Belinda Fu Edit
Jeremy: [00:00:00] Welcome to Think Like an Improviser. I'm Jeremy Richards. In this podcast, we explore how the skills and insights of improvisation can elevate your creativity, confidence, success, and wellbeing.
My guest for this episode is Dr. Belinda Fu, a family physician, educator, and improv actor in Seattle. Belinda founded the organization, improv Doc, to teach improvisation skills to fellow clinicians. She's seen how the surprising insights from this practice can improve communication, cognition, and wellness for both the physicians and their patient.
Hi Belinda. Thanks for
Hi Jeremy. Thanks for having me.
You and I have known each other and performed together since 2009, right. At Unexpected Productions in 2009. Yes. , you wrote it on the calendar. It's
Belinda: it's burned into my heart. Like you were, you were already there when I joined. [00:01:00] I'm pretty sure I
Jeremy: was there since 2001.
Yeah. . I know. And then a few years back before that doing improv in college. But when did you get started? Was that your first foray into
That was Not, not quite. My first, I, I took my first improv class in January, 2007. That is also burned into my heart. And then in 2009 was when I first started doing some shows.
I did a few long form shows over at Jet City Improv, and then got into unexpected productions in the fall, joined the ensemble.
Jeremy: Awesome. And when did you start making that connection between improv and your practice in medicine?
Belinda: That happened very gradually.
Well, right after I joined up, I started a job as faculty at a family medicine residency program. So that's teaching their doctors who are done with med schools, they're totally doctors. They're doing their specialty training. So I was one of their faculty [00:02:00] teaching the family medicine and. . One of the things, or among the things that we're tasked with teaching the residents are things like communication.
And I was very frustrated with the tools that we had to teach communication. They felt very well, they didn't feel useful because a lot of them are scripts, they're mnemonics. I'm particularly galled by anything that has e for empathy. Like, what am I supposed to do with that when I walk into the.
Like e I'm being empathic. Like, it just, it, it always felt very I don't know. It's like you listen to a lecture and they say like, be empathic. You're like, okay, that sounds good. But it just, it just didn't feel very useful. And so then, and I, I am on my own time learning these improv skills in parallel and starting to see like, whoa, wait a second.
I am learning these skills of listening and connection and what feels like empathy in this performance theatrical setting. This should be used in. Medical teaching and medical communication, medical practice. So it was very, it was gradual over a period of years [00:03:00] that, that, that came to
Jeremy: mind. Do you have any memories of a specific story of when it really clicked for you or where you saw improv helping fellow physicians improve their practice?
Belinda: One really common example, I, this is, okay, here's a good example because this one's evergreen. It comes up all the time, and improv very clearly helps in this. So one thing that we are taught in improv is, to accept the offer and build on it the yes and thing, and just breaking down any conversation into, or any interaction into something so simple as you have to say yes to the thing the person gave you and acknowledge that was their reality before you add something else and move on. That simple. Skill I see play out a lot when in, when you're speaking with [00:04:00] patients recommending a certain therapy or treatment and they are not interested in it.
And a, a common example would be vaccines. And this is long before covid, but there's always been understandably hesitation around vaccines. And so the flu vaccine is one that. I Feel very strongly about recommending in the past, and I would often see these encounters. Typically I remember this is, I remember specifically it was a med student.
Went to go see one of my patients and came outta the room and said, the patient is totally not interested in having a flu shot. I said, would you like a flu shot? And they said, no, absolutely not. I don't believe in them. So like, make me sicker. I was like, , okay, well that's really common. We actually get that response fairly often.
So, so I was like, okay, well we'll go back in the room and and talk to her again and to figure out the med student's meeting this patient for the first time. Like there's no knock on the med student at all. And , but I, and I've known this patient for [00:05:00] a long time, so I said, " Oh, I heard that you you talked about having a flu shot."
And my patient said, yeah, I'm not really interested in getting it today. You know, I've got a lot of concerns around it. And I said, oh, okay. Sounds like you're totally clear. You don't wanna have you don't wanna get a flu shot today. And you mentioned that you had concerns about it. I'd love to know what those concerns are and the patient's like, oh.
Well, I heard that it can cause, and you know, she started to explain all these things about what her concerns were, and then we had this whole conversation and at the end of it she's like, oh, great, I'll totally get my flu shot today. And the med student was like, what? You know, just . But for me, like the example was, I, I said it's like I'm not a wizard.
It, it's just a yes and principle as the patient said, I don't want it. And I said, you don't want it. I heard you and. , I'd love to hear more about your concerns. So it was just building on that which created a room for more of a conversation so that, that is like a classic
What would be like an example of an objection to explain why they don't want it and how you build on that or eventually turn it around?
Belinda: Sure. So one of the concerns if we're talking specifically about flu shots would be, let's see, now, concerned about a flu. Is that
Jeremy: or we could, we could even play this out like, do you want me to be a patient?
And you certainly can. I mean, I , this is the one thing improvisers actually get hired to do is to work with doctors and be difficult patients, right? Yeah. Okay. Dr. Fu, I don't want my flu shot cuz I feel like it's just gonna actually give me the flu instead of.
Belinda: Oh, Jeremy, thank you so much for sharing that concern with me.
You know, you're, you're concerned that if you get the flu shot, it would actually give you the flu. Is that, did I understand that correctly? That's
Jeremy: what the message boards say. Yeah.
Belinda: That's the message I'm say. Okay, cool. Thank you for sharing that with me. I would love to underst. your concern even more just to make sure that I'm giving you the correct information and supporting you and your healthcare choices.
[00:07:00] When we're talking about the flu, I wanna make sure we're talking about the same thing. What does the flu mean to you? Just getting
Jeremy: aches and pains and maybe even nauseated or cold symptoms. You know, all the stuff that the flu shot might. .
Belinda: Mm, okay, gotcha. So the flu to you in your mind means like a consolation of symptoms, ax, pains, nausea type thing, and those feel like the same side effects that the flu shot could potentially give you?
Is that right? Kinda the same thing. Okay. I'm so glad you explained that to me because it points out really what I think is a deficit. Our healthcare education for the general public, which is that the term flu is like common public vocabulary that's actually used kind of sloppy, and I'm guilty of that too.
It's used to mean a ton of different things, but the flu shot is actually. . It's really specific. It's only for influenza, which is one particular vaccine. [00:08:00] But when we talk about the flu, just in general, we're talking about, you know, stomach flu, which is not influenza or common cold, which are also not influenza or like all these other things.
And so we like muddied the waters. No wonder you're afraid of getting the flu from the flu shot because, , you would be afraid of getting like generic flu if it was like a generic flu shot. It's actually totally not. They're totally different things. So the influenza vaccine is really great for preventing influenza.
And cannot give you influenza just the way it's built. I have to talk about that. And so that's why there's just this confusion.
Jeremy: That seems like obviously the conversation might go on longer than that. How would you go forever? Yet I can hear how you're really empathizing and you are Yes. Ending and really connecting in a way that, and frankly in my experience in medicine, doctors don't always have time for, or the disposition for, and they just wanna like, Nope, you're wrong.
Sorry. I just. [00:09:00] Blocking, as we would say in improv. So you must be an awesome physician and, and yet you are not practicing medicine actively in the last year or so. Correct. You've kind transitioned into something new.
Belinda: So, I, my current clinical practice, I don't currently have my own panel of patients right now.
I, my clinical practice is in working as faculty in a residency program. So I continue to work with the residents, supervising their patient care, seeing patients with them, discussing their patients stuff. I just. I, I don't have appointments like 2 45 on Wednesday, so that kinda thing. Right now I'm in the supervisory clinical role and spending most of my time teaching.
I mean, I, I'd like to think I'm an okay doctor, but I mean, it's hard to say. It's not it's like you don't get like scores or points or something like that, which thank God. But I think one of the things I really learned because of improv. . It really helped me in my clinical care because sometimes you'd have these interactions that don't go well and you don't know why.
But with improv, I felt like it [00:10:00] really gave me these specific tools and insights to slow the conversation down. And it's true that we do not have time. The, the current American healthcare system is terrible. It's, I have so many. inappropriate words, to describe When I think about the healthcare system, and it's it's not good for patients, it's not good for doctors.
It's not good for the actual practice of medicine. What happens in the room, the human interaction, the healing it feels like the conversation we were starting to have feels like. , it could take a long time. And if someone's running a schedule and a budget and looking at dollar signs, they'll be like, don't spend that much time with the patient talking to them.
But if we slow down that moment and say, Hey, you are, I hear you and I hear your concerns. I'm, I have the opportunity to build a relationship with you and teach you something that empowers you and your health for the long term. And that's the real benefit. If we're just looking at it like, 15 minutes are up, you need to get outta here cuz we need to.
[00:11:00] see the next patient and like crank it through. Sure. Then I don't have time. I'll be like, oh, you don't want a flu shot? All right. Too bad. Bye. You know? Mm-hmm. , which is terrible. That's terrible care. Yeah. Yeah. But with improv, I can have this conversation, which I can dial up or down in terms of its length.
I was like going, going full in there, , . But I can have a much faster version of that conversation that, you know, lasts less than five minutes. Always worth it, whether or not they get a flu shot. What matters is that they have a better understanding of their health and their choices and their options.
So they're making it an informed decision rather than one that's based on incorrect information. And I feel like improv gives me the ability to have
Jeremy: that conversation. , and this is something that you're continuing to teach and share through keynote lectures, and you have this website, improv doc.
Can you tell us a bit more about the, the business you've created around this?
Belinda: Yeah. So like half of my time I spent doing teaching at U University of Washington and some of the affiliated residency [00:12:00] programs here. I teach specifically family medicine. The rest of the time is spent doing freelance work, teaching many of the different realms in which.
Communication and improvisation can improve the practice of medicine and general health and wellbeing. So a lot of the shape that tends to take is in doing either keynote presentations or workshops or designing courses at different institutions around the country and even internationally.
Sometimes sharing the many different ways in. Improvisation inspired and based work can be used to help different aspects, whether it's patient, physician communication, interprofessional communication. There's a ton of teamwork that happens in the practice of medicine. More specific niche areas, like difficult conversations, delivering bad news.
Unfortunately, we do a lot of that in medicine. General tolerance of uncertainty. How do we handle stress management for ourselves, for our students and learners or for our [00:13:00] patients? And a lot of work too in wellbeing and resilience, which has, especially over the last few years, become even more and more at the, for.
Jeremy: Yeah, just imagining what's at stake in your profession is humbling for somebody who's spent a career in the corporate world where it's rarely that urgent, but knowing sometimes , that you had a little bit lower stakes. But it's interesting how that plays into. The research also around imposter syndrome for me to sort of crowbar that topic in because I've been, as you know, you know, writing this book about it.
And an article that came out just in 2022 was about how the medical profession. Is one of the areas where imposter syndrome is most prevalent because there is this feeling that you always need to do more and contribute more, and maybe there's a savior complex mixed up in that as well, and that someone else is, is [00:14:00] always better at that.
Can you talk a little bit about how complicated you've seen that or experienced it at all in your.
Belinda: Absolutely. Yeah. The, and I wanna be specific that this is really western medicine as we, we know that we're, that we're speaking of. But yeah. The, this practice of western medicine as it's, as it's trained, has baked into it this culture of perfectionism and.
Rigidity. And of course it didn't. I, I, I think there's, if you go far enough back, it didn't start that way because Les was known. But for some reason, as the centuries have passed, the expectation is that well, really maybe because Les was known that you knew everything there was to be known. But that is absolutely impossible.
It is just quantifiably impossible for any one person to know all that there is to be known. But the expectation. You know, complete authority and knowledge and infallibility still exists. And [00:15:00] also in the training of the, the traditional western medicine training system there is this, unfortunately punitive culture and one that's shame based and intolerant of error.
And I'm sure there are medical historians who know far more about how it came to be. The, as the literature verifies what we know to be true, that is definitely the case where there's shame, there's guilt, there's perfectionism. And that's why you're, you're seeing that number, that statistic about imposter syndrome being so so prevalent.
Jeremy: Do you see anything in the tools of improv that can help you manage.
Belinda: Yeah, absolutely. Like for me personally, it's been this incredible rehabilitation practice of, of doing, of doing improv. So in improv right out of the right outta the gate, I remember learning from one of my early teachers, who's Matt Smith,
and he very early on taught us the failure. Ak the circus bow or Oh yeah. Ta-da. Or, yes. So you
Jeremy: [00:16:00] go ta-da. Yeah. I failed. I failed. I failed.
Belinda: Thank you, . Exactly. It was, it was so shocking to me because it's so antithetical to everything that I. Had internalized throughout my medical training, which is that if you mess up, you are, you know, deserving of scorn and inadequate and insufficient in every way.
You know here, every time you mess up, you're supposed to take a gigantic bow and everyone claps for you and you're supposed to celebrate that cuz that's an opportunity. That in itself is one of the most powerful life-changing things. That I've ever learned because, one was just the repetition of the training doing improv,
you alter your reflex so that my instinct when I make a mistake is not to self-flagellate, but simply to, I made a mistake and we move on. And I also learned over a time that I have a, I don't, I don't do you know, in the clinic, ah, took
Jeremy: off the wrong
Belinda: leg. Yeah, exactly. Woo. [00:17:00] You know, but I have learned to be able to acknowledge like, okay, I made a.
There's, there's this knee jerk reflex that's still always gonna be there of like, oh, you're not perfect. Oh, you messed up. And I have also cultivated all these other reflexes that say, and this is how you learn, and you acknowledge that you're, you made a mistake to the person and it does not define who you are.
And perfectionism is impossible. And so this, it's just given me this whole other way of existing and responding and being in the world that is so much more healthy and more realistic.
Jeremy: That's beautiful because the rigidity of responding to smaller mistakes could coil around itself to lead to bigger mistakes if you're so fixated and rigid in that way, as opposed to improv being more
Well, we are, what is the quote? We are what we repeatedly do or what is it? Something like that, right? That's, yeah. Mm-hmm. . And so in medicine, we pr [00:18:00] practice, unintentionally practice becoming ashamed of ourselves or hiding or feeling like an imposter. And in improv the antidote where we over and over and over again, practice failing and regarding that as growth and opportunity and development and constantly saying, come as you are.
You have everything you need. , you know, they, every, mistake is an opportunity and, leads to new things. Like that's, that's all the mantras of improv that's a great alternate philosophy
Jeremy: no matter how much I've heard them, it always helps me to remember them.
Oh yeah. You know, because the practice is another thing and yeah, we're never done, and that's what improv teaches us as.
Belinda: that we're never done, that we have to keep practicing. I, I, you know, I think that's wonderful. So now I'm just thinking about this. So in improv, we're always practicing. , even though our friends ask us, it's improv.
Why do you practice? But we're always
Jeremy: practicing presence is the practice, as I say. Yeah. Present. Yes.
Belinda: [00:19:00] And it was just in a wonderful session led by a colleague of mine on Kip Meta on, on uncertainty the uncertainty in medicine about sort of similar things that we're talking about right now.
And we were talking about how the medicine is practice as well. It's the practice of medicine, like you're never actually there. It's. , it's not a fixed endpoint or it's attainable. So both of these things are, are practices and the more we practice, the more we get better at whatever the deliberate practice we choose to do.
And so that intersection of taking an improvisational. A mindset which does cultivate that kind of resilient spirit and philosophy, has an effect on the practice of medicine, that it can make it feel better, honestly, because I think that the, the med practice of medicine need not have that destructive aspect to it.
It's unfortunate that it's developed that mm-hmm. and I feel that the practice of improvisation superimposed on the practice of medicine can kind of reclaim it for the, the [00:20:00] healthy experience that it could and should be.
Jeremy: Yes, absolutely. And I hope we get a chance to help you get your message out to more people who practice medicine, people who are patients.
So between those two groups, that's everyone . And in, in that light, where can people learn more about the work you're doing?
Belinda: Thank you for asking. There are a couple places my Own website is belinda fu.com. And I have a couple other sites that with which I'm affiliated, so improv doc.org which you can also get through my website is a a source for some references and resources and just general concepts about some of the things we were talking about improv and medicine, and then related, but different medical improv.org is specific to a course.
For medical educators, and that's anyone in the healthcare realm medicine being using. I'm using that in the broadest sense of the term. For educators in the healthcare realm who [00:21:00] would like to learn how to use improvisation as part of their teaching skills or their teaching toolkit. It's called Medical Improv Train the Trainer Workshop.
And it's run out of Northwestern with professor Katie Watson who. Learned medical improv from Once I got these ideas rolling in my head, I connected with her and together we launched this course based on a curriculum. She has been teaching for a very long time to medical students at Northwestern.
And so we hold this I'm able to teach at it still. It's about every year, depending on a pandemic or not , you find out information about that there. So improv doc.org, medical improv.org.
Jeremy: And Belinda food.com and belinda food.com . All right. We'll share the links to all of those in our show notes, and thank you so much for joining us, Belinda.
Belinda: you, Jeremy. It's really a treat.
Jeremy: We have a video highlight from that interview [00:22:00] [email protected]. You can find more information about Dr. Belinda Fu and her work at belindafu.com and improvdoc.org I also featured Belinda's story in my new book, the Accomplished Creative Overcome Imposter Syndrome, forge Courage, and Tap Into Limitless Creativity.
Now Available on Kindle in paperback, and as an audiobook on audible.com. For more information about the book, this podcast, or to connect with me, visit jeremyrichards.com.