It is ironic that we commit our professional work to the care of others, yet often fail to care for ourselves as well as for the significant others in our lives. The disturbing reasons that underlie this reality are many, but the “final common pathway” carries the potential for burnout, impacting ourselves, those close to us, and the care we provide.
Burnout, as characterized by Dr. Christina Maslach, is marked by emotional exhaustion, detachment, and a lack of fulfillment. Burnout is pernicious because of the dysfunction and disability it leaves in its wake, making its prevention vital for a personal and professional life that is balanced and fulfilling.
Recalibrating this reality demands that we step back, reflect, and commit ourselves to reengage the commitment that brought us to medicine. Much like our advocacy for prevention in health care, we ought to be focused on initiatives that deal with wellness and forestall burnout before it materializes.
Framework for Well-Being
As Craig Irvine puts it, “We are ethically obligated to care for ourselves.” Linda Clever, M.D., a prominent physician leader in renewal initiatives, issues a similar reminder. “Taking care of yourself is not selfishness, it is self-preservation,” she writes.
Accomplishing this requires attention to advice we liberally dispense to others: getting enough rest, eating sensibly, exercising, cultivating interests outside of medicine, avoiding “chemical coping” as a strategy for dealing with problems, taking regular vacations, and many other beneficial “interventions” well-known, but often ignored, by us. Without the framework for personal wellness in our own lives, we are not in a position to afford aid others.
Caring for Significant Others
How often do we discuss our life priorities with those close to us? How often do we ask for their validation about our plans? We need to remain connected to our family, significant others, colleagues, and friends — connections requiring an appreciation of the centrality of others in our lives.
Our well-being is intimately connected with our work and comes from remembering and valuing the joy inherent in caring for others. Joy that comes from the daily application of our scientific skills and our talents for listening and caring. As wonderfully stated by Christine Cassel, president and CEO of the American Board of Internal Medicine, “Medicine is, at its center, a moral enterprise grounded in a covenant of trust … dedicated to something other than its own self-interest.
Our first obligation must be to serve the good of those persons who seek our help and trust us to provide it.” Our role as physicians is demanding and asks us for a measure of equilibrium as we confront economic and regulatory pressures. Yet, we are afforded the privilege of caring for others in moments of health and in times of struggle and death.
This most vital and sustaining life lesson, interwoven with a pursuit of kindness, mindfulness, humor, curiosity, a desire to learn, and daily lessons of humility that the practice of medicine brings, all serve to encourage the wellness essential to our lives as practitioners and individuals striving to lead a full life. Without the emphatic attention to all of these issues we cannot sustain our caring for others and ourselves.
Dr. Hatem is chair of the Department of Medical Education at Mount Auburn Hospital in Cambridge, Mass. This article first appeared in the February 2012 edition of the Massachusetts Medical Society publication Vital Signs.
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