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Hello Reader,

After a change in administration and a government shutdown, Dr. Jess Bunin's institution rewrote policy after policy. At a meeting afterward, a senior leader said no one was coming to them with questions anymore, so everything must be okay.

Jess was hearing the opposite. As dean of community, she had become an unofficial ombuds, and the complaints were coming to her instead.

This week on the podcast I spoke with Jess, a retired Army colonel and West Point graduate trained in both psychiatry and critical care medicine. She has served as a critical care fellowship program director at Walter Reed and assistant dean of faculty development at the Uniformed Services University. Her new book is Self-Awareness and Trust.

Jess describes two costs of staying quiet. A team member who holds back in meetings gives up influence, and she does not believe anyone needs a title to have influence. Silence also wears down confidence, as "leadership" turns into a separate group people no longer feel allowed to approach.

Rank plays a larger role than most senior people remember. As a lieutenant colonel, Jess asked a struggling student why they hadn't come to her. The answer: you're a lieutenant colonel, I would never. Her other trainees said the same. She had believed she was open and available, and her open-door policy meant little to people afraid of her rank. She sees the same fear in civilian medicine, between students and attendings.

When two student groups at her institution stopped speaking to each other, Jess first built a student curriculum. It did not move much. At a deans' staff meeting, her colleagues stopped her: this isn't a student problem, it's us. So they built a full day for faculty and staff, half on restorative practices and community building, half on civil discourse. Participants reported more belonging and more hope, and 97% called it an effective use of their time. One associate dean realized he had passed a colleague on his own hallway about 100 times without ever saying hello.

For the moment you freeze, Jess teaches from her CLEAR framework: create psychological safety, listen actively, establish common ground, adjust your thinking, and respond skillfully and respectfully. "Tell me a little more about what you meant" gives the other person the floor while you think. When a conversation stalls, return to the goal you share. When something lands badly, "Ouch" or "Can we take a pause?" keeps you from saying what you don't mean.

The teaching point: a lack of questions is not evidence that things are fine. It can be evidence that trust is gone.

Jess's book begins with self-awareness, and she does not believe anyone builds it alone. It takes a coach, peer, or partner to point out blind spots, including the positive impact you may not see in yourself.

Here's my question for you this week: who used to bring you their questions and has stopped?

You can find Jess and her book at jessbuninmd.com, and her team's workshops at alllevelsleadership.com.

🎧 Listen to the podcast sneak peek episode below and listen to the full episode on YouTube, Apple, Spotify, Podbean, or Amazon Music.

Stay mindful and keep leading,
Lillian
Founder & CEO

It's not too late to join us this Sunday September 20, 2026 6-7pm EST in our medTHRIVE® Connect Book Rounds, featuring author Rebecca Thompson, MD book Held Together

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