Before COVID-19, I left the practice of medicine for what would turn out to become an entire year. While away, I found a new way of seeing our hearts and bodies as humans in the medical profession, allowing me to return. Here are five lessons I learned in the hope they might help others. 1. Perfectionism doesn’t make you perfect If perfectionism isn’t an unwritten rule in our profession, it’s, at minimum, a heavily reinforced personality tendency. When I first faced my perfectionism, I tried to argue it was a good thing. Of course, I’m a perfectionist. I’m a physician. We have to be perfectionists. If we’re not, people die. But one of the dangers of perfectionism is it leaves no room for self-compassion. For a physician who prided herself on her empathy, discovering I had no self-empathy came as a rude awakening. But learning to embrace imperfection is not an overnight task. For anyone just starting out along this path of self-discovery, a great place to start is with the seminal work of Brené Brown. It was only after I accepted that I was a perfectionist and there was another way to live that I recognized perfectionism as an inflexible barrier to the practice of self-compassion. 2. Self-compassion is essential and isn’t what you think it is Self-empathy takes practice and hard work. It requires showing up for yourself when it feels like it would be easier not to. We might commit to it in that wellness seminar, but do we follow through? Or do we instead make empty promises? Because secretly, we believe we’re superhuman. Sure, we’ll get to our own oxygen mask soon, but first, we have time to take care of one more thing… Self-compassion means gently but firmly reminding ourselves we’re not superhuman. We need to eat, sleep, rest, breathe, exercise, play. To attend to our own emotions and bodies every day, even when it feels like doing so might slow us down or let down others. Because in the end, it won’t, and it doesn’t. If you struggle with that like I did, I recommend Dr. Kristin Neff’s book Self-Compassion: The Proven Power of Being Kind to Yourself. 3. External validation will never equal happiness For me, a sneaky triad had set the stage for physician burnout. It consisted of the above two issues — perfectionism and lack of self-empathy — but the third was more subtle: a subconscious need for external validation. I’ve come to believe that most physicians experience this triad — as a function of our own personality tendencies, combined with the covert and overt reinforcement of these factors throughout our medical training. Breaking free of it will be different for each person, but crucial for me has been learning to embrace vulnerability as a strength and not a weakness. Only by embracing our vulnerability can we live as our authentic selves. As Brené Brown writes, “If we want greater clarity in our purpose or deeper and more meaningful spiritual lives, vulnerability is the path.” For more of a physician’s experience on vulnerability as a path, I learned from Adam B. Hill, MD’s Long Walk Out of the Woods: A Physician’s Story of Addiction, Depression, Hope, and Recovery. 4. The heart has a back door My specialty, oncology, draws empathetic people, but at no time in my training was I taught how to cope with the deluge of emotional input that comes with serving others in our field. I’ve now learned it’s possible to keep one’s heart open to those in need but allow the things that don’t belong to us to flow through and out. We don’t need to build walls, but we also don’t need to adopt burdens that aren’t ours. Especially when that’s not what our patients are asking — or needing — from us. But if we’re never given the tools or taught the strategies in our training, it’s difficult not to internalize others’ pain. To learn more, I recommend the book Self-Care for the Self-Aware: A Guide for Highly Sensitive People, Empaths, Intuitives, and Healers. By keeping the back door of the heart open, I’m learning to stay present in the moment with my patients and then release the emotions afterward. Which was the step I was missing—and the essential piece needed to then be present for my family when I return home. 5. The game is rigged I hadn’t fully understood the personal stress of working in a broken system (I’m referring here to pre-pandemic; a discussion of the additional pressures from COVID-19 is beyond the scope of this article) while still trying to pretend everything was fine until I read the book Burnout: The Secret to Unlocking the Stress Cycle, by Emily Nagoski and Amelia Nagoski. As they write, “Just knowing that the game is rigged can help you feel better right away.” But if the game is rigged, how do we win? Not by proving to others that the system is wrong because we know now that’s a given. But by showing up anyway to do the right thing. Not for the system, but to hold true to our authentic selves. By not letting the brokenness erode our purpose. For me, this recognition was what helped me discover my purpose again. And to decide to make myself vulnerable by sharing my experience with others. Because one of the key ingredients for self-compassion is a recognition of our common humanity. I’m more and more convinced that the way many of us were trained—to suppress emotion and evince a superhuman outer aspect—was profoundly flawed and incompatible with a shared humanity. Because it turns out that emotions live in the body. They are what make us human and allow us to connect with others. Rather than putting our bodies and emotions in a straitjacket to conform to impossible outer expectations, we can recognize our vulnerability as an integral part of our humanity. By doing so, I’m discovering that I still do want to be a physician. But only as my authentic self. Source
