Erin Hickey, MD, joined the pediatric palliative care team at Washington University and St. Louis Children’s Hospital in 2021. She completed her pediatric residency and chief residency at Cincinnati Children’s Hospital Medical Center, and her fellowship in pediatric hospice and palliative medicine at the Children’s Hospital of Philadelphia. She has special interests in medical education and grief support systems for healthcare providers.
Henkes: The first question I wanted to ask you was if you could tell me a little bit more about how you chose your specialty.
Hickey: I was pretty close to choosing another sub-specialty. It was one that I thought people expected me to enter. And I don’t know, something didn’t feel totally right about it. So I did what I had to do, as a highly self-reflective and mildly anxious introvert: I took a walk. And I realized that Pediatric Palliative Care continually dropped breadcrumbs for me to find throughout residency; I just wasn’t looking for them at the time. When I reflected back, though, the most meaningful moments of residency were all related to building trust, communicating with empathy, continuity and having a genuine relationship with a family of a dying infant, and receiving thanks for just sitting and being with a distraught and angry mother. So did palliative care in a sense actually choose me, maybe, but anyway, I was sitting on a hillside overlooking the Ohio River, and I came to a decision. So I walked back home and restarted my whole application for fellowship that night. I think the moral of the story is that you’ll listen to and be influenced by a lot of people on your medical journey, and you should incorporate those experiences in a way that maintains your own agency and your truth. Because, truthfully, there’s no better feeling than working on a team in a field that allows you to be unashamedly yourself.
Henkes: Looking back, now that you have had some time to reflect, is there any advice that you would have given your younger self based on what you know now? And is there anything that you wish that you knew?
Hickey: Yes, it has to do with my approach to conflict. Conflict is not something to fear. Conflict is inevitable, and it can be mitigated in really thoughtful, professional, and kind ways. What I’ve learned is that if it’s not addressed, it can just perpetuate these cycles of poor communication, mistrust, and isolation amongst colleagues, care teams, friends, whoever the group may be. One frame that has helped me approach conflict with confidence, as opposed to just avoiding it, because that was something I tended to do during the early years of my training, is asking the question: “Why does this good, compassionate person feel differently than I do?” And by eliminating that blame, and approaching with curiosity, I think you’re more likely to resolve the conflict. I really wish I appreciated this 10 years ago.
Henkes: A career in medicine comes with its challenges, some of which you mentioned. What do you identify as one of the most challenging times of your career and how did you navigate that?
Hickey: Actually, just last year, I made a really difficult decision to turn down a faculty spot at an institution that was much closer to home. It wasn’t the right job for me at the time. And even though my head and my heart both knew that, it was still hard to come to terms with it in the moment. It took some serious soul-searching. And, actually, like I do with my patients, it took figuring out what I valued and what was most important to me. Where I ultimately landed was that I valued being on a team, and joining a team of like-minded, and in this case, similarly dark-humored individuals that I could connect and grow with. And I’m really happy with that decision.
Henkes: What aspects of your work bring you joy?
Hickey: So many. The longitudinal relationships with patients and families. Feeling like my presence alone is a valuable intervention. Working with learners like residents, fellows, and of course, the medical students that I coach, who are intelligent and insightful and kind. It’s truly a joy to work with, learn from, and be on this journey with them. It doesn’t feel like a job. And, if I may, the satisfaction of having a skill that you’ve been practicing for years be used successfully in the moment really does bring a genuine amount of joy to me. That might look like restoring calm in a stressful situation, helping a resident through the management of an acute pain crisis over the phone at 2 am, or guiding a family through hard moments and difficult conversations and them asking you to come back tomorrow to talk more: that’s the icing on the cake. There are wins and joys in this work. And it’s easier said than done, but we should search for them on those harder days and remind ourselves of our “why”.
Henkes: We hear about building our own village. How can women do that in medicine?
Hickey: To me, this looks like finding mentors, advisors, and even coaches, all of whom I now understand have distinctly different roles in helping you build your village. Right now, I’m learning about the women at WashU that are doing the work in the same areas that I’m interested in and finding the time to talk about their experiences with them. And at the same time, I’m maintaining open lines of communication with the women that I’ve worked with throughout my career so far.
Henkes: And what makes you most proud of yourself?
Hickey: Honestly, it is the effort that I put into building and maintaining relationships. I highly value connection. It brings understanding, acceptance, and truly a sense of purpose to our work and our lives. A phrase that has resonated with me is: “if you want to go fast, go alone. If you want to go far, go together.” I really believe that. I don’t think we’re meant to do this work alone.
Henkes: If you could give one piece of advice to a young female physician, what would it be?
Hickey: Learn and use people’s names. Beyond your immediate colleagues and beyond your peers. Learn the names of the people you pass in the hall on a daily basis. Get past the generic wave or nonspecific “hello”. This is one of the most basic forms of respect that you can give someone; it shows that you value them as a person and recognize their presence and role in making this hospital system function. And the second piece of advice I’d give is: develop a healthy relationship with learning, because it doesn’t stop after medical school. It continues exponentially for the entirety of your professional life, so lean into it. You’ve likely heard the phrase “be comfortable with being uncomfortable”. That’s where your growing edges are. Choose to grow.
Clara Henkes is a first-year medical student with an interest in internal medicine and women’s health.