Leading Beyond Survival: Swapping the Monkey Brain for Psychological Safety | Ep. 87 ft. Dr Luissa Kiprono

Joshua Seldin: Um, welcome everyone to the Leadership in Quarters podcast, the interview series where leaders come to share their perspectives on different leadership topics. Josh. I'm Josh Selden and Today's guest is Dr. Luisa Kay. Dr. Luisa Kiprono is a refugee from former communist Romania. High risk pregnancy physician, specialist, air Force veteran, founder and CEO of two enterprises, Telemed MFM and Dr. Luisa K Foundation. Through her telemedicine practice, Telemed MFM, she provides quality and equitable high risk pregnancy care to women beyond borders or geographical limitations. Over the past two decades, Dr. Caprono has emerged as a strong advocate for women in medicine and and leadership through one on one motivational development, speaking engagements, international humanitarian medical care and community service. Dr. Louisa K Foundation was born as a calling to empower women everywhere. Her own triumph over trauma inspired this movement for all women to join in self empowerment, intentional presence and resilience. Her recently published memoir and Amazon bestseller, Push Then Breathe, Trauma, Triumph and the M Making of an American doctor is based on Luisa's first 15 years of her reborn life here in America. In this book, she shares her shattering story of physical and emotional abuse, how she overcame her past, rebuilt her own future, and now is helping others in their own healing journey. Since 2019, Luisa has made San Antonio, Texas her home, where she lives with her family. She is an avid triathlete and ironman finisher who enjoys immersive travel and eclectic cooking. So welcome Dr. Luisa.

Dr. Luisa Kiprono: Thank you for having me. M. Josh, very much appreciate it.

Joshua Seldin: Very glad to have you here. A very impressive background and I'm very, very excited to see how all of that kind of builds into our episode today. And for everybody listening in, our episode will be about leading beyond survival. So I'm sure a lot of what we just heard and read will definitely impact our conversation. So let's start off if we can. A lot of times in the professional world, and I'd say in the world in general, a lot of people find themselves in this survival mode. And when you have leadership in this survival mode and everything's happening around them and it seems like everything is becoming an emergency and it becomes very high stakes, how does the leader know and how do they trigger or how does somebody trigger when they're leading through fear of this high stakes survival environment instead of really leading from their purpose?

Dr. Luisa Kiprono: It's a very cool question. As a physician, I'm gonna take just a moment there to just emphasize, um, this neuroscience behind this. So as we are gifted as humans to have our prefrontal cortex, which helps us make important Sometimes life saving decisions. But we also have our primitive brain, which is the posterior brain that really drives our fight or flight or freeze mechanism. That is the survival mode. And bear no mistake, the primitive brain always wins. It's a lot stronger, it's a lot more powerful. I think it's because it's a lot older. So think about this way. You are a cookout or a restaurant or in a meeting and somebody jabs a question at you and the question really grabbed you the wrong way. Maybe you're working on this project and did everything you could and you just didn't come off the right way. Or maybe you just have some personal issues, you know, family issue, whatever, health issues. So this person, of course, doesn't know any better, throws this at you and your first instinct is to just give a rebuttal. Okay? It's your, as I call it, it's your monkey brain, it's your primitive brain at work. And really the difference between how you react in that very moment as the knee jerk reflex versus taking a deep breath and leaving the space between the action and the reaction is actually what allows the prefrontal cortex to take over and be like, oh, wait a minute, we don't have to punch the guy or the girl. Take a deep breath. Let's just come across in a, uh, better, more civilized as we call it, reply. So same thing with survival mode leadership. It's reactive. It's not intentional. Decisions are made through urgency, scarcity, fear of failure instead of bringing together the mission, the values of what the company, the project, people around you are all about. So as a leader, when you operate constantly out of fear, what's happening? Instead of thinking, hey, how can we move through all these challenges and growing pains to really make this better, make this right? The leaders who act out of fear or the survival mode, it's always, okay, I'm doing this is anything that could go wrong, they're operating on the pressure like, of, oh my God, if I don't do this, everything is doom, everything's gonna fall apart. And really it's. Instead of relying on your actions, you should rely on the preparation. Okay, Just imagine like you're playing chess. You always should look and see. Okay, what's your next or two moves from an hour? Three moves for now, if my opponent goes one versus the other, how would I make my own move as opposed to reactionary?

Joshua Seldin: Is there anything somebody can do ahead of time? Like in that chess mode where you're being a little proactive and you're building the skill or in the moment to trigger that this primitive brain is starting to take over and you're starting to get into that fight or flight situation and whatever that trigger is allows you to actually stop and step back and take that breath. You discussed how does somebody either train themselves on that or trigger themselves in the moment to go do that?

Dr. Luisa Kiprono: It is a learned behavior. I really believe that because I practice and I've noticed through my life, my journey, my experiences that when for instance, and some people actually in my MBA school, we had exercises like how would you react or reply or act based on somebody's intention towards you? If they come towards you as a bully, they try to demean you. And one thing that they said to me is you're so collected, you are not reacting to what that person is doing. You're actually becoming calmer and more collected. And I really believe that by exercising it, because it's like we say, hey, you're giving me satisfaction, I'm pressing your buttons and you have to learn. And of course nothing is perfect. I personally sometimes fall trapped to that and I'm like, ah, uh, I should have known better. Or sometimes my husband says, this is how I would reply, but you're so much better than me. He says it's because I take this breath and in. Nowadays when you write an email, uh, when you write the text, always in my mind, I'm like, okay, whatever you put on that paper or on that electronic message, it's there. You can't take it back. So always I am on lookout. How I reply is how I pose myself. Because really, truly is we always can say something negative or derogatory. It takes powers and self control to be the better person. And I think that's important to remember that. Always keeping check. If you feel like the temperature is rising in the room, take a time out, have a glass of water or a bottle of water next to you, take a sip of water or say can, excuse me, I really need to step out to use the facilities, whatever that will bring you back to, okay, what am I doing here? Why did he react to me this way? How could I do better? So that's how I look at it. And I analyze, always analyze. If you don't feel that you did well in a um, situation or if you did very well, analyze both. And this way you get your neg negative reinforcement and say this next time I can do it this way. We have to do maybe the other way versus positive reinforcement. And you'd be surprised. The power of positive or negative reinforcement. If you Analyze them in the back end.

Joshua Seldin: Yeah. And a lot of people always focus on the negative. But there are so many lessons that you can learn from the positive. The positive outcome of the situation that you have. And I feel like there's so many other tools and tips that you touched on as well when you're in those situations. One to your point, once you type up and send an email, it's there, it's in writing. But what you'll find a lot of people do is they'll write the email. They'll just never send it. They get it out of their system. They get the frustration there. And then also, everything sounds really good in your head, but once you see it written on the paper, you're like, I really shouldn't send something like that. But at least it helps become that outlet, as opposed to somebody who just reacts in the moment, sends it, and then, as you said, has that moment where they're like, that wasn't good, and I can't do anything about that now.

Dr. Luisa Kiprono: That's a very good point. Or sleep over it. Just write it. I've done it on a number of occasions. Write an email. And I was like, all coming on hot. And then I said, you know what? I'm just gonna look at it in the morning. And I look in the morning, I'm like, oh, I don't think I like that email. Yep.

Joshua Seldin: Yeah. There's a quote, I think it was from Warren Buffett, who said, you can always tell somebody off tomorrow. And so that was the thought process. It's exactly that you said, you may want to do it today, but sleep on it. And if you really want to do it tomorrow after you've slept on it, then maybe it is the right thing to go. More times than not, you have the reaction that you just said, and you're like, no, I probably don't want to do that. I'm a little over it now that I've slept and calmed myself.

Dr. Luisa Kiprono: Yep.

Joshua Seldin: Yeah. So are there things that help enable those kind of reactions and those thought processes? And what I'm thinking is, does the environment that you find yourself in help enable those. When you have an environment of constant chaos, a, uh, suffocating workplace culture, everybody's on high alert all the time. Compared to, even in the chaos, a more calmer, psychologically safe environment, Definitely.

Dr. Luisa Kiprono: I really can't emphasize the importance of that. Have you ever. I'm sure you did. Walk in a room full of people and you feel the tension. It's palpable.

Joshua Seldin: Yes.

Dr. Luisa Kiprono: What is going on? I Think if someone would take. The temperature in the room will be like 5 degrees higher because you could feel like, whoa, I don't know what's going on in here, but it does not feel we going in. And things are a lot chiller. People seem to communicate. And I was in both kind of situations many times. Nothing really good comes out of those meetings. The initial ones, the first ones. The problem is that the whole makeup of that organization or the staff, the ancillary people, they all. It almost feels like they are walking to work, coming to work, but they really don't want to be there, whether. Because they know that, like you said, it's chaos. Nobody knows what they're doing. Everybody acts or works out of fear. There is no communication. There is a lot of drama. There is a lot of gossip. And I hate drama and I hate gossip. And it just gets me extremely tired. And what's the point? What are we going to accomplish out of this? It's almost hypervigilance because everybody is waiting for the other shoe to drop and everybody's afraid of the other person next to them. Um, how are they going to react and how are they going to be treated? I believe in a environment of learning as opposed to punishment. I believe in an environment of. I'm a huge of a communicator, and I believe, I wholeheartedly believe that almost all calamities, wars and genocides in this world throughout the history happened because of lack of communication. And everybody wanted to guess what this person is going to say or react and act on that feeling. Or, oh, I guess this is what they're going to do. Let me act on that. Let's see who is going to be first beating the other one when actually sitting down. You'd be surprised that just by talking and trying to figure out peacefully and proactively, you can avert so many crises. And it starts from family all the way to a nations. Think about it, right? To come home, you had a horrible day at work. Let's say somebody really ticked you off. You come home and instead of talking it over, you're like, the food sucks, it's cold, the dog is barking. Let me kick the dog, let me yell at the kids. And then to make things worse, you know what you're doing? Like, you know what? I am redirecting. And now you feel really bad, which in turn makes you ashamed. But also it makes you. I don't know, how am I going to tell my wife that I was just being a jerk about it because I had this at Work, but you don't want to. So you see how this all builds up when you can just sit down and say, I just had a crappy day at work. Can I just get a timeout? Go 5 minutes for a walk, 10 minutes for a walk, Let me just have my space.

Joshua Seldin: Yeah. And then it compounds because you're really transferring that energy as well. I'm going to come home and I had a bad day at work and I'm going to snap at my wife. And then now I've transferred this negative energy to her, now she has a negative energy and now it's just playing off of each other. So even once I calm down and I say, wow, I'm really projecting how I feel about my day here. Now I've ruined my wife's mood and now it's just a constant back and forth that normally ruins the rest of the night. Yep, I completely agree and I think you're exactly right. I think I used this in the last episode that we had. But there's a phrase that says the imagination is so much worse than reality. And I think that's what people do in any environment, whether it's home, M nation, work, wherever. Anytime I have to have a semi difficult conversation or any kind of conversation, I start playing it over in my head and I start making my own thoughts of what that person's going to say and then how I'm going to react to that, then how they're going to react to that. And I build up this entire show in my head of how it's going to go and then that's how I approach the conversation. I know approach it unbiased, open minded. I approach it already thinking I know what they're going to say. And now I'm going in defensive and I'm going in on the attack because I have to get them before they get me based on what I've thought.

Dr. Luisa Kiprono: You're already the knight in armor, all ready to roll.

Joshua Seldin: Exactly. We're ready for a fight. And they may just want to go into that conversation very innocently and wanting to have some kind of good outcome. And now it's a very tension filled environment.

Dr. Luisa Kiprono: I, um, agree. Totally agree.

Joshua Seldin: So with all of that, as we look at different workplace cultures, I think we've talked now those kind where you do have your psychologically safe, you have your high stakes survival mode environments. You also find workplace cultures that are maybe over the survival mode. They've gone through the rough patches, but it's built a culture now where, because I've gone Through it. Now that you're part of our group, Dr. Luisa, it's not fair for you not to have gone through something like that as well. And so because I've gone through pain, I feel like you should go through pain as well, because it's only fair. How do people get over those kind of environments and make it so I've gone through pain to make life for you easier as the next new set of people that are coming in, instead of thinking it's more of a rite of passage that you go through the same pain I go through through.

Dr. Luisa Kiprono: I have to tell you that as a physician, I have been through that kind of environment. So when you train as a medical student, but then you train as a resident, you have that toxic environment. And why is that? Because like you said, the culture is built on that idea. Hey, I used to work 247 and I've done all this, and I, uh, devoted and sacrificed my entire life and family and well being. Four patients and so much too. If you do anything less than that, I. E. Work an 80 hour work week, or instead of working 36 hour shifts now you worked 24 hour shifts. That's not good enough. You're just not the type of doctor that just goes through the snow, barefooted, uphill every single day of your life. And it's built on that. It's built that if we suffer, you must suffer so it can get tough. So otherwise you won't be good enough. And not only that, but also the. We were treated, for instance, in residencies. Very malignant. They used to be very malignant. They used to be. And some of them still are. They are very judgmental. Okay. Instead of taking a mistake or instead of taking a bad outcome, because let's be honest, Josh, bad outcomes will always happen.

Joshua Seldin: Yes.

Dr. Luisa Kiprono: There is no such a thing as a perfect world. I'm sorry, but I wish it was right. There was always going to be a bad outcome. And a lot of the times it's multifactorial. So instead of finding in the past used to be like, we have to find someone to blame.

Joshua Seldin: Yep.

Dr. Luisa Kiprono: Oh, look. You mean you didn't see that strip? This fetal heart rate tracing looked horrible. And my mentor used to say, yeah, hindsight is 20 20. Yeah. Now it looks like it was. But at that point in time, it didn't look at the bed. But now that we know after the fact that happened, now we can put it all two and two together. But that time didn't look that bad. So instead of glorifying unnecessary suffering. Okay, to me, it's like, why don't you take that and make a learning point instead of pointing fingers and say, hey, how can we do better? And that is why huddling started coming into place. Because now let's take a situation, figure it out. How could we do better next time? That is so much better overground from improvement. Because now those people involved are going to learn and build upon that experience as opposed to, oh, my God, now I'm just punished because I am humiliated of what happened. And I'm not going to say I'm just going to hide in shame. And next time I'm going to make sure that nobody finds out, as opposed to, hey, communicate. I tell to my nurse practitioners and my sonographers and my staff, I am expecting from you complete trust, and vice versa. I would much rather you come to me and say, I'm not sure if this is right. I think this is how would you go about it, Dr. Caprano, but let me just run this for you just to make sure, or I don't understand this process or whatever, because to me, I much rather you come and show your vulnerability. I wasn't born a doctor, and neither were you a nurse practitioner or a sonographer. So we all must learn and trust me, I'm not perfect. And if you come to me, we'll figure it out together, as opposed to you being afraid to talk to me, something really bad happens, and then I'll be able to trust you again. Does that make sense? But you have to develop. You have to nurture this culture. So my clinics are built on that. They know they can come to me with a question. And I will never say, oh, you're stupid, or Micah, uh, you don't know this. How come you don't understand? This is basic. You just cut yourself, your way of communication, because that person, you just made that person as low to the ground as possible. And what did you accomplish? Next time, she won't ask you or he won't ask you that question. So be okay to allow people to ask questions and also be humble to go and ask them a question that you may not have an answer for. For instance, you have something that is like, well, if I could go do this versus do this, what would be the better way? And you know how we get stuck into our trajectory of field? Our lens gets very narrow. And I have the habit to, when I get into this conundrum kind of situations, I just stop and ask one of my staff, hey, if you would have this kind of scenario, what would you do? And you would be surprised. Two things that you see a different perspective when you ask somebody else. And you know what they say, Actor, you are asking me, I am just your scheduler. I said yes, because I don't know everything. And I want this particular situation to go right, but I feel like I am biased when I look at it from only my angle. So yeah, simple things like that build such a healthy culture. Not a culture of fear or fear of reprehension, fear of punishment, fear of oh my God, I'm going to do bad now, I'm going to get fired. Although, uh, I didn't do it on purpose the first time. I just didn't know.

Joshua Seldin: And asking those questions from the leadership side, like you gave an example, builds that trust. And somebody told me this in the past. I work in manufacturing and there's a word, it doesn't seem like a bad word, but it's the word you use called just because. A lot of times somebody will try to bring something up, but they'll say, I'm just a technician in our manufacturing environment. Or like you said, I'm just a scheduler. I'm just a nurse practitioner. And being able to ask those questions starts belittling that word just because everybody who we work with is so much more than just whatever they're referring to themselves to. And you're now empowering and enabling them to realize that as you ask those questions.

Dr. Luisa Kiprono: No, you're so right. I have physician colleagues of mine. They are OBGYNs and I am a maternal fetal medicine specialist, which I'm specialist in the field of high risk pregnancies. And I hear it, I think once a month at least from one physician. I'm just obgyn. I said, no, you're not just an obgyn. You are an obgyn. And mind you, all this specialists in women health are uh, OB GYNs at the base because I could not be an MFM without being an OB GYN first. And they're like, wow, that's true. I said, yes, of course it's true. Don't put me on a pedestal just because I have three more years of training and it empowers them. And I want them to feel empowered. I don't want them to think they are beneath me because they're not.

Joshua Seldin: And um, imagine what things are hiding beneath the water surface. We think of the iceberg mentality. We can see what's above, we have no idea what's below. And if we don't build that trust with our organization to help show us what's below, what is hiding. You never know what's going to happen. And in my field, our machine may break down, we may not ship things to customers, but in the medical field, it could be so much worse. If you don't create this culture, if you don't build this trust and allow those people to say, Dr. Caprono, this is happening, knowing you're not going to go fly off the handle and reprimand them for it, you turn it into what you said, a learning environment, a learning activity, so you can go put a system in place so somebody else doesn't run into the same thing.

Dr. Luisa Kiprono: And also, if I may add, is flexibility. A lot of our leaders think that, okay, we're going to go all out to this, and nobody asks the magic question, so what if it doesn't work? Oh, my God, it's doom and gloom. No, it's not. Give it three months, give it six months if it doesn't work. And I said it a lot of times to my staff, I'm like, if it doesn't work, we're going to switch gears and do something else. But if we don't try, we'll never know, will we?

Joshua Seldin: Not the end of the world, it's not. And you're exactly right. Everybody is so afraid to make a decision and move forward because they're so afraid of failure and they don't understand we can pivot. And you'll never know what does work and what doesn't work if you don't try. But for whatever reason, and I think it goes back to everything you said about this environment and this culture of trust and learning. If you don't build that, people won't try to step outside the box, try these new things and move forward where you may fail, it may not work. But then, as you said, you're just going to try something else.

Dr. Luisa Kiprono: Right.

Joshua Seldin: And it all comes back to building that organizational safety that we've really talked about. I think that's extremely important, regardless of what field you're in.

Dr. Luisa Kiprono: Yeah, that. I completely agree with that.

Joshua Seldin: Yeah. So how, in your experience and in your opinion, we've talked about a lot of great things that we can go and do, and I think as the generations have changed, you've got people who are more maybe, uh, as your example in the medical field, they're ingrained in what they've gone through and how the old days were. And I worked all these hours, all these days when you need to make this mindset shift we've discussed, do we expect the people who are ingrained in the old days to be able to make that shift or is it more waiting for the newcomers to come through to really change that culture?

Dr. Luisa Kiprono: I think it's a mix and I will say some people you just can't change. There's such a hardliners. But I believe a great organization has to have a couple of paramount structure items. One is a mix of people and we really practice, let's say take the medical practice. You should have people who just come out of residency, out of training or fellowship. You should have people who are boarded to serve as mentors. And then also you should have people who are later on in their career because they have a lot of experience, but also because it can help the younger generation, can help with the changes in the medical guidelines as opposed to getting stuck. As we get older, if we don't keep up with the literature and the academia type data, what's going to happen is we start doing things to make us feel good and make us feel safe. Or I always said, are you treating the patient or are you treating yourself? Because are you giving an assessment and a plan just because you are afraid something may happen? Is it your protection blanket or are you following evidence based guidelines? Because you should always do that and as we get older we run that risk. That's why fresh blood. As I say it, it's always good to have a mix of people because some of them would be like, yeah, this young fellow looks like it's no and it's bringing more to the table than meets the eye. The second is that organizations forget to have a secession plan. Somebody comes in, becomes the CEO or the chairman and they just can stay there. And to me, we got to smooth the cheese every so often and have a plan. Three years into the making, let's say after five years, after seven years, this leader should be like, it's time for me to start grooming the next person or the next persons. In this way, people, the company or the practice won't just start from scratch. If something happens to me where I walk away, I don't know if it's vanity, if it's pride, if it's fear of letting go. But when I started learning about leadership and this was one of the things, you know what, it makes sense. You don't just, okay, I uh, don't know everything. And God forbid I have to step away for any type of reasons. There's nobody to take the helm because nobody's prepared, because I kept everything like a little secret that, oh God, Nobody should know how I'm doing things. So I don't agree with that kind of this again, archaic, old despotic. And God knows I come from a communist regime. Don't like that. Didn't work very well. So thriving organizations really, they demonstrate trust, adaptability, innovation and sustainability. And people collaborate. You must collaborate. Instead of competing, speak up are allowed to speak up and without fear of reprimand. And they should be engaged even in difficult situation situation. So when you have something that doesn't work and is breaking down, you're like, okay, what? Is everybody okay? I guess I'm the only one left because everybody's afraid of the backlash. So thriving, in my opinion, is not the absence of challenges, is the presence of how you deal with it. You're resilient. You learn from your prior mistakes or priorities, challenges. And now you apply because as we all know, we have to grow through adversity. We just don't like, oh God, I am going to endure it because I'm tough.

Joshua Seldin: I think that makes a lot of sense. I do want to thank you for everything that we've been able to talk through today. I'll remind all the listeners that this was Dr. Luisa Caprono. And if you want to learn anything about her, I'll have her information in the description of the podcast. And you can like follow and subscribe to the podcast and all the podcast platforms to my Instagram, YouTube and TikTok at leading quarters. And you can email me with any questions you have for myself or Dr. Louisa@leadencortersmail.com and if you want to get in touch, we can get you all in touch as well. But I do truly appreciate everything that you shared. I think a lot of people feel like they're in survival mode and getting a, uh, glimpse into how to lead beyond the survival mode and through it that you gave us today will be invaluable to all the listeners. So thank you so much.

Dr. Luisa Kiprono: Thank you, Josh. Appreciate you. Sa mhm.