Wellness Series - Episode 3 LaTonya Russell, MD

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Transcript

Speaker 1: 0:02

You weren't listening to vital signs, a podcast for Sentara providers. Welcome to episode three of the wellness series. In today's episode, we are joined by Dr. Tanya Russell pediatrician with Sentara family medicine and pediatrics at Edinburgh. Before we turn things over to Dr. Russell, let's go over some important Sammy announcements. This episode has been accredited for AMA PRA category one credits for detailed accreditation and designation information. Along with disclosure information, please visit the show notes. This information can also be found on our website www.sentara.comforwardslashphysicianeducationaswellasalwaysreachingusbyemailatphysicianeducationatsentara.com. Here is Dr. Russell.

Speaker 2: 0:59

Hi, all my name is Tanya Russel and I'm a pediatrician with Sentara medical group working out in Chesapeake. And on this wonderful day, I offered to you another talk from our wellness series today. I want to speak with you a little bit about something called gratitude. I know over the last few months, weeks, years there've been various topics that we have discussed that lends itself towards the theme of wellness and resiliency and how we can keep ourselves healthy, both mentally and physically, as we all know that the mind and body are intertwined yet, despite all of the many changes and demands that are put upon us as healthcare workers, we still must remain healthy. Now, when you think of gratitude, it is such a simple concept and word yet. It is often very hard to have some times that's simple word of gratitude. Thinking back on the last year and a half to two years, I can imagine that for some people, it would be very hard to even think about being grateful or being thankful for anything that's happened in this world. However it is during our trials and our struggles that we often should think about gratitude and is quite a huge shift in our thinking a huge paradigm shift in our living gratitude is often hard when you have been faced with so many hardships, like we have been for the last year and a half a simple thing, gratitude. So just take a moment and think about what gratitude is and what it is not. What does it mean to you now, as I said before, over the last year and a half, we have struggled through so many challenges and yet, so far we're still standing and pretty tall. I might add, we may be a bit bruised and battered. We may even be limping or crawling, but we are still here. And the reason is because at our very core, there is resilience at our very core is gratitude. But often times when you're just surviving gratitude as a last thing about which you want to think, you're just really trying to get through the day. Am I right? I'm sure. After the last, almost year and a half, we've heard so much about gratitude and positivity sometimes. Is it a bit too much? Yeah. And other times it's not enough. And the reality is is that during these challenging times, who really wants to think about gratitude, who has the time, and I can understand, or really empathize with someone who feels this way, but I would also encourage that same person to think a little differently, not in our toxic positivity type of way, but in an every day, witnessing a bird flying or a patient simply saying, thank you, that kind of gratefulness, that kind of way. You know, you know, everyone is talking about these buzzwords of resiliency and burnout and loss, but no one really talks about how we can control these things for ourselves or even work to make change in our broken healthcare system. We often don't talk about how we can change these things on our company level either. Yes, we may often vent to our friends, our colleagues, but we don't always discuss the ways of changing the environment to help prevent us from feeling these ways. And to help us bounce back, we can tell our patients or even our friends what to do and how to live, but we don't really know how to be kind to ourselves as healthcare workers. We go, go and go. And we push ourselves until we are well past E. And so what I want to question you with is when you're empty or you are an empty, well, how can you get water when you're thirsty? If the well is empty right now, many of us are dry and thirsty and we need a break. We need a recharge right now. Many of us are just surviving. Now the trick is for us to determine how not to survive or just survive, but to also thrive in spite of our stressors, we are indeed in a demanding profession and medicine will always take its pound of flesh. And for this reason I am so focused on something like gratitude. It is because of that simple shift in our thought process and our living process that can often be the difference between life and death, not being able to thrive in spite of the stress is one of the reasons why physicians are more likely to commit suicides than any other profession. And twice that of the general population that's staggering right now. We don't know that while we want to change many things in a system, a lot of things are beyond our control and that is uncomfortable, but there are things that we can control. And what we can control is how we respond to our situations and sometimes thinking about what we have versus what we lack is the key to thriving. So sometimes talking about yoga and talking about eating well and sleeping well, et cetera, et cetera, is what we need, but let's not forget. That is the only thing that needs to change. So now is time that we start to dig a little deeper about gratitude. We're going to take a step back a little bit and try to hit the reset button. So what is gratitude you ask? Well, according to Harvard medical school, gratitude is a thankful appreciation for what an individual receives, whether tangible or intangible with gratitude. People acknowledge the goodness in their lives. As a result of gratitude. It also helps people to connect with something larger than themselves, whether it's a people nature or a higher power. So that's according to Harvard medical school. And since we are very science-minded people, I'll just remind you that there is a little bit of evidence that supports how will changing our mindsets can help us with our health. So I'm not going to go into detail, but just know that there are studies that do support being in a grateful mindset. As I said, I'm not going to list them for you, but just trust that there's a lot of evidence and studies that are starting to show the benefits of being thankful and having these feelings of gratitude. And as I've said, oftentimes we think too much about what has gone wrong. And we don't think about what has gone, right? For example, when a patient dies, even if it was expected and we have tried to mentally prepare ourselves for it, when it happens, what do we do? You got it. We often just think about what we could have done better, what we could have done differently. We don't think about what we did to save them. Even if it wasn't successful. We don't think about what we did to make their last days a little bit better. If these things happen to you, do you think about what you could've done to our longer lives? It's okay if you do, because that's one part of what medicine is about, what can I do to save this life? What could I have done to make life better? What can I do to keep people healthier? And for those of us in healthcare, we think of death as a failure. When it's not, sometimes we should be grateful even for death for it is a glorious part of the circle of life. Now I want you to take minute and think again, just think about the last 24 hours. What has been one of the best thing that has happened to you got that thought now think about it. Did something come easily to your mind? So let's think about something else. What was the worst thing that happened to you today? Was that easier? So now that you've thought about the best thing and the worst thing that happened to you within the last 24 hours, how did it make you feel to think about one versus the other? Did you think about the negative thing and then begin to spiral down this hole of, oh my gosh. And then this happened and this other thing happened and then this thing happened, conversely, when thought about the good thing, did it make you smile? Did it make you happy? Think about what your response is and kind of check how your brain works. Are you more inclined to be able to think about the negative versus the positives or positives and more than negative, and then realize that's how we have trained our brains to think. Okay. So now we're going to shift a little bit and we're going to talk a little bit about something kind of related to gratitude and that's your why? No, I think it, it may seem a little bit jumble, but it'll all come together at the end. So just take a moment just for a brief moment, close your eyes and they'll take a deep breath and blow it out slowly. They'll think about it. What is your, why? Why are you a healthcare worker and then as an extension also think about what is it that keeps you going? That's the pause on this recording for about a minute and really think about it once you've thought about it, take a minute and just jot down one or two lines about why you're a healthcare worker and what it is that keeps you going. Okay. You're good. Did you ate, were you able to write it down? So are you familiar with a Greek tragedy in a Telus who wrote in the Greek play? Promethease bound that like some inferior doctor who has become ill you're in despair and unable to discover by what medicine you yourself can be cured. Now, while he talks about a doctor, it serves for any of us in healthcare who so selflessly give we as healthcare providers, we give moral directives, which we don't apply to ourselves. We should be attending to ourselves while attending to others. And oftentimes we spend more time caring for and thinking about our patients or our friends or our family than we do tending to ourselves. We are then gasping for air because we forgot to put our own mask on. We suffocate and we don't know how to put the on ourselves to give ourselves oxygen. We don't know how to allow our Wells to be refilled. So there, when the dry and service STI and struggling. So this one piece of the mask is how do we change the things that we see and make them more positive? How do we change our interactions so that they become more positive, this mask that we're building to give ourselves oxygen or this well that we are rebuilding so that it doesn't leak out all of the precious water that sustains us. That's what we're talking about today. Just one piece of that mask. So when we start to talk about gratitude, part of what we need to do is to go back and to think about the things that are important to us. Again, all kind of going back to this, what is your why? We also have to think about what motivates us to keep going, because in that we can find our gratitude. Once we are to know our, why we can then reconnect with our original mission as to why we went into healthcare, and this can make figuring out gratitude so much easier. So we're going to do another quick kind of writing thing. So just, if you don't have a sticky note or a piece of paper, just go ahead and grab one. You can pause it again. I want you to close your eyes and just concentrate on two questions. One, think back to college. When you started applying to medical school, PA school in peaceful nursing school, business school, think about your white coat ceremony, your graduation. Think back. Why did you want to become a part of our healthcare system? Why did you want it to become a provider of healthcare versus a teacher or a lawyer or a fireman or police officer? All those other professions are helping for oppressions too. But why did you choose medicine and number two. So fast forward now to today and think about why are you still a provider of healthcare? Why are you still working in the business of healthcare? What do you love about it? And then conversely, what do you hate about it? Try to be cautious, not to think on so much of the why you hate it. If that is your inclination and try to think more on why you love it, but whatever, it's your writing. So you take your moment. If you're not a writer, take a couple of minutes to meditate on it, just think, think about it. So again, why did you decide to go down this path and then are you still happy with this path? Why are you still on it? Okay. So take those two pieces of the paper that you have and just think about it. Why are you grateful for being a healthcare provider again? Think about just how far off or how close you are to your original goals, to where you're now, or do they still actually mirror each other and if they still mirror each other, well, man, that is something for which to be forever grateful. And if they don't then kind of take a step back and kind of think about, well, what is it that you are missing now? Now I know what I'm talking a lot about being grateful and what you're grateful for may not even be remotely rated related to medicine. It could be your family. And that's what keeps it in your medicine, providing care to someone the way in which you would like for your family to be treated. It could be because you have this insatiable passion to just do good and be good. And to help those who are misfit fortunate. And you can think about these things, your family, your friends, these may be your purpose and your reason why you're practicing medicine. So now that you've written these things, guess what you have just written your first part of your gratitude journal. And that brings us to our next part. So when we think about gratitude or gratitude journaling, as I've said, no, I don't mean that it has to be some long ingrained journal. It could be writing three things on a sticky note for which you were grateful or putting it on a scrap piece of paper, or it could be this great, wonderful leather bound journal. It doesn't matter. But when you do gratitude journaling, when you do this every day or couple times a week, it forces you to pay attention to the actual good things in your life. And with time it'll will eventually change all you see, and all you think about life. You'll be less likely to think about the negative and more likely to think about and see the positive. Now we often just take the good things for granted. So as an extension of thinking about the good journaling can help us to continue with these feelings of gratitude. We can start to pay attention to the everyday sources of pleasure and our world. Not only thinking about these things and the events that help us, because putting your thoughts into concrete language can make you more aware of the good things. Our goal is to start to exist in a semi constant state of gratitude or appreciation, gratitude in general can really help to increase and maintain your happiness. It can improve your relationships. It can improve your optimism and surprise, surprise. It can decrease your stress despite everything that is going on around you. Even if, sometimes it feels like your world is falling so far apart. I mean, you're welcome to fall apart, no judgment here, but at least you would be able to have a different perspective on it. It would still suck that you fell apart, but you can find a tiny, tiny, tiny little rainbow after the storm or even in it. And if you can do that, then you're already rocking out and improving things for yourself. Now in this last year, I'm sure many of us have had so many losses from family members who have passed away. And we were unable to be there for them to holding the hand of a person whose family member has passed away, or even just holding the hand of someone who has passed away because their families couldn't be there and it's been really hard. And so I'm going to make things a little bit personal because I've always thought that sometimes the best way to share and help people to understand a perspective is through, at sharing a personal experience I can say teach, but my job is not to teach it's to share with you and to just help other people not to suffer and the way that you have, or I have, you know, if you can help it. So, um, well, sorry time. So this year for me has been kind of tough to find things for which I'm grateful as I'm sure it has been for everybody. And this being grateful saying, this is my jam. I talk about gratitude journaling. And I talk about my kid. Talk about it with my kids at work, who are struggling with depression and anxiety. And yet this year I found myself struggling so much so that it has been very difficult to find something for which I'm grateful. Even for me, medicine has become a chore. I love my babies. I love being their pediatrician, but our personal struggles are real. We're humans, not robots. We, we feel and we mourn, we cry and we laugh. And like with so many of us, the strains of worrying about when we will be able to quit and when we will be able to serve our family members to financial worries, because we had pay cuts. It's just been a lot to handle. So from a husband and I we've also had on top of that, our struggles with infertility, um, and right at the start of COVID, we had actually decided to stop treatments and that was in April and then magically, I became pregnant with a little free baby and I found out good way into the first trimester that I miscarried did. I also mentioned that I'm kind of old. So this was just like a little rainbow, that little tiny, tiny rainbow during the midst of all this stuff. And when I miscarried, I had an exceptionally hard time finding anything for which to be thankful. My babies in the office who brought me so much joy started to bring tears to my eyes. It's a new babies and their parents that I helped. It became really hard. I struggled a lot and I became bitter. And now I'm just getting back to being able to be grateful. So even though I lost my pregnancy, I am grateful that I've been able to carry a tiny human, even if it was for a very short amount of time, I'm grateful that I was able to know her gender and to name her Luna, grace and I am so thankful that though I never held her in my arms. I am her mama. It is very hard to sign gratitude and to give yourself grace and to be vulnerable and to work through your bitterness and anger. That's the reality is that bitterness and anger, it will surely kill you. Gratitude and grace, however can make this life bearable, including working your job, where you feel like you may be beating your head against the wall. It will help you. When you have talked with the insurance company 20,000 times, and they're still denying your patients, something that is so desperately needed, it will energize you when you have for the 20th time dealt with the death of one of your most beloved patients. It will keep you saying when you have just coded your fourth patient of the day for us as healthcare providers to heal ourselves, it is such a complex task and such a complicated things to discuss. But the one thing that you can absolutely freaking lutely control is how you process and how you deal with all of these challenges and these rocks being thrown at your face. It is up to you to choose how you build your mask or your shield or your well, for which you to hide in. And gratitude is just one way to build that shield. Now we're still going to work on the system. That's for sure because our system has some challenges, but in the meantime, less work on our protective masks, let's work on thinking about the things that make us make this job worth doing, and that makes our lives worth living. But we also have to be careful to not look at only the sunny side and that well lit side. When we think about gratitude, because it's important to think about our losses too, because if you don't know loss or sadness, then you cannot truly appreciate the goodness and the sweetness of the things that you do have experienced loss and love and disappointment and grief just as anyone else. But we have to allow ourselves to sit with the grief and the frustration and we can't push it down. So as they end really start thinking about gratitude, journaling, it can only, it only has to be about 20 minutes a day or three times a week, a little small piece of paper, a sticky note, or a leather bound journal, or a simple five minute meditation. Just write five things for which you are grateful, make it personal. Look at the good things as gifts. So thank you for listening. I am grateful for you. And I just want to leave you with this point, this quote by Morgan Harper, Nichols, I will have gratitude for the little things, even while I wait for the bigger things to fall into place. I can still have hope while facing a future. I don't know. I will soak good seeds, even with an uncertainty. I have found boundless peace and the freedom to let it run over absolutely everything it's going to be okay. Not perfect, but okay. I may not understand all that has held all that is happening, but I will bloom anyway, even after the harshest, winter, the flowers still blue. Thank you.

Speaker 1: 29:49

Thank you for joining us. You've been listening to Sentara healthcare is vital signs, a podcast for Sentara providers, as a reminder, re today's show notes for information about claiming your continuing education credits. Well, that's it for now, but we'll be back soon with another episode of vital signs, a podcast for Sentara providers, the podcast that provides evidence-based education programs for physicians and healthcare providers on the go.