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I recently mentioned the possibility of burnout to one of my doc clients the other day. An orthopedic surgeon in his late 40s, a powerhouse of stamina, he became defensive. “I’m not burned out. Not any more. Maybe I used to be. But I’m fine now.” The words came out of him before he could stop them, each one attempting qualifying the last. Door closed. Or so I thought. But the next day, as if he’d been thinking about it all night, he came into my office.

“You know when it started?” he said, before he even sat down.

“When what started?” I asked.

“The burnout. It started in residency. You couldn’t be tired or hurting. It was as thought we weren’t supposed to have normal physiological responses or needs. It was — bullying.”

“Bullying,” we both repeated together.

Did you always want to be a doctor when you grew up? When you first thought about being a doctor, what was it that drove you? Was it a calling, a family expectation to follow in your parent’s footsteps or a challenge to do what they could not? When you took the Hippocratic Oath was it a marriage of love for your work or more like an arrangement? And if it was the latter, did you eventually fall in love? Where are you in that relationship now?

How to manifest happiness, part I:

• Get yourself a big, juicy dream.⁠

• Spend time with it every day. ⁠

Experiences shape your body and the way it moves. Just look at how athletes are built to perform their particular sports. Body shape and function, of course, have some genetic components, but it is training -- the way one moves repeatedly -- that so perfectly prepares the body for that particular sport or life. But, did you know it goes both ways? Not only do experiences shape our bodies, but the way we move and hold ourselves shape our experiences in everyday life. ⁠ ⁠

“'I am because we are', because we belong to each other," wrote Gene Gincherman, MD, an emergency medicine physician. It is this definition of Ubuntu, an African concept that helps Gincherman navigate burnout. “Emergency medicine is such a sacred space for [Ubuntu], for it is where we get to meet strangers who are hurting and try to become whole again," he says.

Physician burnout, in many ways, is about missing things; parts of our lives, our relationships to ourselves and ultimately to ourselves. This grief might show up as cynicism, impatience, depression, pain, apathy, to name a few of the symptoms of burnout.

Just like lifting weights at the gym, you become mentally stronger — able to be quiet amidst the storm of the clinic or hospital — by doing repetitions of the exercise. In this case, the exercise is being. By learning to quiet your mind, simply breathing, even for just five breaths, actually changes your brain in the same way you change your biceps by doing dumbbell curls. After just six weeks of regular mindfulness meditation practice, changes can be observed on MRI.

When I ask physicians how their work-life balance is going, I get a range of reactions from scoffing to sarcasm to despair. “The notion of a 'work-life balance' is a new and strange concept...my 20-something kids are more comfortable with it than I am,” a physician recently confided. As he faces retirement earlier than he’d planned, his very identity is at stake as he faces the Life part of the equation.

What does work-life balance mean?

Increasing your adaptive ability, or resilience -- not to just shore you up so you can go back to a toxic work environment, but also to help you create boundaries, build courage to say No, get creative about Yes and maybe even find a new direction altogether -- THIS is the power of coaching.

These three golden tools — which may also be called Mindfulness, Movement and Empathy toward yourself -- are practices that together may be the most powerful medicine you can take . They don’t need a prescription and addiction to them could save your life.

As medicine increasingly relies on performance reports and data benchmarking tools, many physicians feel increasingly stripped of their ability to exercise the profession’s oldest powers: intuition.

When you walk into a room for the first time, what do you see, a patient or a person?

I recently spoke with one of my clients, a neurologist specializing in stroke, about this. For him, this question of patient or person is absolutely and inextricably linked to the fixer-healer question. As a physician in a specialty where events have often already happened, a good deal of his energy is spent providing comfort and information, ultimately empowering the patient with knowledge.

The answer may have everything to do with how happy you are at work.

And beyond.

How you see yourself as a physician — healer or fixer — reflects back to what you see is possible for your own life.

You binge watch 60s television Westerns because you can’t quiet your mind any other way.