Well-being Word

October 10, 2023

The Well-being Word

Erin Herrera, CRNA
Erin Herrera, CRNA
Associate Vice-Chair of Well-Being

Hello Friends!

We bring you a special Tuesday edition of the well-being word this month since today, October 10, is World Mental Health Day.

Talking about things like mental health and suicide is complex and often uncomfortable. Mental health isn’t exactly a fun dinner party conversation topic. Talking about your OWN mental health can be even more challenging. Opening up to others about mental health requires vulnerability and trusting relationships. But the truth of the matter is that many in the healthcare sphere struggle with mental health issues. The statistics from the field of anesthesiology are startling.

The Anesthesia Patient Safety Foundation reported that “prevalence of burnout in anesthesiology was 38%” and that by specialty “anesthesiologists were second only to surgeons in the number of deaths by suicide.” They called physician suicide “a disturbingly common occurrence” and that the rate of female physician suicide is “more than double the rate of their non-physician counterparts” (Our Own Safety February 2019;33[3]).

Anesthesiology News reported that “of all professions, physicians have the highest rates of death by suicide, and the risk may be higher for anesthesiologists” (“New Guidelines Focus on Anesthesiologist Suicide,” June 2020).

Despite these scary statistics and the critical need for peer support, many in healthcare are still apprehensive about talking openly about mental health. Many stigma and misconceptions remain associated with mental health, and many worry about how others will perceive their mental health concerns.

Here are some ways that we can help create a culture of support and acceptance of mental health:

  • Openly discussing mental health raises awareness, validates concerns, facilitates discussion, and can help create safe spaces for sharing.
  •  Engaging in education about early warning signs, available resources, and techniques for seeking help can improve the safety of teams and individuals.
  • Normalize seeking help when you are struggling and promote a proactive approach to mental health. Whether you see a professional or take time to talk with a supportive colleague, talking with others about your mental health can help! Early intervention can help prevent the escalation of problems.
  • Create an environment where individuals can openly express their feelings and experiences. Allow for support, compassion, understanding, and empathy.

When mental health is openly discussed, individuals are more likely to prioritize their mental health and improve their overall well-being. We have so many great resources and options here at WashU. Please take advantage of them if you are struggling or just need a little extra support.

Today, World Mental Health Day, take a few minutes to check in with a colleague or friend. Ask how they are doing and really LISTEN. Work to create a safe, supportive space for a friend.  

Thanks for all that each of you do for the culture of this department and the support of each other.

Yours in Wellness,


The Well-developed Podcast

It is difficult to learn and perform well when you are not at your best. The Well-developed Podcast is a space to validate, normalize, and explore the ways we bring our whole selves to work. Learn how to capitalize on your own unique strengths, preferences, and sense of self to improve and develop your well-being!

Have an idea for a podcast topic? Share your suggestions using the form at the bottom of our webpage. Thanks for influencing our podcast’s evolution!

A Day in the Life of Melissa Milbrandt, MBA, MHA

Melissa Milbrandt is the business director for the Divisions of Pediatric Anesthesiology, Obstetric Anesthesiology, Perioperative Medicine, and Innovation. She is a St. Louis native and completed her undergraduate degree at WashU. In her current role, Melissa is responsible for providing business and operational leadership for her divisions, including strategic planning and financial and operations management, and supporting the development of people, programs, and initiatives. She loves to spend time with her fiance, family, and friends in her free time, travel, and be active, especially to be outdoors with her Brittany Spaniel, Tillie.

A Day in the Life: Melissa Milbrandt

My alarm goes off, and the first thing I get to do each morning is let my dog, Tillie, out of her kennel and watch her enthusiastically greet the day. My fiancé, Derek, is a resident, so he is typically headed out the door before me, but if we’re lucky and he has a later start, we will make lattes together and watch Tillie play outside. If I am by myself, I take Tillie on a quick walk and then get ready for the day.

My days are always different, which is a really exciting part of my job. I am a business leader in our pediatric and obstetric anesthesiology divisions and our perioperative innovation center in the perioperative medicine and innovation divisions. I feel very fortunate to work with so many fantastic clinicians and staff across our department every day!

Thaddeus Budelier, Dr. Fritz, Dr. Murray-Torres, Dr. Gregory, Me, and Dr. Higo in the Perioperative Innovation Center
Pediatric Anesthesiology Division photo

As I walk from the garage to St. Louis Children’s Hospital (SLCH), I am on my phone, looking at what meetings I have and reviewing any outstanding emails or messages I need to respond to. I get to wave at a few kids and chat with colleagues as I make my way to my office in the anesthesiology suite. Once I am settled in, I typically start preparing for the day’s meetings. I review reports, analyze data, and review notes from previous meetings or related emails.

I head next door to meet with Dr. Njoku and Meredith McLaughlin to prepare for our annual pediatric anesthesiology retreat. We discuss speakers, content, the flow of the day, and Jilly’s cupcake flavors! Recruitment and retention is the theme of this year’s retreat. I then hop into a meeting with Dr. Palanisamy to discuss our OB staffing model and review this quarter’s call count distribution. Next is a meeting with Thaddeus Budelier and Thomas Kannampallil to discuss the upcoming launch of the recovery control tower in our perioperative innovation center, and brainstorm on lunch and learn topics. Afterward, Tiffany Peppers and I are meeting with Mary Sommer, Sofia Delgado, and Jake Meinkoth from the reporting team to go over any updates to the pediatric anesthesiology reports.

At this point in the day, many people have dropped by to ask a question or chat. I always keep a running list of project ideas and questions from these drop-ins. The follow-up to many of these questions involves me messaging my boss, Randall Stateler, on Teams, until we eventually call each other (thank you, Randall). I have a quick lunch and then grab a piece of candy from Dr. Weinhold’s stash in her office 🙂

Pediatric Anesthesiology holiday party

In the latter half of the day, I typically look ahead and figure out who I need to engage with and what I need to investigate to meet upcoming deadlines. We are currently kicking off our hospital contract negotiations in pediatric anesthesiology, so I’ve been working closely with Dr. Njoku and other clinical and business leaders in our department on compiling information and presenting it to our hospital partners. We are in budget season, so I spend time each day digging through profit and loss statements, evaluating our past performance, and looking for growth or cost-cutting opportunities. I am working closely with the reporting and finance teams to meet budget milestones. I finish my day by clearing up any outstanding emails and making a to-do list for tomorrow.

I listen to music on the short drive to my gym, and I make it there just in time for a Pilates class. When I get home, Derek tells me our friends are at the pickleball courts, so we head to Tower Grove Park and play a few games. We just got new paddles that have really improved our play! After pickleball, we head home and start dinner. We both love to cook and try out new recipes, but tonight, we keep it simple and make tomato soup with grilled cheese. We spend the rest of the evening hanging out with Tillie and catch half an episode of Master Chef before heading to bed.

Mental Health Resources

Did you know that physicians have one of the highest suicide rates among any profession? We can all help prevent physician suicide by learning the signs, starting the conversations, removing intrusive mental health questions from applications, and sharing the resources that can help those in distress seek mental health care.

Do you want to read a great article about ways to mitigate depression? Check out this NPR article sent by our friends in the psychiatry department.

Check out this handout for mental health resources available for clinicians, residents, fellows, students, and staff — we have everyone covered!


Mental health resources are available when you’re feeling down

Did you know that 5% of the global adult population is experiencing depression? It’s a mood disorder that causes a persistent feeling of sadness and loss of interest in previously rewarding or enjoyable activities.

We might not fully know what everyone is going through but we can support those who are going through depression by educating ourselves to reduce stigma. If you are personally experiencing depression, remember that you aren’t alone. The resources below can support you on your mental health journey.

Here are some recommendations from Calm, our mental wellness partner, that you can do in a few minutes anytime, anywhere: 

Rethinking Depression Masterclass: Learn the six science-backed strategies for overcoming the toxic elements of modern living so you can start living a more vibrant and joyful life.

Distortions: This 10-minute session on cognitive distortions will help you strengthen your relationship with yourself and challenge your negative thoughts.

Limiting Identities: This guided meditation includes a visualization exercise that’ll help you be more compassionate to the different parts of who you are and the ebb and flow of your emotions.

2023 Fall Wellness Challenge: Walktober

Walktober is a fun way to take advantage of autumn’s cool temperatures and spectacular views as you step out and step up to better health. You’ll be taken on a virtual color tour through some of the world’s most vibrant, breathtaking landscapes — while boosting energy, improving mood, and making walking a priority.

Learn more about Walktober, then be sure to opt in by Friday, October 13 to participate.

Professional Development Cohorts

Fall and winter dates for our Professional Development Program are now available! This program caters to all members of our department, regardless of your role. Our objective is to assist you in shaping your professional journey in alignment with your individual goals.

Across a span of four weeks, each cohort will encompass a series of four sessions. The uniqueness of these workshops lies in their adaptability – there are no prerequisites, meaning you can select and attend sessions purely based on your interests.

PIA SAFE “Tacos & Training” Event

Join PIA Safe for our October training session, “Tacos & Training,” on Tuesday, October 17, from 6-7:30 p.m. at Hacienda Mexican Restaurant. We will cover how to establish behavioral boundaries, engage in exercises focused on adopting the role of an upstander, and enhance conflict management skills. You do not need to be a PIA SAFE Champion to join us! If interested, please contact Erin Herrera at erinherrera@wustl.edu.

PIA SAFE Check-in App

Have something on your mind? Need to share a cultural concern or simply talk about a tough day? We’re here to listen and support you.

Accessible on the PIA SAFE website and intranet, the PIA SAFE Check-in App provides a safe and confidential platform for you to express your thoughts or concerns.


When interacting with colleagues, asking targeted questions to move beyond the usual surface-level exchange of “Hey! How are you?” can prove highly beneficial.

Try questions like this:

  • I know your kiddo is playing soccer this season—how is it going?
  • I know you love the Halloween season—are you doing anything special for it this year?
  • What was the best part of your weekend?
  • I know you have a lot on your plate at work right now— how are you holding up?
  • Have you been to any great restaurants lately?
  • I know you have a vacation coming up—what are you most excited about doing on vacation?

A few minutes of a caring conversation can make a big difference in someone’s day!