This blog was originally published on The Healers Health Collective on 17th December, 2020.
I actually wrote my first blog piece "So I've burnt out" just a few short weeks after I stopped working. Little did I know it then, but there was an immense journey ahead of me. A journey that in some ways I think I'll always be on. This path of life that we all walk, I now walk more intentionally. No longer swept just onto the 'treadmill'.
Some people are fortunate to have the self awareness to have always been on this intentional path. Yet for many of us, this path is in fact a treadmill. A moving conveyer belt on which we feel sometimes passively shifted along. The 'Medical Treadmill' has such inertia from school, to medical school, to internship, residency, unaccredited positions, being a junior reg, senior registrar, fellowship and eventually consultant. Don't get me wrong, there are huge life decisions to be made in that time.
"Which college do I want to join?"
"Will I have any say into where I go?"
"When will I have time to have a family?"
Ultimately however, this process does tend to move along in a fairly linear pattern. Unless we are forced to or choose to step off.
What do we say to our colleagues who express a desire to 'step off' the treadmill at any point? Whether for a short break or even forever?
I experienced a lot of well intentioned encouragement not to do that.
That I would have to work too hard to "get back". Or that I would "miss opportunities". That it would be a "waste of my skills".
The dialogue here is really important I think.
As it turned out, I ended up needing to 'step off' for a while anyway. Perhaps I could have done this in a more intentional way sooner? Perhaps not.
For me personally, I am immensely grateful for the journey I have been on as a result of the last couple of years and my 'burning out'. That doorway I felt myself standing in all that time ago was in fact this doorway into working to support the wellness of the healthcare workforce. Healing the healers. Caring for the carers.
I am excited and hopeful for the future.
If you are feeling swept up on the medical treadmill, passively shuttled through your professional life towards some seemingly far off goal, I'd encourage you to try and familiarise yourself with the concepts of mindfulness.
Of self compassion.
Self awareness comes as we take our consciousness inwards to become more familiar with our own internal environment rather than only focussing on those things outside of ourselves and our control.
Sometimes it involves some time "off the treadmill" for self reflection. And that is OK.
Sometimes it involves staying "on the treadmill" but building a support structure around you so that you can lean on that and just lift your feet up every now and again.
Sometimes it involves the speed and incline being turned up so far that eventually you end up flying off the end of the treadmill, unable to keep up anymore (like I did...). Look, it's not ideal- but that too is manageable.
The most important thing to realise is that ultimately, you control the treadmill.
Even at the times when you feel like you don't, you always have the choice to step off for a while.
There's a lot of things that I want to talk about (hence the blog), but it strikes me that the most important thing right now as those of us in Victoria are looking at the start of another lockdown and potentially the actual start the COVID-19 pandemic in Australia- is kindness.
I am very lucky to have met very few people in my life who don't actually want to be the nicest, kindness person they can be. For most of us, the thing that gets in our way of this intention is our own Ego. Most people when they think about our ego's, think about someone who is "egotistical". But that's not what I'm talking about. Our Ego is anything that we associate with an "I" or "me" statement. For example "That person cut in front of ME", "I shouldn't have to be doing this, it's not my mess/problem", "I can't believe they said that to ME". Our Ego is a protective layer that we often build between our Self (the true self) and the world. It is therefore often our Ego that gets hurt in the day to day happenings of life, not the true self.
The problem here is that our Ego's can be a bit turbulent- kind of like the choppy waters at the surface of the ocean. The Self on the other hand sits beneath that, calmly and quietly. Most of us are existing every day on the surface, dealing with the ups and downs, the insults and constant questioning of whether we're doing the right thing or going the right way. From this uncertainty it can be easy to deflect away from our pain and towards others. We can cast blame or insults ourselves, we can see perceived imperfections in others because it hurts too much to find them in ourselves. This is a pretty exhausting place to be.
By actively choosing kindness when our Ego is trying to tell the story, cast blame or get angry- we're CHOOSING to duck beneath the water for a bit. We're CHOOSING to find calm in an ocean of turbulence.
Right now, there's a lot of blame going on- towards those leading us and making the tough decisions in a time of crisis, towards others we perceive to be "doing the wrong thing" and not locking down appropriately. Our Ego's are driving the narrative away from kindness. Do we feel better for it? Probably not.
Choosing kindness isn't always the easy path to take. Whether it's kindness towards ourself- towards our actions in the past or thoughts as they come, or kindness towards others- greeting their shortcomings with compassion and forgiveness, choosing kindness often means putting aside those thoughts driven by our Ego. The one's that tell us WE have been personally affected by something and WE deserve to be annoyed and angry. As if our anger is likely to change things. Like I said earlier, most people I've met in my life really want to be kind but like all humans- we struggle sometimes. Dr Rick Hanson (PhD) says in his book The Buddha's Brain- "Paradoxically, it takes time to become what we already are". We need to work hard to move past our own Ego's to find a place where kindness is the 'default' reaction. By actively CHOOSING kindness, we're re-wiring our brains.
I'd challenge all of us to take this thought into the world today. To CHOOSE kindness when our bodies and minds want to naturally default to anger, fear, blame or any other emotion our Ego's conjure to protect themselves. Start to become familiar with what it sounds like when your Ego is talking- when you hear the "I" and "me" thoughts that sneak into your head, twisting and turning through you trying to keep your little boat being tossed around violently on the surface of ocean.
Choose KINDNESS. Choose calm.
One year. One year since I 'Burnt out'.
At the time it felt like a soul crushing lesson in defeat. Not something I was familiar with feeling as I was so used to pushing, pushing, pushing until I achieved what I desired. Yet I couldn't push through this. So I stopped. I gave in. I relinquished control. The last year has been amazing, overwhelming, enlightening, difficult, affirming, sometimes challenging but ultimately a blessing.
So today, I've spent the afternoon messing around with this website in preparation to finally clicking the 'publish' button for the first time. This website that I've had mocked up for years but never felt robust enough to shine my light out into the world for scrutiny. Yep, that one. And I came across the blog post I wrote one year ago now (you'll find it in the archives). I had written about the feeling of standing in a doorway, not so much stuck as just aware that I really wasn't able to move forward or backwards at that point in time.
One year later and the delicious inertia of the last year has finally brought me to clicking 'publish' on this site. I've been listening to the amazing Amy Ahlers and Dr Lissa Rankin MD as part of their Visionary Ignition Switch course and as Lissa said "speak your truth" I knew that this was the time for me to do this. Now I know that my "truth" isn't everyone's truth, and I'm certainly no 'expert' on much else other than my own opinion. But that's what a blog is, my own opinion.
So here I am, stepping out of the doorway.
I plan on blogging about the many things that interest me- mindfulness, meditation, yoga, breathing, stress management, sleep, motherhood, behaviour change, relationships, eating and generally just trying to be the best sort of human that I can possibly be. The 'simple' stuff that seems so damn obvious and straight forward but really takes up at least 90% of my (and I'm assuming many other peoples) brain space at any one time.
Join me if you wish to. Scroll on by if you don't. There's no medical advice here just my thoughts.
Time for me to step out of that doorway...
I've had this website mocked up for a while now. Like every other over achieving person (doctor or otherwise), I usually have a plan for most scenario's. This one was meant to be an adventure in self promotion. Something I have historically been terrible at. Hence the unpublished website gathering cobwebs in my own little corner of the internet.
So here I am, three weeks into a surprise sabbatical from work, writing a blog post on my long ignored (and as yet unpublished) personal website. Facing the gnawing feeling of dread at simply the idea of going into work and seeing a patient. Left to consider the moments, thoughts and feelings that pave the path behind me.
I am a good doctor, an empathetic doctor. The sort who listens intently to you and tries to reflect back what I've heard you say with a mixture of comprehension and gentle advice. I've spent the last 15 years either training towards or being a doctor. But right now, I am a doctor who feels jaded and empty. Like the 'doctor' light globe inside me has gone out. The weighty responsibility of trying to help people in their darkest hours finally causing my legs to buckle under me. An unfamiliar mixture of panic and despair stopping my whole being from even getting out the door to go into work. To a job I am good at. A job that helps people. A job that (outwardly at least) appears so fulfilling. So why do I feel like this?
In the last three weeks that I've been hiding from the world since panic set in and stopped me in my tracks, I have come up with a variety of explanations. My amazing GP helpfully offered "Anxiety likely secondary to burnout" as a reason for taking some time off. Seems reasonable. Right now I am incapable of seeing a patient. One, because of what it evokes in me (the afore mentioned fear, dread and panic for the most part). And two, because it is not fair to patients for me to be seeing them right now. There is a certain amount of resilience and strength required to take the worries and ailments of others and help them carry this burden. Have you ever stopped to consider the health (both physical and mental) of your doctor the last time you went to see one? We are all human also. There is no special course at medical school that takes the fleshy vulnerability of humanity away from us. We, like you, sometimes struggle to sleep with worry (which in my case is often about you, my patients). We feel that sickening sense of overwhelm and fear that we may make a mistake while at work. Except in our cases, people lives are the fragile cargo we carry. We also deal with all the behind the scenes issues that everyone else is, family, money, life in general.
I feel as though I am standing in a doorway. Three weeks ago, all I wanted to do was close the door and hide inside. In the last three weeks, I have found some satisfaction in the fact that I no longer want to do that (everyday at least). Some days I am quite content to remain standing in this open doorway, pondering the space in front of me.
I write all this not to garner sympathy, but simply to muse and offer support to those walking a similar path. A silent call into the ether of the internet to encourage those reading to look outside themselves. Consider whether the job they're working, the life they're leading, is congruent with their values and self. And maybe, just maybe, as I stand here in what feels like a doorway of change, waiting to see what path there is in front of me, I may begin to contribute to the world in a way I had never imagined.