Whether we think of it this way or not, we are all in the healing business or, as I prefer to think of it to avoid hubris, we are in the business of facilitating the patient’s self-healing. To heal is to proceed out of disease, sickness, and illness. Of course, the disease does not always permit its removal and we are left with mitigating and controlling it. And once the patient is healed or simply improved, we work to keep the disease that way, to ensure the disease doesn’t recur or worsen. In other words, half our job is to sustain the patient’s re-established health or nearness-to-health.

Given this, for a long time it has astounded me how poorly we clinicians take care of ourselves. We act to sustain others in health, but not ourselves.

This realization struck me years ago when, after three years away at the NIH on a research fellowship, I returned to my home department at the University of Illinois and found that the first-year residents I had left behind were now fourth-year residents and many of them looked like hell. I could not believe the toll three years took on them in terms of their physical health and vibrancy, and what horrible shape they found themselves in. One resident had gained 50 pounds over those three years, all from, it seemed, stress eating with contributions made from disrupted sleep patterns.

How unsustainable, how sad, how absurd! I often think of my grandfather who lived and died in Poland as a poor farmer. I’m struck with the happiness and success and long, healthy lives he and my grandmother had, how they raised and educated four kids, and how little resources they had to do all this. And here I am – here all of us are – with so much wealth and so many resources, and how unhappy and unhealthy too many of us are.

Of course, my family story may mean little to you. I bring it up because you probably have a similar story to tell and, perhaps, have also been struck with how ill-spent our substantial personal and national wealth often is.

I believe in hard work. I believe in struggle, in pushing past boundaries. But all the striving must be tempered with a life that is sustainable. I always think it would be a travesty if my life turned out worse than my poor grandfather’s, not because I am a better man than he but because I have so many more resources and opportunities than he ever had.

My message is that each of us must find a way to live sustainably. I don’t know what changes would be required of you to do so, but you probably know.

The main reason for this post is that you have to count on yourself to make those changes. All too often you cannot count on anyone else to concern themselves with your well-being. Almost everyone has a boss of one kind or another. Your boss may be friendly but that is not the same as being a friend. It is rare for the person in charge to tell you to slow down, take it easy, destress, etc. That person has their job to do and, given the many shortages of clinicians, that person is focused on getting the organization’s needs met, ensuring there are enough clinicians to handle the patient numbers. All too often, they’re looking to get more out of you, not less. It’s not that that boss is a bad person; they’re just acting out of the pressures placed on them, just as you act out of the pressures placed on you.

Thus, it is up to you to notice, consider, decide, and act to reach and maintain a sustainable life, in and out of work.

Let me know what you think, what measures you think you need to take or have taken and whether they were effective or not. Share your wisdom with us. I’ll pick up on this issue again in the coming weeks.

Thanks and ‘til next time.

Dr. Jack

Language Brief

“Life isn’t about finding yourself. Life’s about creating yourself.” ― George Bernard Shaw

“I like to envision the whole world as a jigsaw puzzle … If you look at the whole picture, it is overwhelming and terrifying, but if you work on your little part of the jigsaw and know that people all over the world are working on their little bits, that’s what will give you hope.” ― Jane Goodall

“Burn bright, not out.” ― Hamza Kahn

“Think I’ll go eat me a doughnut and take me a nap.” ― Ray Bradbury

“Burnout often has as much boredom in it as exhaustion.” ― Ingrid Fetell Lee