It’s hard to imagine a job that would be more stressful than being a trauma surgeon. In a single shift, the surgeon may see a gunshot wound, a fall from a significant height, a devastating automobile crash, or any other traumatic accident. In a recent post, I discussed the troubling rate of burnout, depression, suicide, and substance abuse among physicians. I wanted to get real-life examples of doctors practicing self-care, and the struggle to find balance.
In this article, I interviewed Dr. Jamie Coleman, a trauma surgeon at Indiana University Health. She is a trauma surgeon and a mother, and also writes a blog titled Hot Heels, Cool Kicks, & a Scalpel. In addition to the helpful advice she offers below, she finds ways to build in self-care practices throughout the day. For example, she doesn’t listen to the radio on her way to work so she can pray, meditate, and gather her thoughts.
As a trauma surgeon, you are constantly confronted by human suffering. What strategies or coping mechanisms have you found to be helpful in dealing with your patients’ suffering?
Although I was never formally taught about self-care, it became very evident during my surgical training that I needed to figure out some sort of strategy to keep myself healthy. I was introduced to Franklin Covey’s concept of “sharpening the saw” by my father, and it has stuck with me since. My favorite self-care strategies are exercise, reading, and writing.
What are your favorite ways of practicing those self-care strategies?
Running and barre classes are my favorite exercises, because they require so much effort. Literally sweating it out is one of the most effective strategies I use. Participating in an activity that absolutely requires my mind to go elsewhere because of physical exertion helps me wipe my mental slate clean, so to speak.
The one thing that all of my self-care strategies have in common is that, yes, they do take time. And for every minute I spend on exercise, reading, or writing, I could be spending it elsewhere. But acknowledging that, accepting it and, quite frankly, embracing it is what gives that time value, which allows me to enjoy that time, rather than feeling guilty over it.
In order for me to be the best surgeon I can be, the best wife I can be, and the best mother I can be, I need time to mentally and emotionally regenerate. My husband not only understands but also supports it. Although my family may “miss out” on an hour with me a few times a week, what they gain is a happier and healthier wife and mom–one that can truly enjoy every minute with them. Okay, well mostly every minute – I am the mother of a 3-year-old, and for anyone who has parented a 3-year-old, that should be enough said!
Most people recognize the importance of self-care but find it difficult to find the time. How do you make time for it?
I’ve always found that phrase “finding time” as slightly humorous. The time is there. There is nothing to “find.” As hard as I have tried to “find” more time in a day, it just doesn’t exist.
I stopped searching for “more time” and started utilizing the time that is already there slightly differently. Oftentimes, that means waking up early to get a workout in before the rest of my house is awake. Sometimes that means stopping by for a barre class on my way home from a 30-hour call. Sometimes that means staying awake on call, even if I am not busy with patient duties, to fit in paperwork or other non-clinical work into that time. And sometimes, that means arranging childcare so I can sleep in every once in a blue moon.
I would imagine it’s difficult to maintain your compassion and humanity — as you describe it, “surgeon’s survivor’s guilt.” How do you go about maintaining that balance of maintaining your humanity, yet not suffer from compassion fatigue or burnout?
Maintaining compassion and your humanity while being a physician in general, and a trauma surgeon in particular, is a fine balance. You have to let yourself feel to retain your humanity, to not lose your ability to empathize – but you can’t let your feelings paralyze you, either.
One of my mentors, a transplant surgeon, always said, “The last thing a patient needs is a surgeon who feels sorry for themselves.” And he is 100% correct. I distinctly remember a case where a child came in with injuries clearly secondary to abuse, close in age to my own child, who I pronounced dead virtually on arrival. I made it back up to my office, sat down, called my husband, and cried. And then my trauma pager went off again. And as hurt as I was for that small, broken child, I knew… my next patient needed me more.
Being a trauma surgeon is about remaining vulnerable, but not breakable. If you stop feeling, you stop caring. If you allow your feelings to paralyze you, you are useless to all the patients that still need you. It is about compartmentalizing but not forgetting. Realizing that some days, you will have to revisit feelings at a later time that you just can’t address in the moment.
I mentioned in my piece A Surgeon’s Survivor’s Guilt about my own personal graveyard, filled with patients and families that I can’t forget. After that piece, I was asked if those memories haunted me. The answer is “no.” My graveyard isn’t about ghosts. It is about memorializing the people and the situations that make me the very human trauma surgeon I am today.
This article previously appeared on Forbes.