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This is What Wellness Looks Like

May 20, 2018
by Mark David Siegel

Hi everyone: 

I generally have no dispute with therapy dogs or chair massages, but I got queasy last week when I learned both would be offered at this year’s American Thoracic Society Conference, which I’m currently attending in San Diego. The dogs and massages are available at Booth 904 in the Exhibit Hall, by the way. 

I think the ATS has its heart (or lungs) in the right place, and I understand the attraction of puppies and back rubs, but I also question the focus.  Like many professional organizations, the ATS has a growing interest in wellness and burnout.  The latter is especially problematic in the ICU where staff attrition is rampant.  My concern, though, is that we tend to focus more on alleviating symptoms than solving fundamental problems. 

The wellness crisis isn’t new.  Rather, we’re finally paying attention.  Though I’m not an expert on this topic, it’s clear that many factors, both personal and institutional, undermine wellness.  We have to fix problems on many levels.

Physician vulnerabilities vary.  In equivalent clinical settings, some physicians thrive while others drag.  Some residents like 28-hour call while others can’t bear it.  Genetic factors may impair one’s ability to withstand sleep deprivation.  We should consider these variations when we debate overnight call. 

Medicine is both rewarding and stressful.  To stay well, we have to care for ourselves.  I don’t always succeed, particularly when it comes to resting, but I try.  Let’s dispense with the fantasy of the superhuman physician.  We need to eat, exercise, sleep, pursue hobbies, go to the doctor, nourish our spirits, and nurture friendships and relationships.  We need to listen to our own voices when we choose career paths and not worry about others’ expectations.  I feel blessed to be doing what I was meant to do- teach residents and care for patients in a phenomenal medical center.  We need to build our homes in the right neighborhood.

We have to pay attention to how we spend our days and honor the factors that drew us to medicine in the first place.  Medicine gave me the chance to study science (particularly physiology), work in teams, teach and learn, and care for desperately ill patients.  It’s too easy to neglect what we love about medicine, particularly when we find ourselves drowning in tasks.  We mustn’t let our spirits starve.  When I need to recharge, I visit patients or spend time with teammates.  It always helps. 

On an institutional level, we have to create and maintain a healthy work environment: a shared commitment to high ideals; clean facilities; ample support services; humane schedules; time for reflection; talented teammates; honest discussion; and promotion of diverse perspectives. 

Which leads me to how we treat one another.  We can only be well when we listen to each other (and put our cell phones down); act with integrity; choose our words thoughtfully; show kindness and respect; keep faith in one another; rejoice in everyone’s successes and commiserate when we’re down; cherish our diversity; and treat our colleagues like brothers and sisters.  When we do all these things, we’re unstoppable.  This is what wellness looks like. 

There’s much more to say on this topic and I welcome your thoughts.  I’ll be attending some wellness sessions over the next few days in addition to sessions on sepsis and ARDS.  Today I’m having lunch with my sister and her family, and later I’ll catch up with old friends, including graduates of our residency and fellowship.  Let’s continue this important discussion when I return to Connecticut. 

And now, it’s off to the conference.  Maybe I’ll relent and get a chair massage, or even pet a therapy dog.

See you soon, everyone,
Mark

Submitted by Mark David Siegel on May 20, 2018