Art, Meditation, and Medical Practice: Johannes Vermeer's The Geographer

Art therapy is often used to help to restore a sense of well being in people who are suffering from psychological stress or turmoil. We can experience similar benefits, while at the same time developing a deeper appreciation of our patients as fellow complex human beings, though the mindful experience of art.

Girl with Pearl Earring by Johannes Vermeer, ca.1665; credit Mauritshuis, The Hague

Johannes Vermeer was a Dutch painter in the 1600s. He is particularly known for his interior scenes that depict everyday life in his world. The Girl with a Pearl Earring is probably the most famous of his works. In 1999, a book by the same name, exploring the fictional life of the girl depicted, was published. In 2003, it was made into a movie.

 Sadly, Vermeer was not well recognized or appreciated during his lifetime, and he struggled financially. Vermeer died at the age of 43, leaving his wife with 11 children to care for. The cause of death is unclear, but it was said that stress played a role. Today, only 34 of Vermeer’s paintings are known to exist.  

As a physician, a fine art photographer, and a teacher of mindfulness, I am drawn to Vermeer’s paintings because of his strong connection to his subjects, and his emphasis on their humanity.

Johannes Vermeer, The Geographer, ca: 1669; Image credit Städel Museum, Frankfurt am Main

As a photographer, Vermeer's The Geographer calls to me for its almost photographic frame of reference. This is not surprising, given Vermeer's use of the camera obscura, an early form of photographic projection that creates an image on a wall. As in an un-posed photograph capturing a moment in time, The Geographer appears to be unaware of the painter, and engrossed in his thoughts.  

Vermeer uses the light and shadowing to shape the space of the gentleman's study, creating a strong left-to-right diagonal perspective. Diagonals are important in art, because they often suggest action and energy.

Your eye might first notice the illuminated face of the man, then it may travel from left to right as the line of the light echoes the diagonal of his desk, the movement of the shadow behind the cabinet and even the pattern of tapestry that is draped over the table. The instrument he casually holds in his hand repeats this same diagonal and intentional feeling. 

The Geographer's face is illuminated in much the same way as the globe above him, and his Japanese style robe tells a story of a man who has a wide and diverse experience of life.  

The colors in this painting serve to unify the composition and create a soft sense of boundary in which this man lives and works. The gorgeous oranges and blues, as complementary colors, create a lush and intimate feeling. We see them in his robe, the tapestry, the small chair in the background, and in the shade of the light entering the room.  

In color theory, blue evokes the mind, reflection, serenity, and the intellectual, while yellow is a color of creativity and confidence. The orange speaks of passion, but perhaps of frustration as well. And the soft brown conjures nature and quiet. 

The variety of textures in the textiles and furniture elevates the sense of intimacy and deepens the richness of these colors. There is a sense of balance between the foreground and the background, holding The Geographer in the middle of the painting, and setting him firmly in the world.

Experiencing art mindfully

Art can be a way to access mindful exploration. Sometimes this is called slow looking. You don’t have to be an expert in art or a mindfulness practitioner. Even just a few minutes with a work of art can allow your mind to clear and give you space to create a sense of connection to another human being. The Geographer is a perfect stepping off point for this kind of exploration.

To drop into a meditative mindset, allow the experience of Vermeer’s painting to guide you into a sense of tranquility and space. Notice your breath as you spend time with this work of art, paying attention to your slow inhales and exhales. Feel your body loosen, even just a little.

Of course, you don’t have to turn to the Old Masters to experience the meditative power of art. If you’ve ever lost yourself in a song, you know that to be true. Abstract art, photography, sculpture—all can be portals to mindful exploration.

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An earlier version of this article originally appeared on this site in July 2022.

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My Podcast Interview with Tax Expert Alexis Gallati, MBA

I really enjoyed my conversation with Alexis Gallati, EA, MBA, MS Tax, CTS for TechLink Health. This was such a practical and well explained deep dive into tax strategies for physicians.

Alexis is married to a surgeon, so she has seen firsthand how little education most of us have in financial strategies, and how this lack of knowledge can hurt us and leave us vulnerable to bad advice.

This podcast addressed financial strategies related to side gigs, managing independent practices and more. Alexis is an engaging speaker and shares a wealth of practical insight.

From Conflict to Collaboration: Overcoming Challenges with Your Staff

As a cardiologist in practice for nearly 30 years, I was fortunate to work with a fantastic team of nurses, medical assistants, and office staff. I give much of the credit to our no-nonsense in-house nurse manager. But not all physicians are so lucky. And even one bad apple can make going to work a miserable experience.

Although medical training involves teamwork, it’s uncommon for physicians to learn managerial or business skills during medical school or residency. If you’re learning on the job, getting off on the right foot can impact your experience at work for years to come.

Until my practice was acquired by a larger organization, I served as chairman of our Human Resources (HR) committee for a number of years. So if you’re a physician dealing with challenging staff members, I’ve got some expert tips and insight to help you get to the other side of this common problem.

First, a little perspective. In years past, most physicians owned their practices. So in these situations, the physician or a trusted administrator typically did the hiring and firing. And the staff understood that keeping up good relations with their physician-employers was vital to maintaining happy employment. Now that most physicians are themselves employees, the relationships have become more muddied. And the truth is that depending on your organization, you may or may not have much say in the way the practice is run.

Be that as it may, as a physician, your leadership is crucial to maintaining a good working environment. Whether it is implicitly stated or not, your staff should understand that their job is to support the work that you do. And ultimately, that means providing optimal care and a supportive experience for your patients.

Whether you’re employed or not, your patients depend on you for your expertise and your care. Your employment status is irrelevant to them, and they view your staff as an extension and a reflection of you. That means that if the practice feels chaotic and uncomfortable, your patients are likely to feel unsafe and unwelcome.

It’s likely that most of your staff will appreciate a physician who is kind, principled, and clear. Most people who work in healthcare take pride in their jobs and care about the people they serve. But unfortunately, you can also expect to encounter some difficult folks along the way.

To maintain your sanity, your ability to provide care for your patients, and your role as a team leader, it’s important to have a clear plan for dealing with troublemakers.

Some people may be negative or disruptive, others may be passive-aggressive, and some may simply be incompetent. You may even encounter employees who delight in getting you upset. Regardless of the type of difficult staff member you are dealing with, rule number one is this: do your best to remain calm, cool, and professional at all times.

When dealing with the inevitable conflicts and other tough situations at work, here are some important things to keep in mind.

• Don’t make it personal

Although it can be tempting to let your emotions take over, the minute you make it personal, the problem becomes about you. This can be very difficult if not impossible to turn around. By keeping it professional, you have a much better chance of remaining above the fray.

• Consider involving HR:

If you have access to an HR staff member or administrator, and you feel reasonably confident that they will support you, it’s best to involve them early on in a difficult situation. This can help to protect you from accusations of harassment or favoritism.

When you try to go it alone, especially as a new physician, there’s a good chance you will end up making some important missteps. Never underestimate the power of a passive-aggressive or disgruntled employee to undermine your reputation. In the worst cases, this could mean the loss of your own job.

• Document everything

Documentation is not necessarily to get the employee in trouble. You’re documenting in order to protect yourself.

Be sure to include the specific behavior that is causing the problem, the date and time of the incident, and any steps that you have taken to address the problem. It’s a good idea to make a note of any witnesses as well.

• Try to understand the root cause of the behavior

Although your practice’s administration is likely responsible for managing the employee and their disruptive behavior, getting a handle on the behavior and its root cause may be helpful. Once you understand this, you may start to develop a plan to turn things around.

For example, if a staff member is negative and disruptive, it may be because they are feeling overwhelmed or undervalued. That doesn’t mean that you need to acquiesce to their demands or accept the behavior. But understanding what might be contributing will make it feel less personal. It may also give you insight into the path forward. And armed with this information, you may be able to work more collaboratively with your administration.

• Be direct and honest. 

If your administration takes a hands-off approach, it may be left up to you to manage the issues. This is often the case for minor procedural problems, lack of education, and misunderstandings.

When you address the problem with the staff member, be clear, calm, and truthful. Avoid being confrontational or accusatory. Instead, focus on the specific behavior or issue that is causing the problem and how it is impacting the workplace.

Consider having a trusted colleague or nurse present for the discussion. That will help to protect you from any undue accusations.

• Be prepared to offer a solution

It may be necessary to work directly with the staff member to resolve the problem. For example, if a staff member is struggling with a particular task, it may be up to you to provide them with additional training or support.

Set clear expectations and provide regular feedback. Sometimes these individuals become the most loyal employees, if they understand that you are on their side.

• Be supportive and encouraging

The process works both ways. By contributing to a work environment where your staff members feel valued and supported, you are more likely to be listened to and treated with respect.

• Be fair and consistent

Treat each of your staff members fairly and consistently. Avoid favoritism and keep your personal life separate. When you spend most of your life at work, it may be tempting to see your staff as friends. This is a pitfall that many early career physicians fall into. Over time this can create divisions and expectations that will only make things more difficult for you.

As a physician, you have the right to expect a positive and productive working environment. If a staff member is making it challenging for you and others to do your jobs, it’s critical to take the necessary steps to address the problem. Whether that means involving administration, providing additional training opportunities, or even terminating the employee, embodying a calm and professional leadership style will help to ensure a safe and supportive environment for you, your staff, and your patients.

If you’ve enjoyed this article and would like to stay in the loop for more insights on creating a sustainable, fulfilling, and happy life as a physician, sign up for my newsletter or reach out on my website. I’d love to hear from you.

And if you’d like to schedule a complimentary introductory meeting with me, click the link below.

My Podcast Interview with Health Tech Expert Shanil Ebrahim

Shanil Ebrahim is on the cutting edge of healthcare technology, with expertise not only as a scientist but also with meaningful experience in the fields of AI and health equity. His insights are timely and thought provoking.

As a frequent host of the TechLink Health podcast, it's always such a pleasure and a privilege to meet with leading innovators in the health and tech space. The industry is moving at warp speed, and it's great to have a front row seat!

You can listen to the podcast at TechLink Health as well as Spotify and Apple Podcasts.

My Podcast Appearance with Kevin MD on Meditation and Mindfulness

I enjoyed my recent conversation with Kevin Pho, M.D. We discussed how mindfulness can have far-reaching effects not only for yourself, but for those you care for. We also discussed the best times for meditation, when you might want to avoid it, and how a brief meditation can impact your sense of well-being.

As a physician coach, I love sharing this story, because it encapsulates how such a simple and brief practice can have a meaningful impact.

Despite often heavy-handed corporate efforts to the contrary, mindfulness is not a bandaid to fix all that is wrong with healthcare. And it’s not a substitute for the meaningful change that is so desperately needed. Instead, it’s a reminder to be present and engage with what is happening right now, without judgement or reactivity.

Through mindfulness, you are can find a way to take a moment in the middle of the daily storm to re-center and reset. And for physicians, that can go a long way towards building stronger relationships with patients and staff based on trust and respect.

My Podcast Interview with Grenville Thynne of Neuroflex

I recently had a fascinating conversation with Grenville Thynne for the Techlink Health Podcast. We discussed his work with the trailblazing Neuroflex company. Neuroflex’s portable technology can quickly detect evidence of concussion on site, which makes it especially valuable to athletes of all types.

The technology is also being studied in aging and neurodevelopmental disorders, and has the ability to provide objective measurements of brain function that can be tracked over time.

This was one of my favorite podcasts of the year. I hope you enjoy it.

My Podcast Interview with Phage Therapy Research Scientist Dr. Jennifer Sacher

It was such a pleasure to interview Dr. Jessica Sacher for the Techlink Health Podcast.

We discussed her fascinating work using phage therapy to defeat superbugs, and how she got started in the field.

We also had a great conversation about the personal aspects of this work, and how she has adapted her laboratory process to meet the growing need for phage therapy.

This interview is a great reminder of all the people whose work contributes to saving lives and furthering the progress of medical science.

Jessica’s passion for her work shines through in this interview. I hope you enjoy it!

My Podcast Interview with Dr. Keith Matheny, Medical Entrepreneur

It was a real treat to have the opportunity to interview Dr. Keith Matheny for the TechLink Health podcast. As a colleague and fellow Vanderbilt alumni, I was especially interested to hear his story and discover how he designed an innovative and physician-driven approach to challenges in the Ear Nose and Throat specialty.

Keith is a fantastic clinician and an inspiring entrepreneur, and I think you’ll enjoy our conversation.

Check out the podcast here, or you can listen on Apple Podcast, Spotify, or on the TechLink Health website or app.

Navigating Burnout: My Podcast Appearance on KevinMD

If you’re a physician, or anyone active in healthcare today, you have probably heard of Dr. Kevin Pho and his KevinMD podcast and website.

Kevin posts interviews and articles daily, and I was thrilled to be a recent guest. In the episode, we discussed the burnout epidemic, and why it’s not the same as compassion fatigue.

Burnout is a symptom of a system that is not working for you. In many ways, it’s a form of grief. It’s not your fault. But that doesn’t mean there’s no way out. In the interview, I went over actionable steps you can take to improve your life as a physician and to combat the effects of today’s stressful environment.

My August interview with Dr. Kevin Pho on the KevinMD podcast.

My Podcast Interview With Dr. Cliff Han of AllerPops

I recently had the opportunity to interview Dr. Cliff Shunsheng Han for the Techlink Health podcast. Dr. Han is a physician, a medical researcher with the Human Genome Project, and the creator of AllerPops, an innovative product designed to help fight the seasonal allergies that plague so many of us.

An allergy sufferer himself, when medications failed to get his problem under control, Dr. Han decided to look beyond the traditional factors that contribute to allergies. he was also motivated by the allergies suffered by his young son. That led him to explore the idea of prebiotics and the importance of a healthy oral microbiome.

Dr. Han is a wonderful example of a physician who followed a nontraditional pathway. Although he trained and practiced as a doctor in China, he has worked as a research scientist since coming to the US over 20 years ago. He shares more about his story on the podcast and in his book, Nothing to Sneeze At.

But once a physician, always a physician. Through his curiosity and resilience, Dr. Han has created something completely new with AllerPops. The science is still in the early stages, but the testimonials on his website are inspiring.

As a disclosure, I will note that Dr. Han has kindly offered to supply me with a sample kit of Allerpops. As a nearly year-round allergy sufferer, I am really looking forward to giving them a try.

Listen to my podcast interview with Dr. Cliff Han, co-hosted with David Sanchez, RN.

If you’ve enjoyed this article and would like to stay in the loop for more insights on creating a sustainable, fulfilling, and happy life as a physician, sign up for my newsletter or reach out on my website. I’d love to hear from you.

This post contains Amazon affiliate links. I may earn a small commission when you click on the links, at no additional cost to you. These commissions help to support the website.

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As a physician coach, I can work with you to explore what’s possible and create a plan that aligns with your personal values and aspirations. Schedule your exploratory conversation with me by clicking the button below.

My Podcast Interview with Dr. Vicki Rackner: Surgeon, Entrepreneur, and Financial Coach

I thoroughly enjoyed meeting Vicki Rackner MD on the TechLink Health podcast and learning about her work in the field of physician financial well-being.

It was a fascinating conversation, and her story is inspiring! Through personal adversity and challenge, Dr. Rackner created a business helping physicians discover financial freedom.

While she is not a financial advisor, Dr. Rackner works with physicians to help them leverage their medical expertise, generate multiple income streams, and develop critical business and marketing skills. She has authored three books on the subject, with another one on the way.

Take a listen on Spotify or wherever you listen to podcasts.

My podcast interview on Techlink Health with Dr. Vicki Rackner.

Combating Neurophobia: My Podcast Interview with Dr. Michael Kentris

I recently co-hosted an episode of the TechLink Health podcast featuring neurologist Michael Kentris, D.O.

In a wide-ranging discussion, my co-host David Sanchez, RN and I learned about Dr. Kentris' cutting edge work as a neurologist and as a physician educator. As a podcaster himself, Dr. Kentris combats "neurophobia" by breaking down complicated topics in neurology for clinicians across a broad range of specialties. Look for his entertaining and enlightening podcast "The Neurotransmitters" on Apple or Spotify.

I was also excited to learn that Dr. Kentris and I both studied at Vanderbilt University School of Medicine. I graduated from medical school at VUSM in 1988, and he complete his clinical neurophysiology fellowship there in 2018.

My TechLink Health Podcast interview with Dr. Michael Kentris.

Defeating Superbugs: My Podcast Interview with Dr. Steffanie Strathdee

As a podcast host for TechLink Health, it was a privilege to interview Dr. Steffanie Strathdee, an epidemiologist and Distinguished Professor at UC San Diego.

Dr. Strathdee literally saved her husband's life when he suffered a catastrophic antibiotic-resistant superbug infection.

Through her investigations, Dr. Strathdee uncovered the possibility of phage therapy. Considered a risky and largely unproven treatment modality at the time, it was a last-ditch effort -- and it worked!

Dr. Strathdee is now the Co-Director of the Center for Innovative Phage Applications and Therapeutics at UC San Diego. You can find her book, The Perfect Predator, on Amazon. There’s an audiobook version as well, which I highly recommend.

DISCLAIMER: As an Amazon Associate I may earn from qualifying purchases, which means that if you click on one of the product links, I’ll receive a small commission. This helps support the website, for which I am grateful! Please do your own research before making any important decisions.

If you’ve enjoyed this article and would like to stay in the loop for more insights on creating a sustainable, fulfilling, and happy life as a physician, sign up for my newsletter or reach out on my website. I’d love to hear from you.

My Podcast Interview with NeuralPositive’s Dr. Yasmine van Wilt

Recently I was fortunate to have the opportunity to interview Dr. Yasmine van Wilt for the TechLink Health Podcast. Dr. van Wilt has a fascinating story in the field of medical-grade music. She is a founder of Neuralpositive, a company that is on the forefront of medical music innovation. Dr. van Wilt has partnered with Cornell Tech, Columbia University, and Stanford University, among others.

As we work to integrate evidence-based mindfulness and other non-pharmaceutical practices into healthcare, there is a powerful need for well designed research backed up by academic commitment. I’m excited to share this interview with you, and would love to hear your feedback.

What the Failure of the ER Match Says About the State of Health Care

And How Physician Coaches Can Change The Story

When I was in medical school, the cool, smart kids went into ER medicine. It was a hotly competitive residency, and there was no guarantee that you would match. Now things are entirely different. Over 550 residency spots went unfilled by US med school grads in the residency match this month. Some centers had zero applicants match to their programs. Compare this to 2021, when only 14 ER residency spots were not filled.

The reasons? Just about any physician in the US can tell you:

• Disrespect fueled by social media personalities and irresponsible "news" outlets

• Dangerous working conditions

• Overloaded ERs being used as a source of primary care, often because people lack insurance or access

• Corporatization of medicine with a focus on numbers of patients seen and metrics that often don't relate to patient care

• Management of physicians by business people and those with less responsibility and training

• Intrusive, redundant, and burdensome EHR requirements

• Lack of adequate support staff

Some of my best friends are ER physicians. They are some of the hardest working people I know. These are the doctors who will save your life at 2 am, no matter who you are or whether or not you have insurance. And they are also the doctors that are tasked with waking up their colleagues at all hours of the night to request a consult or hospital admission. Most manage their work with grace, strength, and courage.

The steep decline in the desirability of ER residencies is a really scary trend. It’s easy to say that doctors can be replaced with mid-level care providers, but the truth is that the expertise, skill, responsibility and knowledge that an ER physician provides requires years of education, training, and commitment. Mid-levels can reduce some of the burden of less complex patients, but they are no substitute for a physician.

This sudden and shocking shift should be a call to action for hospital directors, ER directors, and the corporations and private equity firms who own and manage many of these practices.

As we wait to see how this recent revelation will impact the decisions and practices that affect ER physicians, it’s important that physicians take steps to stand up for ourselves and our profession. This is a new way of thinking about medical practice, but times have changed irrevocably. By learning how to work within the systems we now have, we can start to make important changes from the inside out. Ultimately, such changes will benefit not only physicians, but also their patients and indeed the very institutions and corporations that currently control our healthcare systems.

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 How can coaching help? Well clearly, coaching will not fix the problem. Coaching means working with one physician at a time, very much like patient care. But coaching will help you clarify your goals, identify your frustrations and obstacles, and give you the tools to create your way forward. Will that be

• Negotiation, understanding your own value?

• Creating a streamlined workflow that will allow you greater efficiency?

• Acquiring new skills to make your time more effective?

• Courage to make a lateral move to a new facility?

• A switch to a different type of practice altogether?

• A change in working hours?

• Reframing conflicts so that you are able to create a more positive working environment?

• Honing interpersonal skills?

• Advocating for change in EHR management?

Regardless of your specialty, the healthcare world is shifting. The work you do matters. By recognizing your own worth and power, and by taking action that is beneficial to both you and your patients, you will be able to create a happier and more sustainable life.

If you’ve enjoyed this article and would like to stay in the loop for more insights on creating a sustainable, fulfilling, and happy life as a physician, sign up for my newsletter or reach out on my website. I’d love to hear from you.

My Podcast Interview with Dr. Naomi Lawrence-Reid

After appearing on a recent segment of TechLink Health’s Podcast, I was invited to interview Dr. Naomi Lawrence-Reid of Doctoring Differently. Dr. Naomi, as she prefers to be called, describes how she pivoted from full-time practice and found new opportunities to use her skills as a physician.

Her story is inspiring and engaging. You can take a listen right here.

How My Experience with Pain Made me a Better Physician

This article originally appeared in Doximity.com, where I am an Op-Med Fellow.

Although I don’t like to admit it, I am a typical Type A cardiologist who takes absolutely everything far too seriously. Like many physicians, this extends well beyond my professional life and reaches into every corner of my existence.

I am also a competitive equestrian. And my big, red, and rather fancy horse really doesn’t care what I do for a living, or how seriously I take myself. In his mind, I am both a reliable source of carrots and a nuisance who sometimes keeps him away from his friends while trying to boss him around. My horse is a source of joy and a beautiful connection to the natural world. He also seems to delight in keeping me humble. But I never expected him to teach me a profound and enduring lesson about the nature of pain, empathy, and mindful compassion.

Several years ago, while training on a cross country jumping course, I suffered a serious fall. One minute I was on top of the world, flying across the open fields with my beloved equine partner, and the next I was on the hard ground, writhing in excruciating pain and unable to walk without assistance. My horse, meanwhile, high-tailed it back to his friends, grateful for the unexpected interruption.

While I fortunately had no broken bones, it turned out I had sustained a severe injury to my right psoas and my left piriformis muscles. I returned to work soon after, hobbling on crutches for support and trying to shrug off my injury as a minor nuisance. However, I quickly became intimately familiar with the anatomy of my lower musculoskeletal system. Initially, it was the psoas muscle that I noticed, since it kept me from walking. But within a few days, the piriformis injury became the center of my existence, as it cruelly squeezed my sciatic nerve. The pain was truly mind-blowing and would sometimes escalate without warning. Because I was back at work, my options for medications were limited.

I am by nature a quiet person, but during this time one of the only ways I could deal with this monstrously searing pain was to scream my head off. This was only possible when I was safely out of earshot of my patients, partners, or any other human beings. I don’t know if it was the endorphins or the temporary distraction, but it was remarkable how well screaming helped, if only for a few minutes.

After more than a week of unrelenting agony, I began Googling similar injuries (because, of course, you Google). I realized with dread that there was no promise that my pain would ever completely go away. Thankfully I had an excellent orthopaedic team. And, as a physician, my pain was always taken seriously. Sadly, I knew this was not the case for many of my patients. 

Although I don’t treat pain, my cardiology patients are among the estimated 8% of Americans who live with what is termed “high-impact chronic pain.” Like a light switch turning on, after my accident I began to recognize the manifestations of pain and misery in their faces. The anxiety of being asked to change positions on the exam table, the fear of having their medications taken away, and the frustration of feeling dismissed and disrespected. I understood deeply that pain could not always be measured, proven, or relieved. 

I found myself engaging more empathetically with these patients, acknowledging their fear and our shared humanity. The 55-year-old woman with chronic back pain who always remained standing during our visits, shifting back and forth, who used to perplex me? Now I realized just how difficult sitting could be. The anxious 45-year-old man with the perpetually furrowed brow and litany of complaints about his medical team whom I had previously written off as a chronic malcontent? With my newly informed awareness, he now came into sharper focus as a suffering human being. And the 70-year-old woman with severe arthritis and scoliosis, who was nonetheless always ready with a smile and a thank you? She became a messenger of grace — someone who showed me that it was possible to rediscover an innate good nature, despite the difficulties life presented. In acknowledging my patients’ pain, and accepting their well wishes for me, our sense of mutual trust and connection deepened.

As physicians, we learn early on to create healthy boundaries between ourselves and our patients. Hard-earned experience teaches us that we can’t always take everyone at their word, and that in some cases patients will exploit their doctors’ compassion for personal gain. For instance, most medical and surgical interns will eventually encounter characters who seek pain medications for what sound like legitimate reasons, but are eventually discovered to have visited multiple doctors and ERs with similar stories. Often a call from an astute pharmacist uncovers the ruse. Consequently, by the end of residency, it’s common to have developed at least a little cynicism. And indeed, we learn quickly that objectivity is critical not only to our decision-making but also to our ability to leave our work behind at the end of the day. 

My practice, as I mentioned, does not include treating pain or prescribing pain medications, and I have not lost my natural sense of vigilance. Yet my intensely personal experience has opened a window of understanding and taught me a new way of relating to my patients without judgment. This shared experience of pain was something I could acknowledge and be a witness to, without the expectation of a solution. In fact, I found that simply recognizing a patient’s pain often created greater trust and made it easier for them to accept my medical advice. On a practical level, our encounters became more efficient and resulted in fewer after-visit phone calls and cancellations. And as a result, I felt that I was able to offer a higher quality of care, with greater satisfaction from all standpoints, despite being powerless to impact their unremitting pain. 

In my case, I was fortunate: after a combination of several rounds of steroids, high quality physical therapy, a mindfulness practice, and time and patience (plus bedtime narcotics on non-call nights), my symptoms subsided and I was granted a near complete recovery. Still, this is not guaranteed for all pain patients — and I know that not everyone has the resources, good fortune, or support to come out mended on the other side. I was also lucky to have friends and family who tolerated my pain-fueled bouts of insolence and short temper. But many people with chronic pain understandably become so focused on their misery that they drive away loved ones and others who offer help or kindness.

Although I would not wish my experience on anyone, I cannot deny that it has taught me so much. Today, I recognize how chronic pain affects everything — it changes our sense of self, and can make even kind and gentle people become mean, angry, and impatient. As a physician and as a patient, I am tremendously grateful for the unexpected pearls of wisdom and empathy that emerged from beneath the layers of pain.