Blog: Wellness in Cardiothoracic Surgery, by Dr. Amy Fiedler

Amy Fiedler is a senior cardiothoracic surgery fellow at the Massachusetts General Hospital (MGH) in Boston, Massachusetts.  After completing medical school at The George Washington University, she joined the 4+3 integrated cardiac surgery training program at MGH which she will complete in December, 2018.  Outside of cardiac surgery, Amy is passionate about endurance sports, having completed 5 full distance ironman triathlons while in surgical training, her family, and her French bulldog Lucille.

Email:  fiedleramy88@gmail.com

Twitter:  @FiedlerAmy

 

Wellness in Cardiothoracic Surgery:  Isn’t that an Oxymoron?

Wellness (noun):  the state of being in good health, especially as an actively pursued goal.  According to Wikipedia, the term wellness was partly inspired by the preamble to the World Health Organizations (WHO) 1948 constitution which states: “Health is a state of complete physical, mental, and social well-being and is not merely the absence of disease or infirmity.”1  The experts define eight dimensions of wellness:  emotional, spiritual, intellectual, physical, environmental, financial, occupational, and social.  They say focusing on these components will optimize health and allow an individual to be considered “whole.”

Feeling “whole” sounds like a pretty incredible option when you are in the middle of what can be a grueling cardiothoracic surgery residency or career.  There are patients to take care of, operations to perform, books to read, and papers to publish.  Not to mention, you need some time to brush your teeth, rest your eyes, and see your family. So, one may ask, how is it possible to focus on eight additional life dimensions when it is so easy to develop such a singular focus on cardiothoracic surgery that there isn’t any space for other aspects of life including being healthy or connecting with others?

When I reflect on the definition of wellness, I think the key statement is that wellness is an actively pursued goal.  At an early stage in my training, I found myself burned out, tired and emotionally exhausted.  During this time, I was laser focused on work and research, to the point that I had entirely stopped doing certain things that provided me with fulfillment, as I was confident that they took time away from my surgical development. I stopped exercising entirely (despite being an NCAA Division I runner in college) and although I am an extrovert, isolated myself socially.  I was convinced that this strategy would allow me to thrive during my training, leading to a laundry list of publications, technical excellence, and a worthy fellowship.  By definition, I was healthy, since I wasn’t sick or infirm, but I wasn’t well.  I had become a shell of my actual being in an attempt to obtain clinical excellence.

Then one morning I woke up.  Well, I think my pager went off, but I was up nonetheless.  It was 4 AM. I couldn’t fall back asleep, so I went for a run.  I hadn’t gone for a run, something I used to do twice a day, in over a year.  I was out of shape, I wasn’t fast, and I didn’t make it much farther than 3 miles.  But the run invigorated me.  The rest of the day I felt energized, focused, and I found myself to be more productive.  That was the first time I had felt like myself since I began residency, and it was because I took 30 minutes for myself, as an actively pursued goal, to make myself feel whole.  I was experiencing wellness.

This rejuvenated my passion for endurance sports.  I began to look forward to my busy daily clinical schedule again, especially when I was starting my days with a run or a bike ride.  I re-engaged socially with friends and family, and my performance in the hospital improved.  I used time management skills to actively develop a schedule that allowed me to be personally successful (well), which for me, meant blocking in time for athletics.  This was time well spent, because the result was mental clarity, a positive attitude, and work satisfaction.  I channeled this energy all the way through 5 full length Ironman triathlons, a Boston Marathon, and countless local road races during my cardiothoracic surgical training.

While a full discussion of time management, and how I can train for ironman triathlons while a cardiothoracic surgery resident is beyond the scope of this piece (hint:  a bike in my call room, a very supportive spouse, I’m happy to answer any questions via email or twitter), the driving point is this:  wellness is an active processFor me, to be well was figuring out that it was important for me to have endurance sports in my life.  For you, it may be building a garden, spending dedicated quality time each day with your spouse, or rock climbing.  I encourage you to identify one aspect of your life that if actively pursued would make you more whole, and then go do it.

We as cardiothoracic surgeons are a busy group, participating in a high stakes, stressful, yet incredibly rewarding profession daily. We may not have as much time as the average individual to focus on wellness, however we owe it to our patients, ourselves, and our families to be as well as possible.  Krall has eloquently developed and published the “Ten Commandments of Physician Wellness” and I will leave you with the fourth commandment:

“Remember what is holy to thee…physician-hood cannot be lived in isolation from total life beliefs..defining a strong sense of purpose gives sustenance in the face of adversity and is a powerful source of motivation, determination, and resilience.”2

Be well!

References:

  1. Kirkland A. What Is Wellness Now? J Health Polit Policy Law. 2014;39(5):957-970. doi:10.1215/03616878-2813647.
  2. Krall EJ. Ten commandments of physician wellness. Clin Med Res. 2014;12(1-2):6-9. doi:10.3121/cmr.2013.1211.