Treadmill of achievement: How it can be addictive and dangerous [PODCAST]

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In this episode, we sit down with Dawn Baker, an anesthesiologist and author of Lean Out: A Professional Woman’s Guide to Finding Authentic Work-Life Balance, to discuss the dangers of the treadmill of achievement. We explore the unwritten rules about success and praise, how achievement can be addictive and dangerous, and the impact of hedonic adaptation on our pursuit of happiness. Dawn shares her insights on how our sense of self-worth can become intertwined with the treadmill of achievement and the resulting consequences on our priorities and values. Join us for an insightful conversation with a medical professional who brings a unique perspective on finding authentic work-life balance and living a fulfilling life.

Dawn Baker is an anesthesiologist.

She shares her story and discusses her book, Lean Out: A Professional Woman’s Guide to Finding Authentic Work-Life Balance.

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Transcript

Kevin Pho: Hi, and welcome to the show. Subscribe at KevinMD.com/podcast and get CME for this episode by clicking on the CME link in the show notes. Today we welcome back Dawn Baker. She’s an anesthesiologist, and we’re going to talk about her book, Lean Out: A Professional Woman’s Guide to Finding Authentic Work-Life Balance. Dawn, welcome back to the show.

Dawn Baker: Thank you, Kevin. I’m so happy you have this platform.

Kevin Pho: So we’ll get into your book in a little bit, but for those who didn’t listen to our first episode almost a year and a half ago, just briefly share your story and journey to where you are today.

Dawn Baker: Sure. So I am a second-career MD. I had an engineering career before I went to medical school, and part of my journey is that I wanted to have a career that had more freedom. A lot of people don’t associate medicine with freedom, but I did, because of location freedom: There are sick people everywhere. And I wanted to have schedule freedom, and if you pick the right specialty, you can have that. So I ended up going into anesthesiology, which I thought would give me those things.

But I got caught on what I call the treadmill of achievement. I was told that I was really good at a very niche, particular specialty area, and I was going down a path that would have led me into something that really wasn’t very free. It would have led me into a very specific area of academic medicine that I could only practice in certain cities.

At the same time, I ended up having some non-specific symptoms during residency that led to the diagnosis of a pituitary tumor that had to be surgically resected. It was very large and causing vision changes. I had actually attributed my issues to burnout, because my symptoms were so non-specific and were really just depression-related: lack of motivation and sleep issues. But it turned out that once I got that fixed, I was able to get back on my path, and it was a wake-up call to me to get back to my original values of freedom and why I had gone into medicine.

Now I do very general anesthesia, and I also started doing writing, speaking, and coaching, and writing this book, so I could help other physicians find a path that was right for them and not necessarily what was dictated by other people.

Kevin Pho: Now, would you feel that in your current professional state, you have that freedom now that you envisioned when you got into medicine?

Dawn Baker: I started out, after my residency, doing an academic practice that was purely clinical. So I found a job that had a very simple set of roles, which is what I wanted. I wanted to focus on clinical medicine. It happened to be in an academic practice, but it didn’t have certain duties with it, such as administrative roles and research and things like that, which appealed to me. I liked that I was seeing more acute cases in that kind of academic center.

And then when I had a child, which I struggled to have after my cancer (I had had infertility, which is what we talked about on our last podcast episode), it really also brought to the forefront that I wanted to go more part-time. So I did that after I had her, when the time was right for my practice group. And then a few years ago, I left my practice and became a location-independent anesthesiologist. So I practice per diem and locum tenens only now.

Kevin Pho: All right, let’s talk about your book, which goes more into your journey. It’s titled Lean Out: A Professional Woman’s Guide to Finding Authentic Work-Life Balance. Now, tell us how this book came together, or tell us the events that led you to write this book.

Dawn Baker: I have wanted to write a book for some time. I think after everything that happened to me, I had in my mind that someday I wanted to write a book about some part of my journey. I started a blog a long time ago, really near the end of my residency period, and started writing snippets of what would maybe comprise the book later. I didn’t really know exactly what my take-home message was supposed to be until recently. I put it all together and figured it all out within the last year or so.

As for how that came together, I don’t know. I think it was ruminating, trying different fits and starts of writing a book, and figuring out what I really wanted to confer to people. I did not want my book to be a memoir. I wanted my book to be something that would give benefit to the readers and would give more of a how-to for doing work-life balance on your own terms.

Kevin Pho: All right, so tell us some of the key messages that you want readers to come away with.

Dawn Baker: Yeah, so the beginning of the book is a refutation of a very common book named Lean In, so that’s how I got the name. It talks a lot about how the do-everything, go-in-with-all-of-your-might, work-as-hard-as-you-can, stay-on-that-treadmill-of-achievement type of hustle culture is costing women, and not only women but men as well, their sanity, their health, and their fertility. To my knowledge, this is the only book that actually addresses the epidemic of infertility among physicians, and so I have an entire chapter dedicated to that, which is somewhat related to the type of high-stress environment and work and the delayed family building that we experience in medicine. So that’s the beginning of the book.

Then the second half of the book carves out steps that you can take to try to design your own work-life balance, and it’s really a lot about developing your own sense of self-awareness and self-knowledge. So I help people figure out how to recognize their position on the treadmill of achievement, if they’re on the treadmill of achievement, which most of us are, because we’re groomed to achieve. That isn’t necessarily a bad thing, but you need to make sure that you’re not deriving all of your identity and your self-worth from it.

And then we talk about addressing rules; addressing thoughts that are holding you back from the kind of lifestyle that you really want, which might be different from what all your peers are doing; figuring out who you really are and separating your self-worth from your achievements and from the traditionally defined ways that success is seen in our society; and then practicing doing hard things, which will help you ask for what you want in your workplace.

Kevin Pho: So you mentioned the treadmill of achievement several times now, and I think medicine self-selects for people who are on that treadmill, or else they wouldn’t have gotten into medical school and residency. You mentioned stopping on that treadmill, having that insight to take stock of what’s going on around them. So how can physicians who’ve been on that treadmill for decades have that insight? What are some tips that you can share?

Dawn Baker: Yeah, well, I’m hoping that by sharing the information in the book, they don’t have to get to a full-on health crisis like I did to recognize that situation. So some of the steps are to do things that are unlike what you typically do, such as focusing on yourself when you’re taking time off, for one thing. A lot of people don’t take the proper time off that they need. There’s vacation that goes unused all of the time. People feel like they’re trapped when it comes to taking vacations and breaks. But even small micro breaks and spending time by yourself is really the foundational key.

That can be a practice of mindfulness when you’re driving to and from work, really just sitting with yourself and not being distracted by things that are on the radio, talking on the phone, or getting things done while you’re doing your morning commute. That’s something that I talk about, and spending time just doing what seems like nothing and just listening to what’s going on in your head, writing down thoughts, doing thought work.

And also you can do some assessments. There are outside resources that can help you, and I share a lot in my book about ways that you can learn more about yourself and what you really want: figuring out what you really want and taking that time to sit there and think about it.

Kevin Pho: So if a physician does that, they take that time to take stock and have that time to themselves, what’s the step after that? Like, what happens next?

Dawn Baker: Yeah, well, I think it really depends on what you’re looking for. Looking to outside resources for inspiration and for help can be something that people use to go to the next step. That can be a trusted family member, or that can be a community. There are so many Facebook communities and online communities of physicians, especially women physician moms. There are a million different groups, and I’m in some of these. Hiring a coach or a trusted therapist, someone who helps you, who is objective and can look at your life from an outside perspective, can be helpful to figure that out.

But I think it really depends on what you decide your values are and what you want. Then you can peel away certain parts of the roles that you’re filling, which I call the instruments in the balance orchestra. There are all these different instruments that can play at different times, and some of them need to rest, and some of them need to just get out of the orchestra at times. You can figure out if there are roles that you can peel away from the work that you’re already doing so that you can practice sustainably. It doesn’t have to be all or nothing. You don’t have to just quit and pursue something not clinical when you decide that you want to do something that’s different than what you’re already doing.

Kevin Pho: So many physicians associate their self-worth with that treadmill of achievement, right? So it’s a very difficult mindset to break. Now, tell us a success story from your coaching, from one of your colleagues, where you can paint a picture of how a physician can disassociate her self-worth from their achievements.

Dawn Baker: Yeah. From my perspective, people ask me this a lot, because my situation was one where it seemed like all of a sudden I had this cancer diagnosis, something that really woke me up and that clicked something in my head, where all of a sudden I didn’t care about what people thought of me. Now, that is really difficult to achieve, and it takes a long time for a lot of people, like what you said.

So it means doing the work to sit down and think about what rules you’re following, and whether those rules are something that you actually care about, something that came from you, or whether they’re coming from something else. So there are exercises like that, and I have had clients do that. And then it means deciding if you really want to be living someone else’s vision of what your life is, or if you want to go by your why, and then taking that why and remembering it all of the time. If it’s something that you have to remind yourself of, then you write it down, you talk about it every single day, you have a mantra that you follow, something of that nature.

As far as a success story goes, I’ve had many clients come to me who know that they need to make a change, but really what they needed was permission. Giving themselves permission was something that they needed to do self-work on in order to do, and some of it comes from having an outside source, like a coach or another person, a mentor, or somebody to help them. For certain people, it takes, like, I have one client where it took less than a month for her to go ahead and ask for the decreased work schedule she wanted. And then I had another client who wanted to step down as program director in an academic setting and just focus on clinical. It took several months for that person to get the permission.

How do people get to the permission? It kind of depends on you, but it takes a lot of self-reflection and self-work, and just remembering that why. Why are you doing this? Reminders: Who are you doing it for? Is it just you, or is it your family, you know? In 10 years, in 20 years, when you’re on your deathbed, are you going to look back and wish that you hadn’t decreased your work or changed a role? Or are you going to, you know, be regretful that you didn’t spend more time with the people that you really care about in your life?

Kevin Pho: What do you find are some of the biggest obstacles that prevent physicians from giving themselves that permission?

Dawn Baker: Hmm. I think that, I mean, I hate to sound like a broken record, but one of the biggest things is personal: just holding on to certain ideas, holding on to rules and things that we think need to be true, thought processes like, “Well, if I am going to be a successful physician, I have to do X, Y, and Z,” and not questioning it, just not opening your mind up to that. I think we hold ourselves back more than anything. You could talk a lot about the system, about how the system is broken, about how the system hurts people, about how there’s moral injury, but there are certain things that you can do and not wait for the system to change, and a lot of it is what I’m talking about.

Kevin Pho: We’re talking to Dawn Baker. She’s an anesthesiologist, and her book is Lean Out: A Professional Woman’s Guide to Finding Authentic Work-Life Balance. In your excerpt on KevinMD, you talk about the concept of hedonic adaptation and how it affects happiness. So talk a little bit more about that concept.

Dawn Baker: Yeah, hedonic adaptation is where we have a kind of set point for our happiness. As positive things happen, or dopamine hits or inputs happen, and it’s really applied a lot to finances, you buy something new, you upgrade something in your life, like you get a new house or, you know, get a fancy car, and you’re very excited about it at first and you get that boost of happiness. But eventually it fades, and your happiness levels go back to baseline.

And it actually works the opposite way too, which is that something bad happens in your life, and there’s psychological data on this subject. Something bad happens in your life, and you come back to your happiness set point after a time. It can be, you know, distressing and off-putting for a period, and then you get back to kind of where you were. And so you adapt to your inputs and your dopamine boosts over time, and it works with achievement, and it works with things that you buy. It is something that people don’t really recognize, and they just keep adding more and more. And when we achieve, we get rewarded a lot with more work and more responsibilities, also from outward sources, and so that feeds into the problem.

Kevin Pho: So what are some solutions to something like that?

Dawn Baker: Yeah, well, first, recognizing that you’re on it and taking stock. I have a questionnaire in the book in chapter four, which is part of the excerpt. The excerpt that was on KevinMD is part of chapter four. There are no right or wrong answers or a score. It’s just questions to think about what you’re doing. Like we talked about before, if you were faced with a life-changing diagnosis or thing in your life, would you be happy with what you’re doing now? Would you be satisfied, or is there something else missing? Things of that nature. Do you derive a lot of happiness and pleasure from when people give you praise, from external validation? So it’s recognizing that you’re on that.

And then it’s looking at the thought processes that are keeping you there. Are you succumbing to all-or-nothing thinking? Are you succumbing to the sunk cost fallacy, like, “Well, I’ve spent so many years doing this,” or, “I spent so much money doing this degree, and if I don’t do it to the nth level, where I am the golden child in my specialty, then I can’t do it at all and I need to leave”? That kind of mix of all-or-nothing and sunk cost is something that people go through a lot. And so examining that and taking the time is so valuable. People say, “I don’t have any time,” but investing some time in yourself, in sitting alone with your thoughts or with a trusted third party, can be so, so useful.

Kevin Pho: Tell us some of your take-home messages that you want to leave with the KevinMD audience.

Dawn Baker: OK, well, I want people to know that it is possible to do something different in medicine. Like I said, you don’t have to be like everyone else, and you don’t have to be the perfect person in your medical field, your practice, or even a non-medical area, or else be nothing, which is what I thought. I thought, “Well, I need to quit and go be a Starbucks barista.” I thought that multiple times during my residency and at times when I was having trouble.

Recognize your position on the treadmill of achievement, and be honest about whether you’re on it or not. Address your rules. Figure out who you really are by spending time by yourself. Redefine success by going through and figuring out what your true values are. And then practice doing hard things, and that can be something like being alone, practicing mindfulness, or spending time learning something new: Take a class in something that is different from medicine. Lastly, give yourself permission to do something that’s different.

Kevin Pho: Dawn, thank you so much for sharing your story, time, and insight. Thanks again for being on the show.

Dawn Baker: Thank you so much.

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