Mary Coughlin: [00:00:00] All right. Well, welcome, Sue Ludwig. I am so wicked excited and honored to have you on our podcast today.
Thank you so very much for sharing your time. as we were just chatting the thought that came to my head was when we first met. working with Children's Medical Ventures. And now, as I look back I knew you then as this super amazing, passionate, clinical, occupational therapist, and now I'm sitting with you today, and you've made Quite the developmental journey yourself over your career and impacted the world with your expertise and your passion.
could just share a little bit with everyone listening in about that journey from clinical OT to entrepreneur, published author, president and founder of an incredible organization, the National Association of Neonatal Therapists. So take it away, my friend.
Sue Ludwig: Well, first, just thank you, Mary, so much for inviting me.
It's thrilling to be [00:01:00] here. And I was thinking of the same thing, of just how long we've known each other. but to your, to your question about the path yeah, I was a clinical OT for over 20.
Plus years in the NICU in Cincinnati, Ohio. And, specializing in the NICU was just something that once I spent one day there, I really never wanted to do anything else. I found my passion for sure. I did have that opportunity to, consult for other NICUs around the country
About developmental care and that started to open my eyes to the bigger picture of how we really wanted to improve care for babies and along that pathway meeting therapists, OTPT speech all over the country. I saw how much we. Were the same in that we were all isolated in our own NICUs. Sometimes there was only one of us in a NICU, one of us in a state, maybe even.
And, other people had pretty big teams that were doing great [00:02:00] things even way back in the day. But what we didn't have were any common resources or a place to call home or standards that we could all grab onto and, and really do what we wanted, which was to make things better. You know, we were driven group of people, but we just didn't have the place or the resources.
that we were just sort of doing the work you know we were like it was like another ICU that we were serving but, but I think the difference in the NICU is that it's such a special population that you really do need a specific set of skills.
They're not just small pediatric patients, as you well know, and so I, I think that's what really made it feel to me like we needed something more than just if we were going into a different ICU, I guess, Yeah. So over time and I, I felt like, you know, Hey, we should kind of do something about this.
You know, we should, come together somehow. I spent a long time kind of looking for the leader of that charge and saying, [00:03:00] Hey guys, here's a really good idea. We should be a group of people in the world and somebody really smart or charismatic should go do that.
And so I did spend some real actual time looking and Shopping the idea, before, a lot of soul searching coming to the conclusion that maybe I should, if I'm the one who keeps talking about it. So in 2009, I founded NANT, the National Association of Neonatal Therapists.
And so we're, 14 now, which seems crazy it's really been an adventure and a privilege to. try to be a good steward of that vision.
Mary Coughlin: Well, my goodness, you've been an incredible steward. I don't know if I ever told you this story Sue, but when I was a bedside nurse trying to feed these people. to get them to take the prescribed volume and the baby continued to struggle and they put in a consult for the feeding team over at Boston Children's. And, I felt like such an incredible failure as a nurse that we were now [00:04:00] calling these specialists over and they were OTPT speechy folks that I had never interacted with before.
Because that just wasn't how our unit at the time was set up. we did not have a dedicated team of therapists it was just this really crazy silo driven orientation that was just such a a silly way of, constructing a care team for these incredible fragile babies.
But again, it was in the absence of any standardization, any recognition that people other than nurses, had, significant expertise that could add to the care and and the support. And the, the recovery of these babies and their families.
And so that was another big piece of what I think your organization and your vision for therapists really helped serve. And I, I, I know that there are still some areas where there is a little bit of friction, you know, I mean, I think you, you always have that, [00:05:00] but for me, it was just such a breath of fresh air to really recognize that.
I didn't have to do it all alone,
Sue Ludwig: Yeah. I think one thing that I had to try to continue to advocate for in my own unit and then in the. country, the world, whatever is, is really that, you know, as therapists, it also doesn't work as well when in that kind of consultative model that when we were sent in like a rehab team to fix a problem versus we are part of the team and we are in a preventative mode, then when necessary rehabilitative mode and that, you know, I, I had a really strong respect for and sense of that if I were you as a nurse and I just waltzed in there, never been, you know, you never have seen me before that there's no trust there.
And so I, I always have tried to. keep in mind and advocate for the relationships between, nurses and therapists and physicians and therapists and [00:06:00] for the actual hours for therapists to be dedicated to the NICU instead of being sent to the NICU, because I think it works best when you and I have worked together and we partner making decisions together for the baby is a very different model
And I also had a appreciation for the nuances of how, quickly a baby can change and how, if I only come in there Monday, Wednesday, and Friday at one o'clock as a therapist, I don't really get that kiddo. Yeah, you guys would right being there all the time. So I just felt like all the time was necessary to really understand the baby and then also build the trust in the care team.
Mary Coughlin:
Yeah, I like how you use that word trust and and definitely being part of the team, because the other thing that I've seen at least in my, you know, my opportunities to collaborate with therapists and nurses in other settings is realizing that there's a multi [00:07:00] pronged approach to the care of the baby that it's not just, oh, call the therapist to come in and do something to this person, really understanding the breadth of service that therapist needs. provide to babies, there's a lot of things that you can do without doing two. Do you know what I mean?
Like, I mean, you guys make incredible assessments and and you, you're able to do that in such a way that supports kind of like Natural encounters, right? Like I think a family centered care, for example, you know or family integrated care, any, any of that language that that you're able to do an incredibly comprehensive assessment on a baby about their motor capacities, their state orientation, you know other types of assessments that you make just, you know, while the parent is, is holding the baby, you know, it's not this thing like nurses and I think [00:08:00] as a nurse practitioner, you know, I, I, I would do this as well, you know, really feeling like I had to get in there and, and manipulate this person and, and do all these kinds of things, but that, that was something that I, I was taught from my therapy colleagues that, you know, although my default setting is to You know, I get in there moving my hands around and touching the person that I can really gather a lot more information that is in a, in a less stressed state for the infant, right?
Because every time I touch them, I'm, I'm disrupting them. I'm dysregulating them. And I've, I've learned that a lot. Through my therapy colleagues and it's just been an incredible evolution in my understanding and my appreciation of, of caring for these infants and their families by not being so invasive or intrusive and, and cultivating that relationship based on trust.
Through those interactions. And, and I think [00:09:00] you do that a lot. I remember when I first signed up for NANT, I got this lovely little DVD. That's how long ago it was. About intentional caregiving and, and other types of really great guidance and direction. And you know, it's not just for therapists, it's for anyone who's interacting with these individuals.
Sue Ludwig: it's been really fascinating to, you know, in my own life, look at, you know, over time, I was very focused, of course, on my clinical work for so long, but over time, being able to kind of become the observer of myself in that.
In that interaction as well and understanding that what was I bringing to that infant? What was I bringing to that family in myself? You know that I think we just think about in health care like we think about what we know and what we're skilled at and that that's what we're bringing and we forget that we're also bringing ourselves and we really downplay that.
I [00:10:00] think we're taught to downplay it from the beginning. But what I. You know what I came to believe or understand is just how much it mattered, my presence when I showed up at the bedside what was I really bringing there and I had a choice, and that if I was frustrated if I was rushing around.
If I was in that do do do mode. I had to just kind of. Figure out how to stop and take a breath and really be more intentional because I was going to transfer that into incubator into the family, and really in the end, in my own life, I had found, myself at a significant place of burnout and what helped me get out of that place was the same things.
Go figure that helped the most vulnerable humans develop and thrive instead of just survive. And so I really ended up kind of looking at what, what helped the babies because I think as a therapist and then, you know, as just someone who cares so much about developmental care, family centered care is that, you know, when we understand[00:11:00] what helps the most vulnerable people among us that it does help us.
As adults as well. And that kind of exquisite level of care that we provide in the NICU under the best of circumstances when applied to us is amazingly helpful. You know, I mean, just being intentional in our own lives. How we sleep uh, not interrupting our own sleep and getting enough of it. And I think that if I could summarize it, I would say, That in the NICU, the whole NICU has undergone an evolution over time of, just focusing on survival, which was super important, obviously, and neonatology got very good at that, but, I think what we've tried to come back and say is that's fantastic that babies are surviving, but how do we help them thrive?
And then figuring out that we didn't have to wait until they kind of were quote in the clear to help them work on thriving, that if we're really [00:12:00] helping thrive, we're doing it in real time. Yeah. And even on the worst day, we can do something that's really additive to their life. or not making them more stressed but making them feel more comfortable so we could weave the thriving.
into the survival. We didn't have to wait and hold our breath and then go fix things. And I think that's true for us as well.
Mary Coughlin: Oh, absolutely. And I, I I love how you said that about the things that we do for these babies and families helps ourselves as well. Because I think what we need to be reminded of is that we all started out.
As babies we all have a story and, and a lived experience that has shaped how we show up to our lives and, and to our work. And if we can just take those pauses, you know, how you articulated that was, was really lovely. And I love the way you use the word exquisite. You know, if, if we can, if we can be [00:13:00] intentional, if we can take that moment to align ourselves with that individual in that moment of time.
It's an invitation for us to then step in as our, our best self in that moment. We got the skills, you know, I mean, it's all good. You know, we've, we've been trained to use our fingers and our minds in, in ways that align with our discipline and that sort of thing. But these individuals need so much more and we get so much more out of the experience when we can connect at that human to human level.
And so when you, when, when the thought. came to you about writing this incredible book, Tiny Humans, Big Lessons how, how did it, how did it percolate and how did it then kind of manifest itself? I, I had a
Sue Ludwig: really hard time actually deciding sort of the direction of it. Yeah, I, I remember sitting on a hill in Asheville, North Carolina with one of my friends [00:14:00] discussing this, you know, she had written a book and so I was kind of picking her brain about how do you decide what the Kind of through line of this whole thing is all of these thoughts and this life experience and everything and, and I, I didn't know how much it was going to connect to the NICU at first.
I didn't want to write a full on memoir or something but I didn't know how to weave it together well. But I think over time. I look back at everything I had written kind of for Nant even, you know, I've been writing newsletters for Nant for over a decade already. And, I kind of look back, like,
What are the things I can't stop saying? You know, like, what are the, what are the pieces that I have been, like you said, you've got a DVD about intentional caregiving. And that's basically so many of those concepts are in that, in the book. You know, if I So I've been saying this stuff for a long, long time,[00:15:00] but what I hadn't been saying as much of is how I was using them in my own life.
And so over time, as it percolated, kind of, wanted to show not just those of us in healthcare or in the NICU, but kind of everyone that, behind the curtain of this strange place called the NICU, there are these miraculous lessons that can apply to all of us as people and started to build the idea or the structure from there.
Yeah.
Mary Coughlin: Well, I mean, it is, it's an incredible book and it's so profound. It's not an exclusive book for NICU clinicians. I, I you make me think about asking in writing a book, you know, and kind of sharing that, that wisdom and And the lessons that you gleaned over the years of your work and your metabolizing your experiences to kind of uncover these gems of wisdom have you experienced other folks kind of coming [00:16:00] back to you now as an author, you know, when you put your stuff out there?
I, I, I sometimes think you're not. You're not writing for those people. You're kind of, you're, you're writing for yourself. You're writing to get this message out there and it touches people's hearts and souls. How has that impacted you? Have, I mean, I'm sure you've gotten tons of feedback. I see the, the reviews on the, on the book and that sort of thing.
How does that impact you now that you've kind of put all of this wisdom out there in the universe? How has it impacted you? And, where does it take you?
Sue Ludwig: That's a great question. Uh, impacted me. It's been. It's been such a surprise. I think you know, it's just amazing to me and humbling and clarifying, really.
So, hearing Both how, for some people, how it's impacted them similarly as it impacted me in my [00:17:00] life one of my favorite things to hear is that people are doing something differently. Yeah. Yeah. Cause cause inspiring people is great, but actually helping people do something differently in their life.
really makes me happy. You know, like, things could actually change for the better and that, inspires me so I think that's been so fun and gratifying to just know that it would be meaningful enough to them to then incorporate into their, into their lives is really rewarding is, is what that feels like.
And, and then there are the. The stories, you know, that people have shared with me about their own lives, whether NICU or non NICU related, that are just profound. And I feel very fortunate that, you know, people would share those changes or those experiences with me. It's been just a surprise. It's just a such a happy, happy thing to experience, honestly.
Yeah,
Mary Coughlin: It is sharing something very personal and intimate about yourself, [00:18:00] right, your own growth experience, your own take on this super intimate part of your life, you know, caring for vulnerable babies and families, but also the lessons that you've learned from those experiences and to have it resonate with folks.
I mean, friends and family. Cool. Yeah. But with, when it resonates with. People that you may, may not be too close with, right? People that may actually be strangers. It almost feels like it, it creates this bridge of connection and and that you've touched something in there. Lives are in their heart and soul.
That is a shared experience, um, between the two of you, whether you know each other or not, right? It kind of comes back to that thing about that you mentioned how did you phrase it? You You know, just being your, your best self, you know, when when you're coming into care for these babies and you have to kind of let go of all of [00:19:00] that energy because you want to be there with them, it's that shared connection that you try and create that in your writing.
That's what you've created through the book with the world. And so folks that get to read that book and experience those stories, whether they work in a NICU or not, it touches them, and I think that that's just such a powerful thing,
You know, when you were saying you were looking for that leader, so you could say, Oh, we need this, that, and the other thing. And meanwhile, you're sitting in the skin of that leader, and not realizing it at the time. It's just these kinds of profound happenings, awakenings. I think that.
Our true expressions of folks that are considered thought leaders, those folks that are on the leading edge of of healthcare, of society, of, mission work, if, if that's all right for me to refer to the mission work that is so unique and takes so much [00:20:00] courage. To, to be able to step up and do in this, in this wiser place now that you've evolved to, which is just a snapshot in time, because I know you're moving on to even greater wisdom and, and, and greater stuff.
How has this journey helped you gain maybe a better understanding of. the needs of human beings that are in a vulnerable situation. Have you, any thoughts about what is it that we need to better serve these individuals?
Sue Ludwig: I think it's both in getting the, responses about the book and then in, the work itself. I think what it's made me consider is just how much everyone needs to feel just seen as an individual. They need trust. They need safety. I always feel like with the babies, how poignant it is in the [00:21:00] moment that every single life matters and being able to bear witness to that, whether it's this vulnerable person in front of you or your best friend or your partner or whoever, continuously trying to show up for each other in a way that is deserving of the other person's trust and energy and everything, I think, is just a continuous journey for all of us.
I think that people are lonely. You know, I mean, I think that's one thing that's pretty apparent both in, in getting you know, some feedback about the book, but also just in the greater healthcare. I think one of the, you know, things NANT has made me aware of is just all over the planet, that kind of feeling of isolation that therapists were feeling, you know, back when I started is, is pervasive.
And, and yet so is their spirit of saying, but I don't want to be isolated. I [00:22:00] want to be part of this. I want to do better. I want to know the people that are doing things better that have the same passion. So I think we're all seeking connection with, common places that we happen to care about. And there are a million.
Different ways different passions and thankfully, because the world needs a lot of things. But I think finding those like minded people or like hearted people and, and being able to connect and be of good use for the world. I mean, people want to feel on purpose. Yeah.
And being able to be in a group of people that's doing something that feels like that goes a long way. Yeah,
Mary Coughlin: I love that. You said people want to feel on purpose. I mean, that's just, it's such a powerful thing. You ask anyone and they'll say, I just want to know I'm making a difference.
And, and I think that that's just inherent in all of us, not just healthcare professionals that we, we want to do our best. We want to make a difference. We want to live on purpose. And so [00:23:00] how can you help guide people on that journey then? You know, is there some, is there, is there some wisdom that you can offer folks or you know, just from your own lived experience that can help folks find that sense?
Of purpose and mission, what would you say to them
Sue Ludwig: so many things? But I think one thing is so many things. One thing is that I, I think I think about purpose differently than, than a lot of people in the, in the sort of realm of, you know, I don't know what my purpose is or what is my purpose and, and people can spend a lifetime chasing different versions of, of that.
And that's fine. There are different seasons of our lives. And I think we can have, of You know, a lot of different versions of that, but, but what I feel like is that we, like you embody your purpose, like you are it. Yeah. And so every single [00:24:00] person has their own unique skills, lived experiences, stories, genetics, like literally no one is like you in the whole wide world.
So, and that's like the, the best news. So I think you know, to me, That, like making whatever you are as an individual, anybody that's listening to this, like doing, being yourself to the best of your ability and taking care of yourself so that you can go use your, all those combination of unique things that are you in the world, whether you're volunteering, whether it's part of your job, whether it's raising a family, like whatever you're doing anywhere all the time, it's like you're bringing your purpose To the world instead of looking in the world to find your purpose.
And I think that that when we, when we can believe that we carry that in us, then we can start to feel purposeful wherever we are because. I think so [00:25:00] many times we, we, we wait until we think it's in the future. We think when I finish school, when I pass this, when I get a credential, when I, whatever the thing is, the, the promotion position, then I will feel like I'm living my purpose.
But almost all the time, those things Yeah. Even if you achieve them, which is fine and great, and I love having goals and I'm all about the goals and everything, but, but they can feel really empty once you, if they're the end, if they're the end thing, the trophy, it usually feels empty like the next day.
Yeah. Because the achievement is. If the achievement's the goal, then we, we keep tying our worth to the achievement. And I think we have to say, we are the worth, we have it, we carry it around. We are the purpose. And then whether you're, you know, working the worst job you ever thought you could ever have while you put yourself through school or whether [00:26:00] you're in, you're thinking, what am I doing?
Why this doesn't feel, I have a greater purpose than this. But I think that it's because you you're doing the thing and you're collecting lessons from every single thing you ever do None of it is wasted. Right? It just keeps adding to that purpose. You're gonna bring somewhere else in your life Yeah so and I think the babies have taught me that a lot Development is continuous and it never ends So you know that we we're just always developing and always learning no wasted lessons and we get to carry that around and and I think. That's how I would want to help people view their purpose.
Mary Coughlin: Yeah, yeah, that was absolutely so ridiculously profound. And on point, it had the smackings of like what's his name?
Eckhart Tolle. You know, talking about the now, if you keep hitching your wagon on tomorrow, you're going to miss out on all of the joy [00:27:00] that's just sitting around you in that. In those moments yes, goals and objectives, but your, your worth is much bigger than that. That's a, a super profound message.
And I think a lot of us, you know, we've been a cultured into this very hierarchical patriarchal Society globally. And and I think that that wreaks havoc with our view and our vision of our potentiality and where we can go. But I digress. As the leader of this international organization and a distinct thought leader do you have any top priorities for the upcoming year, your vision for NANT that you can share?
And or you know, not one. Yes.
Sue Ludwig: I think in general and and and and and I do officially sort of review these at the end of the year. So I've I've reserved some time. But I I think, one of the priorities continues to be to break [00:28:00] down the silos. And And what I don't mean by that is I'm not trying to melt everyone into the same discipline, I'm not trying to say that it's really the opposite is kind of just like the, the purpose, is that we each do have this unique contribution to make.
And when we're all doing that well and in service of the patient, uh, or for NANT in service of our members or, you know, whatever layer of people that we're talking about. But without that kind of hierarchical and siloed approach, you know, I think then we best serve the situation, the person, the patient.
I love what I learned from my colleagues, whether they're nurses, physicians, other therapists. Dieticians, everybody that I've always shared that space with I, I love knowing somebody else's perspective so that I can better understand how to deliver what I'm going to bring to a patient or to a situation.
[00:29:00] And when I see sometimes at the Nant conference, when I see something that people wouldn't expect, for, for example a PhD physical therapist talking about her research and feeding, because she's looking at, you know, The lungs and the respiratory component in this very PT thing, but it's, it's around feeding.
And I think, see, this is, this is the good stuff, you know, like this is why it's important that we can all have a conversation together. Cause wow, look at, look how much we can improve something when we're willing to say, well, you, you get, you know, you not only get to talk about that, but we please.
Please educate us. So I think one of the priorities will continue to be to to break down the silos so we can better serve patients in the end. And then, really continuing to look at building. What does it mean to build community, both in Nant and internationally with with and without an outside of Nant too, but I think there is [00:30:00] a You know, one thing that, you know, I know you a degree that our careers have taught us is just there's so many good, passionate people out there and and collecting them and bringing them along and saying, you know, how can we help support you?
And so really providing an avenue for community, but also then how do we support you to keep doing the great work that you're doing? And I do really want to, keep hounding the healthcare world I know the word self care gets tossed around so much that it seems meaningless sometimes, but, but really we're really poor at it inside of health care.
And the world probably wouldn't believe how poor we are if they could watch us eat lunch in three minutes or not go to the bathroom for 12 hours. But we're, we're like the last frontier of, of really taking good care of ourselves. And, and I, I can only imagine what good could come from [00:31:00] us dropping that narrative and, and really being, having permission and support to do that
Mary Coughlin: well.
Well, I mean, then your beautiful segue into this idea of caring out loud, I mean, you certainly exemplify what it is to care out loud in all of the work that you've done in all of the contributions that you've made to your distinct profession, but also to the world of healthcare at large. I would love to just get a little bit of insight from you about what does it mean to you?
Or what does it look like to you to care out loud?
Oh, I think,
Sue Ludwig: I think you do this well. So I'll say that. It's very well. So I, think it means to not only use your literal voice to tell the world, what you care about and, and to try to convey. Both educationally and passionately, you know, the things that are, that we do care about and [00:32:00] in healthcare and beyond, but, also to care out loud to me means we're doing the work,
big work maybe if you're in a place and then you have a platform or you have a way to do work that's at some national or international level. Sure. But I think the, the most important thing is doing the work incrementally every day, the hard work of, you know, when you're just tired and you're just have to go see the next patient, or you still have to do one more thing to try to show up for that.
Well, it's really hard work over a lifetime and and to give, have a lot of grace for ourselves. So that we can, in the next moment, we get to read a side if we were too tired in the moment before, but I think we. I think we just have to do the things that match what we say and and we're human and we're going to fail and we're going to make mistakes.
And that's, I think, all expected. And that's part of development as well. [00:33:00] So I think it's in kind of in word and in action showing. And doing the work that that says that we care and we can't say we care for patients while also like not letting parents in the NICU, so it has to be at a level that some systematic as well,
Mary Coughlin: and sustainable and yes, exactly.
Oh my gosh well You are an incredible role model for what it is to care out loud. I mean, everybody I talk to who knows you and even folks who don't know you personally know of your work, know of your contributions and are just blown away by the incredible contributions that you have made to your field and also to healthcare at large.
thank you so very much for sharing your insights, your wisdom, and your incredibly huge heart on the, on the podcast today.
Thank you so very much.
Sue Ludwig: Thank you for having me. It was so much fun. A joy.
Mary Coughlin: Oh, you're a very kind.
