Define Your Values to Create Your Ideal Life a Physician

Your values are integral to your identity. They are a very personal and multifaceted set of foundational qualities that have the power to provide a guiding light, leading you towards a life that feels in harmony with your true and ideal self. While they are a fundamental aspect of the complex person that you are, external pressures, social circumstances, and even inertia mean that it’s common to live out of sync with your values. But once you give your values a name, the way forward becomes far more clear.

Most of the time we can distill our core values into a set of five or six concepts that give our life meaning and purpose. In this article I’ll guide you through a simple exercise that can help you to get clarity on your own values. From there, you may begin to see patterns of alignment, or perhaps misalignment, in your life.

Through this process of awareness, you’ll find that your decisions become more clear. You’ll begin to feel the confidence to say “yes” to the opportunities that serve your higher purpose. You’ll find a way to energetically reach towards the next foothold, even when it’s challenging. And you’ll feel more certain when you say “no” to those choices that are not the right fit.

First, Define Your Values

The first step is to define your values. This might seem a little contrived, because you may feel as if you know yourself well enough to understand what matters to you. But putting a name to your values, and seeing them written out in black and white, can be surprisingly enlightening. For the purposes of this exercise, a value is a single word that encompasses an idea or belief in a certain way of being in the world. I’ve created a list of values for you to get started with. You can find them here.

Go through the list and circle the values that speak most strongly to you. Don’t overthink it. Your values may change over time, and that’s completely normal. There are no right or wrong, or good or bad, answers.

Once you have circled your top values, write them out. Take a good look at what you have written and see if you can narrow them down into five groups. From there, discover what themes emerge. These are your core values.

Next, Put Your Values into Action

Now, thinking about your core values, consider how you might choose to elevate these values in your daily life. Don’t try to make sweeping changes. Instead, think of small actions or choices that might more completely align your values with your life.

If there is a big disconnect between your values and your life, it might be time to reconsider your path. It is often challenging to get a handle on these ideas and put them into practice. If so, a physician coach can be a great ally. Through coaching, you will generate greater self-awareness and discover options and opportunities that more completely align with your unique set of values.

If you’re not ready for coaching, but want some clarity, consider downloading my free Values Workbook. It’s free when you sign up for my newsletter.

An earlier version of this article appeared on this website in January , 2023.

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.

Setting SMART Goals: A Guide for Physicians

If you’re a physician, you’re no stranger to goal setting. You wouldn’t have gotten to where you are now without setting some very specific and actionable goals.

But once you’ve made it through your training, landed a position in your specialty, and begun the process of living your own life, your goal setting muscle may have atrophied a little. What’s more, no matter where you are now and where you might want to be in the future, there’s no longer a prescribed set of steps to get you there.

If you seek growth or change, creating the map is up to you. Unlike the well-worn trail you may have followed in the past, the direction you will take is based on your own unique talents, interests, and visions. As Joseph Campbell warned, in his book The Power of Myth, “If the path before you is clear, you're probably on someone else's.” And starting this adventure begins with setting goals.

Choosing, planning, and carrying out your own goals can feel daunting. Whether professional, financial, personal, physical, or even spiritual, it can all seem like a lot. Where to start? And what can you expect along the way? As with so many other life skills, it’s likely that no one ever taught you how to set goals.

Fortunately, there’s a template that you can follow that breaks the goal-setting process down into clear and accessible parts. Innovators and movers in the business world have been using this tool for years, and it’s something that can work for physicians as well. In this article, I’ll walk you through the process of setting SMART goals that matter to you.

Defining and setting your goals will pave the way for your ultimate success. For instance, a study of medical students undergoing a surgical clerkship found that those who set clear and specific skill-related goals were more likely to get the outcomes they desired than those who just hoped for the best.  And goal setting may also reduce your cognitive load, meaning that you have exert less mental effort to get the work done.

Writing out your goals by hand is more likely to ensure that you stick to the process compared to typing them into a document or entering them into an app.

Give yourself an uninterrupted stretch of time to really think through the goals that you want to set, and the outcomes you hope to achieve. And then map it out using the SMART template. You may be surprised by what you’re able to achieve, and by what you discover about yourself along the way.

Specific

Get as specific as possible about your goal. As author Jack Canfield puts it, “vague goals produce vague results.”   Define your goal clearly and succinctly. It should be something that you can describe in one to two sentences.  

To make it clearer and more engaging, phrase your goal in positive terminology.  This has the added benefit of making it more likely that you’ll get it done. For example, instead of deciding you want to get out of an unhappy work environment, you might reframe this to a desire to get into a more fulfilling position.

Measurable

You should be able to objectively track your progress, whether that’s a checklist, a habit tracker, a set of numbers, or anything else that gives you a way to measure your efforts towards the goal.

Achievable

Choosing a realistic goal that is within your control is important, since you want to set yourself up for success. Choose a goal that requires a moderate stretch, but that you know is achievable.

The magic of the process is that once you reach that goal, other possibilities that are currently out of reach may open up. In the words of writer Joseph Campbell, “Follow your bliss and the universe will open doors for you where there were only walls.”

Relevant

Get in touch with your core values and ask yourself how this goal aligns with your personal vision. The goal should matter to you, not just to your friends, family, or administrators. It’s great if the goal will make everyone happy, but if it’s not your own, you’ll be less likely to commit to it.

Time-Bound

Unless you set a deadline, or a series of deadlines, you may find it hard to get started. That’s just human nature. When you set and commit to a target date, you’ll be more likely to bring your goal to fruition.

Once you’ve identified your goal, break it down into “micro goals” that you can complete within a very short period of time. This progress of completing will help propel you forward, keeping the momentum going.

Don’t forget to celebrate your wins, even the small ones. Calling a friend, going out for dinner, savoring a cookie, listening to music, or even taking a walk are all ways to honor the effort that you’re putting into the process.

Goal setting is naturally tied to effective use of your time. Looking at a big goal can seem daunting, but simply devoting ten to fifteen minutes several days per week can move you forward.

If you struggle with time management, I have a number of articles available on the website that may be helpful. They focus on issues that are specifically relevant to physicians and medical practice. If you’re looking for more guidance, my Four Week Focus Shift course is a self-guided way to find focus for the goals that matter. I also offer 3 and 6 month Time Management coaching packages for physicians.

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.

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

References

Campbell, J., & Moyers, B. (2011). The Power of Myth. Anchor.

Doran, G.T. (1981) There’s a SMART Way to Write Management’s Goals and Objectives. Journal of Management Review, 70, 35-36.

Etkin, J. (2019). Time in relation to goals. Current Opinion in Psychology, 26, 32–36. https://doi.org/10.1016/j.copsyc.2018.04.013

Gardner, A. K., Diesen, D. L., Hogg, D. C., & Huerta, S. (2016). The impact of goal setting and goal orientation on performance during a clerkship surgical skills training program. ˜the œAmerican Journal of Surgery, 211(2), 321–325. https://doi.org/10.1016/j.amjsurg.2015.07.028

Locke, Edwin & Latham, Gary. (2002). Building a Practically Useful Theory of Goal Setting and Task Motivation: A 35Year Odyssey. American Psychologist. 57. 705-717. 10.1037/0003-066X.57.9.705.

Nebel, S., Schneider, S., Schledjewski, J., & Rey, G. D. (2016). Goal-Setting in educational video games. Simulation & Gaming, 48(1), 98–130. https://doi.org/10.1177/1046878116680869

Oscarsson M, Carlbring P, Andersson G, Rozental A. A large-scale experiment on New Year's resolutions: Approach-oriented goals are more successful than avoidance-oriented goals. PLoS One. 2020 Dec 9;15(12):e0234097. doi: 10.1371/journal.pone.0234097. PMID: 33296385; PMCID: PMC7725288.

Van Der Weel, F. R., & Van Der Meer, A. L. H. (2024). Handwriting but not typewriting leads to widespread brain connectivity: a high-density EEG study with implications for the classroom. Frontiers in Psychology, 14. https://doi.org/10.3389/fpsyg.2023.1219945

My Podcast Interview with Digital Diagnostic’s John Bertrand

Artificial intelligence is making its way into healthcare at a rapid pace. By harnessing its benefits while at the same time recognizing its limitations, we have an opportunity to improve and expand access to care for a wide range of people.

This was a thought-provoking podcast conversation with John Bertrand of Digital Diagnostics about the practical and potentially life-changing uses of AI for early detection of diabetic retinopathy. The beauty of the process is the fact that it can be used virtually anywhere, and does not require a highly skilled technician to acquire the data.

My Podcast Interview with AI Pioneer Dennis Cogan of Caresyntax

It’s no secret that artificial intelligence (AI) is rapidly becoming a powerful tool in healthcare and medical science.

As a TechLink Insights podcast host, I enjoyed this very forward-thinking and inspiring conversation with Dennis Kogan of Caresyntax, a company pioneering the use of AI in surgical practice.

It’s normal to feel uneasy about these new technologies. But AI is already here, and it’s up to physicians and others in healthcare to guide its implementation and develop reasonable safety rails to protect our patients. Having met with a number of pioneers in this space through the podcast, I believe that the future looks bright for innovations in care when AI is applied thoughtfully and collaboratively.

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.

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.