It is hard to be a physician today and not hear about wellness. Everywhere I look, I see conversations about the reasons we are burned out, and the responses our institutions and communities are making to fix it. I hit burnout myself for the first time in a while this summer, which made me think about my own coping mechanisms: what I do well, and what I can do better.

Obviously the first step to treating burnout is recognizing when it occurs. For me in June, that meant registering that I was more irritable and less patient than my baseline. I felt perpetually tired and stressed, and relatively antisocial, which is also unusual for me. It was hard to get excited about things (like this blog!) that normally thrill me, and the icing on the cake was when my sister told me over dinner that I had “not been my best self.” <insert emoji here>

I do not mean to excuse the systemic issues that contribute to our burnout in any way. That being said, I find it empowering to take responsibility for the things that are under my control, which helps me get back to my usual happy self.

Everyone knows the basics: good sleep, regular exercise, healthy food. When I don’t get enough sleep, I get cranky, and I am less productive. From conversations with friends, I have realized that not everyone knows the tenets of good sleep hygiene, so here are some tips from the CDC and the National Sleep Foundation. Arianna Huffington has famously talked about this problem, too, and even wrote a book called The Sleep Revolution.

For exercise – the phrase “thirty minutes a day, or fifty minutes three times a week” comes out of my mouth during virtually every single clinic visit. But, my own tendency to make it to the gym, or to dance class or yoga, is variable. There are any number of articles like this one that clearly show exercise is beneficial, so why am I not going more consistently? I think the answer goes back to this frankly revolutionary TEDTalk I heard a few years ago, where the speaker pointed out that time management is more about prioritizing activities and less about “making time.” The video is worth the view, I promise; it has fundamentally changed the way I think about arranging my day.

I don’t think I need to explain a good diet to a bunch of physicians. I will say that as I have gotten older, I have found that stress-eating feels worse, like the crash that happens a half-hour after the candy bar or grilled cheese sandwich is just not worth it.

But all these things, while universal needs, are not enough in and of themselves to combat burnout. Something I’ve been thinking about a lot lately is how many daily distractions we have in our lives. A residency friend told me about Cal Newport’s book Deep Work, which MEHP classmates have mentioned, too. I haven’t read it yet, but I have noticed that these days, it often takes me longer than it should to complete an activity, and I’m fairly certain that’s because I keep looking at my smartphone. A high school friend practices “No cell-phone Tuesdays,” where he puts his phone away in a drawer after getting home. He still uses his computer when he needs the Internet, but he intentionally closes off other options that might eat up his time. I tried it for a few months and was really surprised to notice how freeing it felt. (I do realize the irony of saying this in a blog post that will ultimately find its way to my Twitter account, but, it is what it is).

In that same vein, my former program director used to check his email three times a day: in the morning, at lunch, and before leaving. In between he would close his Outlook; he said he always had his cell phone if someone needed him urgently. As a person who has spent thirty minutes crafting a single email, I see the value in this approach, and it’s something I am trying to implement more in my own life, even on the days I work primarily from my desk. Last month an ophthalmologist friend told me she had stopped checking her work email on weekends, and how liberated she felt as a result of that choice. I genuinely think that the onus is on us to be cognizant about the technological interruptions we let into our lives, not only for stress, but also for anxiety. Much of this recent article about anxiety resonated with me, and there is definite overlap in the subject matter.

Beyond these commonalities, we each have to find our own personal antidotes to stress. One of my big ones is hiking, or really spending any time outside. The Japanese phrase “shinrin-yoku” alludes to this idea – I first read about it in this article, which I love – and now I know that part of why I like hiking is because I find it calming. Similarly, I’m reading a book now called Blue Mind that discusses the neuroscience of why we find being near the water relaxing and soothing, why it makes us happier. If we know what works for us, we need to make a conscious effort to get more of it. I’m 34, not 84, but I love doing jigsaw puzzles. Is there anything more satisfying than snapping two pieces together? I finally opened a new one last month, and I am sure it’s one of the reasons I feel back to baseline.

Yoga works for me, too; meditation does not. And in fact, when I try to meditate, I find myself even more frustrated by the fact that I can’t turn my brain off. What I’m trying to say is that there are no cure-alls – but we all have a cure (or more than one!). It’s annoying to think about working towards relaxation, I get that. But the reality is it’s 2019, and smartphones and social media are not going away, so we have to find a way to live with them. Beyond the basics of eating, sleeping, and exercising, we have to find ways to play well, and to prioritize those ways, every day.

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