Head, Shoulders, Knees and Toes, Knees and Toes...
I have to admit, when I was young, I did not like to color. We all had to do it in elementary school. Coloring was a skill that taught us how to follow instructions, express creativity and stay in the lines. As a child, I followed instructions well, was more creative with words rather than drawing, and honestly, I had trouble staying in the lines, (though, my difficulty staying in the lines helped discover a vision problem).
How are you doing? This is usually the first question I ask my patients when I see them in the office. I suspect like many of you, the typical answers I get now (terrified, I don’t know, bad) are different than what I would have gotten six months ago (good, ok, not bad). What hasn’t changed is the thing that patients most need from us – information.
Postdoctoral training is rigorous and time-consuming. The emotional and physical implications of residency and fellowship call for trainees to take what little time they do have to participate in enjoyable activities that keep them going. As co-residents at Albert Einstein Medical Center in Philadelphia, we found the popular indoor cycling class, SoulCycle, to be our go-to wellness activity. Since our intern year, we have been arranging meet-ups at the music-blaring, sweat-dripping, lights-flashing dark room that is SoulCycle. Now, carrying on into our separate fellowships, we still find time to enjoy a 45-minute jam and cycle “sesh.”
I’m fortunate to sit on our residency leadership committee at Lehigh Valley Health Network and attend conferences where we discuss a wide range of physician leadership topics. A common topic is physician burnout and what healthcare leaders can do to mitigate it. At a recent meeting, we discussed an article from the Mayo Clinic Proceedings titled “Executive Leadership and Physician Well-being: Nine Organizational Strategies to Promote Engagement and Reduce Burnout.” The authors, Tait D. Shanafelt, MD and John H. Noseworthy, MD, cite evidence suggesting that physicians who spend just 20% of their professional activities focused on the work they find most meaningful are at a dramatically lower risk for burnout. There was also a ceiling effect to this benefit at 20%, meaning that physicians who spend 50% of their time in the area most meaningful to them had no further decrease in burnout rate.
“Art is the queen of all sciences communicating knowledge to all the generations of the world.” If this statement hadn’t already been so eloquently articulated by Leonardo Da Vinci, it would have been my own. These words perfectly illustrate my view of the relationship between art and science, and how this relationship has fueled my unique path towards a career in medicine.
It doesn’t matter if you are new to medicine or more experienced, we will all be faced with a situation where a patient we are caring for dies. Regaining your strength when this occurs is a challenge. Depending on the situation there may be sadness, inadequacy, fear and loss of self-confidence. Allowing yourself to feel these emotions and move on is critical.
I seldom park in the designated “Physician Parking” spaces. Mostly, because during this time of very active construction at the hospital where I work (or as I refer to it, the “employee wellness program” encouraging all of us to get that 10,000 plus steps in a day) I have found a strategically placed, out of the way “spot” that no one else appears to have claimed. It is not designated for patients, it is not a handicapped spot, I have to travel a couple of side streets to get to it, but it works for me.
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.
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.