Two Award-Winning ED Residents

We’re all familiar with the stereotype — overworked and exhausted medical residents with little time for outside interests, let alone serious artistic pursuits.

But Drs. Diksha Mishra and Cleavon Gilman, third-year residents in emergency medicine at NewYork-Presbyterian Hospital, defy simple categorization. The pair, which has so much and so little in common, won awards in this year’s Expression of Clinician Well-Being contest, sponsored by The National Academy of Medicine (NAM). Dr. Mishra, a resident at NewYork-Presbyterian/Weill Cornell Medical Center, won for her video: “Echo — The Reason We Breathe.” And Dr. Gilman, a resident at NewYork-Presbyterian/ Columbia University Irving Medical Center, won for his video: “Rise Up Now.” Both deal with physician burnout and well-being. Health Matters spoke with them about their respective roads to music — and medicine.

Dr. Gilman: I was born with a stutter. But, luckily, when I was 12, my mom won tickets from Hot 97 Radio to LL Cool J’s camp in upstate New York for inner-city kids, where I was exposed to rap music. I quickly learned that if I rhymed over an instrumental or beat-box [mimics drums with his mouth], it inhibited my stutter. After that summer, I began transcribing rap songs from the radio. One day, I was in class and one of my friends said, “I’ll pay $5 for the lyrics to ‘Mass Appeal’ from Gang Starr,” which only increased — and incentivized — my passion. After transcribing 30-plus songs, I began to notice lyrical patterns, which allowed me to create my own songs.

Dr. Mishra: I grew up with a stammer, so I didn’t talk for years. My dancing started from that — because I couldn’t communicate, and you need an outlet for your anxiety and your stress. It’s really interesting and fantastic that Cleavon and I ended up here in the same residency.

I didn’t grow up having friends. I hung out with my mom, who with my dad is an immigrant from India, and I would talk to my mom — little as I could — and my family. We watched Bollywood movies. We read books. I didn’t want to meet new people because what if they asked me my name — I can’t say my name! (I still can’t say my name.) So I just didn’t talk.

My mom and dad would take me to watch shows at the temple near our home in Pittsburgh where people were dancing, and that was always my thing. I would practice and do moves in my room. Then I started sharing it with other people because I decided, “Let’s just be comfortable in our own skin and do everything.”

Dr. Gilman: When I was 19 and in boot camp, I lost my stepfather to a heroin overdose. Since then, opiates continue to destroy members of my family. “Rise Up Now” captures my powerlessness and personal loss to the heroin epidemic, both as a son and a physician. My song allows loved ones and the general public a glimpse into the daily hardships physicians face, in a way that a casual response to “How was your day?” simply can’t encapsulate.

I was a Marine medic in Iraq in 2004. I worked in a trauma unit, and treated battlefield casualties in our small makeshift hospital. As physicians, we learn to compartmentalize our emotions in high-stress environments in order to provide better patient care. It should come as no surprise that countless tears are shed. When I revisit these experiences — spending countless hours writing a song that draws upon my experiences from childhood, or working as a combat medic in Iraq or my residency — it takes an emotional toll. Writing music is how I reflect and make sense of the world. When I started, I wanted to eventually get to a point where I could talk about social issues like gun violence, abuse at home, physician grief. At the time my stepdad died, I couldn’t do it because I didn’t have the knowledge yet to create a good song.

When I write a social song, I usually cry. If I don’t shed a tear, it’s not worth it. I did everything for “Rise Up Now”: I found the pictures, I put them together and then I transcribed and edited the video.

Dr. Mishra: [My cast for “Echo — The Reason We Breathe”] was basically all of the faculty and staff at my medical school, Drexel University: the dean of our school, fellow medical school students, the cafeteria workers, security. At least 60 people. I believe people, especially physicians, should feel comfortable being uncomfortable and silly together – making mistakes together; learning together. I said, “Let’s do it! It’ll be a lot of fun,” and before I knew it everyone was involved and excited. It was so cool that so many people stepped out of their comfort zones to be a part of it. Whenever I would have time between rotations, surgeries or during my lunch break, I’d be running around. Filming took a few months, because of schedules. Making it was a year.

Dr. Mishra: I started off in journalism because I wanted to hear and share people’s stories, understand where they came from, see what uniquely made them who they are. But then I loved brain behavior and neuroscience, as well, and wanted to be a doctor, too. In the past I’d say, “I want to be a journalist or a doctor,” and people would say, “But you can’t talk. You can’t even say the word doctor.” That definitely left an impact and made me want to do whatever I could to reach my goals.

Dr. Gilman: In high school, I was on the wrong path. I was going toward a life of crime and drugs. I would try to get a job, but because of my speech impediment, how I look … I didn’t know how to tie a tie; I didn’t have clothes for an interview. I tried to get a job pushing shopping carts and I wouldn’t get hired. I tried to get a job as a cashier.

One day I was carrying the plates from my car, and this police officer pulled me over. I’m like, I know what this looks like. I’m hanging in the street and there’s a sign: Join the Navy. And I was like, “Man, let me get the @#&^ outta here before I get locked up.” I joined the next day. I took the exam, and I scored high. They said you can be anything you want to be. So, I was like, Well, I want to work in a hospital.

Dr. Gilman: We are a dual-campus program, which means sometimes you’re doing three, four shifts in a row. It’s challenging. You have to make sure you get sleep. On days off, I do my music. I go to the gym. I’m also a very open person. If I’m having a bad day, I’m like, “Look, I had a hard situation with this patient; she passed on me.” I cry after I lose a patient. That’s like a hit on me. I’m like, “Oh my god, Cleave, you got to hit the books more.” I take it personally.

I do not sit down. I move all day long for 12 hours. You get notifications when sick patients are brought in. You try to stabilize them very quickly. You give them I.V. fluids, and antibiotics. You’re just moving around all the time. But it’s great. I love it. You’re the face of the hospital. A lot of people don’t look at it like that, but when you walk into the emergency room, you’re the hospital’s gatekeeper.

Dr. Mishra: Working in the ED is definitely challenging because you have to be comfortable with being uncomfortable — but that’s also why I love it. Growing up, the uncomfortable made me anxious, but now, I’ve discovered how to thrive in it. You’re not going to always know what’s coming through your door. You’re not always going to be able to be the hero and help them or save them all. And that’s okay, as long as you’re aware of the tools you have and are lacking, you continually keep an open mind and learn and you try your best.

My job allows me to feel very close to people and society in the sense that there’s a person who’s out there going about their daily life, something happens, and they need somebody to take care of them. They can literally walk into the ED and we will take care of them. It’s bare-bones medicine. It’s from square one. It’s phenomenal.

Dr. Gilman: During a theme day on rashes, I made a song called “SICCC GERMS,” which is a mnemonic for vesicular rashes in children, to help residents prepare for the emergency medicine boards. A few weeks later, one of our attendings, Dr. Rama Rao, a toxicologist, urged me to submit a song to the National Academy of Medicine Action Collaborative on Clinician Well-Being and Resilience. I decided to write “Rise Up Now.” When I won, they invited me to speak about the song at the National Academy of Medicine. I’m a first-generation college student, so at the time I didn’t realize what an achievement this was. It was such a wonderful experience.

Dr. Mishra: I was actually traveling in Norway, and I happened to check my emails. I saw it and thought, “Oh, this is from NAM.” My piece is close to my heart but it is also very silly. However, they wrote that my piece was thoughtful, and I was invited to come to the conference. It made me so happy that my video got to be a part of such an important cause and conference.

Dr. Mishra: I want to do a lot in education and public health. In an ideal world, I would be working some clinical shifts as a physician, teaching some classes, helping create resident curriculum/programs on the new future of physicians, do some global women’s health and public health work. That’s one of the biggest reasons why I came [to NewYork-Presbyterian], because education and community are a big thing here.

And I want to dance. I want to make people dance. Everyone dance! I’ve done a couple of sessions at NewYork-Presbyterian Morgan Stanley Children’s Hospital, holding dance groups with the patients. Even if the kids can’t get up from their wheelchairs, they can still move their hands. I’m hoping to do more as my schedule allows.

Dr. Gilman: Looking forward, I’m going to continue to create medicine-related hip-hop songs, which I hope will ultimately get high school and college students interested in medicine. I want to create a new genre of hip-hop — I call it scholar rap. Hip-hop is like poetry. It’s a way of telling a story in a fun way; getting a large amount of information in a three-minute period that’s engaging. I also want to expose people to issues that physicians face on a daily basis such as burnout, gun violence, grief, overdoses. You make a song, a video, and you put your heart into it, and for other people to connect with the music is just great. I do this to get a point across and they are able to receive it. It’s the greatest honor.

* This interview has been edited and condensed.