Blog

“I just want to clean off my desk before I go home. Otherwise, it will be there in the morning and start all over again,” a physician recently told me. “But it’s endless.”

This is how the practice of medicine is like a beach house in which physicians are not guests, but glorified house cleaners. Between the parade of patients, you are constantly trying to “sweep up” the sand of the ever-present Electronic Medical Record (EMR).

A physician friend of mine confided in me that he wasn’t sleeping well. He confessed the cause of his poor sleep: “I take charts to bed with me. And sometimes I fall asleep like that.”

I pictured him, this lovely man in his late 40s, single, sleeping with his patients’ charts, the details of their condition closer to his heart than any woman had been in a long time.

I often felt that my physician-husband wasn’t with us, that he never fully came home from the hospital.

I had the sense, though couldn’t name it then, that he’d brought others home with him; other families’ grief, fear, dysfunction and love.

It was as though their stories clung to his clothes like the perfume of another woman or a crying child hanging onto his leg.

He dragged or carried them home. It it felt like there was a crowd with us, clambering for his attention.

When I asked him, “How was your day?” it wasn’t meant to elicit a reflexive answer like “Fine” or “Okay.”

I really meant, “Please introduce me to these people you brought home with you.”

One day, when I first became separated from my physician-husband many years ago, I found myself sitting in my living room in a comfortable low slung chair that I almost never had time to sit in.

I couldn’t focus on reading.

My children were at school. The house was clean. My freelance writing deadlines had been met.

A friend had invited me out and, for the first time since I was 10 years old, I had no idea what to do next.

It wasn’t boredom, but freedom.

This may be similar to what you face on your days off. Today may be that day…

What do physicians and soldiers have in common? More than you’d think…

If you’re like me, you’re a giver. If you’re a physician, you’ve devoted your life to giving. Perhaps, your identity is wrapped up in giving that you don’t know how to receive, even when the gifts are foist upon you. The true challenge for givers is to receive wholeheartedly.

As physicians, you might be facing extra stress, especially if you are on call for any Christmas, Thanksgiving or New Years Eve/Day. I know, because I lived it. My former husband, a neurologist, was often on call for the holidays — at least one of them — each year. Patients come before family. This is what we signed up for. Is it still?

Through my conversations with doctors — and my own life’s journey — here are 7 common practices of happy people…

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.