[00:00:00] Christine Ko: Welcome back to SEE HEAR FEEL. Today, I have the pleasure of speaking with Dr. Thomas Helm. Dr. Thomas Helm has been Chair of the Department of Dermatology since 2017 and Director of Dermatopathology at Buffalo Medical Group since 1994. He received his MD from Albany Medical College and his BS from Rensselaer Polytechnic Institute. He is the author or co-author of more than 20 textbook chapters and 160-plus peer-reviewed scientific publications. He has received numerous awards for teaching excellence and is dedicated to service, including in medical missions, as well as for the American Society of Dermatopathology, of which he is a past president. Welcome to Tom.
[00:00:41] Thomas Helm: Hi Christine. Thanks for having me.
[00:00:44] Christine Ko: Would you share a personal anecdote about yourself?
[00:00:46] Thomas Helm: Sure. I remember being age eight and my dad thought that my brother and I were getting too Americanized. So he signed us up to go to "Boy Scouts of Austria", which is the Boy Scouts of Austria. So my brother and I found ourselves in the Alps at a camp, segregated by age group. So I was sharing a tent with another boy, and this was really not well supervised at all. One of the kids actually had throwing knives. And in the evening after dinner, the kids would take off their hiking boots and see how close to the other person's foot could you throw these throwing knives? I remember thinking, Oh my gosh, what have I gotten into? What is this? Luckily my brother, who my parents had said, Check on, your little brother, came by, said, What are you idiots doing? It broke up. I didn't have to do anything. And I remember being so relieved, but I also remember learning how susceptible I was to peer pressure.
[00:01:38] Christine Ko: Oh, that's a nice story. Siblings are awesome.
[00:01:41] Thomas Helm: Yep. I agree. I think it's really important that you have healthy relationships. And then you also have to have the ability to appreciate another person's perspective. I think some people can have a lot of emotional intelligence but lack in empathy, I see influencers and politicians that I think are very good at understanding other people's emotion. And they can regulate their message. They can do it in such a way that it can influence how other people respond, in a manipulative way, and I'm very sensitive to that cause I think some of the things happening in our country are problematic.
[00:02:16] Christine Ko: Yeah. I have always thought that about emotional intelligence that when you, if you really know how other people feel, that it can maybe start to border on a little bit of the manipulative if you're trying to control them.
[00:02:28] Thomas Helm: Yeah. I really admired Wilma Bergfeld. She was one of my mentors at Cleveland Clinic. I was her dermpath fellow the year she was President of the American Academy of Dermatology. So we had a really close relationship. She was at an important point in her career. And nonetheless, I saw how she interacted with her kids. Her husband is a busy orthopedic surgeon, and I saw the demands on her life. I was really impressed with her priorities and the authentic relationship she had with her fellows. opportunity to really get close to her set the trajectory for my career. With my wife being a physician as well, I had the opportunity to really firsthand consider the other person's position. Why should it be about my career? Why not advance my wife's career? And I think the two of us have actually gone through different phases. Many times people talk about a linear progression, and I really haven't found that to be the case in my life. At some point one of us is making some compromises so that the other person can maybe advance some of their dreams and ideas.
[00:03:31] Christine Ko: I really like that. My husband's a physician. It's not easy.
[00:03:35] Thomas Helm: It's not easy, and that's where I think the priority setting is so important. One thing for me, my wife and I both attend a nondenominational church, and we have gone on medical missions together. That's really been a great chance for us to work together on a common goal, and our kids have all been involved with that. What my wife and I have found is that really focusing on the strength of our marriage is actually one of the best things you can do for your kids. And that's something I didn't realize earlier.
[00:04:02] Christine Ko: Wow. Yes. I think that's true.
[00:04:04] Thomas Helm: I'm gonna say how important aunts and uncles are. You mentioned you're close to your sister. I actually found that my kids liked talking to their aunts and uncles at various points to get different perspectives. It was a safe space where someone else with unconditional love could step in where they didn't wanna hear it from their parents.
[00:04:23] Christine Ko: Absolutely. You said it's sort of like an up down. How do you navigate the two careers and the family, and does emotional intelligence have a role in that?
[00:04:33] Thomas Helm: It absolutely does. And I think one book that actually helped me a lot was Gary Chapman's Love Languages. Have you heard about that book?
[00:04:42] Christine Ko: I have heard about that, but can you explain it?
[00:04:45] Thomas Helm: There are basically five ways that Chapman discusses people can experience love. So one is words of affirmation. You're encouraging, you're saying, Great job. I'm so proud of you. Another is physical touch. Your kid comes home from school, you give 'em a hug. Receiving gifts, that can be something. You think about their birthday, you remember the anniversary, you have a dozen roses there waiting with a nice lobster dinner or something. Quality time is another one where some people just want to hang out and be with you. And then another's acts of service. And I think early on in my marriage, I thought my wife knew how much I loved her, and I would give her gifts, but she really didn't care for them so much. She's an acts of service person, so if I vacuum the house, I do the dishes, and I can pick up the stuff from dry cleaning when she has a late day, that's what she wants. And it took me a while to figure that out. So me giving her a hug, giving her a gift, that wasn't the main thing.
[00:05:39] And then with my son, it was really about quality time. I remember it was like a shot to the heart when he was 12. I asked him, What do you want for Christmas? I was expecting, new snowboard, mountain bike, something like that. He's like, Dad, can you spend some more time with me? I was like, Oh my gosh. It was a big a big switch for me and I actually made changes. That's when I moved more into the dermpath here. As you and I know you can do a lot with dermpath but it's kind of like your time. If I need to take a break or I want to go to school and see a play or watch a sporting event, you can do it. But if you've got patients lined up, there's no way out.
[00:06:15] Christine Ko: Yeah.
[00:06:16] Thomas Helm: I make sure that each of the kids: we speak their love language.
[00:06:20] Christine Ko: I love that. I knew about that book and I haven't really thought about what my kids love language is. I should think about that.
[00:06:26] Thomas Helm: Well, you know, you could actually often tell someone's love language by what they do for you.
[00:06:30] Christine Ko: Yeah.
[00:06:31] Thomas Helm: If someone's super good about remembering your birthday, that's probably what they want back. You can see, too, perhaps, with some of your colleagues, words of affirmation. They're knowing what you're doing. They're there with those words of affirmation.
[00:06:43] Christine Ko: That's really good advice too, to see how people treat you. You do get a certain amount of insight into what's valuable to them, by the way that they are acting and treating you. That's true too.
[00:06:56] What do you wish you had known earlier in your career?
[00:06:59] Thomas Helm: I think I wish I would've been more patient. Early on I was saying yes to everything, and that is not a winning formula. I think you really have to prioritize. I think you should have confidence in your abilities and what you offer. I had a little bit of a scarcity model rather than the win-win model in the very beginning. I wish I would've adopted a more open and flexible mindset early. I really worked hard, tried to build a work culture with really exceptional people that are all aligned in terms of the culture to serve patients well and do a great job.
[00:07:37] Christine Ko: When you're talking about culture right now, it reminded me of your story of when you were sent to Austria by your dad saying, Oh, you're becoming too American. And so you experience the Austrian culture and that probably helps you also to be more flexible, and emotionally intelligent, because you have a recognition that there can be different perspectives.
[00:08:00] Thomas Helm: My wife was born in Taiwan. She's Chinese American, and I got her perspective. My wife immigrated at age nine, right? She was more comfortable in that outsider role and she was very confident in her principles.
[00:08:15] I think in derm training we have the perfectionistic mindset; kids that can't handle getting a B or some other problem. They view it as catastrophic, where really it's inconsequential in a lot of ways. And again, people breaking down if a patient isn't fully satisfied. Wilma gave a talk at the American Dermatologic Association, and she talked about grit as being one of her key attributes, and I really believe that. In some ways we're undermining grit. It's okay to not have the best project. The main thing is put in the best effort.
[00:08:48] Christine Ko: I would say: Really to emphasize the process, to not have such a perfectionistic mindset. To just really be more appreciative and more seeking of growth, and to appreciate a challenge instead of feeling that it makes me bad, like a bad doctor or a bad student.
[00:09:08] Thomas Helm: That's my role as Chair of our Department here in Buffalo Medical Group. I really do try to align all the different subcultures in the department. We're all trying to do the best thing for patients.
[00:09:20] Christine Ko: That's great. You had also mentioned your career right now is not really what you had imagined. How is it different?
[00:09:29] Thomas Helm: I was originally thinking that I was gonna work at the university. I work at a physician-owned multispecialty group. My sister has MS that's debilitating. And actually for 13 years, I had my mom living next door to me. I actually had both mother-in-laws living next door to me. So I've been in a caretaker role. To me it was important to be able to have that caretaker role, too. So I needed a certain amount of flexibility and stability. I wasn't gonna be moving around.
[00:09:55] Christine Ko: I find you inspirational. It sounds like you have an awesome work culture, something for us to aspire to.
[00:10:02] Do you have any final thoughts?
[00:10:04] Thomas Helm: I just heard Jack Resneck speak. And Jack, as President of the AMA, and he's a dermatologist, he left us with a thought, and I'm gonna quote directly from Jack. "The happiest, most satisfied physicians work in mission driven environments among colleagues and staff with shared values where they can use their skills to serve the needs of patients and communities by improving health." And I think my situation allows me that, and what I would recommend to any young trainees listening, Look at the culture. Look at a place where there are shared values. You want the mentors and the people ahead of you to be people that you can admire in terms of not just their professional choices, but their personal choices, their integrity, who they are. The best kind of leaders are ones that you want to emulate.
[00:10:51] Christine Ko: The quote, you just read, it goes along with another book that I'm reading. I don't know if you've read it yet. It's by Simon Sinek. It's called The Infinite Game.
[00:10:59] Thomas Helm: I have listened to his Ted Talks while working out.
[00:11:02] Christine Ko: Yeah.
[00:11:02] Thomas Helm: I'll have to get the book.
[00:11:04] Christine Ko: Simon Sinek touches on what you were just talking about, to really make sure you know what your why is. In medicine, I would say the vast majority of us, I think, do have a shared why: that we want patients to get the best care. That's why we wanted to become doctors. I think very few of us are motivated by money, for example. That's not really the main reason I think that most people go into medicine or at least stick around in medicine, especially these days, given the level of challenges that healthcare is facing.
[00:11:36] In this book called The Infinite Game, he's talking about that infinite game, meaning not that really that we're playing a game, like Game of Thrones or anything like that, but meaning that there's really no winner or loser in life. So if we think about it, if we're trying to think about each thing we do in life, where, Oh, if I get an A, then I've won. And if I get a B, then I've lost. That's just too short term. 20 years from now, you're not gonna care that you gotta B or an A, really. And I think we do that a lot in medicine.
[00:12:04] It's, Okay, get through this day, or See this one patient and then I'll go to the gym. And then if I go to the gym, okay, it was a successful day. But your point with Jack Resneck's quote was really like, What is infinitely what we want? And I think infinitely what we want as doctors is the best patient care overall and over time, so that with the research articles or chapters or whatever, that's still, that's the same purpose. That it's not about getting another paper out there, but really what is the best treatment for patients. And new information is coming out all the time. So we can modify that or we need to modify that as new stuff comes out.
[00:12:40] Thomas Helm: Thank you, Christine. I really appreciate you having me on. Christine. I enjoy what you're doing. I appreciate the information that you're putting out there for people to consider carefully: where they are in their lives, and where they can learn and follow new passions. Thanks so much.
[00:12:56] Christine Ko: Thank you again for spending the time.
