When was the last time you had an idea, a big idea, and immediately talked yourself out of it? You wanted to change your schedule, or go on a 2 week trip, or paint a room a new color, and you just shut the idea down right away. Why? Did you need permission?
When we entered medical school, or residency training, we were at the whim of our supervisors. We couldn’t just make any decision we wanted too. This was true of clinical decisions (for good reason), and for our time and schedules. We were, to some extent, at the beck and call of our education.
And then, we graduated and became “real doctors.” “Real Doctors” get to do what they want, right? Um, right?
For many of us, that didn’t seem to pan out.
Loss of autonomy is recognized as a factor in burnout, and unfortunately it’s very common in medicine for many reasons. Hospitals and clinics need predictable staffing, so not everyone can be on vacation at the same time. Insurance companies negotiate formularies, so you may have to choose this medication for your patient, even though you would prefer to choose that one. And because we have been conditioned to abide by the rules of our training and then from our employers, insurance companies, etc, we start assuming that we don’t have permission to make decisions for ourselves.
An example of this? Lunch.
Many of us are used to working through lunch. We tell ourselves we have to do this. The load of work on our plates, the patients who are scheduled to see us before or after (or still on our rounding sheets), etc, makes us believe that we are not eligible for a break. And yes, perhaps some of the time, there really are time-sensitive issues arising. But much of the time, we feel we don’t have permission to stop for lunch. We don’t believe that we have the authority to give ourselves permission to eat (vs maybe cramming some food down in a few gulps).
This feeling, this inability to recognize our own authority and agency, is a toxic presence in our lives. We may feel oppressed by our employer (or our patients) because we “don’t have permission” to eat. We may feel that we are being held to impossible standards. And putting aside the VERY REAL problem of Physician workloads for a moment; we make it worse because we can’t or won’t see that we have to choose to take care of ourselves in these ways.
I invite you to start choosing to give yourself permission to eat. Even to take 10 minutes out of a crazy day to eat at a table (not your desk), to sip on a warm beverage and savor it, to not look at work. For 10 minutes in the middle of your day.
When you start to give yourself permission to do this, or to use the bathroom when you need too, you honor your human-ness. We are not machines. We need food, and air, and coffee, and bathroom breaks, and sleep and love. And it’s so easy to believe that we don’t need those things because we have gone without permission to have them for such a long time.
Give yourself permission. Permission to pause. Permission to notice your hunger, your emotions, your needs. Permission to meet those needs.
I wish that someone was there to tap you on the shoulder and tell you “it’s your lunch, see you in an hour.” But they won’t. But show up to tap your own shoulder, and at least give yourself 10 minutes to sit and eat and be a regular human.