeon and educator, she instills mindful behaviors in her students and helps her patients feel most comfortable when under her care.
This is episode four of Beyond the Mouth, a podcast series in which Dr. Betsy Shapiro of the American Dental Association (ADA) chats with a diverse group of people who can help with the non-clinical challenges dentists experience every day.
This episode was released on February 27, 2019.
Dr. Emelia Sam
Dr. Emelia Sam hails from Edmonton, Canada. She completed her bachelor of science with specialization in genetics at the University of Alberta prior to obtaining her DDS at Howard University in Washington, DC. Following a residency in oral and maxillofacial surgery, she joined the faculty at her alma mater and is currently a clinical associate professor in the department of surgery.
For over a decade, she has maintained a blog, currently known as 360SOUL (three-sixty soul), concerned with matters of mind and spirit. She has also written extensively for various platforms including MindBodyGreen and Huffington Post.
Her latest endeavor is her third book, Compassionate Competency: Healing the Heart of Healthcare. It represents the intersection of her experience as a practitioner with her long-time interests in personal development. Compassionate Competency attempts to enhance the overall patient experience while concurrently addressing wellness for the practitioner.
Betsy Shapiro: Welcome to the ADA practice podcast, Beyond the Mouth, where we won't discuss clinical dentistry, but everything else is fair game. I'm Dr. Betsy Shapiro, a director with the Practice Institute of the American Dental Association. In this episode we are talking about wellness in dentistry. Joining me today is Dr. Emilia Sam. She's an oral surgeon, an associate professor of oral and maxillofacial surgery at Howard University, an author, a lecturer.
She's also the author of several books on personal development and wellness, and how this all impacts the overall patient experience and the practice of dentistry, and if we really want to dig deep, how it impacts health care too. Emilia, welcome to the show.
Emilia Sam: Thank you so much. I'm so excited to be here.
Betsy Shapiro: Well, we're delighted to have you. I would like to start out by asking you how you came to be where you are today. I mentioned that you're an author, and we'll talk about your website, but anyone who's read your books or followed you on your blog is aware that this has been a very personal journey for you. I'd like if you would share some of your story with all the rest of our listeners.
Emilia Sam: If I remember correctly, it was some career day event in, I think the seventh grade. So I didn't really have a personal familial connection to dentistry, but it was a really practical choice for me at that time. And I can't remember what the presenter said. I can't even remember his face. I just know it was a male, but by the end I had just chosen dentistry as my path.
Then once I got closer to entering university, I did think about the possibility of going to med school, but in all honesty I did not want to have to do a residency after going to school. So that was one of the things that really tempted me about dentistry as well, because I wanted to be a doctor of some type, but I didn't want to do that extra three, four, six years.
Yeah, so for me, once I got to third year of dental school, something just wasn't connecting with me as far as general dentistry. There's nothing wrong with it, but I just wasn't excited, I guess, to go down that path. And the thing that was drawing my attention was oral maxillofacial surgery, but you know that requires at least a four year residency, so I ended up doing the thing that I was trying to avoid in the first place. So that's how I got to surgery.
Betsy Shapiro: Funny how life does that to you, isn't it?
Emilia Sam: Right. You can't escape certain things. You're still going to get them, maybe in a slightly different way, but you're going to go down that road. I learned so much during my surgery residency, and even beyond surgery, there was a whole lot of personal growth. But there are also a lot of things that I experienced that at the time I couldn't articulate, but in retrospect, I think, along with my dental training, impacted me and kind of brought me to where I am today as far as the personal development and wellness aspects of things.
Betsy Shapiro: So when you first started in practicing as an oral surgeon, was the wellness a big part of your being and your practice at that point?
Emilia Sam: No, absolutely not. I had been somewhat of a personal development junkie, and I always felt like my personal interests, I had to keep separate from my professional world. They were just two things that I did not see coming together, and there were probably a few times, a few exchanges that I'd had with colleagues where if I started to delve into what I was learning as far as personal development was concerned, they'd look at me with a side eye or "Oh, hey, what? I don't know what you're talking about." And I kind of learned to stay away from certain subjects.
Betsy Shapiro: Yes. Because that's not science, right?
Emilia Sam: It's not science. It was not accepted as science. So yeah, that was just a boundary that I learned early not to cross, but it actually, it worked in my favor. So I'd always had a love of writing, but I had put that aside while I was doing my schooling because I just figured that was a hobby, and I needed to just buckle down and deal with my formal education. But after I started practicing, I just found that there was something that was missing for me, and I really, I just wasn't really happy.
I just noticed that there was this void that I couldn't quite explain, but that was probably around the time where I started to pick up my writing practices again and journaling a little more frequently. I used to do it years before, but I returned to it, and it was also around the time where blogging became a thing, so all of a sudden anybody could have a platform and write for others, and one day I just had an inspiration to start my own personal development and inspirational website. So that's how I got started with that.
Betsy Shapiro: Can I ask if your patients or your students knew at this point in time that you had this blog? Did you share that with them?
Emilia Sam: Absolutely not.
Betsy Shapiro: Well, I wondered.
Emilia Sam: That was around the time I think Emilia emerged, because my first name is Francis, and everybody had known me as Fran or Dr. Sam, but I like to say after 5:00 and on weekends, Emilia came out. So that also gave me the freedom to just explore what it was like to put my own thoughts out in the world, because it could be really scary baring your deepest thoughts and what keeps you up at night, and things that aren't necessarily related to the professional realm. But I had this ... Care may be too strong a word, but I was just concerned that I may be found out. So that was why I was using my middle name for the longest, and it stayed that way for quite a few years.
Betsy Shapiro: That's interesting. And it's also very flattering to me because you actually asked me to call you Emilia, and so I feel like I got to meet the after-hours weekend person, and maybe that's why I always perceive you as so calm, and competent, and relaxed, and embracing the moment. Maybe that's why. If I called you Francis or Dr. Sam, I would see a different side.
Emilia Sam: Well, thankfully the two have merged along the way. You know, I've never really asked people how they experienced me, say 10 years ago, because I know now Emilia is ... I hate talking about myself in third person, but you get the idea. I'm the same person wherever I'm at. There really is no ... There's not a huge boundary between Dr. Sam and Emilia anymore. I feel like I can be the totality of who I am wherever I am. So it would be interesting to see if people had noticed a shift, if they had known me 10 years ago, how they would have perceived me in practice, from a colleague or a student or a patient's perspective.
Betsy Shapiro: That would be an interesting podcast. Maybe we could get a couple of them in some time and we'll talk about their changing perception. But I actually, I think what you just described, and I'm not a psychiatrist, I am not a mental health expert in any way, but I think you just hit on the nut that all of us are searching for. The method to have all of our personalities, and we all have them, whether or not we admit to it or not. The face you put on in front of your grandmother is probably not the same one you use in front of your boyfriend.
Emilia Sam: Let's hope not.
Betsy Shapiro: Well, I don't know. It depends on either your grandmother or your boyfriend. However, I think that the ability to have all your worlds collide, if you will, and be comfortable in it, is such a wonderful goal for all of us. You've talked in the past about a wellness revolution. Is this kind of what you mean by that?
Emilia Sam: Absolutely. So in talking, I guess, about the convergence of things, how my personal and professional life finally started to merge. I think it really came around after I'd read the book “A Whole New Mind” by Daniel Pink. And he just talked about how times are changing, and how we've been through all of these phases. We've been through the Agrarian Age where farmers were at the head of things. We've been through the Industrial Age where it was factory workers, and we've been through the Technological Age or the Information Age, where we valued what he refers to as knowledge workers.
But the age that we're in now is what he refers to as the Conceptual Age. And he talks about this shifting from the knowledge worker and the left brain, if you want to refer to it that way, as a time where the qualities of the right brain are being heralded. So he talks about these conceptual senses, and one of them being empathy, and throughout the book he had examples of how this sense was developing, specifically in health care. And the minute I read that, all of a sudden my whole life finally made sense, and it felt like the parts of me that I'd been hiding were exactly what we needed to bring to health care in order to see the next iteration.
Betsy Shapiro: I know you've talked about health care needing an overhaul, and I suspect that what you've just expressed is what you mean when you talk about overhaul. We have other versions of overhaul in health care out there in the world, financial and regulatory, and all those kinds of things, but I'm sensing you're speaking mostly to the empathetic nature of health care and how we're delivering it. Is that true?
Emilia Sam: Absolutely. I think we've just come to a point where, and again, this kind of goes back to Daniel's book, where we're all searching for meaning and connection. Even if we're not able to articulate it in that specific way. So when it comes to health care, our patients may be looking for something just beyond our clinical competence, and for practitioners, just delivering treatment is not enough. They want to have meaning and fulfillment as well. And the way that we serve all parties involved is just to create connection. It's just very human, and it's the human aspect that's been missing out of health care. You know, it's interesting, we have "care" in the term, but I think up until now patients have been serviced but not necessarily cared for.
Betsy Shapiro: So what do you think would be the practical application for a dentist in the practice, or his staff person, what would be the baby steps they might take to start down this same path, to be more caring, to be more empathetic? Or how would they display that to a patient?
Emilia Sam: It really starts with self, with self-awareness. And here's where all the emotional intelligence and centering around mindfulness, where all of that comes in. How do we just become more aware of our emotional state? And that evolves around us in a way that serves, again, all parties involved. So it starts with self-care, and this is what I mean by this whole wellness revolution, and not only what we're doing outside of the office to restore and rejuvenate ourselves, but also what we're doing within the office. So for example, it might be in how you're communicating with your patients.
I happened to see at a meeting a couple months ago, an event held by the National Academy of Medicine, and right now they're very interested in clinician well-being. And at the top of the meeting they had a discussion around the topic of loneliness, and it was Dr. Vivek Murthy, who was the Surgeon General who was heading part of this discussion. So he was talking about loneliness amongst practitioners, and that really struck me, because over the years, I've heard a lot of reference to how lonely being a full-time practitioner dentist in your own practice can be.
And it's not necessarily something that's addressed during training, and it's not necessarily something that people know how to navigate once they're out there, and it's not something that people necessarily want to reveal about themselves.
So as far as communication is concerned, in that discussion, when they were talking about loneliness, there was another woman, Dr. Marissa King, and she was saying that she studies social interactions and how to improve them. So she was talking of an experiment that they did where they had placed sensors on physicians to monitor their interactions throughout the day, and what they found out is that the positions who have the highest number of interactions were the most dissatisfied with their job and at the highest risk for burnout and turnover, or the more they found out that it wasn't necessarily the number of interactions, but it was really about the depth and the quality of communication.
When they were able to connect with their patients and their colleagues, it not only gave their patients a higher sense of well-being, but it did the same for them as well. And they found that the people who did have the deeper connections were at less risk for burnout. So in choosing how you communicate, that affects how you feel, how your patients feel, your professional success, and really your personal fulfillment.
Betsy Shapiro: That is fascinating. And I wondered, when you were talking about the loneliness, and I agree with you that that is a problem, it leads to stress and burnout, and we do not want to admit to it very often, I wonder if we're going to see that increase because many of our newer graduates come into the practice being much more connected than perhaps, for example, I was. I graduated 30 years ago. We didn't text message, we didn't chat. We didn't do any of that.
So to suddenly be in private practice on your own, and you don't have time to pick up your phone and do these exchanges, I wonder if it will be even more exaggerated or if we'll find that the newer generation is better about being mindful. Do you have any thoughts about that?
Emilia Sam: Really interesting question, because it can really go both ways, can't it?
Betsy Shapiro: I would think. I'm not sure which way the pendulum will swing here.
Emilia Sam: Yeah. And it's interesting, actually, because yesterday I was doing a presentation for a group of undergrad students who are heading towards health professional careers, and interacting with them for three hours was really eye opening. So on one hand, you do have this population who is attached to their technology, as am I sometimes, because I had to take my phone out of the room, and I wasn't sure how engaged they were actually going to be when we were having discussions around this topic.
But they were really eager to share, and I was surprised at how many of them had already ventured into the world of wellness, whether they refer to it as that or not, and really are preparing themselves for what's going to be a challenging path. So it's just going to be interesting to see how the technology plays into it, because technology can take us away from connection and then in other ways it definitely brings people together.
Betsy Shapiro: I know you mentioned “A Whole New Mind” by Daniel Pink as a book that sort of changed the world for you or changed your view of the world a little bit, and you have a book, “Compassionate Competency,” that I'd recommend to anyone of our listeners. I loved the format. It was for people who are busy, it was so easily digestible, but I think very on point, and just very well structured from my perspective. What are some other resources that you've found have been helpful for you?
Emilia Sam: In trying to understand what mindfulness is, I really like the book “Wherever You Go, There You Are” by Jon Kabat-Zinn. And Jon Kabat-Zinn is really the person who popularized mindfulness. What, it's been about 30, 40 years now? Thirty plus years now. So that's another, that format is easily digestible as well. It's not made up of long chapters that are going to take a lot of your time. They're brief readings, whenever you have time. I call it a side table book, a night table book. So I really enjoy that one.
Betsy Shapiro: I think that's one of the things between Jon Kabat-Zinn and Daniel Goleman. They're putting the science out there, which makes it more comfortable. For people who think, "Oh, that's a lot of hokum." We actually see proof now that it really is a functional change and a healthy thing to pursue.
Emilia Sam: It's interesting, because I think up until now, well, in a lot of spaces, but I know certainly in dentistry, with practices, a lot of time the focus is on productivity and efficiency, and unfortunately we put our well-being aside for that. But what we're finding now is that when you attend to your well-being, productivity and efficiency are natural byproducts of that. So with the studies that they're doing now, they're finding how mindfulness decreases your blood pressure, it improves your efficiency on tasks, it seems to improve working memory, and thus tend to be less reactionary and respond more appropriately to challenging situations.
Betsy Shapiro: I think we see all those things in the industry, either real or perceived pressures to produce, or to be faster, or somehow be superhuman, and we simply can't be. We have a survey, a health and wellness survey that the ADA does, and it's a periodic survey, and we see increasing changes in unfortunate patterns, for thoughts of suicide or depression or loneliness, mental illness indicators, things like that. And so I think what you do and what everyone is starting to learn and embrace can make the shift for not only for the profession, but for our patients and for the whole health care overhaul that you and I talked about earlier.
Emilia Sam: Exactly. It serves everyone involved.
Betsy Shapiro: As we wind down our conversation today, I'm wondering if you have a takeaway you'd like to share with our listeners.
Emilia Sam: So yes, it's that you can build the most successful practice. And if you think of that like a building, a skyscraper that's just magnificent, that everybody stops and stares at. However, if the foundation of that building is compromised, it's going to come down at some point. And I just want you to remember that your well-being is the foundation. So it'll serve you well to make sure that you are protecting that and nurturing that in the ways that you see fit, to ensure not only your professional success, but personal success as well.
Betsy Shapiro: And I think that's a perfect note upon which to thank you so much for your time and your expertise. It's been a pleasure speaking with you.
Emilia Sam: And you too. Thank you so much for the opportunity, Betsy.