Most of us on a day to day basis just get through the day with The Big C – That’s right: c.o.f.f.e.e.!!. The line up at the hospital café first thing in the morning before ward rounds is worse than peak hour traffic. There are mobile latte vans that visit our surgeries in private practice. We need our coffee. When we have breaks in the day, we have more coffee, and yes, we like the taste, and the smell, because its amazing!!! But, how well do we feel without our coffee? And that’s a telling point…..
If we are needing sugar and caffeine to get through the day, then there is something not quite right. Apart from its taste, it is a stimulant, it heightens the nervous system, and then it drops us again.
Animals don’t need stimulant drugs to make it through their days. Dogs do great without it. They’re pretty happy too. So, as an interesting note, why do we?!
Can we really say that we are living well and truly vital if we are needing stimulants to get through the day?!
The history of doctors and their association with stimulants is well known. Not, that it is something to aspire to, just something to be aware of ? I once read that one of the founders of a famous US teaching hospital was addicted to cocaine having to give himself a dose each day just to function….I do not know for sure if that story is true, but as we know in medicine our rates of addiction are high, and they are not even measuring our addiction to caffeine… ?
Most of us are so used to feeling tired that we think it is normal. But, whilst it might be the norm in our profession, its actually is not natural to feel so tired and exhausted that you can’t get through a day without a stimulant! That is a sure sign that we are not as well as we could be. We’ve just become used to this way of living that it is ordinary for us, and its become a collective team activity at morning tea time, or post ward round….
As health care experts, why do we accept being so tired as our normal? Why are we tired only a few short hours after waking up when sleep is supposed to regenerate us and give us energy?
Can we say it is something of being truly well to need a drug like caffeine (as tasty as it is!) to keep us going?
Lets face it, as doctors, we are so used to dealing with the most horrendous diseases, that we consider that if we don’t have a disease that we must be well!
But being chronically tired, is not part of a state of well-being.
Being well is more than the absence of diagnosed disease.
To me, a state of well-being is feeling fully energised joyful, vitalised on waking and during the day, having a sustained zest for life. It is a wonderful feeling on the inside, not just the absence of cancer.
Most of us feel grateful that we don’t have a horrible disease. But what if there was more to well-being than just not having disease!
If we knew what well-being really was, might that give us a benchmark to work towards?
Statistically, we know that our well-being as doctors as a group is not so good! 41-55% of us are burnt out. We have high rates of depression, and higher rates of anxiety, high psychological distress, suicidal thoughts and suicide rates than the general public. And what about the rest of us? Are we truly well, or just free of ‘diagnosed’ conditions….
I feel its important as doctors that we check in on a regular basis as to how well we are feeling. Often we don’t notice we are not feeling well until it is too late. We are often so busy trying to make it through our days, to do all the work and do all of the studies, that we forget to check in on our own state of health and well-being, until a disaster strikes.
We live in survival mode, not thriving mode!
Here are some key questions to consider to reflect on your state of well-being:
1.Do you feel energized when you wake up?
2. Do you feel energized and full of life during the day, without the need for sugar or caffeine….or social media?
3. Do you feel joyful during the day?
4. Do you enjoy who you are when you are at work?
5. Do you look forward to going to work?
6. Do you feel that your life has purpose and a deeper meaning?
7. Are your relationships with people truly loving and caring?
These are all positive indicators of true well-being!
1. Do you slump by mid-afternoon, or perhaps 8am….?
2. Do you struggle to feel alive by the end of the day, or the end of the week?
3. Do you find it hard to get out of bed on the weekends or wish you could stay in bed all weekend – except the kids get you up for sport!
4. Do you need coffee as a kickstarter for the day…..and/or an energizer during the day? And if so, how many sugars….
5. Do you need alcohol to unwind at the end of the day?
6. Or perhaps, do you need to take recreational drugs to cope with life, to get a ‘buzz’ more than daily life?
7. Do you have pains in your body, or your body ache for no reason at all?
8. Do you feel stressed much, if not all of the time?
9. Do you feel anxious during the day?
10. Are you plagued with thoughts of self-doubt, questioning, and self-criticism?
11. Are you your own harshest critic?
12. Do you feel ground down by the working environment, feeling that nobody appreciates you and/or that nothing you do makes a difference?
13. Do you struggle in personal relationships with frequent fights, tensions and irritabilities and/or completely try and avoid people?
14. Do you count down the moments until you can leave work to go home and deal with the day and/or hide from the day?!
15. Do you feel like you are on your own with no-one to back you up or to hear what you have to say?
If you answered yes to any of the above, then that is a sign that you are not feeling as truly well as you could be!
Negative thoughts are not a sign of well-being! We may live with them, but they do not make us well nor reflect a state of well-being.True well-being begins with a true care for oneself, that automatically extends to being a true care for all others.
As doctors, as a profession we are not well on the whole. We generally accept lower standards of health and well-being as ‘normal’.
- We accept chronic tiredness as normal.
- We accept constant high levels of stress as normal.
- We accept poor eating as normal.
- We accept and encourage negative self talk as ‘normal’.
- We don’t recognised when we are burnt out until it is extreme!
- We accept environments of bullying, harassment and intimidation as normal, and perhaps even participate in these ourselves!
While we are accepting these feelings as normal, it is not possible for us to live in a way that makes us feel truly well. And whilst we do not consider true well-being possible, we will accept our systems as they are and nothing will truly change.
As doctors, it’s not just important that we are disease free, it is important that we are leading truly well and joyful lives.
We deserve it, just like everybody else. After all, we are people too.
We need to empower ourselves to accept that true well-being is possible for us all, and to check in regularly to see how well we are truly feeling – and not just whether we still have a pulse!
If we can check in and see that we are not feeling truly well at times, we can begin to address the things that are affecting us adversely and then make changes to take care of ourselves more deeply to live in a way that supports our health and well-being, instead of placing strain on it.
So before things reach crisis point, check in and see how you are doing. Self-awareness is the beginning of your personalised path to true health and well-being.
Dr Maxine Szramka (MBBS Hons 1, B Med Sc, FRACP) is a physician based in Sydney who works full time in private practice in Rheumatology. She runs her own business, is a university lecturer, and is the founder and director of a research council. She is a sought after educator in health care, both for patients, peers and students, serves on the editorial board of an international peer reviewed journal and is on the peer review panel for Rheumatology for another international medical journal. She has had a vast experience in different fields of medicine before specialising in Rheumatology and her interests and experience in life and medicine are diverse.
Maxine is passionate about and an advocate for the health and well-being of the medical profession. Equally passionate about education, equity, equality and empowerment, with a deep care for all people, here Dr Maxine writes on health, well-being, medicine, science and society. Stay tuned for her healthy lifestyle tips!