Welcome to Exploring Wellness, a three part exploration by Dr. Janet Roseman on how medical students and residents can center their own well-being. Read Part 1 here and Part 2 Stress is your ally, honest. below:
Ok, I want you to answer some questions about stress. Take a moment, and think about the word: stress. What is your reaction to that word? Say it out loud. STRESS. How do you feel? Most medical students and residents believe that stress is a horrible and negative aspect of health. We all know that stress is not beneficial for the body and can cause countless health problems, both physically and emotionally. Well, I would like you to consider that stress can actually be your ally – honest. Stress is not always a negative and can even be a source of empowerment. Remember how much you studied to get into medical school? Well, your stress level was highly motivating, no doubt, so it can have purpose. Some people thrive on stress while others are defeated by it; it can be quite wounding. However, it is difficult to identify your own stress pattern without your awareness of what your triggers for stress are and how it works (or does not work) for you.
Stress does not have to be the saboteur; by understanding the wisdom of your body, you can decipher its messages. How? By listening to your body and learning its language. This language will also help you understand the language of your patients’ bodies as well. Look. Listen. Learn. Ask yourself: how do you deal with stress now? How did you deal with stress when you were a child? It’s not unusual for stress patterns to be repeated, especially during the rigors of medical school training. Pay attention to your somatic clues: lack of sleep, fatigue, irritation, depression, headaches, gastro-intestinal problems, insomnia. In one residency program where I taught, over 90% of residents scored in the moderate to high-burnout range in terms of depersonalization or loss of empathy. This type of dehumanization in interpersonal relationships can lead to decreased empathy in the patient-physician relationship. It is easy to understand how the stress of residency reveals heartbreaking patient encounters to young physicians. Often, because of that stress of witnessing acute suffering and even patient deaths (that are not usually discussed), physicians can find themselves with blunted emotional responses to patients and friends as a protective mechanism. Over 58% of medical students I have worked with told me that they never received any type of wellness curriculum during their years in medical school, which is very alarming.
Only you can recognize your stress triggers and know how to relieve those triggers. Stress is beholden to the beholder and the key is to work with your stress rather than struggling against it. Imagine that your stress is not only your ally but your friend, and it has an important message to convey to you. It is here to let you know what you need to pay attention to in yourself before you are overwhelmed or suffer ill health. The foundation for this recognition is knowing what sets you off into a stress spiral. The word ‘stress’ is derived from the word ‘distress’ from the 16th century, which itself comes from the Latin word ‘districtus,’ or divided in mind. This division is a main culprit for stress and you may feel that you are unable to handle a multitude of problems. When you feel that you cannot handle your stress alone, seek out professional guidance at your medical school or at the hospital where you work. Tell a friend or trusted family member. You don’t have to deal with your stress alone, especially if you feel that you can’t. Honor your feelings at all times.
The root word for healing is “healen,” or to become whole. Balance is essential, and that balance, no matter how small, is important. Decide that your wellness is your priority, not because someone tells you so but because you acknowledge that you matter, your time matters, and your health matters. When you provide that affirmation for yourself, then you can offer yourself the compassion you require. Professional competence includes compassion for self, and hopefully this self-compassion will carry you through the humanistic interactions you will provide for others.
What can you do? Set realistic standards and decide to make self-care a priority. Remember to eat well, exercise, get outside every day to let the sun shine on your face and body, and surround yourself with family and friends who support you. Remove negative people from your life. Take breaks. Find the beauty in whatever form it takes. Find a way to bring your “soul” into your daily life. Don’t forget who you are. Learn to say no. Most importantly, appreciate your position to help another human being in need.
Maintaining a practice for recognizing and ultimately reducing stress (when it does not work to your advantage) is key. However, making stress a familiar and even welcomed ally can preserve your abilities as a humanistic physician..
Dr. Janet Lynn Roseman is an assistant professor in Integrative Medicine at Dr. Kiran C. Patel College of Osteopathic Medicine, Health Professions Division, Nova Southeastern University in Ft. Lauderdale. There she specializes in spirituality and medicine and teaches courses in humanism in medicine. She is the Founding Director for the Sidney Project in Spirituality and Medicine and Compassionate Care™, a unique residency education program.
She was awarded the Presidents Award from Lesley University for her work in oncology and was the second person in the world to be named a fellow in the Spirituality and Medicine fellowship at the Kluge Center at the Library of Congress. Her research on compassion and spirituality has been published in numerous journals, and she edits an ongoing section on spirituality and medicine for the Journal of Complementary and Integrative Medicine.
A published author, her most recent book offers empowerment for people with cancer: If Joan of Arc Had Cancer: Finding Courage, Faith and Healing from History’s Most Inspirational Woman Warrior (New World Library)