By: Nadia Sabri MD, FAAP
As medical students, residents, and physicians, we’ve taken care of hundreds of thousands of patients from birth to death and everything in between. We are trained for mind over matter, to multitask to the max, make decisions rapidly and knowledgably, and live in chronically stressful situations with minimal sleep. We are expected to be “on” at all times, perfect, perform at the max in every sphere of our life, balance it all without complaint.
This is our everyday “normal” and yet it is not normal at all.
Over time, we can lose ourselves in the system or become statistics in the rising rates of burnout, mental illness, or physician suicide.
Truth: Medicine is not just a job, it is an all-encompassing lifestyle. Our journey as medical professionals can destroy us or it can propel us into new levels of personal and professional growth.
Fortunately, we can empower ourselves with knowledge and skills that can help us heal from the vicarious trauma of medicine, work with wellness in mind, and connect authentically to ourselves and our patients.
Understand the difference between resilience and burnout
Resiliency and burnout are two separate concepts; they are not two ends of the same spectrum.
If we are unaware on the distinctions between resilience and burnout, we will not be able to support or heal ourselves from the effects of our medical lifestyle. We may fall prey to the current toxic narrative that resiliency—or lack thereof— is a personal problem.
You know that narrative: “if you are resilient/strong/deserving enough, you’ll make it. If not, well, it’s on you”.
Resilience is the ability to bounce back after stressors, adversity, hardship. We utilize resilience every day as we show up to medical training, study diligently and take exam after exam, as we care for the best and worst of humanity, and as we show up to each patient encounter with a smile despite whatever else is going on in our personal lives.
Just like taking the MCAT or going to medical school, resilience is an obvious requirement of being a physician. By being here, you’ve proven that you are resilient.
Then, what is burnout?
Burnout is a well-defined syndrome that occurs when the normal stress response is depleted. Burnout is a predictable outcome of years of unrelenting stressors in an environment that does not honor time to rest and recover. Burnout is not a lack of resilience; it is mind-body-spirit shutdown.
Not surprisingly, when stressors are removed and there is rest, support, and time to recover, the effects of burnout reverse. However, if one is too enmeshed in the system, lost in negative numbing habits, without a support system, or chronically sleep deprived, it becomes that much harder to reverse burnout syndrome.
Read more on about the systems approach to stress, stressors, and resilience.
Rest improves resilience
Fact: Tired brains do not function as well as rested brains.
The link between disrupted sleep/chronic sleep deprivation and suicide is well studied. Chronic disruption or deprivation of sleep reduces coping mechanisms, increases stress response and reactivity, and puts a person at increased risk of suicide.
So, knowing this, wouldn’t it make sense to change the current model of sleep deprivation as a “necessary” part of physician training?
Until we get to the actual reason for the requirement of chronic sleep deprivation on physicians, please protect your sleep as best you can. Sleep when you can, often, and use your circadian rhythm for restorative sleep.
Align Your Actions with Your Intentions
We chose medicine for a variety of reasons, the why for going into medicine.
When you feel stuck, lost, adrift, or confused, think back to your reason for choosing medicine in the first place. Then, look to your current situation and see if your actions align with your intentions.
Of course, situations change and intentions can evolve. That’s perfectly fine. However, if your inner voice is saying something is not right, listen. Approach from a place of curiosity, not judgment. If what you are currently doing doesn’t make sense to your overall goals, what needs to change? What do you need to take away from your current situation and what needs to be added?
Connection is Key
One of my favorite quotes about wellness is by Rumer Godden, “…[E]veryone is a house with four rooms, a physical, a mental, an emotional and a spiritual. Most of us tend to live in one room most of the time but, unless we go into every room every day, even if only to keep it aired, we are not a complete person.”
We are taught mind over matter for most of our training. However, focusing only on one aspect of ourselves—staying in one room— negatively impacts our wellbeing and our life. We must acknowledge and accept that our environments (mental, emotional, physical, spiritual) matter. The mind-body connection is strong and affects our spirits, our joie de vivre, and our outlook on life.
Connection to others is also incredibly important. Seek out mentors and role models who inspire you and support you. Find a tribe that lifts you up. Most importantly, seek out people who model and embody the qualities you wish to bring to your life. We are affected by the company we keep. Take care to choose relationships that enhance your life, not absorb or drain your energy.
Make Intentional Choices
To go from survive to thrive, we must connect back with our humanity, teach ourselves how to maintain our mind-body connection (instead of mind over matter), and adjust our lifestyles to counter the toll that our profession takes on us.
There is a lot in life that we cannot control. However, there are still many things that we can intentionally choose. However, if we are in survival-mode, running from one activity to another, or on autopilot, conscious thought takes a backseat. We end up feeling adrift, losing sight of our why, and questioning our place in medicine.
Give yourself permission to make your career your own
There are some things we all need: nourish our minds, bodies, spirits. Rest. Healthy boundaries to say no to things that add weight but take away stability.
However, we each have our own reasons for choosing medicine and the elements that give work-life satisfaction varies per individual.
My work-life satisfaction mix includes clinical and nonclinical work, creativity, advocacy, wellness. I enjoy working as an acute care pediatrician. The challenge and acuity is exciting; however, it’s not my only passion. I teach yoga and meditation to physicians, actively participate in professional organizations, speak at conferences, write, volunteer, travel, spend time with friends and family. Some days or weeks I may need more of some elements and less of others.
Remember, you don’t need anyone’s permission to live your life.
As a physician, there are countless opportunities to use your medical degree, make a positive impact, and be the kind of person you want to be. Get out of your comfort zone. Work and live with intention.
You worked hard and deserve to be here. Please know that you are not alone. Truly, the options to creating a fulfilling life and career in medicine are endless. Don’t let anyone tell you otherwise.
About the Author:
Nadia Sabri MD FAAP is a board-certified Pediatrician, Fellow of the American Academy of Pediatrics, writer, public speaker, and certified yoga & meditation instructor (RYT 200). Dr. Sabri is the founder of the award-winning blog, The Mindful MD Mom, and her health and wellness tips have been featured in national publications like Washington Post, Insider, Parents, Thrive Global, USA Today, Elite Daily, Doximity, KevinMD, Motherly, Physicians Weekly, Doximity, and more.