The Gifts of Burnout: An Evolutionary Wake-Up Call for Doctors

It has been fourteen years since I graduated from University of Michigan Medical School. I have journeyed far from the field of medicine, and yet my heart keeps hearing the call to return to my physician communities and share what I have learned. I simply cannot ignore my sense that the pain within our health care system - now felt at every level, including patients, physicians, and payors - is a resounding call to wake us up to our next stage of evolution.

It takes only a cursory scanning of the headlines of medical blogs like this one to get a sense for the unrest, the frustration, and the abundance of innovative practices emerging as a result of the rising sense of powerlessness among doctors. I left medicine immediately after receiving my MD, moving into uncharted waters after the Dean of Career Development at Michigan told me, "You're on your own. We can't help you with that." This was when, as a fourth year student, I announced I would be pursuing a career in venture capital.

I volunteered at a private equity investment firm - yes, I worked for no pay - and six weeks later, I was hired as an Associate. Within two years I was the youngest partner-level Investment Manager in the firm. No one told me this was possible. I simply would not accept anyone else's opinion of what I could or could not do. Especially after what I witnessed in my world of medical training.

One of my most vivid memories was on my Vascular Surgery rotation, where I was absolutely loving the concept of what we were doing - as intellectual masturbation material. But in practice, what I saw was my future laid out in the following scenarios. The second year resident, sick as a dog, showed up to work anyway, and, too weak to stand, lay down on a gurney in the OR while a case was going on. The third year vascular surgery fellow, a gentile Southern man, was in the middle of a lower extremity bypass graft and stepped out of the room. He lifted his mask, vomited into the scrub sink, and then reentered the OR to continue the procedure. This happened two more times within the same procedure before he completed.

Many of you reading this may be nodding and saying, "Yup. That's just the way it is. Suck it up or leave it." And my question is, "If you have trained yourself not to feel, what else might you be missing in your experience of other people?".

Later in the month, on a Saturday night call, we brought Mrs. X into the OR at about 10pm. This was hospital day 50-something for her. She had come in for a routine renal artery stent, and apparently had embolized into her IMA, killing off part of her gut. Her wound was infected, she developed multi-organ failure, and was kept alive, with an open abdominal incision, on a ventilator. She was unresponsive, and it was unclear, each day of the month we rounded on her, whether the family was aware of her prognosis. One day I spoke to her husband, and he told me, glossy-eyed, that the day before she was admitted to the hospital, they had played tennis together. He looked forward to the day they could do this again. What a far cry from the rigid piece of meat that was plugged into machinery and called "alive". I was confused, then, when we suddenly decided to bring her back to the OR to "drain her abdomen" or do something surgical, when there was no clinical evidence of any change in her status.

I will never forget the first snipping of the sutures holding her abdominal fascia together, as a wave of black liquid gushed out of her belly. We tried to catch some of it in a test tube to "send it for culture". As if we couldn't predict the lab report of "multiple anaerobic organisms not otherwise specified". Then, at around 11pm, our 63-year-old attending vascular surgeon walked in. He had street clothes on, and held a mask over his face. He leaned about ten degrees in over the body and said, "OK, I'm signing off". Then walked out.

We were left with closing her up, bringing this woman - not just a body - back to the ICU, and coming up with a story in our notes about what we did and why.

I moved on to a different rotation before she was ever pronounced dead. I wasn't there when someone had to break the news to her husband that they would never play tennis again in this lifetime. But I internalized a lesson in that month about the price of actually DOING what I LOVED. A door inside my heart closed, believing that my heart's desire - to do a job I loved, and to live a LIFE I loved - was simply not possible. I had to choose one or the other.

Since then, I have been a partner-track professional in a venture capital firm (again, something I was told would not be possible given my experience), I moved to California to follow my childhood dream of starting a violin school, built a successful six-figure business on my own from scratch, and then experienced the loss of that school through what I now see was burnout.

The gifts of burnout have been the rediscovery of my humanity, my desire, my creativity, my purpose, my own healing, and my love. I love empowering people and being co-empowered in relationships. I love seeing my ideas in action. And I love being the facilitator of true healing and transformation in people.

I have created a life in which I do what I love, and I am fully supported in the very uniqueness of my expressions of love. I have received trainings in life coaching, sound healing, traditional Thai massage, Breema bodywork, and Bio Optic Holography. I made a conscious transition from playing only classical music for thirty-plus years to improvising on my violin, voice, and other instruments. I co-created an acoustic rock duo with my partner-in-life, and we perform in public regularly. We live in a beautiful natural setting, among a community of people who value artistic expression, stewardship of the earth, and mutual support. I birthed myself as a visual artist, and have exhibited in a juried show during my first year as a painter. I have traveled the world and studied with the most inspiring people I have ever met in my life. And I share this with people, one-on-one, in groups, by phone and face-to-face.

I have avoided sharing the fullness of my learnings with physicians, other than those who happen to find me in their own internet searches. I have been hiding my joy. And now, even as I feel my fear of wading into shark-infested waters, I choose to bring my message to you. It is not necessary to settle for what others have told you is possible, or even for what you have defined in the past as possible. You are a creative force far beyond your current imagination.

I have followed the public and academic discourse on physician burnout and suicide, and I notice several things. First, the good news. It's being discussed and therefore legitimized as a "syndrome" in the eyes of the medical establishment. Not surprisingly, however, burnout is being "medicalized" as a diagnosis that must be prevented, eradicated, treated aggressively, and fought like a battle against a raging enemy among us. This is the medical mindset. It's how we were all trained to see the world - to focus on what's right and wrong, eradicate the wrong, and restore the system to its previous state if at all possible.

I have a different perspective. I see the experience of burnout not as something to be eradicated, shamed, attacked, or avoided, but as something to experience with full participation and curiosity. To see the depths of despair and loss as a form of structural tension within a system that holds great innate latent potential to launch a powerful trajectory in the direction of your greater mission in life. Yes, I believe your personal, specific experience of burnout holds the very keys to the fulfillment of your wildest dreams and desires for your thriving life.

Fundamentally, the process is one of remembering your love. Remembering your art. Remembering YOUR medicine. And LIVING YOUR MEDICINE. Yes, that means looking at yourself. Shining loving light - transcending right and wrong - on those experiences within you that require healing attention. When you have walked with courage through your own healing process, and you have touched the places within you that you did not understand how to love previously, you become your medicine. You embody the grace of healing, and you effortlessly deliver the level of care, compassion, and precision that flows through you as love.

If your heart says YES, please join me for a free introductory call to my new program for physicians, "Live Your Medicine", by registering here. Vote for your own joy, creativity, and desire by taking a courageous step on behalf of your own heart. And please reach out to any colleagues you know who may benefit from this discussion.

What makes you unique?

In the weeks since returning from Boulder, I've been spending more time with the idea of the Unique Self teaching of Marc Gafni and the Center for Integral Wisdom. For me it was deeply integrating to hear a story that finally enabled me to bring together both the parts of me I had discovered and cultivated during the last five years - namely, wordless presence, connection with the Oneness, and recognition of egoless identity - and the parts of myself I had "divorced" from - namely, the rules of classical training, the linear reductionist thinking of mechanical science, and the ignoring of subjective experience.

How refreshing to hear someone say, "You can't meditate your ego away. You can't meditate your story away." This was part of my experience as a meditation practitioner! I wanted to put certain chapters in the past, as "the way I used to be", believing that in order to become who I knew myself to be - both creative and spiritual - I needed to forget who I once was. No matter how many relationships I walked away from, no matter how many new practices I adopted, no matter how many new communities I joined, I could not completely ignore my prior experience and stories, and the curiosity I felt about bringing my new learning back to my old communities. I could not pretend they were not in me. Oh, I tried. But I never felt complete in my expression, or full in my generosity of sharing. It was as if there were problems I knew existed, in distant parts of the world, that I was deliberately ignoring for the sake of elevating myself beyond them, transcending them by trying not to pay attention to them anymore. I kept my eyes forward, visioning my ideal life over and over again. And still I felt there was a connection I was not making.

The image of my Unique Self "plugging in" to the infinite mesh of the One via a radically unique shape - not just a generic plug into a generic outlet, but a unique contour fitting in like a puzzle piece perfectly matching in every subtle turn of form - is supporting me to integrate all of my stories, all of my prior and current experiences, and to show up as me. I am now opening my vision to include all the parts of me I would rather hide and avoid, the parts I would rather not have you see, AND embracing my brilliance and light and infinite creativity at a level previously unrecognized....not as opposing sides of a coin, but as different and equally essential points on the same sphere of my wholeness.

So what makes YOU unique? What are the points that constitute the unique shape of your piece of the mighty jigsaw puzzle of all that is?

The invitation of our times is to hold this paradox: what you think you are is not who you really are, and exactly who you are is all you need to be.

When you show up as all of exactly who you are, you heal, transform, and create a world in the way that only you can.

Success 3.0 - Wake Up, Grow Up, Show Up

It's been a BIG few weeks for me. I've been away from my desk, discovering more of my tribe, in places I never thought to look. Experiencing the feeling of coming home to myself, my story, and my place in the evolution of all that is. I trusted the feeling of just knowing (without knowing why or how), and I was rewarded beyond my wildest imagination.

Three weeks ago I attended a four-day event like no other in Boulder, Colorado. Called Success 3.0 Summit, this was a gathering of entrepreneurs, CEOs, authors, spiritual leaders, artists, musicians, doctors, coaches, healers, and other thought leaders for the purpose of rewriting the myth of success in our culture. Success 1.0 was survival. Physical survival at the most basic level. Success 2.0 was the accumulation of wealth, status, achievements, and symbols of power at any cost, even at the expense of health, relationships, and well-being.

Success 3.0, as we are co-creating it to be, is the awakening to the fact that we can no longer operate as if our individual actions have no effect on the collective. We must wake up to the reality that we are all interconnected, and that we have both the capacity to destroy ourselves as a species and the infinite possibility of expanding our consciousness to include the whole cosmos in our own evolution.

Summarized in six words, Success 3.0 is a call to "Wake Up, Grow Up, Show Up." Wake up to our true identities not as separate beings, but as expressions of the oneness of all that is. Grow up to take responsibility for our actions as part of a larger whole, beyond our egoic concerns, beyond even our immediate family or tribe or community, but to include the entire cosmos as an extension of our sphere of influence. Show up as a leader by expressing our own unique gifts, standing fully in the truth of our unique life experiences and stories.

For me, the conference was profoundly integrating of the many chapters of my life experience that had previously appeared separate or unrelated. I now see that every single world I have lived in - from the suburban middle class neighborhood of my hometown in Libertyville, Illinois, to the halls of the Ivy League, to the training of medical school, to the partnership track in a venture capital firm, to solo entrepreneurship in Silicon Valley, to the experience of burnout, to transitioning from classical music to improvisation, to performing acoustic rock violin, to training as a life coach, to traveling to Southeast Asia to study bodywork, to becoming an artist - informs my perspective wherever I show up. My ability to listen deeply across multiple disciplines, and my unrelenting vision of possibilities, is my unique gift to any situation I am in.

I am a weaver and collage maker, drawing threads from seemingly disparate elements and incorporating them into a new tapestry with every interaction I have. I am a living expression of the evolutionary impulse, coming through me, existing in me, and experienced by me. And so are you! Within your unique set of life experiences and stories is the unique expression of life as you - and only you - can express it. When you choose to wake up, grow up, show up, you enter into the process of co-creating, with the evolutionary impulse of all that is, your unique definition of Success 3.0.

I'm excited to continue showing up in new ways, to start conversations about what really matters, and to continue bringing my unique art into the world.

Is it time for you to upgrade and update your definition of Success? Join me in the conversation.

Exercise Your Write To Be Free

I rarely share client stories, but a recent experience is birthing a whole new way of working for me. I just finished a 30-day writing experiment with a physician client who is just starting out on a brand new path. Having already found the courage to leave his medical practice and head into the open space of the unknown, we worked on rekindling a secret dream he's held for a long time, maybe his whole life: writing.

He always wanted to try writing, but never did because he had a belief it was too impractical and was no way to make a living. Yet he knew he had stories to share, and ones that would help others if he did.

I wanted to hear these stories myself. I was curious what touched him so deeply about his experiences in medicine. I knew that in hearing these stories, we could both experience a healing journey.

So I came up with this idea, which I had never done with a client before: a writing experiment. The assignment was to write daily for ten minutes a day, thirty days in a row. Then send that writing to me, which I read every day. Mostly we let the process run itself, but we had two phone conversations during the month, once to check in and then again to review the entire process.

I knew that a small, daily commitment done over a sustained period of time would lead to something. A new habit at the very least. An awakened sense of hope and creativity I envisioned as possible.

What I didn't expect was the vast territory we would cover in those ten minutes of daily writing each day. Not only did I learn from my client's deep minings that occurred from this type of reflection, but I heard accounts of key moments, important feelings, and long-held beliefs that it might have taken months to get to with traditional weekly phone coaching calls. In timed writing, you get to the heart of the matter quickly. You can try to dance around, squirm a bit, but the hand keeps moving and the clock keeps ticking, and something gets said that has juice to it, even if at the very end.

And when you have a curious, compassionate witness, who wants to hear more, and will ask you questions and deliver you the next prompt to inspire more writing, it unfolds with surprising beauty.

It was so beautiful that we are continuing the process for another thirty days, this time including a few additional daily and weekly practices like meditation and art-making (yes! eek! art!). And now, I want to offer this powerful experience to you.

First, here is the practice, which you can do entirely for free on your own. Form a group of friends and do this together. It could, in my client's words, be a "life-altering experience".

The practice:

1. Choose a start date. Why not tomorrow?
2. Choose a time and place you will do your writing every day for the next thirty days. Yes, you need to think about this in advance, or it will not happen.
3. Choose a pen and notebook that you LOVE, and that you will use only for this writing practice. You can use the computer too if you must, but I highly encourage the use of pen and paper for this. There are enough reasons we are called to the computer, and not enough good reasons to go manual these days. Here's one.
4. Get a timer. Most phones have a timer app. Or use a good old-fashioned egg timer or stopwatch or alarm.
5. Set the timer for 10 minutes. When you sit down to write, you start the timer. When the timer starts, your hand starts moving across the page. You don't stop. You don't pick the pen up off the paper. You are not thinking. You are letting your hand move, letting it lead the process. You don't edit grammatical or spelling errors. Don't cross anything out. Just keep writing. Lose control. See what happens. Don't have a plan.
6. When the timer goes off, you stop. That's it. Pick your hand up off the paper. Close your notebook. Go do something else. This is important, too. Give yourself an endpoint that is defined.
7. The next day, repeat.
8. And repeat again and again for thirty days.

The page serves as a mirror to our present state, in a beautifully unedited and raw form. We get to see inside ourselves in a way we probably don't look for on our own. Our minds are too busy arranging things. Or we're reacting or responding to something outside ourselves.

With this form of writing (which is influenced and inspired by several of my favorite creativity teachers), we come into contact with the reality of the present moment, and how raw and fresh and changing it is. With practice, we also begin to create a space for ourselves to witness what is. To be OK with whatever shows up on the page. To not always be meeting some idea of an expectation. To let go of an agenda and trust, even if only for ten minutes a day.

And all of this, again in my client's words, could lead to "a whole new world opening up".

You can totally do this effectively on your own as a practice. There are great books that speak to the depth of what this can uncover, and provide you with pages and pages of prompts to go far and wild.

But if you want to work one-on-one with me, receive weekly written responses to your writing (I am not an editor or a coach or a critic, but a supportive, curious listener who tells you when I want to hear more), and have two phone conversations during your thirty-day process (one brief check-in after week one, and another full-length conversation at the end), then I am offering the opportunity for a limited number of individual clients, starting October 15th.

I've learned this about myself during the past few years: I don't do online forums, and I don't do auto-responder emails. I thrive in one-on-one interactions. According to the online marketing experts, this breaks all the rules of becoming a rock-star millionaire business owner. But that doesn't faze me. I'm following the bliss of what I know to be an extremely potent process, which is in alignment with everything I know from experience to be valuable to the recovery of the soul.

Here's how to join me in October.

Surrender and Loving It 'Til You Know What It Is

I am in a large group of women artists who have driven up to the ridge of a mountain range and then down a very windy road to a secluded artists retreat program in northern California. All I want to do is stare at the dreamy landscape, watching how the golden green hills go back and back and back, disappearing finally into a fog bank which hovers just above the sea in the distance. I want to watch as the wind blows, the fog clears, and the misty outlines of the hilltops begin to glisten in the midday sunlight. I want to sit and sketch it, and fill in the colors I am seeing, and try to capture the dreaminess, the haziness of it all, the lack of precise outlines which gives it that quality of mystery that makes me want to keep staring.

But we have a schedule. There are ranchers and herders moving us along in this schedule, ensuring that we are on time. I help myself to a large lunch - two servings each of lentil soup and kale salad with some fruit on the side. My idea of a perfect meal. But my stomach feels slightly full after all that, and I am ready to rest and digest.

Having forgotten the schedule momentarily, I’m jarred when it is announced that we now need to move into another room for a “movement activity”.

I take my time walking there, hoping those extra few seconds will give my digestive system time to bring the food down a little more.

By the time I join, the circle has been formed and all the women are bouncing lightly on their bare or socked feet. This being one of only 14% of artist residency programs in the country who have a fully spring loaded dance floor, shoes are not allowed.

Ann Swanberg is the leader. I had experienced her work once before in a large church, where she presented her improvisational approach to life in a humorous show. We kept bouncing - this was Ann’s method for keeping us out of our thinking minds and in some other realm governed by the moving, breathing body - and we did a whole host of games designed to get us to drop our personalities by acting silly and free.

What I noticed is that my recent experiences with becoming present were done in the stillness and silent meditative movement of the Breema Center. Somehow in that setting, where I was truly not a personality and there was absolutely no imperative to show up as entertaining in any way, I could feel my own bodily presence. In this setting where everyone was asked to do something silly, there was slight pressure to be “silly enough”. As if stillness would not have been accepted there. But I don’t know because I just flowed with the energy of the room.

One of the more silent and inward-turning exercises of the day did capture my attention. She called it “The Infinity Box” or “Loving It ‘Til You Know What It Is”. The instructions went something like this: Reaching into an imaginary box from which anything is possible, allowing the “Body First” to lead the improvisation, follow the shape your hands spontaneously take as you reach in. As they emerge from the imaginary box, just be with them. Don’t change them or manipulate them into what you think they might be. Just breathe with the shape, feel it.

"Love it ’til you know what it is."

It was fascinating to watch the different shapes my hands took on when I allowed them to. Fingers apart and curved, palms facing up. Fingers together, joined at the thumbs and index fingers. Palms cupped, joined together, facing up. And then waiting. Breathing. Feeling. An answer or image always emerged. But sometimes I had to stay with it longer than expected. The final one I ran out of time on. So I sketched it, and it is permanently imprinted in my bodily memory. I am still wondering what it is.

It reminded me of painting. How the creative practice for me is staying with something long enough to find out what it is. Not to give up. Not to decide in advance that something’s “never going to work”. So often when I have mustered the courage or audacity or love to stay with it, to keep going, to keep loving it, something else so beautiful and magical emerges right on top of it all.

Chris Zydel sent out her newsletter yesterday too, and I happened to read all the way to the bottom. The article was about "Surrender". How surrender is not giving up or weakness or defeat. But rather a form of full presence. That in order to fully participate, there is surrender involved. As I write this, it occurs to me that the four “No…” principles from Breema touch on what kinds of surrender are involved - No Judgment, No Force, No Extra, No Hurry No Pause. Well that’s a lot to give up in order to get to presence! How often are we drowning in judgment, doing more than is needed, rushing around, or not acting because we feel stuck in hesitation.

Surrender is the sweetness of letting life lead. Of loving whatever life gives you until you know what it is. I am attempting to apply it to my body, my relationships, my work decisions, all of which I apply a certain amount of control, changing, and fixing to. I don’t really know the state of full surrender into acceptance. I am pointing towards it sometimes, but I haven’t sunk to the depths of that pool to say, “Huh. So this is it. I’d like to know how this feels. Really.”

Here’s what Chris had to say about surrender:

When a sunflower turns its face to follow the sun, that is surrender. When a seed planted in a rich soil breaks free of its encasement and pushes its way up to the light of day, that is surrender. When a wild mustang gallops wildly and joyfully across a meadow, that is surrender. When a baby tries to grasp a beam of light, laughing delightedly, that is surrender. When you look at a sunset and feel the peace of simply breathing in and out, that is surrender. When you enjoy a delicious meal, letting the flavors tickle your tongue, that is surrender. When you feel drowsy and begin to fall asleep, that is surrender.

In all these experiences you, or the horse or the sunflower are completely giving into what's right there in front of you. You are simply being in the present moment with what you feel drawn to do.

So in other words, surrender is something that happens daily, hourly, minute by minute in our lives. It's so very common and down-to-earth. It's in the most intimate fabric of our existence. And includes everything from the mundane to the ecstatic.

And tomorrow, with the start of the final Energy Gardeners' Club of the year, I am ready to apply the principle of Surrender. Making things happen is not about controlling in order to get what you want. Making is allowing.