Burning Bright Without Burning Out

Happy New Year!

Did you make resolutions? I never do. It's so exciting to see people promise themselves to change, to be better; and it's awful to see people abandon those same promises. I've always wondered what happens. Did he lose support from his spouse? Did she experience a disappointing set back at work or school? Why do we abandon our resolutions? 

Maybe the idea of a resolution has been tainted by only making one once a year. The joke about saving a resolution for the next year speaks to how seriously we take our own personal evolution. We don't. 

Enter the concept of self-care. I don't think it's a buzz word or a trend. I don't think it's all fizzy baths and nail polish. I think it's crucial to anyone's identity and for pushing forward toward positive personal changes. 

As a naturopathic medicine student, we start exploring self-care in the first year. The doctors who teach at the school don't want us to feel burn out before we even get our feet wet. Medical school is grueling, but I don't think it's good to feel like death 24/7. And I think my professors would agree. 

I wish these two particular resources were shared at the beginning of the my first year, because I got them at the beginning of my third quarter. Better late than never.  The medical community is greatly concerned about physician burnout, specifically "the progressive loss of idealism, energy, and purpose experienced by people in the helping professions as a result of the conditions of their work" (1). 

Ick. While the first resource was specifically written about oncologists, it did point out that no physician is immune to burnout. (Read the full article here.) And as many of us know, the slow burn really starts when we crawl into the jaws of medical school. Please note, I think pretty much anyone can experience burnout, especially if we're defining it as a loss of idealism, energy, and purpose. Therefore, anyone can benefit from evaluating or establishing self-care routines. Additionally, this article pointed out that being married and having children are protective against burnout. I would interpret this to mean that creating and maintaining deep relationships is vital for one's wellbeing. 

The second resource I want to share is the "How Healthy Are You Survey?" put together by the University of Wisconsin School of Medicine and Public Health's Department of Family Medicine. The survey is a part of the Department's Aware Medicine website which is geared toward health professions students and residents with the purpose of creating compassionate, self-aware healers. 

It's a highly subjective survey inspired by one created by the American Holistic Medical Association. That is intentional, because people tend to have different versions of "healthy." Like-wise, the definition of self-care is highly nebulous. In the article "Caring for oneself to care for others: physicians and their self-care," the authors only define self care as "a cadre of activities performed...to promote and maintain personal well being throughout life." The survey focuses on six aspects of health: physical, environmental, mental, emotional, spiritual and social. You score yourself on 200 activities that are considered healthy or unhealthy and can certainly be considered the many forms of self-care. 

The survey required a lot of personal reflection on my part. I thought I was taking good care of myself. I’m going to a Naturopathic medical school after all! But I’m wasn't. Not even a little bit. I was barely passing. My mental and emotional health was in the gutters, and I didn’t know what to do. I tried to be kinder to myself that week, not worrying about deadlines and to-do lists. But I found myself thinking one day “I think I’ll treat myself to a shower.” That was all the self-care I could muster, and I realized I deserve more than that.  

Medical school is hard, but is shouldn’t mean that I give up the things I love or the things that make me happy to succeed. There is sacrifice, and then there is total death of self. 

Physiologically, self care could mitigate the negative effects of stress brought about by increased levels of catecholamines and cortisol such as decreased immune function, distractibility, and poorer cognitive function. However, at the most basic level, self-care—exercise, meditation, relationship building, or just enjoying the little things—can be the one thing that brings consistent contentment. Self care is important because it protects who we fundamentally are. Stress changes us. I consist of values, passions, hobbies, relationships—all the things that make up me. But burnout can eat away at the joy I have for what I do, and I don’t ever want to despise what I feel called to do. 

So that term I started taking time every day to do something that was not related to school or work. I went on walks through the park with my husband, exercised more, took time to enjoy my food, and read books for fun. Everything thing I needed to do for classes still got done, was done well, and I felt so much better about myself (my test scores even went up!). At the end of that spring term I retook the survey, and I was pleasantly surprised to realize that I was finally taking care of myself. 

As a future healer, it is important to cultivate the emotional maturity to see past my own feelings during a stressful situation and address the needs and feelings of a patient. As a future primary care provider, I will walk through difficult diagnoses with patients: diabetes, miscarriage, malignancy, etc. I am a aware of my capacity for strong emotions under duress (I do work in an emergency department), but I am only aware through engaging in self care activities.

A survey, even one produced by a medical school, should never ever replace seeking professional medical or mental health help. My intent is to bring awareness that life--school, work, family--may eat you up and leave nothing behind. I think all of us could taking better care of ourselves whether it is through eating better, being more active, spending more time with loved one, or enjoying a bubble bath. 

If you love new year's resolutions, make them. Change your diet, exercise more, read, write, create, change. But I know for myself, it doesn't matter what time of the year it is--I promise myself I will pursue what takes care of me and shun what pushes me to burn out. 

I'm still not sure what causes people to drop resolutions. But I do know that no one should worry if he/she gets off track with a resolution. Whatever. Caring for oneself is continuous. Don't wait for a special occasion, like celebrating a new year, to starting taking care of yourself. 

Many blessings on the start of a new year. 

References:

1.  Sanchez-Reilly S, Morrision L, Carey E, et al. Caring for oneself to care for others: physicians and their self-care. J Support Oncol. 2013;11(2): 75-81.

2. University of Wisconsin School of Medicine and Public Health – Department of Family Medicine. How healthy are you? http://www.fammed.wisc.edu/files/webfm-uploads/documents/outreach/aware/how-healthy-are-you-survey.pdf. Accessed January 1, 2018.