“Wholeness is never lost, it is only forgotten."
—Rachel Naomi Remen, M.D.
The rigors of academic achievement often begin early in a physician's life, with considerable sacrifices to meet them. Along the way, many physicians acquire a well-practiced, fierce standard of perfectionism. That standard is reinforced by a training culture that seldom prepares for human experiences of self-doubt or uncertainty. Physicians are traditionally expected to command a room and remain in control—while so often events, like the repercussions of the pandemic, are beyond an individual's control. The unexpected collision with one's own vulnerability can feel intolerable, overwhelming, and even inadmissible. Yet emotions are a critical source of intelligence, both in personal and professional relationships, and being cut off from them is a source of great suffering and isolation. For physician well-being, we must acknowledge the right and imperative for physicians to remain fully human.
In addition, physicians are commonly exposed to direct, secondary, or vicarious trauma in the medical setting—sometimes on a chronic basis. This can result in PTSD symptoms that disrupt sleep, relationships, focus, mood, and self-regulation. In a crisis such as the pandemic, there is also risk of moral injury, when circumstances arise that are incongruent with a physician's long-held values and personal standards. Such experiences can result in compassion fatigue and profound disconnect from patients, colleagues, work, even a partner and family, and constitute a seismic jolt to the physician's identity. None of this is a sign of personal failing. Instead, it is a crucial summons: the providers of care cannot themselves be deprived of it. I honor your service as physician, and offer the safe, confidential place to explore and receive steady support for these challenges—as well as practical strategies for preventing future crisis. Conjoint sessions with partner or family members are also available.