I am currently Clinical Instructor and Staff Physiatrist at Carolinas Rehabilitation, part of Atrium Health’s Physical Medicine and Rehabilitation Residency Program in Charlotte, North Carolina. I value the notion of physician wellbeing and studied this as my independent project for The Leadership Program in Integrative Healthcare at Duke University. My study revealed one major correlate to burnout and resiliency: Relationship. To illustrate, here is a story:
I was recently asked to participate in a pilot program of Peer to Peer support for physicians in our organization. We gathered for a training session and introduced ourselves. I shared that I had previously taken a break from medicine but had now returned. As the session continued, one of my colleagues, who I had not seen in some time, shared a memory. He said he was looking at me and, seeing that I was in distress, wondered if he should say something. He didn’t. I was briefly taken aback by the statement, but then I thought it was good he shared this. From a personal perspective, I didn’t reach out to other people and say ‘I feel this way. How do you feel?’ I didn’t do that. On the flip side, no one reached out to me and said, ‘Are you okay?’ This conversation speaks to the truth of our experience of another person. We have a choice to use that gift to inform a response.
I recognize that creating a culture of trust is therapeutic and after years of taking myself too seriously, I have begun taking comedy improvisation classes. A welcome effect has been a practical and fun way to apply The Leadership Program’s core concepts of informed mindfulness, awareness, choice and reaction to a constantly changing environment.1
Last weekend I attended an improv class at Charlotte Comedy Theater by Jonathan Pitts called Taking Care of the Now.2 Improvisation or improv is a form of live theater in which the plot, characters and dialogue of the story are made up in the moment. It’s a remarkable class and basically makes you understand the several layers of awareness (to be aware of) between two people in a scene. One level of awareness is how you experience the other person. Pitts said to honor what you feel physically and respond accordingly rather than scan your head for the next “right” thing to say, which takes more time and is not authentic. In other words, play a scene with self-compassion. Honor the feeling you experience physically, in the moment, and let that inform your verbal response. Then, you honor both your scene partner and yourself. The message is what you feel inside is important and a gift to yourself — embrace it!
Have you ever taken the time to consider how you experience another person? We tend to perceive communication as a passive ear-centered experience, but it’s not just your ears. You experience other people with your heart, your soul, and your intellect as well. It’s with your whole body. For example, if I look at you and say, ‘your hair looks amazing,’ immediately a little smile may come up. Now if I say ‘I want to move out as soon as possible!’ your eyes may get sad for a moment or maybe not. If I move my body to reach out to you, I’m giving information. Add to that the sounds we make, like a sigh or laughter – you get the picture. Within a few seconds, our brains process and tell us all we need to know in that moment, even with no dialogue. Right then and there, we have a choice. Do we respond?
This reminds me of a recent story about my friend Ruth. Ruth is a retiree who serves as a hospice volunteer. She has many stories of hope and healing while sharing in another’s death experience. On this occasion however, there was a significant hiccup. Her client was visibly and audibly in distress, drowning in secretions. Ruth informed the nursing assistant who then responded, ‘I told the nurse about it, but I’m just a CNA.’ Ruth stayed in the room with her client and then called the hospice supervisor to report the problem. Shortly thereafter, the nurse came in to assess the patient who needed to be suctioned. Care was desperately needed, but the nursing assistant didn’t feel she was a valued and respected member of the community. ‘I’m not valued here’ was Ruth’s experience of the nursing assistant. Creating a culture of trust where everyone feels respected and valued empowers us to be life-giving and life-saving.3
Dr. Wayne Sotile, PhD, is a clinical psychologist who has been studying physician resiliency and burnout for almost 40 years. His research shows that when we come together and associate with others who are going through similar challenges we deepen our relationships, promote resilience, and have greater career and marital satisfaction. This requires us to look inward and examine where we are, where we’ve been, and where we’re going and where we’re going with an eye toward self-compassion. We all go through hard times; there are no perfect people.4
Circling back to my experience during the Peer to Peer training: I had an opportunity to reflect on a past interaction with a colleague that I didn’t even know existed. At first, it was a mini-sense of shock that I was carrying my negative emotions around the room and wasn’t aware of it. It didn’t help that I was keeping everything inside and my colleague was aware and stayed silent. Sometimes in our best efforts to do things right, we miss the things that seem obvious in hindsight. Thankfully, I have learned through interior and exterior work that relationship and connecting with others is the foundation of contentment regardless of circumstances. This allows me to serve my purpose of being a healer from within. Building a culture of trust and healthy relationship starts with Taking Care of the Now – once you do that, the scene takes care of itself. You really don’t have to do more than that – just be open to what could be if you shared your honest truth whenever the opportunity presents itself.
2 Taking Care of the Now class by Jonathan Pitts of Second City Chicago 02/24/2018 was sponsored by Charlotte Comedy Theatre, Charlotte NC. Executive director Keli Semelsberger: http://charlottecomedytheater.com.
3In addition to her hospice work, Ruth co-founded Samaritans House, a not-for-profit recuperative care place in Charlotte NC for people who are homeless and in need of short term care following a hospital or emergency room stay: http://samaritanhousecharlotte.org.
4Wayne Sotile PhD, Keys to Resilience Thriving Through Change, North Carolina Medical Society Annual Meeting, Keynote Speaker 10/23/2015.
Judi T Campbell, MD is currently Clinical Instructor and Staff Physiatrist at Carolinas Rehabilitation, part of Atrium Health’s Physical Medicine and Rehabilitation Residency Program in Charlotte, North Carolina.
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