I didn't know that the symptoms I was suffering had a diagnosis of physician burnout. I just internalized the symptoms of emotional exhaustion and a low sense of personal accomplishment. I was depersonalizing patient relationships without realizing it, and I thought my problem was that I was a physician failure. I pushed myself to exceed RVU (relative value unit) expectations in the increasingly profit-driven world of medicine. I could never find the time in my 80- to 100-hour work week to catch up on research, medical records, or tend to my personal health. I started to gain weight and get anxious. I only realized that I needed to slow down when I started to suffer from debilitating chest pain and other physical symptoms that took years to get correctly diagnosed as achalasia.
The only rare times I experienced a sense of hope, calm and reduced pain was when I was practicing yoga or trying meditation. I initially thought it was all in my head and a lifestyle that I had to practice in my rare free time as a hobby. I once again looked to external circumstances to find happiness. I thought the answer was to leave the rigorous world of academic medicine and work part-time in a community hospital. I used my free time to tend to my health and undergo surgery for the achalasia.
My passion as a neurologist to help patients with epilepsy had long extinguished, and now I was fighting for survival. When I couldn't take the stress or had difficulty focusing, I would turn to yoga. I would close my office door and practice pranayama breathing exercises, hoping that no one would see me. Thinking that I was just stressed and in need of a vacation, I took leave for four weeks to pursue yoga teacher training to further my knowledge of the ancient mindfulness-based practice. The yoga community embraced me, and they have always encouraged me to help bring the two communities together.
I started to research why I felt less anxious and reduced pain with my yoga and meditation practice. This was my first introduction into the world of mind-body medicine. I traveled the country and the world learning various meditation techniques. I also discovered that there is a wealth of research on the scientific evidence behind the benefits of meditation, yoga and mindfulness-based stress reduction. The majority of physicians never learn about this research in medical school or residency training. Our first introduction to the research is either through headlines in mainstream media or in our own personal journeys of healing.
Current headlines in the press highlight mindful living, meditation and yoga daily. Earlier this month, I was at a global marketing firm speaking as an expert on mindful living as a top trend for 2014 and beyond. Mindfulness-based practices are not just a hobby for our free time or just a marketing trend. It is a way of living that can prevent or even heal career burnout. What if I had realized this earlier in my career as a physician? When I started on my journey of mindful living, I was either labeled crazy or a visionary physician.
In a highly-publicized study from the Annals of Family Medicine, researchers at Meriter Medical Group in Madison, Wisc. taught physicians simple mindful meditation techniques. These mindful breathing techniques were used to help physicians feel centered and more present with each patient interaction. Results showed decreased symptoms of burnout, stress, depression and anxiety.
I would love to start a mindful discussion together. What can we do together as a community to bridge medicine and mindfulness to prevent career burnout? We can start by taking a moment to close our eyes, take a deep inhale, and take a deep exhale. Just breathe and come into the present moment. This is mindfulness.