Physician wellness begins in realizing our identity in medicine and society. Shamans, priest, and healers have existed in ancient times and in small and large indigenous tribes since man began to gather together in social packs. The unique role of tribal and community leaders who guarded health and wellness was understood as important for the whole of society.
All doctors have degrees of empathy. We as an order select for this trait as much as spiritual leaders look for spirituality or politicians look for diplomacy. Society even measures doctors according to “bedside manners” which tells us this trait defines our order in a primary sense. We may be many things at once or as well but we are at our core empaths.
As empaths, we succumb to the failings of empaths. We misread. We take on too much energy of all kinds. We feel guilty when we don’t help. We feel burnt out when we haven’t recharged. We are alone except amongst other empaths. It is an infrequently admitted truth that we go to fix problems because the pain we feel doesn’t go away until we fix the problem. When we fail the pain that made us accountable, responsible, and moved stays with us. We fail when others suffer. We fail when people die. There will be things we cannot fix and those things add to the crux of what makes doctors unwell.
Physician wellness must take on a new paradigm.
Narrative medicine as a literary form that engages care providers including physicians to share their witnessed stories of humanity can be an instrumental tool to repeatedly resuscitate the physician. Relationship centered medicine has been considered a way to help doctors stay in love with doctoring and that premise is supported by narrative medicine to help refocus the efforts of medicine around relationships.
1. The paradigm starts with embracing our identity as learned healers: empathic intelligent leaders. That is what we are born to do and what society needs from our birth. Society expects doctors to be compassionate. Compassion defines doctoring. Empathy is the origin of compassion. We are empaths.
2. Refueling speaks to what we are. As empaths, we must recharge to then go out and give. Refueling includes time alone. Time with natural elements. Time with other empaths who happen to be our colleagues or aids. Time to grow our self-awareness and mature our natural skills. Security and self-wellness mean there is something to give from.
Running on empty when sick people are coming to you for help will lead to no healing. In fact, it will result in more pains. The patient is unheard. The physician fails and is further depleted. We don’t send broken solders to fight. That gets others killed. We don’t allow pilots to fly tired or stressed. That carries human cargo tangibly into danger. Unwell doctors will perpetuate suffering or create more.
3. Realization that healers are wounded by the pain around them and charged by the success around them. This realization explains why we must try to fix problems. Pain of any kind around us hurts us, and the resolution of conflict and pain is a personal relief to us. This awareness leads to solutions to achieve balance and wholeness despite the more often depleting rigors of being a healer.
4. Reconciliation that some pains don’t resolve neatly or timely so we harbor them. They weigh us down and tear into our ability and deplete our reserve. We must thus unload burden of suffering. We can share our pain by logging the journeys we are so privileged to make with others. We can tell those stories to embrace them and then release those details because they increasingly bog down the engine of empathy. Narrative medicine can bring about this. Even narrative medicine by proxy where another writes with or for someone can do this.
5. Releasing the good and bad that healers stockpile over a day or a week or a lifetime can allow for more encounters and dealings. This is what happens as we seek reconciliation. Currently, physician wellness is flooded with retreats, meditations, and spa relaxations. Narrative medicine is happening now as a medium to connect physicians with themselves, with medicine, with society. It provides to society an actual log of real intimate moments that define humanity and the human condition. Arguably, it is a discourse with healing that can create a conduit to healing the healer.
Writing an intimate story down or sharing an intimate story to be written down or reading an intimate story will all effectively release the healer into a place of renewed purpose and awareness. It will unbridle the empathy so the healer can go back and care again.
6. Remembering the impact healers make through logged stories and sharing can continue the orders’ main agenda and thus role in society.
Physician wellness is not just about security, work hours, time off, meditation, massages, retreats, recognition, resilience. It is about pushing to the forefront repeatedly who doctors are in society. We are healers. It is about realizing what that means and entails. We are empaths. It is about refueling the ability to care by nurturing our empathy with empathy. It is about releasing what we did and can’t do, what we fixed and can’t fix back into the whole society to own. It is about remembering we are here to help and to play our given gifted role. The area of narrative medicine can help create the paradigm shift to making well those that make society well through active reflection on the humanity in medicine.
Jean Robey is a nephrologist who blogs at ethosofmedicine.
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