How Stress Has Impacted Me

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Commentary on a New York Times article called, Stress Can Make You Sick. Take Steps to Reduce It.
2019 has been incredibly challenging for my physical and mental health, and as this article highlighted, I strongly believe my physical ailments are a result of the chronic stress and often daily acute stress that exacerbates underlying chronic stress, which is overwhelming for physicians and clinical providers today. Physicians today are expected to not only be “excellent” and “perfect” in the care of humans, but expected to be an expert in all areas of the practice of medicine. 
Those of us who worked our entire career to achieve “leadership positions” in order to fulfill our internal drive to positively influence our culture and place of work for ourselves and colleagues during these immensely challenging times of practicing medicine in a “business” driven reality, simply can’t just meditate our challenges away. Yoga may help but it’s naive to think that just personal accountability and commitment to whatever it is we also need to do, on top of our 10-12 hour work days, to make ourselves more resilient, is the answer and will save us.
I look forward to reading Dr. Rangan Chatterjee's book mentioned in the article.
January of this year, after changing to the highest deductible plan on January 1st as a savings strategy, I had severe chest pain and drove myself to the ED at 4am. The registration clerk informed me that $2500 was needed and they accepted my Amex.
A nice but fast talking ED physician, who seemed fresh out of training, treated me like any other patient until I shared I was a surgeon and INSISTED on a “CONVERSATION” to discuss best next steps and understand what would happen to me. An Emergent GI consult and EGD found “nothing” and that there were no ulcers, as I woke up in the PACU (post acute care unit) still with chest pain while a GI doctor was reassuring me I was fine because he found “nothing”. I came home and experienced two more days of intermittent chest symptoms before it went away.
After memorial day I developed horrific hives, angioedema, chest tightness, the inability to breathe well, and severe itching. Despite begging, getting in to see an internist sooner than a 3-month wait, an allergist, and so much blood work, and of course pills (steroid, antihistamines both H1 and H2), I still have no diagnosis. I was told this is not food related, my IgE is over 400, and taking time off to go see a doctor is not easy, to even call a doctor’s office during their open hours, NOT lunch hour, while you are seeing patients or in surgery, is almost impossible. I have 3 EpiPens in order to save my own life should it ever be necessary. 
Ironically, intense prayer and what happened to be an almost 2-week vacation scheduled to Paris and Normandy, coincided with the complete resolution of the hives. Chest symptoms continued, 3 weeks of cardiac monitoring and 4 more weeks to find out there was “nothing” wrong, rare pre-ventricular contractions, but no big deal, was not reassuring.
Recently the hives have recurred every evening when I come home from work. The single weekend I committed to not logging on the computer and “working”, were the only two days without hives. 
Quitting my job and leaving medicine is not the answer, and I still love aspects of what I do. I know I need to figure out what is needed to continue living my passion and commitment, and fulfilling my responsibilities to colleagues and patients that I love serving. 
But the body, my body, is telling me that years of neglect, poor sleep, lack of hydration, adequate recovery, enduring immense stress and daily frustrations, unrealistic expectations on physicians and physician leaders, may lead to a terrible reality for me.
I am listening to my body, and Googled about it, like so many others do, so that I may have “hope”. Mast cell activation syndrome seems to fit all of my symptoms, but what will make me commit to going to more doctors and getting more tests? I continue to play tennis weekly, walk on weekends, even tried to start daily meditations like my life depends on it, because it probably does.
Who and what will it take to change healthcare for healthcare providers? My parents are in their 70s and live part time in Los Angeles, CA. I am grateful that over the years so many Asian American physicians and surgeons have cared for them while I am away from them struggling to care for others. My father calls me often to tell me about yet another Chinese physician in their area who tragically died from Leukemia, Cancer, etc. Recently he shared that one physician told him that the average lifespan of a physician is a decade shorter due to what we face and endure. 
Americans are getting sicker—the data proves it. The American physician workforce is also getting sicker and dwindling in numbers. Many have retired early, many have left, and those who are staying may be going through what I am, if not physically, but also enduring divorce, mental health issues, depression, anxiety, and the physician suicide epidemic is no less concerning than that of teenage suicide epidemic.
Let’s hope and pray together. I urge you to help and think about how we can “save a doctor” today and every day. Perhaps send a thank you card, acknowledge that physicians are human, they need care, and rest, and delivering healthcare is simply not the same as making a hamburger or working in a factory conveyor belt style, and metrics for “timed” delivery and other performance metrics are not helping the very group of highly trained, self-sacrificing individuals, and highly skilled and experienced people that are not replaceable, and they who impact all humans must be well and enjoy the life they too are entitled to live. It’s not just about doctors, nurses and all who work in healthcare in care of others are burning out faster than any other industry.
As for me, I am grateful that my own body has decided a physical sign to me is the warning system necessary, to make me pay attention to what I am thinking, feeling, and how to quickly control my mind so that ensuring stress perceived is changed and minimized.
The body is designed to save itself at all costs, but at some point it will give up. I just don’t want to go yet because I have so much to live for and there is so much beauty in the care of others and improving their health and lives. Bearing witness to the joy of alleviating suffering and restoring of health, at the same time as bearing witness to the pain and suffering of those who do the work, including my own suffering, is perhaps the most ironic of all my observations.
Watch a recent talk I made called, From Burnout to Well-Being: Awareness, Accountability and Action. More on my YouTube channel.

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