MD, MDiv

I published my first article addressing physician wellness in 2009. Physician wellbeing wasn’t ever part of my academic plan, but over time it became part of my mission. As a Program Director, Dean of Student Affairs, and mentor I watched, and wasn’t always able to help, trainees and colleagues as they struggled. This struggle, which we have (I believe inappropriately) called “burnout” led to weariness, sadness, and distress for almost everyone in my sphere of influence, no matter where they were in their professional journey. 

For some it was career limiting. 

For some it was life limiting

For some it was fatal. 

As physician suicide and burnout in medicine became a reality that couldn’t be ignored, I became part of the movement of healers who began to work with policy makers and hospital administrators to try to make a difference. We worked on ways to convince those in power that this was not just about doing the right thing, but that it helped institutions with their metrics of success since it was clear that physicians in distress affected the bottom line. Despite these efforts, there was rarely any substantial change. In fact, most of us agreed that both objectively and subjectively things were getting worse. I began to realize we weren’t speaking the same language. They were measuring attendance at mandatory wellness training sessions and celebrating “success” because >90% of docs attended. But they weren’t measuring the right thing. They weren’t paying attention to metrics of healer distress, how many of their physicians were quitting their career in medicine, the number of divorces, the rate of substance abuse, or, most tragically, the increasing number of healers who were dying by suicide.

Let me pause here for a minute to state something obvious. I know that policy makers and hospital administrators don’t go to work to make life difficult for the healers in their systems. In fact, I suspect that they are experiencing much of the same distress that we are experiencing because, at its core, the issue here is what we value and how we talk about those values. 

I began to wonder if we needed an entirely new approach. So I went back to graduate school. Most of my friends thought it was crazy that at this stage of a classic academic career, I would go back to school, but I did. I enrolled in the Master of Divinity program at Iliff School of Theology to learn new ways to think about values… and different ways to heal.

I will continue to talk about how to eat well at work because our physical well-being is important. I will also keep writing here (and elsewhere) about staying connected with and for others, because our mental health is also important. But in the weeks and months to come I hope to write more about values and how we might work together, healers and administrators, to heal our patients – and each other. 

Shapiro DE, Duquette C, Abbott LM, Babineau T, Pearl A, Haidet P. Beyond Burnout: A Physician Wellness Hierarchy Designed to Prioritize Interventions at the Systems Level. Am J Med. 2019 May;132(5):556-563. PMID: 30553832.


Lessons from the Pandemic: Richard Rohr, Walking, and Lawn Chairs

It’s almost impossible during times of stress to be motivated to do hard things. For all but the most hardcore exercisers, ice cream just seems more soothing than running when you are emotionally exhausted (Right?). I’m no different. But, as much as I would like to think “later” will be ok to regain what I have lost in these months of being more sedentary than usual, I have begun to realize that I needed to get moving again.

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Enter Richard Rohr

I’ve been a fan of Richard Rohr for years. He’s a gifted writer with the laugh and smiling eyes of someone who has tapped into something I want to know more about. I subscribe to his weekly email, which this week introduced Jonathan Stall’s practice of moving “as a way to invite brave creativity.”

There is a lot to unpack in that idea.

What exactly would “brave creativity” look like? I’m not sure, but it sounded like something I, and I suspect all of us, need more of right now.

“We invite you, as able, to take some time this weekend to move mindfully through your local area.”

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I set off on a different kind of walk.

I grabbed my mask and headed out for a walk in my neighborhood, trying to think about this not just as exercise, but as something more. I read Jonathan Stall’s advice again:

  1. Bring something to jot ideas down while you are out, but more importantly, invite your “goals/pains/dreams”  to join you on this walk.
  2. Walk for at least 30-40 minutes
  3. Wear a mask if you get within 6-10 feet of anyone (respect for your neighbor)
  4. Start the walk with a sense of being open. “As you begin to move, seek the realms of wonder, of space, and of reaching high into what’s possible…”

Where did all these lawn chairs come from?

I’ve walked many times before in my neighborhood, and I’m an observant person.  But today, as I walked, I began to notice all the chairs on people’s lawns and all the swings, and “tires” hanging from trees. 

Were they always here and I didn’t notice them?

Are more people sitting outside now than before – even though it’s outrageously hot here in August?

Is this because of how much we all need (safe) connection to each other during the time of pandemic?

Are there actually more chairs, swings and tires because of how much we all need to hear birds, see trees and listen to the cicadas in the summer evening right now?

Next steps?

Yes, there will be next steps. This experiment led me to more questions than answers, but I had a real a sense of being taught, too.  

Try it?

Let me know what you see.

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#CareForTheHealers – “Guard Your Spirit”

Taking care of patients in this time is beyond stressful. I’m keeping my eye out for anything that might help support healers of all kinds. This was sent to me today and I found it profoundly helpful. Take 5 minutes to listen to this amazing professor, pastor and friend.

This video was made for the students of Illiff School of Theology by Dr. Cathie Kelsey. Although the specific examples she uses are from the Christian faith, the practice she teaches in this video can use text from any religious tradition, or no religion at all – perhaps a poem, a quote, or an inspiring song?

Anything Can Be A Prayer

I Happened to Be Standing

Mary Oliver

I don't know where prayers go,
     or what they do.
Do cats pray, while they sleep
     half-asleep in the sun?
Does the opossum pray as it
     crosses the street?
The sunflowers? The old black oak
     growing older every year?
I know I can walk through the world,
     along the shore or under the trees,
with my mind filled with things
     of little importance, in full
self-attendance. A condition I can't really
     call being alive
Is a prayer a gift, or a petition,
     or does it matter?
The sunflowers blaze, maybe that's their way.
Maybe the cats are sound asleep. Maybe not.

While I was thinking this I happened to be standing
just outside my door, with my notebook open,
which is the way I begin every morning.
Then a wren in the privet began to sing.
He was positively drenched in enthusiasm,
I don't know why. And yet, why not.
I wouldn't persuade you from whatever you believe
or whatever you don't. That's your business.
But I thought, of the wren's singing, what could this be
     if it isn't a prayer?
So I just listened, my pen in the air.

Happy New Year’s Resolutions!

Like most of you, my New Years resolutions in past years have been something like “Exercise every day” or “Eat fruits and vegetables with every meal.” And, I bet that you had the same experience I did… a few weeks of “success” and then they seemed to fade away. The problem with these kinds of goals are how they are structured. They end up being “either-or” goals … you are either able to do them or, more often, you miss a day (or two… or three) and feel like a failure.

I recently read a blog post by Ryder Carroll, the originator of the Bullet Journal which profoundly changed the way I think about goal setting and New Year’s Resolutions

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It’s a simple, but very powerful concept. Set your goal as a destination… as a “lighthouse” in the distance, and then head in that direction every day. As Ryder Carroll explains, “When goals are lighthouses, success is defined by simply showing up, by daily progress no matter how big or small…”

So instead of the usual New Year’s Resolutions, pick a few “lighthouse goals”. Write them down and keep track of how you are doing (every journey needs a map). This can be as simple as one piece of paper for each goal, but I am such a fan of the Bullet Journal, I hope you consider using it.

When you get up every morning think about how to move towards your goal(s). If you veer off course, that’s part of the journey…. look up, find your lighthouse, and correct your course.  Every once in a while (maybe monthly?), look at the progress you’ve made and celebrate it! If, on the other hand, the goals you originally chose don’t make sense for you any more, pick some new goals, draw a new map and start over.

Potential New Year “Lighthouse” goals

  • Learn more about compassion and practice it
  • Be a better friend
  • Write genuine thank you notes to people who have helped me
  • Become more fit
  • Eat real food for as many meals a week as I can
  • Find out more about who I really am through meditation
  • Keep a “stop doing” list
  • Be better at my work through deliberate practice (practicing and learning the things I don’t like and aren’t good at until I’m better)
  • Stay organized so I don’t waste time (and end up focusing on trivial things instead of what’s really important)
  • Read things that bring me joy
  • Learn about and use a Bullet Journal
  • Find a community to support me
  • Learn the names of as many people at work as I can
  • Take the stairs as often as I can
  • Make my living spaces enjoyable spaces
  • Keep a journal to remember milestones and work out struggles
  • Get good sleep as often as possible
  • Learn Spanish (or any new language)
  • Be on time
  • Remember people’s birthdays and send a card
  • Start the day with intention
  • Appropriately limit email and social media time