Hello friends,

Friends,

I was running into a clinic a few weeks ago and glanced into the passenger seat of the car next to me. This is what I saw – a bit of trash on the floor, some wrappers, and garbage of a busy driver. Something haphazardly strewn in a moment of rushing. And I saw an empty bowl with a spoon on the seat – some type of yogurt, the creamy residue was left in the bowl after a busy breakfast on the way to work. And here was my immediate thought: Whose bowl is this? Was she rushing into work after scarfing down a parfait in traffic? Was he getting his teen to eat just a bit before school while dashing into clinic? Was this a lunch break in someone’s car as the only respite from patients? Was the bowl from this morning or days ago, now forgotten?

This is my bowl.

This is your bowl.

It’s all too busy right now. It’s rushed and chaotic and we are being asked to solve problems that are brand new to us or that we have limited resources to solve. We are rushing into work, out of work, cramming in an endless task of to-do’s during an unprecedented time of continual barriers. We are having to justify our opinion and expertise. And we are supposed to balance our work with self-care, family care, partner care, aging parent care, child care, and the like.

Can you stop and feel this for a moment?

One of the largest contributors to burnout is emotional exhaustion. And the only cure for emotional exhaustion? Feel the feelings. Yep. Sorry if that’s not you; but we must begin. And if you can’t begin for you, can you feel it for this person? The person with the forgotten bowl?

I had SO much empathy for him or her. I had tears in my eyes and no judgment in my heart. Probably because it hit so close to home. What had I rushed through that day? A meal? A hug? A sweet text? My shower? Saying goodbye to my kids before school?

We must begin to feel our feelings. I know it’s scary to many of you. I know some of you are thinking, “If I feel my feelings, I’ll never come out of it.” But the truth is that the sooner we acknowledge the pain, it dissipates; and the more we ignore pain, the bigger it grows. Think of emotional pain like an incessant toddler knocking on the door for attention. Or the dinging that happens in your car until you put on your seat belt. It demands to be heard.

Once we acknowledge emotional pain and overwhelm, then we can begin to address it. So, that’s the first step. Saying, “this is too much for me right now” or “I’m lonely in this pain and unsure what to do” or noticing someone else’s overwhelm and saying, “me too.”

Send me a picture of your passenger seat – I embrace all of your mess!

Once we tackle step one, we’ll move on to step two. Messy bowls, for now, my friends.

With compassion,

Dr. Amy

Friends,

Last week, I talked about necessary steps to engage in “Unbeautiful Self-care” and attached a piece of writing from an incredible author. If you haven’t had a chance to marinate in her words, please take the time to do so.

As I’ve sat with providers, clinic leaders and medical organizations over the past many months, it is clear that caring for oneself is not an intrinsic tool. It needs to be made explicit and given permission to practice. As selfless healers, caring for oneself is actually “trained out” of us. Putting our needs behind others is a badge of honor, a way of being and encouraged as standard practice. Here are things I hear from providers:

• I try not to drink water so I don’t have to use the bathroom as much
• I try to pack small snacks because I don’t have time to sit down and eat lunch
• My milk stopped coming in because I didn’t have time to pump
• I can’t take vacation right now because my team needs me
• I’m working 60 hour weeks because of staffing issues
• Sleep? I’m used to not sleeping.
• I don’t feel safe walking into my office right now
• I’m having panic attacks in my car

If this is you, you are headed towards burn out if you’re not there already. I want you to give yourself a gift and take an honest inventory of where you might be neglecting yourself, where boundaries are necessary and where more compassion might be necessary. It’s more than self-care friends, it’s necessary practice to continue doing the work we do.

As an incredible provider confided in me, “I don’t even know where to begin, so I’ll use your list for now, Amy. Then, perhaps, I’ll be able to create my own.” Here are the steps she followed – much of this was inspired from work that I have been doing in the leadership space for medical providers, the work of Nagoski & Freudenberger, as well as listening deeply to the needs of healthcare professionals and my own.

The Self-Care You Don’t Think You Need Right Now

1. Breathe deeply – 90 seconds a few times a day decreases cortisol hormones significantly.
2. Laugh – find a Netflix episode, listen to Comedy Central, re-watch Friends, tell bad jokes. Belly laughs release those feel-good chemicals that are important for recovery.
3. Creative expression – paint, draw, sing (even horribly!), knit, bake – something that gets you into a different part of your brain and connected with artistry.
4. Move your body – you need not run a marathon – but move, stretch, bend, dance. If you need motivation here, check out my buddy, Gurdeep Pandher.
5. Hug someone – physical contact releases another amazing chemical – oxytocin. You know it. You love it. That’s our bonding chemical – the attachment magic that makes us feel safe.

On a practical level – here’s what my list might look like:

1. Before I get out of bed, deep breaths. Just 90 seconds focused on my body.
2. Take the stairs at work. Park at the back of the lot. Stretch between patients.
3. Big hug to my teenagers when I get home. Dog cuddles.
4. Watch something OTHER THAN NEWS. Something that makes my heart happy. Bridgerton anyone?
5. Read a book, bake something yummy. I do not sew or paint, but I make a mean cupcake with cream cheese filling. YUMMY.
6. More hugs, hand-holding, hands-on belly, and deep breaths.

If I really want to challenge myself:

1. Peloton in the morning – Alex Toussaint will kick your butt. Or, if I want to torture myself (because I’m horrible at this) – guided meditation for 10 minutes. Yes, 10 minutes of meditation is harder for me than 45 minutes of pure cardio – guess which one I need more?
2. Ask for a hug. This is hard, but necessary (Why am I so bad at this??? I’m working to get better!). Let them be the first to let go. Or, offer a hug to a friend/colleague.
3. Say no to something this week. What feels like more of an obligation than rejuvenation?
4. Do something creative that makes me work – a new recipe is challenging but fun. Or, give myself a break and order food in (trigger, mom guilt), but make a yummy dessert. Did I mention I love dessert?
5. Let myself feel ok for not getting back to people right away. How do they know I got the email??
6. Read a book for me! Something I want to read. I’m diving into Brené Brown’s new book right now.
7. Go to sleep when I’m tired. What??? Yes, listen to my body, put away my computer.
8. Say no to making holiday cards this year – I’m embracing this one fully.

Even these small steps help us begin to heal and address overwhelm. So, borrow my list for now – the simple or the challenging one. Let me know how it goes. Let’s all do some UNBEAUTIFUL SELF-CARE!!

Finally, if you want more of this, I encourage you to sign-up for my Provider Lounge membership! This is the LAST week to sign-up for a space of true collaboration and learning AND get it at a founding members’ price. Learn more and sign-up here.

With kindness,

Dr. Amy

Friends,

As we enter the month of December and all-things holiday merry-making, I want to remind you that it’s ok to feel overwhelmed. Almost 2 years into a global pandemic, I know most healthcare providers are still reeling from what they’ve been through. If you’re like me, it’s as if the last two years have been an eternity. So, just a short reminder from author Brianna Weist that self-care is often unbeautiful. It’s not about eating better, sleeping more and exercising – but often about tough choices and creating boundaries. It’s certainly something to ponder as we enter the holiday season of mounting obligations.

Here you go:

Self-care is often a very unbeautiful thing.

It is making a spreadsheet of your debt and enforcing a morning routine and cooking yourself healthy meals and no longer just running from your problems and calling the distraction a solution.

It is often doing the ugliest thing that you have to do, like sweat through another workout or tell a toxic friend you don’t want to see them anymore or get a second job so you can have a savings account or figure out a way to accept yourself so that you’re not constantly exhausted from trying to be everything, all the time and then needing to take deliberate, mandated breaks from living to do basic things like drop some oil into a bath and read Marie Claire and turn your phone off for the day.

A world in which self-care has to be such a trendy topic is a world that is sick. Self-care should not be something we resort to because we are so absolutely exhausted that we need some reprieve from our own relentless internal pressure.

True self-care is not salt baths and chocolate cake, it is making the choice to build a life you don’t need to regularly escape from.

And that often takes doing the thing you least want to do.

It often means looking your failures and disappointments square in the eye and re-strategizing. It is not satiating your immediate desires. It is letting go. It is choosing new. It is disappointing some people. It is making sacrifices for others. It is living a way that other people won’t, so maybe you can live in a way that other people can’t.

It is letting yourself be normal. Regular. Unexceptional. It is sometimes having a dirty kitchen and deciding your ultimate goal in life isn’t going to be having abs and keeping up with your fake friends. It is deciding how much of your anxiety comes from not actualizing your latent potential, and how much comes from the way you were being trained to think before you even knew what was happening.

If you find yourself having to regularly indulge in consumer self-care, it’s because you are disconnected from actual self-care, which has very little to do with “treating yourself” and a whole lot do with parenting yourself and making choices for your long-term wellness.

It is no longer using your hectic and unreasonable life as justification for self-sabotage in the form of liquor and procrastination. It is learning how to stop trying to “fix yourself” and start trying to take care of yourself… and maybe finding that taking care lovingly attends to a lot of the problems you were trying to fix in the first place.

It means being the hero of your life, not the victim. It means rewiring what you have until your everyday life isn’t something you need therapy to recover from. It is no longer choosing a life that looks good over a life that feels good. It is giving the hell up on some goals so you can care about others. It is being honest even if that means you aren’t universally liked. It is meeting your own needs so you aren’t anxious and dependent on other people.

It is becoming the person you know you want and are meant to be. Someone who knows that salt baths and chocolate cake are ways to enjoy life – not escape from it.

-Brianna Wiest

Grateful for you in all the ways you show up – for yourself and for others!

Dr. Amy

Friends,

This is a quick note to all of you. During this week of gratitude and giving thanks, I wanted to give something back to all of you. Over the past many months, so many of you have reached out and trusted me with your stories of overwhelm. Stories of compassion fatigue. Stories of self-doubt, frustration, optimism and distraught. Thank you for trusting me as a colleague and professional who holds that space with you.

Above I’ve attached the recent workshop that I gave for medical providers. So, even if you didn’t register, or if you weren’t able to attend, it’s here for you. Watch, listen, throw on ear buds and walk. Whatever works for you. It’s about 45 minutes on how to address burnout and overwhelm. My hope is that it offers a few nuggets of insight and, then, perhaps your heart can rest with less angst as we head into holidays.

With immense gratitude and partnership,

Dr. Amy

Hello Friends,

Holy smokes, do I have news for you! TWO opportunities to get some support during this time of uncertainty. I know you’re all overwhelmed. I know burnout is real and fatiguing. The only way to address burnout is through connection, support, and practical tools. When we come together as a community and acknowledge how challenging the last 20 months have been, then some healing and reconciling can begin. So, with that being said, here are two opportunities for support. FREE and FREE!!

“Amy, no one had told me that ‘it’s ok to not be okay’ until you did. Thank you for reminding me that we’re human.”
Chief Medical Officer (after Summer Wellness Workshop)

Mark your calendars! The first bit of support is through a free workshop on November 10 at 6pm. Beyond Burnout: Navigating your way through trying times as a provider. In this workshop, we’ll discuss symptoms of burnout, what’s contributing to burnout and how to address what we’re going through. I promise you, I’m not going to give out nuggets that focus on eating better, getting sleep and taking a vacation. I mean, that’s all-important, but I’m going to give you tangible things you can do to address overwhelm. Let’s be honest, we need to focus on what’s possible and practical. And more importantly, when we only focus on a few parts of self-care, we miss the big picture! We’re going to walk through actionable steps you can take to address overwhelm and find more purpose in your work.

Register for this free workshop here.

Join us! Many of you have joined us for Refresh – our monthly meetings for providers to gather as a community, gain tools around resilience-building and gather resources to support your patients. Well, Refresh will now be known as The Provider Lounge: A Community to Build Resilience. The Provider Lounge is a community of like-minded medical providers that want to focus on building resilience in their patients and themselves. If you’re looking for a place to find purpose, create meaning, and respond with practical tools that build buffering forces for whatever our patients face, this is the community for you!

The Provider Lounge is also an online portal for providers. In it, you can access tons of content that build resilience for your patients including scripts, videos, resilience interventions, and cards for connection.

For now, The Provider Lounge is free! Come to a meeting and check out the portal. If you want access right away to see what’s going on inside, just reply to this email and I’ll send you a login so you can join us. Our next community gathering in The Provider Lounge will be Thursday, November 4 at 12:30 pm. And yes, all meetings are taped so that, even if you miss us, you won’t miss the gems!

Join us via Zoom on November 4th at 12:30 pm for The Provider Lounge.

OK friends, I hope you feel like help is on the way. I’m working hard to make myself available, provide resources and free support as much as possible.

See you November 4 and November 10th! Mark your calendars now!

Speaking of free and easy…. did you know that 90 seconds of deep belly breathing has been shown to decrease cortisol by 30%??? Yep – breathing is straightforward and simple – but we don’t always take time to do it.

So, deep breaths friends, help is coming!

With compassion,

Dr. Amy

Friends,

I thought I’d make it easy on you as many of your patients with children, or patients who are children, have questions about returning to school this fall. Delta variants of COVID cases are rising, mask mandates are in effect, parents still linger with vaccine questions – all of this creates a bit of angst as the calendar turns and school plans begin.

Feel free to use this as a handout for parents as you navigate questions during visits about returning to school this fall. Sign this with your name, you clinic’s name – just make it easy. Or print it and hand it out, or use it as a script. You’re going to have to give this speech a thousand times!

With kindness and compassion,

Dr. Amy

Friends,

A young nurse and I spoke recently about her experience of secondary trauma. She indicated how she’s worried about her small patients and the tiniest of errors she might make that could have life-altering results. She admitted to ruminating about drawing blood from PICC-lines, moisture in ventilators, and uninvolved parents in patient care. She reported worrying about COVID, TBI, and violence even when she’s not at the hospital. She exhibiting symptoms of early career compassion fatigue and vicarious trauma.

I sat. I listened. She was tearful and full of anxiety. We discussed the pressures of medical care and the drive for perfection. She also admitted that she was terrified to talk with colleagues about her worries, fear of mistakes or overwhelm because she was certain that they would see her as incompetent.

Any of this sound familiar?

We live in a performative society. Medical models perpetuate a complexity of perfection, hero complex and unreasonable expectations of human performance. And, by the way, all of that cloaked in messages of stoicism. Never let them see you sweat. Save others, deal with your needs later. Don’t talk about overwhelm or uncertainty for fear of looking incompetent. And self-care? It’s a great idea…for someone else.

I’m not going to scold you or shame you or even judge you for the space that’s been created – not by you, but through decades of creating a culture of perfection and performance. But what I am asking, in fact begging of you is this: Can you put down your capes? Not always, but sometimes? You are heroes but you need not be heroic all of the time. Medicine can be BOTH life-saving and life-draining. It can be fulfilling and exhausting. Recognize that the cape is heavy and after 18 months of healing during a pandemic, it’s a bit tattered.

I simply want to provide a space where you can be human, seen and accepted for being a WHOLE person. Healing begins with acknowledgement. Often from others first, then through grace and self-compassion, for ourselves.

You can pick the cape up later, I promise. Or change in a nearby phone booth – wink.

PS – if you’d like to take my newest creation for providers – Healthcare Provider Burnout Quiz, you can find it here and share with friends. Let’s continue to talk about all of the overwhelm!

With compassion,

Dr. Amy

Over 1,000 engagements on social media….and several “shares.” This tells me people are hungry to be reminded of this message from Wes Angelozzi:

It’s one of the core assumptions I teach to parents, providers & teachers – unconditional love. We all get stuck here, especially those who’ve not received it in their childhood. But it can transform relationships and earn secure attachments.
 
I encourage you to try it on… or suggest that someone else do so. Unconditional love is what we all crave and what children require for healthy attachments.