Priority Setting: personal wellness versus getting your job done

stephen_merrell_wht by Stephen Merrell

I recently confessed to my fellow residents a personal struggle of mine: getting the amount of exercise that I encourage my patients to get.  The setting of our discussion was a safe one, so I described multiple reasons why I haven’t run, biked, walked, or moved as much as I want to (sleep deprivation, recent life changes, just finished moving, etc). My friends shared some great counsel: modify what you consider to be exercise to include an enjoyable walk with your significant other, or a brisk walk through the hospital around lunch time, or a dance class in the evenings.  Another suggestion has stuck with me as well: “You know Stephen, it really comes down to your priorities; what do you value in life?”

Ouch! I thought.  But knowing there was no malicious intent to the comment, I smiled and kept my heart open to the counsel. My friend continued, “Maintaining personal wellness is how we care for others; without our health, what good can we do in our personal or professional lives?”

Alas, I had to admit he was right: My priorities needed adjusting (never a comfortable feeling for a doctor with a type A personality J). But how did I get to this point of fatigue and exhaustion? And how can I focus on personal wellness and also complete my work responsibilities?

Most physicians remember the personal sacrifices made during the years of pre-medical training, medical school, and residency training. We stay in the library those extra hours so we can get good grades in order to get into that really good medical school, so we can become a great doctor. And then in medical school, we stay in the library those extra hours so we can keep up with our colleagues (who all seem to be cruising through the sea of information we are to learn), so we can get good grades, so we can take excellent care of our patients.  And when we stumble into residency training, we stay those extra hours at the office finishing our documentation from patient visits, we read into the night (and often fall asleep trying) to unlock the secrets of our patients’ diseases, and we work on weekends because the illnesses of our patients do not take breaks.

So how does one balance personal wellness and fulfilling work responsibilities? I’m applying the following steps: First and foremost, be emotionally and mentally kind to yourself. Most of us who are caught in the above predicament are trying to do what is right for our patients, family, and self.  And we got here pursuing worthy dreams. Dwelling on thoughts of just giving up, or concluding that we are the worst physician to earn the title of ‘doctor’, or other self-defeating thoughts only makes the situation worse. All of us have talents and skills that match the unique needs of our patients and family members. Ignore the extreme thoughts, and remember that your gifts really are needed and cannot be provided by someone else.

Second, take one day at a time. Try to plan out what you want to complete by the time 9pm roles around and it really is time to wind down the day. My wise older brother once shared with me, “Stephen, everyone has 24 hours in a day; decide how you want to spend it.” So ask yourself, when I finish the day, what do I want to have accomplished? This will be a mix of personal wellness items, work responsibilities, and family duties.

Third, view the items on your to-do list for what they are: A way to help others. This is not only true of your work as a physician, or your fulfilled family duties, but also taking care of yourself. When you take a break for lunch or try to sleep for 8 hours, you serve others by keeping your mind clear and body rested.

Lastly, feel grateful for the opportunities before you. A friend and pediatric resident once told me, “Remember to be grateful for your residency training – folks would kill to be in your shoes.” Very true – I am blessed to have a job (my dream job), family to care for and who care for me, and colleagues who want me to succeed in my career and personal life. So when I’m starring at my computer screen wishing my charts could close themselves, when I’m waking up for the day at 4:30am, when I feel like my priority-setting neurons just aren’t firing correctly, I find solace in sitting back and remembering that the problems in front of me can be opportunities, and that I am a very blessed man.

“But what about the evidence for your formula?” cries the scientist in me.  A clinical trial could be in the makings, just as soon as I find the time….

Stephen Merrell, MD is a 3rd year resident at the University of Utah Family Medicine Program. He will be starting an Obstetrics Fellowship after completing residency this year.

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