In college, I once slept through my tympanic membrane rupturing. In pain all week, I was just too busy with finals to make the trip to student health and too tired from sleep deprivation to awaken when the eardrum finally burst. My guess is that every physician could tell at least one story like this, where he or she pushed his or her own physical or emotional needs aside in order to accomplish some “greater” goal, whether it be during their school studies, seeing a few extra patients, adding on another case, giving a high-needs patient extra time, or sacrificing sleep in attempts to balance work and home life. This ability to consistently power through adversity to achieve a certain end is one of survival, and it is what enabled most physicians to achieve success, so to speak, but often at the price of blatant self neglect.
The ability to ignore our own needs temporarily is often times necessary in providing health care, but it is neither sustainable nor healthy. In fact, it’s probably contributing to our burnout. A mere mortal can only push aside aches and pains, fatigue, loneliness, or daily frustrations so long until this leads directly to burnout (a combination of feelings of inefficacy, emotional and physical exhaustion, and depersonalizations.) At some point in our journey, we need to stop functioning to survive and start learning to thrive. Ironically the first step of thriving is merely creating the space and time to realize not just our own needs but also our source of joy. We’ll never create a life of fulfillment if we cannot slow down and imagine what that looks like.
Recently, I had the pleasure of partaking in a short mindfulness retreat with 30 of my colleagues at UHA. It was a wonderful experience, and I’m very grateful to everyone who attended. During that process I tried Walking Meditation for the first time. In this practice, I first noticed what it is like to be standing and grounded. Then I chose a point about 10 feet from me and was instructed to become aware of my body and each sensation as I walked to that point. If I was distracted, I stopped walking and took the time to notice what distracted me, for example a bee or a flower, and give it my full attention until I returned to the walking meditation.
During the exercise I found myself walking very slowly and felt like I might fall with each step. Purposefully taking feedback from my body as I walked was very unfamiliar and very uncomfortable. At one point I became a bit irritated. If I could just use my normal pace to get from point A to point B, I would arrive at my destination more quickly and not have to worry about noticing the distractions along the way. Yes, the bees and flowers were lovely, but they were slowing me down and making me feel awkward. In that moment I was struck that this was a metaphor for my life. For most of my life, I have moved quickly, getting from point A to point B. I have ignored most of what might have slowed my progress. However, I realized that by doing this, I never allowed myself the opportunity to enjoy the flowers in my path, to evaluate if I like my pace, or even if I still want to go to point B. In the past past few years I’ve tried to slow down and notice more, including my definition of success and fulfillment. That process has been very unsettling, and often times I felt like I might fall. With practice, I now realize that I’m not going to fall, and the intentional reflection has resulted in greater sense of delight in the journey and awareness of which elements in my life need attention for me to achieve success and happiness.
It’s terribly disturbing that, nationally, around 50% of my amazing, ambitious, intelligent, compassionate, and creative colleagues are experiencing burnout. The drivers of this health care crisis are many, but I cannot deny that identifying ourselves as a heroes or martyrs does nothing to change that statistic. Impactful changes must happen both organizationally and individually. The first step in helping ourselves is being willing to take time to reflect on what brings us fulfillment. We have plenty external measures of success, many of them related to achievement (publishing papers; seeing a certain number of patients; receiving an award; attaining a certain percentile ranking in a certain appreciation scale). Often times when we reach these outcomes, we want more and aim our goals even higher. But our individual success is made of more than achievement. Personal fulfillment also includes having positive relationships, finding meaning in life, experiencing heightened engagement or “flow”, feeling happy emotions, and sometimes leaving a legacy. We will need to focus on all of these elements and what sort of balance works for us as we transition from surviving to thriving. Sometimes, this does not require a change in behavior but merely a change in perspective or an opportunity to reflect.
We must honor our own needs in order to create the energy needed to be part of the bigger picture solution. In the next week I challenge to take a slow walk and see how it feels, or merely take 10 minutes to honor what makes you feel great. We can no longer afford to “power through”. It might feel uncomfortable to slow down, but I promise you won’t fall over. In fact, it might be the first step to getting back up.
Rachel Seaman, MD
Chair, UHA Provider Wellness