The Heart has a Back Door, and Other Lessons I Learned from Leaving the Practice of Medicine for One Year

Perfectionism Doesn’t Make You Perfect

If perfectionism isn’t an unwritten rule in our profession, it’s, at minimum, a personality tendency that is heavily reinforced. When I first faced my perfectionism, I tried to argue that it was a good thing. Of course I’m a perfectionist. I’m a physician. We have to be perfectionists. If we’re not, people die.

Self-Compassion Is Essential and Isn’t What You Think It Is

Yes, self-care is great and all, but self-compassion, or self-empathy, isn’t necessarily bingeing the latest Netflix series and unlimited ice cream (although those things have their value, too). Self-empathy takes practice and hard work. It requires showing up for yourself, even when it feels like it might be easier not to. Experts in self-compassion, such as Kristin Neff, PhD, and those behind the Compassion Fatigue Awareness Project, have described this as “putting your own oxygen mask on first.”

Self-compassion means gently but firmly reminding ourselves that we are not superhuman.

We need to eat, sleep, rest, breathe, exercise, play. We need to attend to our own emotions and bodies every day, even when it feels like doing so might slow us down, or let down others. Because in the end, it won’t, and it doesn’t. In short, we need to be kind to ourselves.

External Validation Will Never Equal Happiness

For me, it became clear that there was a sneaky triad in my life that had set the stage for physician burnout. It consisted of the above two issues — perfectionism and lack of self-empathy — but the third was more subtle: a subconscious need for external validation.

The Heart Has a Back Door

This one was a true game-changer for me. Oncology is a field that draws empathetic people, but at no time in my training was I taught how to cope with the deluge of emotional input that comes with serving others in our profession. In my coaching sessions, I learned that it’s possible to keep one’s heart open to those in need, but at the same time allow the things that don’t belong to us to flow through and out. We don’t need to build walls, but we also don’t need to adopt burdens that are not ours. Especially when that’s not what our patients are asking — or needing — from us. But if we’re never given the tools or taught the strategies in our training, it’s difficult not to internalize others’ pain.

The Game Is Rigged

The health care system is broken. We don’t have to pretend anymore that it isn’t. I want to write that again. The health care system is broken, and we don’t have to pretend anymore that it isn’t.

Not by proving to others that the system is wrong — because we know now that’s a given — but by proving our own character. By showing up anyway to do the right thing. Not for the system, but to hold true to our authentic selves. By not letting the brokenness erode our purpose.

Before, I didn’t have the tools or understanding to prevent this, and I did lose my purpose for a time. But ending up as a burned-out physician allowed me to find my way back. By doing the best that I could, in the circumstances that I found myself. One moment at a time. That’s it.

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