It’s all over the media these days about what chaos the health care industry is in, in our great country. It’s also all over the media about physician burnout and suicide. There’s a lot of pressure on MDs as if under constant assault. Assault from administrators, insurance companies, other MDs, patients, and even assault from various mid-level provider groups.1 No wonder it takes great courage and strength to keep going in the face of adversity. No wonder why it’s also understandable when individuals do quit or move on. I’d like to take a moment and talk about what we don’t talk about: Heart (or resiliency). What do the following people have in common with MDs?
Vincent Papale, who at age 30, the oldest rookie in the history of the NFL play without the benefit of college football experience. He took a walkon chance try out with the Philadelphia Eagles, fulfilling a dream in the face of public scorn and adversity. Jim Morris – who signed a professional contract with the Tampa Bay Devil Rays organization at the age of 35, fulfilling a dream, in the face of public scorn and adversity. Lou Ferrigno, born deaf and a life of hardship and failure, at age 43 fulfilled a dream and won a national bodybuilding championship at the Master’s Olympia. Kelly Slater, at age 47 still competing in professional surfing chasing his 12th world championship title against competitors half his age (and beating them!).
You guessed it. Heart. Resiliency. Though these are sports analogies, it seems fitting. They kept going in the face of adversity and scorn achieving things that few others have. Though there was raw natural talent, it was their heart that kept them going. Not to say they didn’t each have ups and downs, doubts, thoughts of quitting, laying down etc, but they kept going. So too is it with MDs. To become an MD requires analogous academic rigor, intellectual, and scholarly raw talent, but it is in one’s heart that keeps one going. It’s downright brutal sometimes. We knew that going into it, and yet we kept going. Who among us hasn’t thought about quitting, thought about laying down, thought about suicide, thought about changing careers, thought about giving up? Fact is, we all do to different degrees. We lose heart sometimes. I think part of being human is to bend and feel weighted down when under constant pressure and assault. Sometimes we keep it in and lose heart. We break. At these times it seems daunting to keep going. How to keep going when every fiber of ones being says quit? Heart! But how then to reach into those depths and pull something from one’s heart when it feels so broken or heavy or that nothing is left?
Boxers have used the analogy of having heart, losing heart, and regaining heart:2
“Gaining more heart isn’t achieved through belittling a fighter, bombarding him with negative criticism or crushing his spirit by constantly overmatching him. But, if performed successfully, the process of gaining more heart will push him to the edge of vulnerability and allow him to fight his way back to the “safe ground”. It is accomplished by working him to the point where he believes he can’t throw one more punch, take one more step or go one more round and then encouraging him to do it anyway. Through his new found success, he will gain confidence and will increase his determination to ask for more each time he laces on the gloves.”
What is there left to do? We could learn from boxers and from the aforementioned athletes. Keeping with the analogy from sports, the heart is a muscle, which could represent our resiliency or compassion. It needs conditioning, feeding, exercise, and nurturing. It’s different for each individual. I lost heart 10 years ago at an impasse in life, and a mentor guided me at that time “back to basics.” Today for me the basics are the things I do daily to maintain heart. Today I never leave the basics and as such haven’t had that amount of crisis since. Feeling nostalgic today. Today, not only is it Memorial Day weekend and I’m a combat Veteran, I also put down my short white coat and the medical student hat and get to add initials “MD” behind my name. I would ask that fellow MDs not lose heart in the apparent face of negativity, assault, adversity and scorn physicians seem to be facing these day. Just remember, there can only be one King of the Jungle and the Lion (MD) doesn’t need to remind itself it is King of the Jungle, but it might need to remind others. Have a blessed weekend.