Think Better. Do Better. Be Better.

By Heather Mitzel Levy, DO
Clinical Assistant Professor
University of Kansas Medical Center

Dr. Levy

What a beautiful thing it is to be a second child in this world, to have an older sibling to show you around; you are essentially born with a mentor.  Seeing them explore and achieve you naturally assume you can do it too.  My three-year-old (second born) is no exception; she has no fear.  My first born, however, has always been a little more cautious, always surveying the scene before acting.

This is why the other night at the pool when she said she wanted to jump off the diving board, my natural inclination was to think she would not follow through, but she did! She continued repeating the cycle of jump, swim to side, walk onto dive board, jump again; she did this about 20 times. Later that day we were talking about it and she told me, “You know what mom?  I got up there and I looked down at the water, and I was really scared, and then I just said…I can do it.”  She paused and then said, “actually I didn’t really say that out loud, I said that in my head.”  I gave her a huge hug and exclaimed, “That is awesome-when you say something like that in your mind it is called a thought!” And I loved what her thought had told her.

Being a mom of two young toddlers I read a lot about teaching kids to be good thinkers; in fact if you talk to me for more than five minutes about kids I will probably start chatting your ear off about “No drama discipline,” my favorite book about how we are literally building a child’s brain. The human brain is the most amazing thing, and the more I learn about it the more I continue to marvel at its wonder and complexity. The thing no one tells you (or perhaps they do and we just don’t listen,) is that it is our relationship with oneself which serves as a primary relationship within our life, and colors all other relationships in our lives.  This relationship with oneself starts with our thoughts.

This year marks my 10-year anniversary from graduating residency.  I am finishing this column typing at my desk in the same seat I sat for literally thousands of hours studying during medical school and residency.  Although I am sitting in the same spot, what and how I see the world is dramatically different.  

No longer a young pup in medicine, I have seen and done a lot, and feel that in medicine we have front row tickets to watching a diverse professional and patient population navigate this world.  There is truly a reason there are so many television shows about medicine, because truth and the drama we experience at work, cannot be topped by any fictional writer.  

Gunshots, stabbings, babies dying, organ harvests, patient after patient in the GI lab with terminal pancreatic cancer. These are our days. The unique stressors that physicians face are finally getting more attention. A quick literature search will find a plethora of articles and resources regarding this topic.

This February, I attended the Second Annual “Women’s Physicians Wellness” conference in the Cayman Islands, hosted by the wonderful Erica Howe. Knowing how sharing resources and information is so important, I reached out to Sean Flack, head of the SPA Communications Committee, to inquire whether he would like me to journal my experience at this conference. He was excited about the idea and offered me the opportunity to write on many of her wellness topics from the conference, as well as others over the next coming months in the SPA newsletter.

This series of articles, and my genuine interest in the topic of mental durability in medicine was born out of numerous conversations with friends and colleagues, my own life experiences, multiple leadership programs, books, and my intention to teach my children to have their little minds and coping skills develop more in line with my 42 year old mind, not my 32 year-old one.  

As physicians we are an interesting group, we compete vigorously for our spots in a competitive field, and yet when we achieve them the reward is still more sacrifice. We are taught in undergraduate early, “if you get a B in a class-retake it if you want to get into medical school. Then we compete throughout medical school to get the best grades and board scores to get into top residencies, and the cycle of perfectionism continues.

This is not a bad thing in that those who work very hard are rewarded by the top positions, however it sets us up to be a group who is extremely self-critical and never satisfied.  Add to that the 36-hour call shifts, not being able to take time to eat or drink at work, the high price of a mistake, and a million other reasons and it is easy to see how we are a workforce which gets depressed and burned out.  We go from the group who got the elusive acceptance letter, to the group who now talks primarily about FIRE and burnout.

Today I would like to extend to you an invitation. An invitation to walk with me as we study different ideas and ways of thinking which have been proposed to boost career and life happiness, as well as mental resilience.  We each are a product of our own experiences, home of origin, and coping skills, so depending on what we were implicitly or explicitly taught we come to the practice of medicine with different mental survival skills.

We are losing doctors daily due to depression, suicide, and straight just wanting out as fast as possible! How do we, as a group, get there and how can we each strive to learn healthier principles for navigating this career we fought so hard to get. This series is going to examine a multitude of different conferences, workshops, and podcasts to investigate what we can do as a group to be mentally strong for our families, patients, and ourselves.  There are books on what mentally strong people do every day, let’s explore different ideas and skills which can serve as a framework for what mentally strong doctors can do every day!

I would like to dedicate my column to my mom, who died nearly two years ago. When I was six years old she gave me a “Knowledge is Power” quote framed in my stocking at Christmas. She was always so proud of me, and supported me in innumerable ways. As she was witness to the personal sacrifices I made to get here, she would frequently ask me “was the journey worth it yet?”  I am not sure I ever got to tell her this during her living years, but yes finally I can say “It was worth it mom.”