Welcome to Talk EM, brought to you by the Emergency Medicine Institute, where our goal is promoting clinical excellence. Today we’re going to talk about preventing burnout in medicine. It’s going to be very personal.

What I find in life is that when it comes to something like fitness, I don’t want to hear a theory. I don’t want to hear somebody spout out theories about weight loss. I want to hear about somebody who was heavy or lived an unhealthy lifestyle and made changes in his life. I want to hear about his experience. When it comes to business, I don’t want to hear a business theory. I want to hear from people who’ve been there and done it. They ran a business, got to a higher level than I could ever get to. I want them to tell me what they did. I don’t want to hear a child psychologist spouting theory to me about raising children. I want someone who’s had some struggles to talk about their experiences with me.

When it comes to managing your mental state and preventing burnout in medicine, I want to share with you what I’ve done. I feel that my life has changed significantly in the 20 years I’ve been a PA. My hope is that I can give you some tools that are very personal to you. If it works, that’s great. If it doesn’t work, that’s okay too.

An Outer Circle and an Inner Circle

One of the things I am constantly challenging myself with is two circles. There’s an outer circle and an inner circle, like the bull’s eye of a dartboard. The outer circle is my circle of concern and the inner circle is the circle of influence. I’m in a phase where I don’t want the stress, struggles, trials; I don’t want the drama in my life. I am always asking myself, “Is this something I’m concerned about or something I can influence?” Because if it something that I cannot influence, I let it go. I don’t let it affect a single percent of my life.

If I can’t control it, I let it go, and I don’t let it be a burden to me. I’m constantly asking myself, “Is this something I can affect, or do I just need to accept it?” It’s the classic Serenity Prayer, “God, grant me the serenity to accept those things I cannot change, the courage to change the things I can, and the wisdom to know the difference.”

I live by that. I travel often to do lectures and it’s not uncommon that plans get changed. Flights get canceled. Weather changes where I’m teaching and I don’t let it affect me one second. My heart rate doesn’t even go up because if I can’t control it, I let it go. I know I cannot control the news. I can’t control what happens in the news and in the world, and therefore, I don’t watch the news. I don’t let it be a burden to me and it’s tremendously freeing.

A Monkey Trap

There’s what’s called a monkey trap. A monkey trap is a legitimate trap where they take a box or a coconut, and they bore a hole on the top of it and they put a banana inside. The monkey will smell the banana, come up, look inside, see the banana, grab on to it and try to pull it out. However, when it comes out perpendicular, the whole of the banana won’t come out, so the monkey keeps grabbing it, shaking it, grabbing it, shaking it, and that’s a monkey trap because the poacher will come up behind the monkey. The monkey tries so hard to get the banana out that it won’t let go, and it gets captured.

My experience in life is that there are things we hold on to and we don’t let go for a number of different reasons. Resentments, grudges. There are a lot of things we hold on to that keep us trapped; there are a lot of things that I held on to that kept me trapped. At times, we don’t even know they’re holding on to us. We don’t even know they’re holding on to us until we have the courage to look deep. I’d like to ask you right now, what are you holding on to that you need to let go of?

If you let go, there is tremendous freedom. Tremendous freedom from something that was holding you back from really seeing your best self, being your best self. I also know that at times, we hold on to resentments because it gives us fuel to behave in a way that we may not be able to justify if we didn’t hold on to it. The monkey trap is about holding on to things that we should probably let go.

When you think the problem is out there, that is the problem because you’re giving up your locus of control; you’re giving up your power to control your life. You’re holding on to stuff that you probably should let go. Remember, ask yourself this question, “Is this something I’m concerned about or something I can influence?”

Ask Good Questions

Albert Einstein said it this way, “The significant problems we face today cannot be solved at the same level of thinking we were at when we created them.” I pondered on that for a long time. I didn’t quite know what it meant; I knew it was important, but I didn’t understand it.

I went to a Cirque du Soleil show and saw Mystère, and on the inside cover said something that really summarized what Einstein said, but in a way that I can apply it. It said, “Real solutions will emerge when the questions become more important than the answers.” Real solutions in your life will emerge when you start asking better questions.

That is exactly what Albert Einstein was saying. He’s saying that if you keep asking questions with the same thinking that got you into the position you’re in, you’re going to stay in the purgatory. You’re going to keep asking crappy questions and keep getting crappy answers.

I now ask much more empowering questions like, “What am I supposed to learn from this?” I’ll ask questions like, “What part of my leadership led to this result?” I’ll ask, “Where are the blessings in this situation that I can’t quite see yet? Where’s the humor in the situation that I can’t see yet? How is this going to make me a stronger man, husband, father, entrepreneur?”

We control our thoughts by asking empowering and extraordinary questions. Unfortunately, we ask a lot of questions on a subconscious level that are terribly disempowering. We keep asking, “Why does this always happen to me?” Your brain is going to answer that in a way that doesn’t empower you. This week, when something taxing, stressing or energy-draining comes up in your life, think about what questions you’re asking yourself in these moments. Try to think about, this week, when something happens, what are some of the situations that are coming up in your life that are taxing, stressing, energy-draining, and what questions are you asking revolving around those questions?

Voltaire said, “Judge a man by his questions rather than his answers.” I love that.

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