You Cannot Pour From an Empty Cup

“You cannot pour from an empty cup,” says Jeevan Sekhar MD, who is boarded in four medical specialties. “It took me a while to internalize this concept.”

Yet, physicians try to do the impossible, day after day. It’s as if they, the purveyors of medical science, are themselves somehow impervious to the laws of that same science.

“As Type A personalities, we are go, go, go type people,” says Oluseun Olufade, MD, who’s CV bears this out. Board-certified in orthopedics and sports medicine, he works with several athletic teams, is an assistant professor at Emory School of Medicine, and serves as a co-chair and mentor for the Diversity Mentoring Program. (Oh, and he is married and has three young children). “Many physicians are working on E. We work so hard. So the slightest thing can take us off the road and the car stops working.”

So why don’t more physicians prioritize their own self-care?

“I don’t have time,” comes the answer from many physicians.

Beneath “I don’t have the time to take care of myself” is a deeper truth: Self-care is not held as a high priority in the medical culture, let alone by the clinic or hospital. Physicians not only run dangerously low on their own physical and mental fuel, but the culture of medicine encourages it. In myriad ways, self-care is devalued as quackery, selfishness or laziness. Indeed, the culture of medicine upholds self-abnegation in the name of “putting patients first.” And physicians themselves unwittingly perpetuate this, posting on social media their grueling hours and multiple holidays on call, for example. Other physicians comment on their selflessness and thereby continue to elevate the idea of putting patients ahead of self as the highest form of medical practice. This, despite countless studies showing that not taking care of oneself leads to burnout and decreased quality of patient care.

When you actually prioritize self-care, moving it to the must-haves column, something profound starts to happen. You start to say No. No to constantly picking up the slack, No to always saying Yes. And to do that is risk. I know a physician who blocks time out of schedule for yoga classes by telling his secretary the time is for “physician rehab.” He does not want to risk his reputation as practicing something so “woo-woo.” Indeed, to break down these walls of cultural expectation is to risk being labeled lazy or uncommitted or worse — a quack. Cardiologist and mindfulness meditation teacher Jonathan Fisher, MD, knows this well. He openly practices visualization and positive self-affirmation. He recently published one of these affirmations on LinkedIn, claiming half-seriously that “I may be sealing my fate” as a “quack”. But as a leader in the ending physician burnout movement he knows that self-care is a matter of survival. He is part of a growing movement of physicians who are taking back their power, taking back their lives. By talking positively to himself in affirmations and practicing mindfulness meditation, and teaching others to do the same, Fisher is filling his tank.

Sekhar is also on this path. ”Once I realized that I needed to emphasize and maximize the care for myself,” he says,”only then did I then actually recognize the toxicity of the work environment I was in. When work and self-care balance was not supported I knew that (and had the privilege of) getting out of mainstream practice was essential.”

Taking charge of your own mental and physical well-being may indeed require that you change jobs. But it doesn’t have to. Meditation and positive self-talk are examples of ways to find peace in the everyday hubbub of life.

Olufade offers the following from his own self-care practice:

• Take 10 minutes before you look at your phone to sit or lie in silence.

• Use your commute for silence. “Podcasts and music are great, but silence on my drives can free me of all my to-do’s,” says Olufade.

• Consider finding an “accountability partner” in a fellow physician. Olufade uses his to help him stick to his intentions, one of which is to get home by 5pm.

• Be intentional with goals, including when you leave work, when you are done looking at your phone or laptop.

• Take phone breaks. Phones can be a source for mindfulness and meditation apps, but they are also a source of stress.

• Exercise. Set realistic goals and schedule it.

• Plan vacations.

Dare to be a quack. Take care of yourself. Prioritize self-care as if your life depended on it. Because it does.

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