Self-Care (be)for(e) Patient Care

We have all heard the adage regarding putting on one's own oxygen mask before helping others as a means for ultimately doing the best for everyone in a difficult situation. For trainees and medical providers, I believe this is so important to always remember and implement into one's own life.

During the journey from the pre-medical years (when facing stiff competition for the coveted admission to medical school), through the rigors of medical school itself, followed by residency training (and in some cases subspecialty training), it is easy to essentially "hold your breath" throughout the process. Waiting, hoping, sacrificing...all for what is to come in the future. In some ways, delayed gratification to the nth degree.

It is easy to forget sometimes to breathe. When navigating the challenging road toward one's ultimate anticipated career, it is important to realize that what is here and now is what is real. That joy matters. Taking regular short breaks in the day allows one's mind to regenerate. I believe it is so important that we walk outside, that we rest our eyes from looking at screens and rest our brains, allowing our minds to wander or just be.

As I am writing this entry, I thought I would share a personal story that was pivotal in my own life and occurred at the end of my second year of medical school. It was just 3 days prior to sitting for my USMLE Step 1 examination when I decided that I was going to leave medicine and instead refocus my life to become an interior decorator.

I had been studying non-stop for the several weeks prior to my USMLE examination, trying to absorb and review all the material from the prior two years of medical school that I possibly could. I clearly recall sitting in my family room with my textbooks all around me (we didn't have computers at that time) and looking up to my father, a physician himself, and saying, "I can't remember what the word pneumonia means." After 2 years of medical school. Pneumonia. The spelling of the word itself seemed strange. Could I be a doctor without knowing anything about pneumonia? I decided I could not. So I stopped.

I took a break for 2 days. I went to a musical concert. I relaxed. I allowed my creative mind to consider what life could be like as an interior decorator. Of note, I had no idea about how I would pursue interior decorating as a career but it sounded so wonderful. A welcome change from studying the specifics of immunology with its T cells and B cells, cardiorespiratory physiology with its EKGs and lung volume and pressure diagrams, and histopathology with hundreds of slides to review.

The day before the USMLE, I decided to take a chance on myself. I decided that I would rest my lifelong dream of pursuing medicine on trying my best during the examination and then leaving it to fate. The 2 days "away" had given me perspective. I remembered that there was the possibility of a beautiful life not only within the study of medicine but also outside of it. So I sat for the exam. As I read the questions, the fog that I had felt for the days prior seemed to have lifted. I remembered information from my 2 years of medical school that even I was not aware that I knew. It was reassuring and wonderful to realize that my brain had absorbed the information that I had spent hours, weeks, months, and years studying. All I had needed was time for my brain to process what was already there. At the end of this story was my ultimate success in completing medical school, going on to residency, the practice of medicine, and now a career in academic medicine.

But even now, as I move through life, I realize that I need reminders to breathe. To take time to take care of myself and to focus on my own joy. For those in their premedical, medical school, residency training, or professional practice years, there are now so many resources to help us remember the importance of self-care. I have found some to share below that have been provided through different organizations. As I have shared with my students over the years, focusing on joy (joy in learning, joy in life) is so very important.

So perhaps self-care should come (be)for(e) patient care so that patients benefit from our best self and receive our optimal care.

Thank you for reading this and I wish you peace and joy.

AAMC: https://students-residents.aamc.org/medical-student-well-being/medical-student-well-being

AACOM: https://www.aacom.org/reports-programs-initiatives/aacom-initiatives/osteopathic-medical-education-wellness-initiatives

National Academy of Medicine: https://nam.edu/initiatives/clinician-resilience-and-well-being/

AMA: https://www.ama-assn.org/practice-management/physician-health