A Resilient Physician Cares for Self

Medical Post
Helping Hand Column, October, 2010

Caring for others is inherent in being a physician.  This is what we do best – it is intuitive for us, we are trained to do this, and it is our role and goal. Having empathy for others, a desire to care for others and make a difference in their lives, and the ability and capability to do so enable us to be resilient.  It provides a sense of meaning to our work, which helps to ground us during times of stress and crisis.  Yet, caring for others is not enough; to be sustainable, it must be balanced with caring for our self.

Caring for our self is often less intuitive and definitely not part of our training.  It is not our role – we are care-givers, not care-receivers.  Thus, it is no surprise that this is not easy for us to do consistently.  We put our own needs last, and often, they are lost.

A large aspect of self care is taking care of our physical health.  We are the only ones who can ensure that we eat properly, sleep long enough and restoratively, exercise regularly, keep our brains active, and have a family doctor and see him/her regularly.  We can also monitor our emotional health, knowing and watching out for the signs of burnout.  It is crucial to identify our priorities, both at work and at home, and to regularly reflect on how well we are doing at making time for all of them.  Taking care of ourselves also includes things like taking time to relax, indulging our self, making time for personal hobbies, spending time with people that we enjoy, laughing, taking regular holidays and time off work.   Once you find activities that you enjoy which make you feel relaxed and replenished, use the Tarzan Rule to keep them going.  Just as Tarzan swings through the jungle and does not let go of one vine until he has the other one in hand, do not stop and let go of a positive activity until you have one more booked!  That way, you know it is going to happen again.

Interestingly, I find that when colleagues do have or make some time for themselves, it’s been so long since the last time…they often do not know what to do with it! The first time you have a bit of free time, you may need to stop and think about what you would do the next time that happens.  Take time for yourself proactively. Ask yourself:

  1. If I had the afternoon off to do whatever I wanted, I would…
  2. I remember years ago when I would love to…
  3. I would be really disappointed if I never get to…
  4. Something I have always wanted to try is…
  5. I would love to spend more time with…

Reflect on these answers, and look for a way to make this happen now.

All of this requires that we give our self permission to care for our self.  As a group of professionals, we are very conscientious and responsible, and often feel guilty when we are not working.  We see time for ourselves as a luxury, as being selfish and focusing on ourselves when there is so much else to do.  In fact, this is an investment – if you take a small amount of time and energy for yourself, you are much more likely to be available to those who count on you.  Remember the airline safety demonstration – in the case of an emergency, you are advised to put on your own oxygen mask first before you assist someone else.  You are no good to anyone else if you pass out!  This is an excellent reminder for our work in medicine; we have to stop and do the metaphorical equivalent of ‘putting our own masks on first’, especially in times of stress or crisis. 

While it is understandable to feel guilty, this is not necessary. Self care is not an either/or proposition. Imagine a bubble full of the names of all the people (family, friends, patients, colleagues, community) that we care for and about.  Just ‘open this bubble’ and put your own name in there too. No one will miss the small amount of time and energy they do not get as a result, but taking a tiny sliver from everyone will create a nice portion for your self.

Think of your dream car – bold, beautiful, powerful, a pleasure to drive.  Imagine that you have bought it, and driven it every chance you had for a couple of weeks…then it runs out of gas and comes to a halt.  It does not matter how much potential it has; unless it has fuel, it is going nowhere!  We are exactly the same.  Despite our potential, we also need fuel to keep going.  Unfortunately, unlike cars, we do not come with a gas gauge.  We need to monitor this ourselves on an ongoing basis, and making a conscious effort to “Top Up Our Tank TM” in a proactive manner. This will ensure that we have the energy needed to go the distance, manage during the stress, remain resilient, and bounce back stronger and wiser.

Mamta Gautam is an Ottawa psychiatrist who specializes in treating physician patients. If you have a question you would like addressed in this column, please contact Dr. Gautam at mgautam@rogers.com. Please include “Helping Hand” in the subject line. All inquiries will be confidential. Your questions will not be replied to, but may be selected to be answered in this column, which is intended to be educational, not therapeutic.