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.

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.

News news news

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"One day you finally knew

what you had to do, and began"

- Mary Oliver, "The Journey"

Today is that day for me.

Maybe it was the flyer announcing my talk at Stanford Medical School in a few weeks (finally making it feel real...and making me feel proud of the creative thinking I've been doing on this subject).

Maybe it was seeing the pile of STUFF in my house, moved out of the Cradle of Manifestation, prompting me to revisit what's really taking up the space in my drawers and closets.

Maybe it was the invitation to have dinner this Friday with a couple of doctors who have transitioned out of medicine themselves (making me feel one step closer to finding My People).

Maybe it was finally telling the truth out loud to myself and to a compassionate witness about what I feel in my heart (and experiencing the expansion that came with it).

Maybe it was all of the above.

Whatever it was, I finally know what I need to do, even though I have no idea how it's going to play out or if anyone will even care. But I know enough to trust this particular feeling of knowing. It's not a rational linear mind kind of knowing. It's a whole body energy clearing kind of knowing.

And I can't wait to share the news with you!

So what IS new?

- My monthly meetup in Silicon Valley, "Find Your Own Song" - the first Tuesday of every month at 7pm, at rotating locations. Join the meetup group to get updates>>

- My physician burnout and wellness resources page - I'll be adding to this, but it's a great place to start if you're curious about the problem, the stories of real physicians, and what people are doing about it. Visit the resource page here>>

- All new Name Your Price coaching - I'm most giddy and excited about this brand new experiment, launching next week. I just want to get more coaching love out there. I remember when I had no idea what coaching was, and didn't believe it could do anything for me, until I actually experienced it myself. So I want to pass on that gift to you! For two hours a week, I'll be offering my services on a first-come, first-served basis, and you get to name your own price. Perfect for those of you who are curious about coaching and open to it, but just not ready to make the commitment to one of my other individual coaching options right now. Learn more about it here>>

- The Whole Person Retreat for Women - Saturday April 9th at Stillheart Institute in Woodside, CA. I'm guest facilitating music improvisation and sound healing as part of an enriching day with the wonderful women Eliska Meyers and Johanna Beyer. Find out more details here>>

That's all for now. After some good time and space appreciating the openness, it's nice to witness the arrival of what's next. Hope to see and hear from you soon!