Valerie Brooke, MD
Balancing the See Saw
On the way home from skiing last weekend my husband and I were humming along to the familiar 1968 Moody Blues song, “Ride…Ride my…blah blah…take this place…on this trip…just for me…” We happened to glance at the dashboard and saw the name of the song, “Ride my See Saw.” We were amazed that we had been singing and humming along to the song for our whole lives and had no idea what the lyrics actually were. We smiled with a sense of satisfaction that we had figured it out.
That’s how I felt this week after listening to a fantastic lecture by Dr. Dike Drummond, a family practice physician who stopped seeing patients after ten years of practice because he was burned out. He has spent the last twenty years of his life researching, learning, and educating himself and others about physician burnout and how to both treat and prevent it. He finally put an image in my mind of what I have been trying to do in the last several years to treat and recover from my own burnout. I have been trying to balance my see saw.
Dr. Drummond believes that burnout is not a problem per se, as this applies a potential quick solution. He sees it rather as a complex dilemma, one that needs a strategy composing of many different actions, adjustments, and changes in a physician’s day-to-day life at work. The strategy needs to be centered around balancing and energetic see saw. On the one side is everything we do in medicine that burns up our energy: direct patient care, managing the expectations of patients and their families, communication with our team of healthcare workers involved in patient care, electronic medical records and onerous documentation, insurance demands, administrative roles, continuing medical education requirements, licensing requirements like performance improvement projects, teaching residents and students, educating our teams with the constantly growing field of medical knowledge, and trying to keep up with the research in our particular medical field. I feel depleted by just writing out this list.
On the other side of the see saw are all those things that recharge our stores of energy. I cannot speak for all that work in healthcare, but I have a very solid list of things I make sure to do every single day so that I will feel recharged. I call these my self-care non-negotiables, those things I do that are not open to discussion or compromise. The first one is sleep. I will do absolutely everything in my power to make sure I get as close to 8 hours of sleep every night. The only activity that trumps sleep is eating. Sleep is my elixir, my panacea, the one thing in my self-care toolbox with the most powerful restorative effect.
There are many other recharging activities on the recuperative end of my see saw. Daily meditation, 20 minutes in the morning after waking up and 20 minutes at night before falling asleep, is my second non-negotiable. These transcendental meditation sessions, where I sit and say a mantra in my mind whenever I get focused on a thought (which is constantly), are the supportive book ends to my day, gentle transitions to being awake and falling asleep. After sleep and meditation comes yoga and/or any type of body movement, even if it’s only for 10 minutes, as well as writing, whether in my journal, my blog, or getting down a few paragraphs of my book manuscript.
These four activities only take up about 90 minutes of my day and are essential strategies for me to stay out of the grips of burnout, a place I was deeply in two years ago and never wish to return to. If I miss a day for some reason due to uncontrollable circumstances, when life gets “lifey,” like getting ill, supporting a struggling friend or family member, or my car breaking down, I just get back to those four non-negotiables the following day. The see saw may briefly flip towards the energy burning side, but it’s not that long before balance is restored and I’m riding in the other direction.