Resiliency is the human character trait to suffer an insult and return to a state of dis-despair, to return to one’s homeostatic equilibrium. In life we all will encounter problems, errors, disasters. How we deal with it, is how we come to be resilient.

As physicians, we must take our own advice and practice what may seem the least glamorous part of medicine: preventative care. One way in which we can do this is by taking advice from improvisational comedy. The concept of “Yes, and…” is practiced by an comedian agreeing with another’s statement and then furthering the point along a similar train of thought. In a way, employing it is to accept what’s been presented, foster an armistice with it, and from it create something more. Forge a new solution together. See more in this article, or listen to drunkroomates. Conflict resolution is easy when both parties cooperate as opposed to compete.

One tactic you can employ when another person is competing, and aggressively, is to react with non-complementary behavior. When you walk into the room and someone is already yelling at you, the usual response is to react in kind; you yell back. They expect this, but if you were to act in a different behavior, discordant with their disruptive flow, and more akin to how you would want the conversation to go, namely pleasantly, they may also respond in kind. Listen here on NPR.

And when we finally suffer the pangs of life, we must cope. As students, we memorize the mature and immature and we ought to apply them to ourselves. Mature coping mechanisms consist of sublimation, altruism, humor, suppression. In all of these, you focus your negative emotions around a stressor into something more productive: athletics or a hobby, a park cleanup or good deed for your neighbor, a joke, or into the nothingness that they are worth to you. Read on with the positive psychology program.

Coping immaturely will likely cause more problems then cures. Withdrawal, avoidance, isolation, acting out, passive aggression. We all commit these sins. As bad habits, out of necessity, as rationalizations for our selfish well-being – they are the easiest way out. Knowing what these are and recognizing when commit them is the goal of introspection and self-awareness. Through this, we can fulfill the Kantian moral duty of self-improvement.

Finally, tell your story. Verbalize it, make it tangible, impart it to a listener. Experience another’s empathy and allow yourself to be nurtured. Be grateful for them. Then be grateful for yourself for having the courage to be vulnerable.

Physician burnout

As physicians, we all decided to help others. Those of us in Emergency Medicine decided to help others at their most ill, at the most traumatic moment in their lives, or at their wits end as far as where to seek answers. Sometimes we can help, and sometimes we cannot. Regardless of what their reason or our ability to meet their expectations, patients come to offload some of their burdens of life. Maybe they can no longer care for themselves because their sepsis has drained them of all their energy. Or their addiction to substances (despite the number of times you’ve counseled them on breaking their habit) has brought them back to us either for either intoxicant effects or the pangs of being without for too long.

Regardless, we can feel the burden and it manifests as burnout. Burnout is a syndrome exemplified by emotional exhaustion, depersonalization and a sense of lack of accomplishment. It manifests in those whose careers aim at working with others. While stress is a normal part of life and work, when we cannot defuse the stress between shifts thereby allow it to build up will we be in danger of experiencing burnout. The syndrome can lead to us making clouded medical decisions which can have disastrous consequences.

Some studies suggest 1 of 3 physicians are experiencing burnout at any given time. The Medscape Physician Lifestyle Survey shows an increase of self-reported burnout from 39.8% in 2013 to 46% in 2015. Whether we don’t have enough time off between shifts, work too many shifts to pay off loans, or simply keep our feelings inside, it exists and knowledge of it is essential. Many of these habits perhaps are inculcated from medical pedagogy since day one of our education.

But there is a cure. Recognize it. In ourselves. In others. Talk about it. Talk to each other. Be there for one another. Recommend healthy coping strategies. Provide an ear. The National Academy of Medicine has validated tools for you to determine if you are burnt out.

As physicians, we have an obligation to patients. But as humans, we have an obligation to ourselves.