I’m a Neurosurgeon and This Is How I Navigate Burnout

Overextended, overworked, overtired?? Feeling like there’s no wind in your sails and the currents are stagnant?? When I was a child, my grandfather, a World War II Navy surgeon and first-class raconteur, regaled me with maritime legends about the doldrums, areas of the ocean around the equator that have meager winds and currents.? Nantucket whaling ships on their way south toward Cape Horn would stall there. The most well-known was the ill-fated Essex, ultimately sunk by a whale in the South Pacific. (For a great read and to learn more, pick up?In The Heart of The Sea .)

If the doldrums of daily life have hit you, you’re likely experiencing burnout. And it’s especially prevalent in what’s called the helping professions, including medicine, nursing, counseling, social work, education, and ministry. It can also happen when you are overloaded with caring (in whatever way) for a family member or friend.

What exactly is this beast called Burnout and how do we battle it? Coined in the 1970s by American psychologist Herbert Freudenberger, burnout is defined as a state of exhaustion and inability to cope resulting from the combination of high stress and high ideals in “helping” professions. Because most of us are, in some way, in the business of helping people, few are immune to burnout.

Prescription for Preventing Burnout

To navigate my way forward in stagnant times, I’ve found that partnerships, productive pauses, curiosity, and stewardship can serve as instruments to steer through the doldrums.

·???????? Partnerships: Scientific research in the work environment tells us that meaningful mentorship is protective against burnout. ?This resonated with me because I was shepherded through my own early career by some excellent mentors including Drs. Jannetta and Haid. ?In fact, I still call my Fellowship director, “Coach” when I reach out to him during challenging situations. Having this kind of lifeline to “phone a friend” is extremely comforting in difficult times.? To learn more about this check out one of my neurosurgery rules, “Never worry about a patient alone,” in this Business Insider article.

·???????? Productive Pause:? My life coach, Jim Harshaw, has taught me to create space for a daily Productive Pause .? He defines this as “A short period of focused reflection around specific questions that leads to clarity of action and peace of mind.” I use this technique regularly before the day begins.? I have also modified it to a “mini” session I hold for myself at multiple times during the day, utilizing it whether I’m in the operating room, seeing patients or about to speak to a classroom of cadets.? I close my eyes for anywhere from 10 seconds to a minute or two and step out of the external world.? I imagine experiencing a beautiful vista on a trail along Chimney Pond in Baxter State Park, Maine.? This is a “go to” strategy for me in a stress-filled day or even during a break in surgery. It’s creating your own green room in your mind.? You can’t always be performing; you must have some offstage time.

·???????? Curiosity:? It is a known fact that happiness can be found in lifelong learning . This can be achieved through reading , as I have previously written. And it’s not just the traditional way of reading. It includes curating relevant internet research, listening to podcasts or audiobooks, regularly attending your industry’s trade shows, and holding conversations -- particularly with people who don’t share the same perspective you may have.? I don’t share Bill Maher’s political or secular views, yet I’ll hear what he has to say because he’s intelligent and provocative.? He gets me out of my comfort zone.? Sometimes an ice cold bucket of water on your face wakes you up to all kinds of experiences. My motto is: if it doesn’t challenge you, it doesn’t change you.? I enjoy listening to podcasts recommended by my younger medical staff and premed students.? My mentor Dr. Jannetta always told me young people should read old books and old people should read young books. I mention this in a eulogy I wrote at the time of his passing.

·???????? Stewardship.? Voltaire once said, “The planting of a tree is a modest form of immortality and one of the few truly long-term expressions of hope to mortal human beings.” I did a McLaughlin Modification and added a few more options to achieve a form of eternal life. My version states,

?“If you want to be immortal plant a tree, write a book, coach a child.” Stephen Covey , who had a doctorate in religion but who chose to speak, at least initially, to business people, told us long ago that sharing and helping others be their best is a critical element of a life in which we are effective and happy.? Sharing your own pearls of hard-won wisdom with others can keep you grounded and focused. Doing so can make you less susceptible to burnout yourself, by giving you a new sense of purpose and a source of personal satisfaction.?? I haven’t planted many trees in my day, but it’s on my “to do” list.? But I do coach kids in wrestling and I am writing a book.? Many people have asked me how I can coach, be a brain surgeon and an author. I confess that the book and coaching are not just for altruistic purposes- there are personal reasons, too.? They GIVE me energy and serve as my version of fire retardant to keep me from burning out as a neurosurgeon.? Maybe five percent of the time these extracurriculars will physically tire me out more.? But the other 95 percent of the time they energize me even more at work.

Strange Bedfellows for Neurosurgeons: Burnout and Job Satisfaction

Interestingly you can love your job and still get burned out. I was recently surprised by a survey of my colleagues in the Journal of Neurosurgery. Between September and December of 2012, members of the American Association of Neurological Surgeons were asked a series of questions associated with career satisfaction. Of the 783 responders, 57 percent ?suffered from burnout (based on a validated measurement tool called the Maslach Burnout Inventory ). Despite this finding, more than 80 percent reported satisfaction with their career and 70 percent said they would choose a career in neurosurgery if they could start all over again. This juxtaposition of seemingly incompatible states is not surprising when one considers the whole picture. Although the demanding work of neurosurgery wears me down, I get a tremendous lift, sometimes even euphoria, when I help my patients through some of their darkest and dangerous moments.

When I feel burned out it’s rarely because I’m physically tired.? More often I believe it’s when I’m mentally overdrawn.? It’s when I sense a disconnect with my purpose and what my job sometimes requires me to do.? This can happen commonly in medicine - too much paperwork, regulation, oversight, and seemingly useless mandatory education seminars can crush your spirit. Yet these issues are ubiquitous in most industries today.

Sometimes carrying another’s cross can crush you.? Sometimes just carrying your own can too.? Perhaps you have felt that looming despair of helplessness and burnout.? I have found that the antidotes I’ve mentioned -- partnerships, productive pauses, curiosity, and stewardship have served as fresh winds and strong currents to navigate my vessel out of the doldrums.