Running through the pain

I’m not a runner. But I strive to be healthy (at times) and will jog every once in awhile, and it is generally awesome. Once I get past the puffing and into a rhythm, those endorphins kick in and I am soaring. One day, I was going at a good pace and suddenly felt a searing pain in my legs and was faced with a decision- do I run through the pain, or let up? I tried to push through for awhile but it really didn’t feel right and I finally slowed down for awhile that the pain settled down and I was able to finish my workout. Later, I was realizing that I probably had shin splints and taking the rest had been pretty crucial to not injure myself further. Yet, I had so much inertia that wanted me to ignore those pain signals and push through. Why?? I can’t help but think some of the values of the Culture of Medicine played a role.

The culture of medicine is strong and thick and hangs on you years after training has ended. Most of us come to the field because of our desire to help others, but the risk of losing ourselves in the process is substantial. 

We love the challenge of this work- flexing our cognitive breadth to limits we never imagined, learning more and more while simultaneously realizing the vast knowledge that still remains unknown to us. In the quest for understanding and becoming the best clinicians we can be, we easily put our needs on the back burner in service of others. We want the best for our patients, so we give our very best, sometimes until we have nothing left. We often find ourselves wearing our sacrifices like a badge of honor- going months without a vacation, responding to messages late in the night, saying yes to something even when you have no remaining bandwidth… 

We come to see the hard work as admirable, even if it slowly peels away at our morale and makes us lose pieces of our non-medical identity in the process. It renders us at high risk for burnout/moral injury, depression/anxiety, even suicide. Physicians are at least twice as likely as the general population to die by suicide. We lose about one physician a day to suicide here in the United States.

Isn’t it horrifying that those who are tasked to heal and keep us well are struggling so deeply? 

It is a scary situation we are in, that has only been amplified by the pandemic, and it can seem like an insurmountable problem. How do we heal the healers? How do we help make people feel whole again, and set healthy boundaries, and thrive in this vital work? I grapple with these questions regularly in my work as wellness director for my department. And for a long time, I felt like the world rested on my shoulders with this wellness quandary (which seems so silly, but I see now that it was my own baggage I carried with my taking ownership of too much and not accepting what was feasible for a single human). The fact of the matter is wellness is a team sport - we have to do our part to see our pain and not just run through it, and we also need our system to support us in not pushing ourselves to injury in the first place. (More on this in my “Putting the 'We' in Wellness” article for the San Diego Physician magazine.)

It’s a tough balance- finding the sweet spot between stretching our boundaries to learn, grow, and engage deeply in healing work, while also not depleting ourselves to the point of no return. And this is why things like peer support, engaged leaders, and evidence-based systems strategies can be the guardrails for us so we don’t try to walk that fine line alone. As with any complex health issue that I manage for a patient, I always say, you have to come at it from all angles to really get a handle on it. In this way, the synergy of multifaceted approaches can become an excellent strategy in the quest for well-being.