Hello EMRA Family,
How are you all doing? We have all gone through some life changes lately, haven't we?
Residents have transitioned from one level to another. Medical students have become interns. Senior residents have graduated and entered this new and challenging workforce. It's been an exhilarating time for many, but also a difficult time for most. I have spent the past few months taking the time to invest in others. I talked to people who are graduating, who are experiencing significant life transitions, who are making huge life decisions… and one thing has been clear - many people are struggling. As we near the end of the COVID era of closed restaurants and social distancing, I think many people are retaking inventory of their lives.
Many have made changes, including leaving marriages and relationships, moving to different states or even countries, and many people have straight-up quit their jobs or pursued other passions. It has been a fascinating time to see people bloom, but it's not all just roses. There are bound to be some thorns along the way. We must grant ourselves grace and patience as we evolve from our comfort zone to pursue things that often make us uncomfortable.
I wanted to write this editorial forum for anyone struggling: You are worthy and what you're going through matters. And there are resources to help you.
One of the biggest things I have noticed, especially in high-functioning individuals, is too much compartmentalizing. We don't often take the time to feel and experience our emotions. We shove them deep within us in a box. It's what we are hard-wired to do.
Think about it - we work in an environment where we can potentially see a very sick child or diagnose a pleasant individual with cancer and then literally walk into another room to diagnose an ear infection. And we do this day-in and day-out for years, even decades. This is not how humans are supposed to work, mentally and emotionally. We are empathic and social creatures. We yearn to bond and care and are often not built for trauma as we experience repeatedly in EM. So over the years, our brains get re-wired so we can function at our jobs. Unfortunately, we also let this emotional and mental aspect bleed into other parts of our lives.
We think we can "fix" ourselves like we fix others, sometimes without investing in ourselves. We believe if we can get through one hurdle and onto another, we can be "happy." But that is not how happiness works. I read this fantastic quote that "happiness isn't a goal, but rather the side effect of intentional living." That quote changed my life and has been helpful to many. We are happy when we are in charge of our own life. We are delighted when we make plans and goals and follow through. So if you're going through a difficult time in life, make sure you start with a checklist. Here’s one I together for myself and others.
- Check-in with family and friends.
- Frequently during residency/ medical school, we tend to ignore our friends and families inadvertently. This often also happens when a romantic relationship goes south. Often it's not intentional, but instead, we do not have the emotional or time bandwidth. Now is the time to reach out. With residency ending, I reconnected with old friends. I went on trips to see them. Reinvest your time into people who matter to you and made you who you are.
- List the activities you *used* to enjoy.
- Sit down and intentionally think about the activities that brought you joy and enjoyment in the "beforetime" - before COVID, before a relationship, before medical school. Medicine gives us a lot of meaning and purpose, but, unfortunately, it can also take a lot away from us. Now is the time to take it back. For me, I realized I used to love working out, reading books for fun, hiking, and traveling. I enjoyed playing board games and bar games. Those are things that brought me immense happiness that I have been trying to reprioritize.
- Journal.
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- Often we don't pause to acknowledge our thoughts and feelings. We just jam it down and move on. "If we don't handle the past, it will handle us." Stop and write down thoughts and feelings, especially when it feels like it's just a big swirling mess in there. It'll help us to respond rather than react. And it can reveal the real underlying issues. The writing-down process doesn't have to be perfect; you can even use your phone. The important thing is to be consistent and do it.
- Reach out to get help.
- Often, most workplaces offer access to therapists who provide individual or even couples counseling for reduced or no cost. Therapy works best when one's matched with the ideal therapist and you feel comfortable and honest. If your work doesn’t offer therapy, check out apps and online resources that are manageable even without insurance that covers mental health. Before each session, reflect on your week and write down your expectations for that session. Don't be afraid to be honest about your expectations during the beginning of each session, but it's also equally important to set very reasonable goals and expectations.
And at the end of the day, give yourself time. It's OK to have setbacks, and it's OK not to feel good all the time. Remember, you can't have happiness without sadness. And sometimes we hold onto suffering, but suffering doesn't have to hold on to us. Let it go.