Road to Resilience

The Prescription to My Recovery

July 25, 2018 Dennis Charney, MD Episode 2
Road to Resilience
The Prescription to My Recovery
Show Notes Transcript

Dennis Charney, MD, faces the man who tried to kill him during a highly publicized trial. Listen as he takes that courageous step and details the "resilient factors" he used to stay strong during this emotional stage in his recovery, including setting up a support system and letting go of anger. Dr. Charney is Anne and Joel Ehrenkranz Dean of the Icahn School of Medicine at Mount Sinai and President for Academic Affairs for the Mount Sinai Health System. He is the co-author (with Steven Southwick, MD) of "Resilience: The Science of Mastering Life's Greatest Challenges." Help us tell more great stories by completing our listener survey (http://bit.ly/2knrxzR). Enjoying the podcast? Please rate and review us on Apple Podcasts (https://apple.co/2Nve2Kt).

Check out more episodes of Road to Resilience —as well as guest pictures, transcripts, and more— on the Mount Sinai website.

Road to Resilience brings you stories and insights to help you thrive in a challenging world. From fighting burnout and trauma to building resilient families, we explore what’s possible when science meets the human spirit.

HOST:

Welcome, everyone! This is episode two of the podcast series"Road to Resilience." During the next 25 minutes, we're sharing some different steps you can take to become stronger during times of adversity and trauma. You'll hear from Dr. Dennis Charney, the dean of the Icahn school of Medicine at Mount Sinai, who explains this while taking us further into his own emotional journey. He'll detail the importance of reframing stressful thoughts, a support system, and letting go with anger.

DR. CHARNEY:

I was not going to waste energy on feeling angry. I think if you do that for a prolonged period of time then you're not moving forward.

HOST:

Learn how he applied these resilience factors to recover after being attacked by a man with a shotgun.[sirens]

DISPATCHER 1:

9-1-1 police emergency

SPEAKER 2:

Send everything you have to Lange's Deli in Chappaqua, New York. There's been gunshots. Someone is shot. Chappaqua, New York. Lange's Deli. Now.

HOST:

That shooting at the popular Lange's Deli prompted these 9-1-1 calls just before 7:00 AM on April 29th, 2016.

DISPATCHER 2:

9-1-1 police emergency.

SPEAKER 3:

This is[inaudible] at Lange's Deli. We just had somebody shoot a gun here. We have a customer got shot. We need an ambulance.

DISPATCHER 2:

Are you serious?

SPEAKER 3:

I'm serious.

HOST:

A surprise even to the dispatcher, since the quiet town of Chappaqua, New York, which is about an hour north of Manhattan, is one of the safest communities in the country.[gunshot] A gunman had just ambushed Dr. Dennis Charney in the restaurant's parking lot after he picked up breakfast. The shooter, named Hengjun Chao, who's actually one of Dr. Charney's former employees, carefully plotted the attack. Did you instantly realize you were shot?

:

Yes. Once I heard it--I put it together, that loud boom, looked at the person who was about 20 feet in front of me. Saw that he had a shotgun, or a gun, saw the blood, I said as I was running back in, I yelled,"I've been shot." So I knew right away.

HOST:

You see this shooter--

:

Yeah.

HOST:

--holding the weapon. Did you realize you were the target at that time?

:

I realized I was a target, but I didn't know why I had been shot. Why would somebody shoot me?

HOST:

Dr. Charney spent five days in the intensive care unit at the Mount Sinai Hospital, his own workplace.

:

I felt severe pain in my right side, my right shoulder. I had been hit with around 15 pellets and ultimately I lost half of my blood.

HOST:

He now had to cope with physical injuries, symptoms of PTSD, and publicity since his crime made national headlines.

NEWS CLIP:

First a deli in an upscale neighborhood in Westchester County. The scene of a violent shooting today--

HOST:

And all this attention edit another difficult element to an already traumatic situation.

DR. CHARNEY:

My recovery was very public because I'm the dean here, and everybody found out what happened. Everybody was watching my recovery every day. Literally dozens of people saying,"How are you doing?"

HOST:

So Dr. Charney knew to draw upon his own prescription to resilience. Ten simple steps he created from his pioneering research that spanned for decades. This prescription is something everyday people can apply during times of stress, grief, and trauma. And one of the first factors he recognized was his support system, something he says is critical to anyone's recovery.

DR. CHARNEY:

The people that were visiting me were fearful and worried. The staff and the doctors were terrific in the way--not only in providing me technical care, but emotional care. And I found out that a lot of people really like me! The loving and admiration that I received spanned from the housekeeper to the nurse to the doctors to my friends that came and visited me, you know, before and after. So it really was a full spectrum. So I just felt the love and that motivated me to fight and recover and rehabilitate. People are still saying,"How you doing?" And I try to tell them,"You don't have to keep asking me that anymore." But it reflects their caring. So you can't underestimate the importance of support during your recovery period.

HOST:

Fast forward to a few months later. Dr. Charney still faced mental challenges with reoccurring memories of the shooting, all compounded by the fact that the gunman's highly publicized criminal trial had just begun.

NEWS CLIP:

Now at News 12, a Tuckahoe man accused of trying to kill his former boss outside a deli in Chappaqua, now on trial.

HOST:

In the courtroom we learned Hengjun Chao targeted Dr. Charney because he fired this former research about seven years prior for manipulating data. It was here when Dr. Charney saw the man who tried to kill him for the first time since the shooting happened. Dr. Charney had to find the mental strength to face Chao and deliver a powerful testimony right in front of him. In these moments, he applied another factor from his prescription to resilience--what he calls"reframing stressful thoughts." He used his stress as a means of strength and energy to overcome adversity. Take a listen to Dr. Charney on the stand.

DR. CHARNEY:

Your Honor, I'm here today to ask that you sentence Dr. Hengjun Chao to the maximum sentence available under the law of our state. Dr. Chao's attempt to murder me not only caused me to suffer grave physical injury, but has changed my life and the life of my family forever. Shortly after exiting Lange's, I was deafened by a loud boom. I felt a piercing pain in my shoulder. I looked down, I saw blood streaming from my shoulder and realized that I had been shot. Imagine the fear my children experienced when they received panic phone calls from my wife with the shocking news that their father had been shot. No one knew if I was going to live or die. Your Honor, there is no doubt that Hengjun Chao attempted to murder me. And I repeat that--that he attempted to murder me. For me, it is a living, breathing memory. He shot me at close range with a shotgun. He has no insight into his wrongdoing either with respect to his scientific misconduct or his attempt to murder me. In addition, he's a danger to the community at large. He has shown that he will not stop his attempt at vigilante justice. And I have every reason to believe that he will continue to plot his revenge even while in prison. In summary, your Honor, given Hengjun Chao vengeful, hateful, and violent crime, his lack of remorse, his lack of insight into his behavior, and his irrationality, he presents an ongoing threat, and I believe should receive the maximum sentence.

JUDGE:

Hengjun Chao, you have the absolute right to address the court before I sentence you. Go right ahead.

HENGJUN CHAO:

I respectfully and sincerely apologize to all the residents of Chappaqua, the workers and customers of Lange's Deli. I also apologize to Dr. Charney and his family for his unfortunate injury. I'm also apologize to my wife and to my family.

JUDGE:

It is the[inaudible] of court on count one, attempted murder in the second degree, that you serve a determinate sentence of 23 years in state prison. On count two, criminal use of a firearm in the first degree, a determinate sentence of five years in state prison--affectively a 28-year state prison sentence. There's an order of protection. Don't reach out to Dr. Charney. He doesn't want to hear from you. He wishes he could forget your name. No letters of apology. He doesn't want to hear about you. I don't know if he can forget about you, but he'd like to. Don't reach out to him. If you violate the order of protection, you could be charged with criminal contempt. You are now remanded into custody of the Department of Correction to serve this lawful sentence. Step out of this courtroom.

HOST:

What was it like for you to face this man after he tried to take your life?

DR. CHARNEY:

I worked very hard not to feel anger toward the perpetrator. I think I had done a good job internally. That I was going to focus on moving forward.

HOST:

You addressed him as a doctor. Why did you say his title?

DR. CHARNEY:

First, you know, he was a PhD, a doctor. I felt that was part of the process of not, in my own mind, to not feel anger. That I was just going to be factual. He's a doctor. I was going to address him, you know, that way. I found that that would be helpful to me.

HOST:

Is there something to be learned from this?

DR. CHARNEY:

In my case, I felt I was gonna focus on moving forward. I felt confident he was a disturbed person. He was going to suffer the consequences of it. I couldn't undo what happened to me, so I was not going to waste energy on feeling angry.

HOST:

How can holding onto anger affect one's mental state?

DR. CHARNEY:

I think if you do that for a prolonged period of time, then you're not moving forward. You're staying in the past, which is not helpful.

HOST:

The trial was sometime later, and you had made significant progress in your recovery both physically and mentally. Did being in that situation bring up additional trauma? Did any sort of trauma resurface as a result?

DR. CHARNEY:

You know it brought back the memories. I think the main issue was--What was the sentence going to be? How long he was going to go away for. So that was what was most on my mind and I think was on the mind that my family.

HOST:

Is his sentence enough?

DR. CHARNEY:

I think so. You know, he got sentenced for 28 years with no chance of parole. So he's going to be there a very long time.

HOST:

You're resilient, so you had an appropriate way of dealing with it. But what advice do you have for people who are in this position who have to come to terms with trauma again during their recovery?

DR. CHARNEY:

Keep looking forward. There'll be bumps in the road. There'll be reminders that give you some anxiety, maybe fear. But if you keep moving forward with your life and your aspirations--you can get past that. Just know that you're a trauma victim, but you can grow from that.

HOST:

Sometimes victims blame themselves for bad things happening to them. Is this something that ever crossed your mind?

DR. CHARNEY:

No, because I was very confident in my decision about terminating the assailant. It does raise questions in a more existential way. Why do bad things happen to good people? What does that mean about faith and spirituality--that happened to some members of my family. What does that all mean? Raises deeper questions about the meaning of life. So that happens in a more profound way.

HOST:

Around the same time of the trial, another local shooting made headlines across the country, and that's something Dr. Charney could not ignore.

NEWS CLIP:

[Inaudible] We're on the air to tell you about a shooting. What was reported initially as an active-shooter situation at a hospital in the New York City borough of the Bronx. A deadly rampage inside Bronx Lebanon Hospital. A doctor who's an ex-employee opens fire on his former colleagues, killing one of them.

DR. CHARNEY:

A number of people were transferred to Mount Sinai for treatment because their wounds were serious. And one was a young doctor who was like in his first year of training after medical school. And our staff told me that he was having trouble coping in the beginning. And they thought it might be helpful if I were to go meet him.

HOST:

That's exactly what Dr. Charney did by using his prescription. He stepped up as a support system and role model for this young doctor to help him build resilience and better cope with anxiety.

DR. CHARNEY:

And I walked in and said,"I may be the dean, but I'm your brother." That I've gone through something similar. And I think that was very helpful to him. And I told him what the recovery was going to be like.

HOST:

What did you tell him specifically?

DR. CHARNEY:

I said in the beginning that you're going to have[to] mainly focus on the physical recovery. And that in the beginning there's going to be a sense of anxiety. And you're going to feel very emotional. But eventually that's going to fade. And this experience, believe it or not, was going to make you a better doctor. Because you treat patients who are suffering, and you're going to be able to recall your suffering and be a better doctor and be more empathetic with your patients. He ultimately gets out of the hospital and he's going to find other people to help him, but I probably played a small role in getting him on the road to recovery.

HOST:

How did that help you?

DR. CHARNEY:

I felt good that I was able to help him. There aren't a lot of positive things of being shot by a shotgun. But given the opportunity to show that your resilient to yourself and others, and be a role model to others is something that would not have been possible to the same degree that it is now if I hadn't been shot.

HOST:

Since then we've heard of other mass shootings. This is now a world of a new normal. So is resilience more important now than ever before?

DR. CHARNEY:

I would put it that you need--We've talked about how an individual makes themselves more resilient, which is possible, but you can also make your local community more resilient. You can make your city more resilient. You can make your country more recently. There's no question about that. And so when it comes to preventing mass shootings, we have to do something as a community and a country to prevent that. No individual can prevent that.

HOST:

Is there any research on how this can affect people's mental states?

DR. CHARNEY:

We're just learning what is the impact of all these shootings, which seem to be occurring at a more frequent rate. I'm told, but I haven't seen actual data, that children and young adults are more on-guard. They're more afraid. Their view of the world is affected by all this. And if that's true, that's very troubling. And so we need act as a community, as a nation to reverse the trend quickly.

HOST:

You've done a lot of research on trauma, including how genetics can affect one's response. What is the science behind this? What can people learn about genetics and how it affects trauma?

DR. CHARNEY:

There are many genes that are gonna be related and are being identified that are relating to the vulnerability to different psychiatric disorders like bipolar disorder and depression, PTSD, schizophrenia. It turns out it's many different genes, it's not usually a single gene, but multiple genes that come together that increase vulnerability. As we learn more about what these genes do and interact with each other, it enables us to have a greater potential of developing new therapies. But I would also say that genes are not destiny. That it's part of vulnerability or resilience on the other hand. And you can do a lot with your life, a lot of things we have discussed to make you less vulnerable, even if you have certain genes that predispose you. But the genes are not destiny.

HOST:

How do genetics affect how we process trauma?

DR. CHARNEY:

We're just learning about that. A couple of genes related to neurochemicals in the brain have been identified that suggest that they're related to vulnerability on one hand and resilience on the other. But it's still early in that research. That'll pick up over the next several years.

HOST:

But that could transform the treatment.

DR. CHARNEY:

I hope so.

HOST:

What's the latest research out there for dealing with anxiety, PTSD, trauma? What has changed in the last few years?

DR. CHARNEY:

A lot of work still needs to be done. There's lots of researchers working on developing new therapies, but that's still in progress. A lot of the medicines that are used for post-traumatic stress disorder and anxiety are the same medicines that are used for the treatment of depression. So the field needs to develop more precise treatments for post traumatic stress and different anxiety disorders because they're not exactly the same as depression. So it's still a work in progress.

HOST:

'What do you see for the future five years from now? Ten years from now?

DR. CHARNEY:

I'm hoping that occurs. The ability to discover new medicines based on genetics and our knowledge of brain function should enhance the discovery of new medicines for depression as well as PTSD and anxiety disorders. I'm confident that that will occur with the great science that our scientists are capable, and more precise therapies, I think, are possible ss we learned about what we call"neuroplasticity" in the brain. In other words you can change the brain not only through medicine, but through therapy and other kinds of tasks. We're learning more about the neuroanatomy of the brain with better imaging techniques. So there's a lot of things based on knowledge of the brain and genetics that I think make us poised to discover new treatments.

HOST:

These are breakthroughs Dr. Charney hopes both he and Mount Sinai can be a part of. Meanwhile, he still reflects on his own trauma and finds positive takeaways from the event. How has your own trauma changed you?

DR. CHARNEY:

You always say that, um, you value every day after you've been traumatized, and theoretically--all right, actually--close to death, you really do value every day. That experience does put a different perspective on that. And you also come to value your family even more because you saw how they reacted and were so helpful and loving when you needed that. And in addition, because I've had this experience, it makes me more of a role model for other people, and I take that very seriously. So now when I talk about our research regarding resilience, I can say,"You know, and I'm one of the trauma victims." And so then I can serve as a role model in that. So that motivates me.

HOST:

How can trauma inhibit people? Here you found a positive out of all of this, but maybe not everybody is in that position.

DR. CHARNEY:

If you didn't have what I had around, you know, prior experience, knowledge from my research, role models, support from my family, then it's a lot more difficult to recover.

HOST:

And how do you get over that recovery if you don't have that background, you don't have that strength?

DR. CHARNEY:

Then you actively cope, meaning you seek out help, you get the therapy that you need. You find role models. There are groups of people who have faced trauma and they come together and they support each other.

HOST:

How has this made you a better leader?

DR. CHARNEY:

I don't sweat the small things. I look at the big picture. I look at every day as a gift. And people say that,"You should count every day as a way of doing better and cherishing." But when you've almost been killed, that takes on new meaning. So it makes me more effective as a person and as a leader because I look at every day and say,"I'm going to accomplish something important today. Because you never know what tomorrow will bring."

HOST:

How has this helped you in your profession?

DR. CHARNEY:

When I talk about resilience now and how to become a more resilient person, I can speak with more authority because I've gone through it myself. I think I have more credibility.

HOST:

Does this make you a stronger motivator?

DR. CHARNEY:

I think so. You know I gave grand rounds to the department medicine at our VA hospital on resilience. And I talked about my personal experience in addition to what I had learned about studying resilient behavior over the last couple decades. And now when I combine my speech with my personal experience, it has more power. And when I gave even the speech last week, people came up to me and said,"This has relevance to my own life." So in that way, there's been a positive in terms of motivating folks to become more resilient themselves.

HOST:

Do you have a new prescription to resilience after this trauma?

DR. CHARNEY:

It's pretty much the same. I can say that what we came up with works. So if anybody's listening, I encourage you to get our book,"Resilience: The Science of Mastering Life's Greatest Challenges." This is actually the second edition, and what we did in the second edition is we updated the science in terms of what we've learned about how the body reacts and so forth. And we also put in the second edition more stories of people, you know, that showed great resilience,

HOST:

A prescription to resilience that Dr. Charney continues to stand by after overcoming one of the most difficult obstacles of his life. And now more than ever, he truly recognizes the power this has when it comes to recovery.

DR. CHARNEY:

First, on the positive side, I learned a lot of things that we had studied about trauma and what it would take to recover, you know, were true. And so in a way it was validated through my own personal experience.

HOST:

Go into specifics about that. What did you validate?

DR. CHARNEY:

You know, one is the sense of optimism. So from the beginning, I was optimistic that I was going to recover. Second, it's important to have role models to emulate as you're in the recovery process. Third was the importance, the incredible importance of support from family and friends. Everybody faces tough things in their life: loss of a loved one, disappointment in a relationship, disappointment in career aspirations. So that you want to prepare your children and prepare yourself that these things are gonna happen to you. And that's part of resilience training, of building resilience in yourself.

HOST:

So his message here is that resilience can be learned just by applying these simple factors to your life. You've been listening to our monthly podcast series Road to Resilience. Make sure to check out Episode 3 coming out on August 29th. We'll focus on how you can build a resilient family and raise resilient children. We feature a unique father and son duo, and they'll tell you how you can make this possible by sharing their own success with this. To listen, just head over to iTunes and subscribe.