How can we create weekends if we’re scheduled to work daily for weeks on end?

It’s not about the goal; it’s about the actions…

How often do you hear something and think, “How didn’t I know this already?!” Today, this moment came from learning about Dr. Lorna Breen.

I’ve used February, the month home to Valentine’s Day, to think about love. Over the past month, I’ve found something else I absolutely love…

With the rates of burnout and general ennui with the state of practicing medicine, we don’t have time to wait until the practice of medicine changes before we start making room for the people we want in our lives.

Once we’ve found a thought pattern that may not serve us, we can start to nudge the thought pattern toward one that serves us and gets the results we want.

Many esteemed and very doctor-like doctors have spoken of how much they love practicing medicine. They relish being a doctor, look forward to coming to work every day, and genuinely love each of their patients. I like being a doctor. And I’ve gotten good at it. I’m unsure if I love it…

A lot of us got into medicine because of certain kinds of love: love of science, the love of a challenge, or wanting to help people (which can be a little “L” love as opposed to big, grand, directed-at-one-person-at-a-time big “L” love). Somewhere along the way, all of that love becomes rote…

For those in a moment (Season? Era?) of “head down, do work, grit teeth, repeat” and unable to mark the passage of time, I have a gentle notification coming from a place of absolute love: the month of January is over.

I have been at DEFCON 2 for the past three days…

Thinking about artificial intelligence makes me feel old.

I have a toddler that lives in my brain.

I’m one of those people who picks a new word to guide their year.

Oh, the breathless possibilities of a new, blank planner.

Physicians are deeply accomplished people. If you’re already spiraling into thoughts of, “Yes, in principle, but I have a manuscript I need to submit, and notes I need to complete, and everybody I work with is way more accomplished than I am…” just put a pin in those thoughts for a second and stay with me. Compared to all humans alive on the planet right now, physicians, even those still in training, are deeply accomplished. We’ve accomplished as much as we have because of thought patterns that have moved us from step to step: from quiz to test, from semester to graduation, from gross anatomy lab to board exams, from the completion of training to our first faculty positions.

A few years into my first faculty position, I recognized taking a week off for vacation wasn’t enough time.  I’d spend the first couple of days getting used to being on vacation, two days enjoying myself, and then 2 or 3 days getting anxious about returning to work.  This spring, I looked at what all of my colleagues’ July schedules were doing and realized that I could take the entire month off without any of them having a horrible schedule to accommodate my absence.  The break came at a serendipitous time: I was ending the academic year with a lot of overtime shifts, so I had a long stretch of clinical time without a break.  I was tired and verging on burnout.  I was also admittedly using work as a distraction from grieving a death in my family.  A month-long blank calendar looked like a vast, open space of possibilities. 

My best friend from medical school is currently practicing on the West Coast. When I visited her for the first time, we started comparing notes about the (admittedly stereotypical) personalities of different parts of the country. I relayed that my time in Seattle had worked my Midwest “Smile at strangers when you lock eyes” out of my system because I’d found people in Seattle to be more reserved than those in the Midwest. Moving from Seattle to Nashville brought that tendency back to me, though, because folks in the South are so effusive that they ask strangers how their days are going and actually want to know. My friend said, “The people here are just nice,” but she said it with a tone that conveyed a bit of, I don’t know, distaste, maybe?

Quitting has a lousy reputation for physicians.  It makes sense; we became physicians by just not quitting.  We didn’t quit our educations after high school; we went on to college.  And then from college to medical school, residency, and sometimes to fellowship.  Sometimes we “not quit” our way into advanced degrees.  When my training got difficult, I learned to give myself the “I can do anything for (insert hours to weeks to months)” pep talk.  Practicing medicine requires a commitment to lifelong learning, so “not quitting” is woven into our profession.  Maybe it’s not so much that we don’t quit; it’s just that we never finish.     

“You need to set boundaries” is a common refrain to burned-out physicians. I heard it so much that it became a thought running through my mind whenever I opened my email inbox. Whenever I got a request to give a lecture, join a workgroup at my hospital, or put my name in for a professional organization’s subcommittee, “I need to set boundaries.” It even started to run through my mind whenever my text messages would ping (or, Heaven forbid, my cell phone rang when I was at home for the evening). Common parlance is that we have around 60,000 thoughts a day, most unconscious (otherwise, we would not be able to function). So if “I need to set boundaries” was a conscious thought that often, I have to wonder how often it was an unconscious thought, rolling around in the recesses of my brain, taking up energy and leading to feelings of helplessness that were boiling just below the surface.

“Altruism” is the “practice of…selfless concern for the well-being of others,” according to the New Oxford American Dictionary (via Google, of course). The site also notes that in zoology, altruism is a “behavior of an animal that benefits another at its own expense.” I don’t remember the day in medical school when I learned that my patient’s needs came before mine. But I remember gradually learning to moderate my liquid intake lest I need to use the restroom during rounds or in the OR. Ignoring my aching bladder merged into ignoring my grumbling stomach, and eventually, those two sensations just stopped happening. When I’d overeaten to a BMI of 35 because I couldn’t tell when I was hungry? Maybe that’s when I started to exemplify the zoologist’s more-aggressive idea of altruism.