The call came on Monday night, a medical school classmate calling to ask for information and a referral. His daughter was about to deliver a premature baby in a city far away. I am sure you have all been in a similar situation - the opportunity to fulfill an oath you took when you graduated from medical school, for me 40 years ago, "My colleagues will be my brothers." Fortunately, his daughter was in a city where one of my former neonatology fellows now practices. Connections were made, the baby was born and is doing well, and my classmate is a new grandfather. But the next few months will be stressful for him. His daughter and new grandbaby are far away; but he is tied to his work here in town.
Where now lies the fulcrum of his work-life balance? At what point will an imbalance lead to burnout, frustration, anger or bitterness? If that time comes, how will it affect the care he gives his patients? What will be his resiliency? Will he cope and will it be in a healthy way? Will he have the self-awareness to recognize if he's tilting towards dysfunction?
Much has been written recently about physician burnout and about achieving a "work-life balance." But I have trouble with this term. Isn't work part of life, not something entirely outside of it? Besides, for me plenty of good stuff happens at work - it's not like work is all bad. And, if we do accept the term "work-life balance," is it an equal-arm balance? With time as the beam, do our days teeter-totter back and forth unsteadily, "work" on one side and "life" on the other, see-sawing to find that balance? Are the arms hopelessly one-sided?
Perhaps a better model is that of an unequal-arm balance, much like the one Larry Martin, MD, my primary care physician, uses in his office to weigh me. Today my life in all its complexity, and alas all 200 pounds of me, is equal to the weights adjusted along the graduated scales of the front and rear beams. I can largely choose the weight and composition of my life, given luck, much as I have some control of my body's weight and composition. This takes self-awareness, attentiveness, resources, commitment and, at times, the support of friends and colleagues.
But I must admit I am not an expert in this. And, as I will have to explain to Dr. Martin why I weigh more this year than last, I had to explain to my lovable daughter why I was working on this article, two weeks past the deadline, while sitting on the porch of our lake house on my weekend off. But I did not find myself unhappy in doing so.
When all is said and done, perhaps we all need to accept that our lives are complex and always a little out of balance. And that life can, as it did to my medical school classmate, hand us some weighty issues that tax our coping skills. Perhaps in the end, the most important things for a happy and healthy life are:
We have time to reflect on our lives and recognize what makes us happy and what stresses us out,
We know the resources available to us to get our lives back into balance,
We have a commitment to keep working on it, and
We have supportive friends and colleagues who are watching out for us and willing to fulfill the oath we all took when we became physicians, "My colleagues will be my brothers" and sisters.
So I encourage you all to take time to reflect on your lives and careers. You are in the best profession ever! And, you are doing important and meaningful work. But it can be stressful. Become aware of the signs of stress and burnout in your daily life. Know that the most important resources you have are the people around you: your family certainly, but keep close those physicians and colleagues who can and should support you, in the doctors' lounges, in our offices, in conversations and gatherings, in our own medical society. Do not hesitate to call on each other. We all took the oath.