Melanie Cole, MS (Host): Welcome to Better Edge, a Northwestern Medicine podcast for physicians. I'm Melanie Cole. And we have a two-part series for you highlighting women in physiatry. And today, this is part one, we're discussing women in mentorship roles. Joining me is Dr. Larissa Pavone, she's a pediatric physiatrist and Chief Medical Officer at Marianjoy Rehabilitation Hospital;and Dr. Mary Keen, she's a Pediatric Physical Medicine and Rehabilitation Specialist at Northwestern Medicine Marianjoy Rehabilitation Hospital.

Doctors, thank you so much for joining us for this two-part series, and I think it's such a great topic, women in physiatry, and specifically today's women in mentorship roles. Dr. Keen, I'd like to start with you and how did your mentorship relationship begin, and what role has it played in your professional journey within PM&R?

Mary Keen, MD: Well, I have been doing PM&R for a very long time. I did my residency from 1980 to 1983. And back then, women were a minority in medicine. They were a minority in PM&R. When I started medical school, women physicians made up 10% of the class. When I graduated, we were up to 25% of the class. Now, women are 55% or so. So, the position of women and access to women mentors has changed dramatically over the last 30 to 40 years. I personally had a hard time finding a mentor. And it's interesting that the mentorship relationship can go both ways. That's the most exciting and fun thing that I've discovered about a mentorship relationship.

Melanie Cole, MS: Thank you so much for sharing that, and it's certainly true that it can go both ways where we all learn from each other. And Dr. Pavone, what about you? How did your mentorship relationship begin, and what role has it played in your professional journey?

Larissa Pavone, MD: So, I would say Dr. Keen was my mentor from the moment I met her. I had trained in the city and knew that Dr. Keen was out here in the western suburbs, because her reputation preceded her. And the minute I was connected with her, she started acting like a mentor to me. And it's looked so many different ways through the years. We've been together as partners for-- I think it's our 13th year together. And I don't think I would be where-- well, I know I wouldn't be where I am without the relationship that we've had. I would say, in every aspect of my life, as clinical as well as personal, it's always been nice to have someone to turn to through every step of my development as an attending physician.

And I think it's appropriate to mention that, when you gave my title, one of my more recent titles, I didn't give it to you yet, but I'm now the Chief Medical Officer at Marianjoy, and I don't believe that would've happened without having Dr. Keen next to me as a mentor and cheerleader throughout my years here.

Melanie Cole, MS: Wow. Congratulations. That's excellent. And I do love to hear about the mentorship between women and how much we all learn from each other. So, Dr. Pavone, can you share a moment when your mentor's guidance when Dr. Keen's guidance really helped you through a clinical or career-related challenge?

Larissa Pavone, MD: There's too many moments to count. But I would say some of the moments are the day to day. I've realized being a program director and mentoring younger residents or people who are newer in their career, that mentorship takes many different forms. And for me, Dr. Keen has been that mentor that's just next to me every step of the way. It started first with patient care. We in physiatry and pediatric physiatry, we have textbooks, but there's so much that we learn from clinical practice. And I guess the art side of medicine that you can't replace by what you learn in school.

And Dr. Keen, when all of those questions came up, had some more years of practice under her belt who was really able to mentor and guide me. I have called her at every hour of the day and night, I would say. When I was first in inpatient attending, there were several nights that I've called her. I would say between the hours of 1:00 and 3:00 AM panicked or not panicked, just with a question. And she's always been there to pick up the phone and guide me through something. And I think that type of mentorship is just so important, to have someone you know is there for you at any time. And just even to be able to have a mentor and friend that you can call at 1:00 and 2:00 in the morning, and you don't have to feel bad about it, because you know they're there and ready to help you.

Melanie Cole, MS: I love to hear that. And Dr. Keen, through all of this and what Dr. Pavone is saying about you, what's one piece of memorable advice you've shared with Dr. Pavone that still resonates today, do you think?

Mary Keen, MD: One of the most important things I learned after 15 or 20 years in practice, I learned it very late, was how important it is and valuable it is to take my own birthday off for R&R, but I also take off my spouse's birthdays and my children's birthdays in order to let them know how important they are and for me to enjoy them and reinforce our relationship. I think that has been the most important and consistent piece of advice I've given to anybody that I've mentored. Because especially in medicine, the patient always comes first. We can't argue about that fact. That's why we need to set aside time specifically for ourselves and for our families. So, that I think is the most important piece of advice.

The other thing I want to mention about Dr. Pavone is there were about 20 years before she came here that I was on call 24 hours a day. So, I would be getting calls and then the night all the time. And after she arrived, we shared the load. So, my life was so much better.

Melanie Cole, MS: Well, I'm so glad you brought up the balance aspect. Because as women in these fields, we have to have that balance, and we certainly, as you say, Dr. Keen, have to take care of ourselves or we can't take care of our patients or our loved ones. So, that's really such an important point, and I'd like to ask you both the next question. So, Dr. Keen, starting with you. Why do you think mentorship is especially important and in PM&R specifically, and I'm going to add in women in mentorship roles?

Mary Keen, MD: PM&R is an incredibly wonderful specialty. We have such a variety of patients that we can care for, even just in pediatrics. We have a tremendous variety of patients that we care for. We are challenged every day. But in pediatrics, we don't just have a patient, we have a family, and dealing with a family who is going through a journey, in our case, most often learning not only about a child, but a child who has challenges, learning what the journey is going to like, seeking support for the journey. It requires additional dimension of care, in my opinion, which is absolutely necessary for our patient's development as well as for the family's ongoing development.

 What I'm trying to describe is pediatrics is an extremely rewarding part of PM&R. Just as in regular pediatrics, it's women who more often go into pediatric PM&R. It's not only, but it's women in particular. And maintaining healthy boundaries while at the same time providing our patients and families with what they need in very challenging circumstances can be also another very challenging balancing act.

Larissa Pavone, MD: I would say that's definitely something Dr. Keen talked about, the journey, and going on the journey with the families. And in addition to taking off, I'm not always good about taking off my birthday, but I try to. But taking off my spouse's and my children's birthday, I think was an invaluable piece of advice that she gave me and that I pass on to younger physicians all the time. I think it's really important to do that, and then to go on the journey with families. There's times in our specialty where we don't have a diagnosis or we're not sure what's going to happen next or maybe we can't do something, which I think as a physician is very hard at times when there's nothing really for you to do, like, there's not a medicine to prescribe or an order to write. And Dr. Keen gave me the advice of just go on the journey with the family. And really, I think what that has meant to me is just being there for that child and that family during that challenging time and truly, as she said, going on the journey with them. And I think that's a really important piece of advice that she gave me.

Melanie Cole, MS: I thank you both. And before we wrap up, i'd like to ask you each for a final thought. And Dr. Pavone starting with you, as you found Dr. Keen and she was this great mentor for you, what advice would you give women physicians who are looking to find a mentor or to become one themselves, but also for that balance that you've learned from Dr. Keen about balancing being a physician in this challenging role of pediatric PM&R and, as you say, the journeys with the families and sometimes in very difficult situations? What advice would you like to give women?

Larissa Pavone, MD: I think one would be when you're looking at your career and where you're going to work and your future. I think it's important to look at who your partners are going to be. I've been so fortunate that not only has Dr. Keen been my mentor, but she's been my partner in work every day, and so next to me every day, and also a friend to me.

So, I think when you're looking at your job, depending on the type of person you are, and if you're listening to podcast, you probably think mentorship is important, you're going to wanna look at a path where there's people who can be your mentor. If you do plan to work independently or in a smaller practice where there might not be as many people around, looking to our national organizations within the physiatry world because they do have a lot of really great resources for women to find mentorship.

Melanie Cole, MS: Dr. Keen, last word to you. What advice would you like to give women physicians who are looking for that balance that you brought up and how to find a mentor, or if they've been in the business a while as you have, and they are the expert as you are, how to be a mentor?

Mary Keen, MD: Well, I want to reinforce the idea I believe that Dr. Pavone suggested that, yes, it's wonderful to have a mentor who shares a specialty like Dr. Pavone and I do, but there were years where I really didn't have a PM&R mentor. I've learned so much from chaplains who have worked with us, spiritual care providers at Marianjoy from psychologists and from Child Life.

 As members of a team, we in PM&R have access to individuals who have strengths that are very different from our ideas that can be complimentary and helpful. So, I have also had valuable mentoring opportunities with women in management and with women who are members of our team.

Look around. I recommend that everybody look around. There are probably more mentors that we have that we aren't even really aware of.

Melanie Cole, MS: Thank you both for joining us today and sharing your relationship and the importance of women in mentorship roles in PM&R. And thank you again. And listeners, please be sure to check out part two of this series on women in physiatry, where we discuss the evolution of women in physiatry.

To refer your patients or for more information, please visit our website at breakthroughsforphysicians.nm.org/rehabilitation to get connected with one of our providers. That concludes this episode of Better Edge, a Northwestern Medicine Podcast for physicians. I'm Melanie Cole.