Unshakeable

By Heather Levy, DO

Dr. Levy

I am unshackable.   I saw him type the words into the computer and I had to laugh as I saw the keys click. I had read somewhere that changing one’s password to something that was motivational could be a great mental prompt for change, since a person has to enter it so many times each day.  I shared this with my friend, who tends to get a little flustered over the little things in life and he was trying to prioritize not getting upset so easily.  He had chosen the password “I am unshakeable”; however, with the addition of a “c”, misplacement of a “k”, and addition of an “e”, the whole message was altered…unshackable vs. unshakeable.   We had a good laugh about it, but it also made we wonder, how many of us do this? We think of a goal, and have the best intentions of working toward it but somehow miss the mark of defining what we should be really aiming for, leaving us with a whole different take home message and missing the point entirely.

Lately, I don’t think there are many people who remain “unshaken”.   We as physicians tend to be a fairly mentally tough crew.  We have learned over time to be so well moderated in our emotional responses that perhaps no one would ever know the wounds currently boiling below the surface; howeverall one has to do is look around to see people are tired. As I wrote in my introductory article, I created this column to cover mental and spiritual wellness in medicine, a topic which was already hot pre-COVID in early 2020; however, when the stress of the COVID pandemic hit our workforces and our home livesthe acceleration button was hit on the already existing burnout issue that physicians are experiencing.

One of my favorite people to learn from about physician burnout is Dr. Erica Howe, an internist from Kansas City.  This outstanding doctor became so motivated on the topic of wellness that she created her own conference named “Women Physicians Wellness” which she has hosted for the past several years in the Cayman Islands. I had a chance to sit down with Dr. Howe virtually to discuss how she started researching burnout, what we can all be doing to help heal our own symptoms of burnout, and how to re-center ourselves when we feel “shaken.”

While working at the University of Kansas Health System, Dr. Howe developed a faculty development course focusing on academic teaching and leadership skills.  A few years later, that course gave inspiration to an online training website she founded called the Medical Educator, which focused on providing training for busy physicians on improving teaching skills and other career advancing techniques. All of these opportunities ultimately culminated in her creating her own wellness conference.  

One of the key reasons Dr. Howe created this conference was a realization she had over time. She was not the only woman struggling with the issues she had been shouldering: working physician, three kids, activities, dinner needs, homework, nanny schedules, etc.  As physicians, we become so good at just continuing to work despite anything that is going on in our lives even when we are drowning.  We walk through our day spouting to others many times the question of “how are you?” The general auto-reflex answer of “fine” temporarily satiates our need to socialize, as if that brief word were somehow a human connection. 

Truthfully, we are terrible about being vulnerable and honest with one another as we have been taught how to become a “soldier” mentally, and not talk about anything that is wrong, as our own needs don’t matter, and the show must go on.  Over the years we have learned to sacrifice to a fault,. We learn to not sleep, not eat, not use the bathroom, not rest, not be at events we want to, all as part of the job training criteria. This being said, true inspiration found Dr. Howe when one day she decided to answer that generic question with a more vulnerable and real answer.  She took the time and shared with the inquiring party how she was really feeling and that honest opening made a huge impact and allowed her to see that she was not alone.  It also made her realize that by sharing her story with her coworker, she was able to become informed about other ideas and resources that she had not considered as solutions for some of the dilemmas with which she was struggling . Thus WPW (or Women Physicians Wellness) was formed. 

This February I had the pleasure of attending the conference in Grand Cayman for four days of reflection and growth.   We, as physicians, have a unique set of stressors and work circumstances that this conference allowed us time to intentionally think about.  When to say “yes” or “no”, how to let your “no” become an opportunity for another’s advancement, and how to truly carve your career to follow the trajectory you want rather than having its direction unravel haphazardly, by taking every opportunity offered along the way.  In the next several editions of this column we will dive into the lecture topics from this conference, which included how to do an objective history and physical on your own life and body, aligning your time and values, as well as cognitive behavioral therapy (CBT) in the workplace.  Due to COVID, WPW will not be held in Grand Cayman this year; however, Dr. Howe will host an online summit February 11-13, 2021 with new topics and CME offered!  I could not recommend this conference more to our female physicians out there, and for our male counterparts. I will take good cliff notes and share them with you in upcoming editions of this column!

I have always been a huge fan of quotes.  I have them all over my fridge and have notebooks full of my favorite quotes from books that I have read throughout my life. As we were ending our interview, Dr. Howe shared one of my favorite quotes that I share often with friends and  family, from Maya Angelou; “Once you know better, do better.” There’s a mental wellness revolution going on in the field of medicine and its training programs.  The patient as well as the student, the resident, the fellow, and the attending physician are all people.  Trying to train and practice as physicians without acknowledging our needs and ourselves as individuals is not only unfair it is dangerous, because as Dr. Howe wrote on the first slide of her conference “Hurt people, hurt people.”

Let’s use the resources we will learn about in the next several months to know better, and thus do better!

Take home points for this quarter:

• Go deeper than just saying “I’m fine” to one another
• Be vulnerable: Find one or two friends at work whom you can be real with about the struggles (or successes) you are experiencing
• Make yourself a priority! You are important.  One’s personal wellness is essential to doing well for our families and our patients.  The idea of taking care of yourself mentally, physically, and spiritually is a skill we can learn and improve upon with practice.