Every human being makes mistakes and will continue to do so. The ability to make mistakes doesn't discriminate based on gender, educational level, or social status. It is part of what makes us human. It is how we handle our mistakes that makes the difference. As Dr. Brian Goldman so humbly, bravely, and candidly shares with us in his TEDx talk, there is a culture of denial and shame surrounding how those mistakes are dealt with within the medical profession.
Dr. Goldman's presentation brings to light these important issues:
1) A sleep-deprived doctor should be the exception, not the norm. The archetype of the sleep-deprived doctor being heroic is outdated. The sleep-deprived doctor is what anybody else would be if they were sleep deprived: exhausted. And they shouldn't be put in a position where they aren't at the top of their game when making important decisions.
2) There needs to be more support for doctors to process the emotions that naturally come with the profession. Doctors are going to make mistakes, and the results of their mistakes can have more serious consequences than most other professions. Carrying around guilt and shame is a tremendous burden for anyone, let alone a sleep-deprived doctor who remains dedicated to improving the health of his or her patients.
How Did Sleep Become Optional?
I have had the fortune of attending many medical school graduations over the years. I always go through a lot of tissues because I am so inspired by the speeches of the young people who have high hopes in making a difference in the health of their patients. My heart is also touched as the seasoned clinicians share their wisdom and insights to inspire these new doctors. An eternal optimist, I leave those ceremonies with a renewed spirit and faith that the system can be better.
However, there is an aspect to every ceremony I've attended that has always created some disturbance within my being: listening to countless references to the lack of sleep that is just accepted as being part of the profession.
"Get ready for a lifetime of sleep deprivation."
"Your close relationship with caffeine and sugar is about to go to a whole new level."
Always followed by nervous laughter from the audience.
Yes, it's funny that doctors who are entrusted with the lives of patients have sleep deprivation built into the system. Not funny ha-ha. Funny in the sense of ridiculous.
Every human being makes mistakes and will continue to do so. The ability to make mistakes doesn't discriminate based on gender, educational level, or social status.
Only the Best
Over the years, I have treated many patients for whom surgery was recommended. As they are telling me about their upcoming surgeries and the physicians involved, I hear varieties of the following:
"He's the top guy at Cedars."
"She teaches the procedure to medical students."
"My surgeon is the head of orthopedic surgery at UCLA."
"He actually invented the procedure."
"She treats all of the celebrities." (It's an L.A. thing. They never say some of the celebrities.)
In over 20 years of practice, I don't think I've ever had a patient tell me that their surgeon was the second best -- even if they were.
We have come to expect the best in health care in this country, and rightfully so. We have some of the top minds in medicine, advanced technology, stellar medical education, and cutting-edge research.
We sometimes forget that those great minds in medicine live in a body -- a human body. Those bodies need restorative sleep, nourishing food, stable blood sugar, exercise, and time for connection, reflection, and community. They are basic needs, not options, for optimal health.
Prescription: A Reality Check
I grew up in a time when going to a psychologist or needing help for emotional well-being was not something discussed in polite company. There were no departments of mind-body medicine at universities. Although we still have a long way to go, today there are many more opportunities available for assistance in these areas.
We also see a growing trend in the corporate environment to support the health of the employee. Nap rooms, health incentives, gyms, and visits from massage therapists are on the rise. Research has shown that these practices result in improved productivity among the employees.
The health habits of professional athletes are often closely monitored. Sports medicine physicians, nutritionists, trainers, acupuncturists, mental imagery specialists, life/performance coaches, and sports psychologists are just a few items on the menu that the professional athlete can choose from should he or she have areas that need improvement.
After all, corporate executives and professional athletes often have to make split-second important decisions can greatly impact the bottom line. They need support to manage the stress that is inevitable in their positions.
The cat's out of the bag. Doctors are human, they need sleep, they have emotions, and they need to have a place for healthy and safe expression so they can continue to be effective...
Doctors often have to make split-second decisions that can impact the life of the patient. Their positions are very stressful, and they need support for their emotional well-being.
Shouldn't they be graciously offered and encouraged to take advantage of such health and performance enhancing services? How can the best decisions be made when they are fatigued and carrying unresolved emotional stress?
Physician: Heal Thyself -- and We Support You
I am blessed to have many friends who are medical doctors. And every one of them entered the profession because they wanted to alleviate human suffering. Many of them admit they are worn down by the system, and are not as idealistic as they were in the early days of their profession. Yet they remain dedicated to their calling as physicians and deeply care about their patients.
They share how it's the best feeling in the world when you they can tell their patients that the baby they just delivered is healthy, or that they completely removed the tumor, or that the medication did the job. They love the human connection there.
What happens when things don't go so well? Where is the support for the doctors who give of themselves and inevitably make mistakes and disappoint those they are dedicated to serve?
The resulting guilt and shame and lack of support to process those mistakes is toxic to the individual as well as to the whole health care system. Discoveries within Traditional Chinese Medicine as well as within modern mind-body medicine have demonstrated how not having a healthy outlet for emotional expression can contribute to disease.
We have many issues to address in order to heal the broken health care system. Many people do not even receive basic care. There is much to be done.
Brian Goldman's TEDx presentation has made it clear: No matter how much we improve health care coverage, technology, research, medication, and surgical procedures -- unless the people in charge of providing the services are not well rested, well nourished, and continue to experience denial and shame, we are simply filling a leaky bucket. We don't expect the best performance from athletes when they are stressed and worn out. We need a reality check when considering the needs of physicians for peak performance.
Thank you, Dr. Goldman, for bringing these important issues to light. Let's start the conversation here at TEDWeekends. The cat's out of the bag. Doctors are human, they need sleep, they have emotions, and they need to have a place for healthy and safe expression so they can continue to be effective and dedicated for what they signed up for -- to improve the well being of those in their care.
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