Exploring a Pharmacy Leader’s Journey in Practice and Her Experiences as a Lesbian Woman: An Interview with Lindsey Kelley

Speaker 1: Welcome to the ASHP Official Podcast, your guide to issues related to medication use, public health, and the profession of pharmacy.

Daniel Cobaugh: My name is Daniel Cobaugh. I'm the editor in chief of AJHP and the Vice President of Publishing at ASHP. And I will be your host today for the ASHP Practice Journey’s podcast. In recognition of pride, ASHP will host four podcasts with LGBTQ leaders in pharmacy this month. With me today is Lindsey Kelley, Director of Ambulatory Care Services at Michigan Medicine. Lindsey Kelley, welcome. Let's get started talking about your journey.

So first of all, I have to tell you, I'm looking at one of your photos in zoom right now. And I'm a little bit jealous because I think you're much better than me at tying bow ties. I went to a wedding last year and had to practice literally for a week using YouTube. I would come home every night and practice before the wedding. How long did it take you to master it?

Lindsey Kelley: Probably about the same amount of time and with the same incentive. So my wife had purchased a bow tie for me for a wedding and I had no idea how to tie it. And about 15 minutes before we were supposed to leave for the wedding, I was frantically in the bathroom watching a YouTube video, learning how to tie a bow tie. And so I started tying them and wearing them ever since.

So interestingly, I used to wear the clip-on bow ties for a long time and I didn't tie them. And then, one morning I had a meeting with Toby Clark. He was doing a residency visit and I went to meet with him and I happened to be wearing a bow tie that I had tied that morning. And he said, “Did you tie that bow tie?” And I said, “Yes.” He said, “Always tie your own bow tie, it’s a different level of confidence.” And I have been tying my bow ties ever since I got rid of all the clip-ons and I only tie them now.

Daniel Cobaugh: That is a great message. That is an amazing message. And I can hear Toby Clark saying it. That’s fantastic. Well, first I hope that you and your wife are doing well in the midst of COVID-19. Michigan has been hit hard, I know. And it's actually been the center of a lot of media attention, but I hope you're both doing well.

Lindsey Kelley: We are. Thank you. We've both been working from home for the last several weeks to months. Her work is with the University and so she's been working from home exclusively, whereas I've had to go in now and then.

Daniel Cobaugh: So tell me a little bit about you.  Let's start off with the personal. I mentioned to you when I invited you to do this podcast that I really want to focus on your letter from the book, Letters from Women in Pharmacy, but let's first start off talking about your wife. Tell me about her; her name, how you met, how long you've been together, what she does. It would just be great to hear about this side of you.

Lindsey Kelley: Sure. So my wife's name is Andrea. She works at the University. She's a do-gooder mostly. She is a social worker by background and training, but an administrator because of her love for policy. She works primarily in the community, focused on health equity, and just equity. Not just health equity but equity in general. She used to work in bureaucracy and she was really responsible for eradicating homelessness and bringing equity to communities. She spent a lot of time working for the County as the Director of Office of Community and Economic Development.

And then she just came over to the University of Michigan and she now is the Executive Director of a policy lab focused on... It’s kind of like evidence based medicine for equity policy. So they look at the impact of policy decisions. Specifically, they previously focused exclusively on youth, but now they focus on other kinds of policies. So they look at changes like- if we change the way that we administer curriculum or the way that we think about punishment in schools, what are the long-term impacts on youth and incarceration and how do we draw those conclusions? So she really connects the evidence that is coming out in real time from these researchers to the policy makers in Lansing. So it's kind of exciting work.

Daniel Cobaugh: What's funny is at one point in talking about Andrea's work, you talked about a focus and that's actually the word I was going to select to say that her work must really have been brought into focus recently, given everything that's happening in society. It just seems that it just puts an increased emphasis or amplifies the work that she's doing.

Lindsey Kelley: Yeah. She actually had this really cool opportunity. So, in that COVID impacted a lot of academic work, right? Masters, and PhD students had to pause on a lot of the research that they were doing or had planned to do. She was able to connect… There was also a voice that she heard from the community saying that they needed help understanding the policies coming out around COVID. And so she actually stood up this COVID consultation core. She connected these masters students and PhD students to policy experts in the Ford School of Public Policy and the Institute for Social Research with community members, largely nonprofits, who had organizations they were trying to run, but not the time to figure out policy and connected them so that these masters and PhD students could provide insight and expertise to these community, not-for-profit leaders. And so, it was a really cool thing. She's really impressive. She stood it up in like a few weeks. And so, it was just really cool to watch

Daniel Cobaugh: That's amazing work. And, you know, it's interesting as you started in your letter in Letters from Women in Pharmacy, you talked about the fact that when you were first invited to write your letter, that you spent time talking to Andrea and thinking about what you would write and why you would be invited. But wow, I've had the chance to look at your letter a number of times from the early stages of development of the book. And I just recently re-read it and it's incredibly powerful. So, as I said before, I'd like to spend a fair amount of time talking about the experiences and insights you described in your letter But let's again, take a few more minutes. We started talking about Andrea and your marriage, but let's talk a little bit about Lindsey. We haven't done that yet. So you know, tell us about you- where you grew up… Start there.

Lindsey Kelley: Sure. I often say that I'm mostly from Arizona. I wasn't born there, but I grew up there. I was there for about 22 years before I left. So I did all of my elementary school education and all of my- actually most of my- higher education in Arizona as well. And I lived a little bit of everywhere. So I grew up mostly in in the Valley of the Sun in Phoenix. A little bit in Mesa. And then I did my undergrad in Flagstaff, my graduate school in Tucson at the University of Arizona where I received my PharmD, and then I moved to the Midwest. So it was when I left Arizona, I knew I wanted to go somewhere different. I just, I figured if I stayed in Arizona, I would learn from all the people I've learned from, and I wanted to be taught by other people. And so I was just looking to go somewhere else. And so I ended up in Minneapolis. But my life in Arizona was pretty… I guess for me what feels like pretty normal. I grew up, my mom was a single mom. She had been married when I was young and my sister and I were the children of single parent for a long time. And then around my junior high years, my mom remarried to who is now my stepfather and has been for years, who I call my Papa, and has been happily married ever since. I have two additional siblings. And so now there's four of us and we are very adamant about being siblings. People refer to us as half-sisters or half-brothers. We get really upset. It's a shared family experience. And so we have a really tight family and I think that's been true my whole life.

Daniel Cobaugh: And I bet Andrea fits tightly into that family unit as well.

Lindsey Kelley: She does, she does. And you know, my mom has actually been really great and just always ensuring people were welcome. That's been a trait she's had since we were kids. It was no different when Andrea came home. And so she immediately brought her in and just made her part of the family and I think Andrea really appreciated that.

Daniel Cobaugh: That's wonderful. And you know, one of the things that we're going to talk about later is your advice for the young people coming into pharmacy. That I think that even aside from advice, it's very heartening for them to hear stories like that. Mine was sort of similar where my family embraced Nicolas and us from the very beginning, and I think that's really heartening to hear that now. I think I met you while on the Pittsburgh leg of your journey, so to speak. Right? That's when I think we met, wasn't it?

Lindsey Kelley: Yeah, so my first job was in Pittsburgh after my residency. So I did residency in Minneapolis and then my first job was in Pittsburgh as an operations manager. And I think we had met through ASHP or some other form there, but yeah, that's when I remember meeting you.

Daniel Cobaugh: You also were responsible for… It was ambulatory in Pittsburgh as well. You really started an ambulatory focus basically right out of residency, correct?

Lindsey Kelley: So in Pittsburgh I was inpatient operations. But I had always been ambulatory in my origins. So my internships during pharmacy school, we're in community pharmacy. And when I was in residency the work I did was in BMT for my staffing, and so I saw a lot of the transitions patients experienced coming in and out of that care. And so even though I did inpatient operations in Pittsburgh, my heart has always been an ambulatory care. So when the opportunity came up in Michigan, I jumped at it.

Daniel Cobaugh: Well, and that's where I wanted to go next. So how did that opportunity arise? How long have you been in Michigan now?

Lindsey Kelley: I've been in Michigan the longest I've been anywhere almost. So I've been here almost 10 years. It'll be 10 years next July. I refer to a lot of my life with serendipity and grace, but it really was that I ended up in Michigan. I happened to be looking for it's something else, and through a series of fortunate events, I got connected to a leader that everyone knows and loves, Sarah White. And I was talking to her about, you know, my next steps. And she said, well, do you mind if I reach out to a few people? And I thought, no, Sarah White, I don't mind if you reach out to a few people because who tells Sarah “No”? And so she reached out to a couple of people, of which one of them was Jim Stevenson. He was the Chief Pharmacy Officer here at Michigan, and I remember talking to him and making the decision that this is where I wanted to be based on that conversation, because of a key conversation that we had. I was dating someone at the time, they were in a master's program. And, you know, I started doing the thing that I had done historically, which is to use pronouns when I talked about them. So I was meeting with Jim and I said, you know, I have a significant other, they're in a master's program. And he said, okay, well tell me more about it. And I said, well, so I felt like what was a risk for me? I said, well, she's in this master's program, it's this special type of program. You know, I always kind of monitor people's faces when I introduced this concept that it's probably not who you're thinking of. And so he just… There was no change in his face. He just was like, you know, so interested in what I was telling him about her master's program. And further, his response was, well, I'm certain we can get her connected with the master's program here. And the fluidity with which he responded in what felt like a very normal hetero way was just enough to make me want to come to Michigan and work with him. I had, you know, I'd shared that story with others, other people who I had talked to about jobs in the past, and, you know, they always would like kind of adjust and adapt. And there was a pause. And with Jim, there was no pause. He immediately was just like, all right, well, how do we get her here? How do we get you here?

Daniel Cobaugh: So, you know, that's really interesting because in your letter, you made a comment that the courage required to be, this is me paraphrasing a little bit… But I think the courage required to be you, the real you, the authentic you, evolved with each new city, and new job. It's interesting with everyone that I've spoken to as part of this podcast, that has been a common theme and I think it was my own experience as well. So can you talk a bit more about that? I mean, it's sounds like that's part of that initial conversation with Jim Stevenson that it was that it probably relates to that evolving courage as well.

Lindsey Kelley: I think it really does. I mean, part of it for me was that it may have honestly been my own fear of what was going to happen, not necessarily a terrible experience, but I was always afraid of how I would be received or how my sexuality would be received. And so I often guarded it. And then over time, I think I just had these empowering experiences with people who were lovely human beings who really embraced, you know, who I was, all of who I was. And, and so as I moved through life, I just, I was able to build on those positive experiences and just be a little bit bolder. I think part of it too, is that, you know, this is one of the things I enjoy about new experiences and moving into cities, is that you get this opportunity to kind of reinvent a better of yourself. Right? So like, you get to kind of really capitalize on the parts that you were starting to develop, I think when you left. And so I think part of that evolution was that, in each city, I started to develop deepening comfort with who I was and sharing who I was. And so as I went onto the new city, I would, I would try it out or try it on. And I think that, you know, increasingly as it was met with positive reception, and again this embrace I really started to use, you know, what is now a really common phrase. I really started to lean into it. Right? And so I think it just felt good to be able to do that and to grow and continue to do that as I went on.

Daniel Cobaugh: And yet you describe, in your letter, that the hardest decision you had to make in your career was to live as an openly lesbian woman. So where were you in your career when you actually started that process?

Lindsey Kelley: You know, it's funny. I was actually talking through some of these questions with my wife and I was like… Oh, I remember the exact moment that I decided to do that. I was in Minnesota, it was during my residency. And I was working in the central pharmacy, which was one of my staffing assignments during the two years I was at the University of Minnesota. And someone was asking about my weekend and I started to do the thing that I normally do, which was to use pronouns and just be vague. And I would always share, and I think I talk about this in the letter, but I would always share what I had done. And I would talk about my weekend. But I was always really conscientious of the pronouns I used and how I described it. And I never really used anyone's name. I never really used female pronouns. And it's not like it was a surprise to people when they found out I was a lesbian, but for some reason that was a big hurdle for me.

And I started to do that. And I looked over and, and there was just something about the people I was with. I had this kind of split moment decision of like, I'm just going to trust them. And so I started to just talk about, like- I went out with this person I'm dating and, we went out and did this and she does this. And I just started to talk about it like I would if I were with my friends. To be more open and less cautious and nothing terrible happened. It turns out it was fine. And it was like that little bit of freedom just was really, I think, the encouragement I needed. Everyone was great. Well, you know- “tell us more about it”.

And it was just that it was my own fear that I was able to overcome, and so I started doing that more. I just started talking about it, like I normally would and not hesitating. And I’ve continued to do that ever since, as much as I can. There are still moments where I'm afraid. And I, like I said, when I met Jim Stevenson, I sometimes falter. But then I try and reengage with just being the most honest version of myself.

Daniel Cobaugh: It's really funny because, again, in terms of common themes, that's been something that I've heard throughout every one of these podcasts. It’s a very common theme and one of my own experience. And I will say as comfortable as I think I feel, and as expressive as I try to be, I still get that in terms of- you still have those moments where for whatever reason, it's anxiety provoking. You talked in the book about the influence of Brené Brown’s work on you, and that she talked about showing up and letting ourselves be seen. And I imagine that that comes into play with this conversation that we're having about using the pronoun that reflects the authentic you. But how has that showing up and letting yourself be seen? Can you talk more about how that's affected you?

Lindsey Kelley: Yeah, so there's a lot of things that Brené Brown has taught me that have affected me and impacted my life. But at the time that I was writing that letter and in reading her book, which I think at the time was daring greatly- this concept of being vulnerable was something that resonated with me. And I was really mulling it over specifically related… Primarily to my emotional self. And you know, I think that ties to how we are in the world and who we are in the world. But I spent a lot of my time. And I was actually, I think, trained by a lot of people to be somewhat disconnected. And you know, what Brené Brown inspired me to do was to reconnect with emotions with my understanding of my own. My ability to share them and to see them in other people for the longest time, this is, if you ask my wife, when you meet her, she'll talk about this.

But I used to carry this like emotional cheat sheet in my back pocket. It was basically a grid of emotions at a high level. It had like happy, the sad, mad, right? And it just went through different words of emotion. So that I could begin to develop a vocabulary because I just hadn't been connected to my emotions for so much of my life. And so it was this really, like, freeing time to just discover what it was to feel and to connect with others in a more connected and deeper way. And, you know, kind of coinciding with that, I was being approached by a lot of students and residents around what I had been sharing about my journey, being a lesbian, what it was like, and they were asking a lot of questions. And so I think being inspired to be more connected with others and to share my own experiences in a more authentic way, allowed me to connect better with other humans. And so again, I had this great positive feedback loop of these students and residents, who I was able to connect with, overcoming my own fear of being emotional and connected. And they were just so grateful and, you know, embraced how I felt in a way that just continued to inspire me to have these experiences to their positive feedback.

Daniel Cobaugh: You know, it's funny in reading your letter, it's interesting to hear you talk about this because you talk about this a lot in your letter and you talk about some of this relating to some of the management training.I would say behavior modeling that maybe you saw in your early career. But you also talk about the fact that even as a young person, you learned that connecting with people could be risky. And I'm wondering, how much of that related to the fact that you were beginning to recognize that you were lesbian?

Lindsey Kelley: Consciously, probably I would tell you none of it. But subconsciously, I think quite a bit of it. You know, the idea for me still, it's the idea of rejection is a big one that I think I still process. The idea as a young person of kind of figuring out that you’re a little different and wondering how that’s going to go. Again, I'm really grateful that I've had a fairly positive experience related my, what I guess would be called my coming out story. There were moments of difficulty within my family, but I was never in a position of harm. I was never in any kind of danger for who I was. My mom and I had a long journey figuring out how to reconcile. I come from a really religious family. And so there was a lot of discussion around what that meant for me and what that meant for us as I, you know, discovered who I was. But I think, for me, it was just this concept of- okay, knowing that I could be rejected for something that I couldn't control. And so that I think was really scary for me. And so rather than take that risk of being rejected, I just was like, it would be easier if we just don't talk about it.

Daniel Cobaugh: Yeah. I mean, I get it completely, I think it's like trying to figure out what comes first, the chicken or the egg. I think of myself sometimes as an introvert and have the ability to be a bit of a loner. And you wonder how much of that relates to behaviors that you developed as a child, because in my case, I knew I was gay. And so I, again, I can really relate to that. When you think of the pharmacy community, do you think pharmacy is open to LGBTQ people?

Lindsey Kelley: That's a really good question. I think if you'd asked me several years ago, I would have said, “No, absolutely not.” I think my position has changed over time. You know, it's interesting. So today is Juneteenth and we're celebrating diversity in other ways. And I was thinking about this because of the positive response and experiences that I've engaged in in my own department and in my own pharmacy community, around these recognition opportunities and celebration opportunities of others. And I've had good experiences specifically more recently with pharmacy as a profession, where I feel far more optimistic and encouraged about our profession and where we are. If you've ever had a conversation with me, I joke a lot that pharmacy is kind of square. We're conflict averse in general as a profession. It suits us probably in terms of the role we play in medication safety. But you know, for the longest time I was like- Oh, you know, pharmacy is square, it's going to be a really long journey. And then in the past, you know, I would say a couple of years to several years, I have been really proven wrong. Which isn't to say we don't have our own journey to continue... Right? But you know, again, the feedback that I get from my peers and from those I engage with in our pharmacy community is so positive. And again, you know, it encourages this idea of vulnerability. The more I share about myself and my journey, the more people come to me and say, thank you for sharing yourself. Thank you for telling me about your journey. You know, I have a similar journey, or, I think my daughter is engaging on this journey or, you know, your journey helps me understand. And so I think that's been really powerful. And so I'm encouraged about our profession.

Daniel Cobaugh: Well then maybe the, what we're seeing in the profession also reflects what we're seeing in society here societally here in the United States, and I think in many parts of the world. But you made a comment about the journey, and so I guess, I wonder, are the things so that we can still do to make it better, especially for the next generation that's coming into, into pharmacy? Is there more that we can do?

Lindsey Kelley: My personality compels me to say, there's always more that we can do. I'm a person who is generally dissatisfied with the status quo. So yes. But here are the things that I think about, right, and so if we think about the concept of embracing differences and in this month of pride embracing the differences of our LGBTQ community members and ourselves, then I think it comes to the same thing we always look at, right? So what is the system that builds that embrace? How do we ensure that that embrace happens each time? Not because of a person or a unique interaction, but because the system is designed to achieve that outcome. And so I think about, simple things, like are our policies inclusive? Have we considered the way that our language or the way that our statements might include or exclude certain individuals? Have we, if we have a general way that we always do this around LGBTQ populations, have we put that in policy? So that it's not a question that no one has to wonder. Simple things that are in policy, like partner benefits. That was one of the things I also found really encouraging when I came to Michigan, is that I didn't have to wonder about partner benefits. It was really clear during my HR orientation. Here's how we look at significant others, here's how we look at your partner. You know, should you desire to have one (which I later in years did), you know, these kinds of policy, things that I think we often take for granted. Maternity and paternity leave… How do we build the language around that? So that it clearly demonstrates that it is not about what kind of partner you have or what the gender of your partner is. So I think we have some opportunities in the policies and the systems. And then the other thing I think about in terms of things that we can control as leaders, are representation in our leadership and representation our community in our committees. So when you think about the nursing magnet, it requires that a nurse sits on committees so that nurses are present. And so I think about like, what if we did that with things we felt passionate should be priorities. What if we said- “We're going to make sure that we have a good diverse leadership team. We're going to make sure we're hiring for diversity. We're going to make sure that we're promoting with diversity in mind.” These kinds of things that are just system changes you can make. And that would be true of any group to be fair. But I think about it in terms of our LGBTQ community.

Daniel Cobaugh: Well, and so I imagine that you were quite heartened earlier this week with a landmark decision out of the U S Supreme court, banning discrimination against LGBTQ people in the workplace.

Lindsey Kelley: I was, I was elated. So first- I didn't realize it had happened during the work day because I was in the middle of my work day. And so my wife came out, again, we're both working from home and she was clearly ecstatic about something. And I was like, what did I miss? And she was like, this policy change, major policy change. And so it's interesting because I personally was excited, but then there were two things that happened that made me even more excited. One was- we have like a family social media line in my family. And of course, Andrea and I are engaged in that. And so she sent the article to the family line. It was really awesome to see my family's response. First of all, many of them were like, seriously, that's a thing. You know, the first, the fact that many don't even realize that these kinds of discrimination still exist. So just their, you know, confusion, which was genuine. And then their excitement that it had been overturned, and that the protections were in place or that it was an interpreted that those protections were in place. And then the second thing was- we have some really dear friends who we often referred to as our faux parents. It’s woman I used to work with and her husband, and they're now retired. But they live here in town and they had immediately reached out to say, “Oh, this is great news. Congratulations. We'd like to celebrate with you. Can you come over? We want to make you dinner.”  And it was just this like, amazing moment. It was just really cool.

Daniel Cobaugh: Well, and it’s so wonderful to be able to celebrate moments like that with other people. You know, Lindsey, you've mentioned at least twice during this conversation today, and you talk about this in your letter as well, that young people have reached out to you to seek your guidance, to mentor them... What advice do you have for young people entering pharmacy, young people who are LGBTQ and are beginning their career as pharmacists or pharmacy technicians, what do you say to them?

Lindsey Kelley: That's a good question. I think there are a few things that I think about. And honestly, a lot of it depends on where the person is on their journey. I think often times when new practitioners or new leaders are coming to me, it's because they have questions about their next step. And so in the context of a student seeking residency or a resident seeking their first job, often, they're asking about how do I decide where to go? And so in that context, they often also wonder, is it safe for me to go to X, Y or Z organization? And so I think there's two bits of advice that I give around that question. and I think are good things to consider for anyone. Which is one- it's important that people feel empowered and comfortable being themselves. So I often will encourage new leaders or new practitioners to go wherever they feel most comfortable. And it's hard sometimes to what the culture of an organization or the culture of a community is. And so I encourage them to ask lots of questions and to use the same skills that we would use, the way we teach them to evaluate evidence and literature to evaluate organizations. So go and read their About page. Read their HR pages. Look at the language. What does the language tell you about the organization? And really get a sense for the personality of that organization. And so I think that's some advice that I give to people often. The second part is much easier to say and much harder to do, which is, as much as you can just be your authentic self. When you interview, when you talk to people. You know, a lot of times, particularly with residents and students, they're so worried about getting the residency or getting the job that they're often looking at it from a ‘what if they don't like me?’ perspective, which I think is fair. This concept of are they good enough for you? Right? Like, be yourself, see how they respond. If you don't like it, then don't go there, right? Like you want to go somewhere where you can be supported and embraced and, particularly on residency, it's only a year of your life, but it's a year of your life.

And so I think going somewhere where you feel celebrated is really crucial. The flip side of that, which is not part of your question, which is then that compels us as organizations to create environments where we are embracing and celebrating. So that we get the best candidates. We get the people who feel like they want to be here. And so that turns into like, kind of like my own job so that I can manage my own integrity. I have to continue to create the spaces where that is celebrated. Right? So it's kind of a dual duty.

Daniel Cobaugh: Well, you and I took on some really important work in co-authoring what I think is a really important article that talks about some of these issues for LGBTQ people who are beginning to pursue residencies. And I would hope that they take advantage of that, but also take full advantage of seeking out people like you for this type of guidance. It's funny, you said that that advice on being your authentic self is the one that's easier to say and harder to do. But, you know, in this conversation today with you Lindsey I can't imagine a conversation with somebody who could possibly be more authentic. It's just been really amazing to learn more about you and your journey and just your thought processes. I admire you even more now than I did 30 minutes ago. And that was already a pretty high bar.

Well, that's all the time we have today. I want to thank Lindsey Kelley for joining us today to discuss her journey. Join us here at ASHP Official and the Practice Journey podcast as we learn about how LGBTQ pharmacy leaders seek out, grow and evolve during their careers. Lindsey Kelley, thank you so much for spending time with me this morning.

Lindsey Kelley: It’s been a pleasure. Thank you, Dan.

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