As residents, working 12 hours a day, we often wonder, “How do we do it all?”. It feels easy to be overwhelmed at the idea of achieving wellness. While we strive to have the perfect professional and personal life balance, it sometimes feels impossible to read, exercise, do household chores, and fulfill the role of a loving partner/parent/child/friend when we return back home.
When I was first approached by a good friend to write this article for “how are you DOing”, I laughed. But I wasn’t asked to write a “How are you DOing” I was asked to write “Who DO you walk?”
I knew residency wouldn’t be easy for someone as beholden to REM cycles as I am, though I naively believed I could make it through four years of training unaffected by their relative absence. It turns out that was wishful thinking. Although I took an oath to do no harm to my patients, learning how to practice medicine came at the cost of my own health and well-being.
Have you ever found yourself so overwhelmed you literally didn’t know where to start sorting through your “to-do” list? Been there, done that.
When we were young, my brother and I spent much of our summers at my grandma and grandpa’s farm in Boswell, Indiana. Running around with our cousins in the country and being doted on by grandparents was typically much more appealing than being cooped up in the suburbs and getting assigned the perfunctory summer chores from our mom.
Resident wellness is an important part of today's medical training. We at the Washington Hospital Family Medicine Residency have had the good fortune of having support from our administration in maintaining wellness of the residents in our program. With the help of the POMA Mental Health Task Force and the POMA foundation, we were granted funding to support our idea to create an event combining resident wellness with nutrition integrated with medicine, notably, culinary medicine, inspired by the Goldring Center for Culinary Medicine at Tulane University.
Jab! Cross! Left body hook! Right front kick! Left side kick! Right roundhouse kick! Beads of sweat drip down my face as I finish Round Six. I am exhausted. The sense of accomplishment is palpable. Not only have I made it through one hour of high intensity exercise after a long day of work in the office, but I have learned a few valuable life lessons along the way.
How are you DOing? Or, should I say, “How are you EATING?” During our medical training we spend hours learning about cardiac disease, pulmonary disease, blood disorders, diabetes and surgical emergencies, but relatively little about nutrition. Nutrition, unless properly balanced, has a negative impact on all organ systems!
On my first day in the hospital as a new intern, I had the healthy amount of fear that most new DOs have. I anticipated that long hours and dedication to taking every opportunity to learn would leave very little time to spend with family, friends or for self-care. I thought I would be putting my personal life on pause during the next three years in order to focus on becoming the best clinician I could become. Starting a new hobby or interest didn’t even cross my mind. As a single person entering the rigorous life of residency, I also thought dating would be off the table for the foreseeable future.
The pre-clinical years of medical education leave students unfulfilled. It's a relentless obstacle course full of memorization, stress, and student loans; ignoring our higher calling to treat and connect with patients. The things that light us up and made us want to become physicians in the first place are traded for limited patient interaction, multiple choice exams, and spending hours sitting, reading and repeating until we all have upper-cross syndrome. We learn scores of physiology, pathology and clinical pearls, unsure of clinical correlations due to a lack of experience. In the meantime the things we love about medicine are put on pause and we are told to wait for it, all while the student loan interest accrues. It’s easy to see how students have become bogged down and frustrated before their careers even begin.
We all know that doctor who worked constantly, took little time for himself or herself, always seemed to be doing “okay”, until you hear he or she had suffered a serious health concern, or worse yet, sudden death. Occurrences like this lead one to ask, “Could that have been prevented?”
Depression is defined as persistent feelings of sadness and loss of interest in work or activities. In the medical profession, these feelings can be present in medical students, residents and practicing physicians. In a study recently conducted by the Council of Osteopathic Student Government Presidents (COSGP) and the Student Osteopathic Medical Association (SOMA), nearly 40 percent of medical student respondents admitted to feelings of depression and thoughts of suicide.
In our day-to-day lives as student physicians, residents, fellows and fully licensed practicing physicians, several things can add up to give us a less than pleasant day. Demanding patients, unexpected emergencies, backups in the waiting room, medication changes, pharmacy changes, and my favorite thing to dislike, the electronic health record, overwhelm us and add to our feelings of being stressed. Often we feel as if we are simply driftwood tossed randomly in a sea of regulations and compliance stipulations. Maybe not. How much do we actually add to the feeling of being stressed and under pressure?
As physicians, we’re all familiar with the saying, “It takes 30 minutes to say no and 30 seconds to say yes.” The unique demands of this profession – including the value of our time and patient satisfaction measures not always being what is best for the patient – sometimes cause us to fall into the trap of saying the easy yes when we should say the difficult no.
With the demands of practicing medicine coupled with balancing personal responsibilities, how easy it is to get caught up in our obligations and what I call the “have-tos”? No wonder we feel ourselves needing a vacation from it all!
