By Doug Flora, MD
The Greeks used the word onkos, meaning burden, to describe a tumor, and the specialty of oncology is aptly named. As oncologists we commit to helping our patients and their families share their burdens every day. Most of us know that those burdens get heavy, and we don’t always know how to share them with others. Considering all the hard work to get there and all the pain I experienced alongside my patients, I don’t say this lightly, but the most difficult part of being an oncologist for me was learning to let go a bit and lean on others to help me survive.
From my own journey and experiences working alongside so many great doctors through the years, I have found that the draw to a career in medicine is clear and common—it’s an innate pull to use our talents to help people. And, while there are plenty of ways to help people, it’s difficult to find a better, more intimate, and direct way to do so than becoming a physician. I think I always had that in me, and my career has shown that this instinct is correct. This pull became even deeper when I lost my mother to cancer as a kid. Many of you have a similar story, I suspect. Bearing those burdens when you lose a dear family member is a great way to wire a future oncologist.
The personal nature of our jobs and the long, winding road to reach our calling naturally led to taking on too much and holding on too tightly. Oncologists, like most physicians, are driven by empathy. Your patients are desperate for help. You become invested in each case. You want to do all you can for as many as you can. These are certainly great qualities for a doctor, but it can become overwhelming. I know from experience. It took my wife sitting me down years back and demanding that I take time to step away for me to become more intentional with my time.
Sitting here now, at 51 years old and as a cancer survivor of five years, the importance of self-care has become quite clear to me. In fact, I wish I could sit my younger self down and let him know how important it is. The choices you make with your health now can have huge impacts down the road. Working 100 hours a week is not sustainable. Shouldering the stress of each case is too heavy of a burden. I see so many doctors, friends, and colleagues I love and respect suffering from compassion fatigue. They are worn down, in tears, dealing with migraines and other stress-related health issues. It hurts me to see it, especially because I know the despair.
What began as an attempt to appease my wife’s pleas to step away and disengage from work has evolved into my single favorite aspect of life. We started traveling, the five of us, my wife and three kids. These trips eventually became focused on adventure, traveling around the world, hiking, exploring, leaving our comfort zone, and seeing things I never thought I’d see. We first went to Yellowstone and Jackson Hole, then to Peru, Africa, Costa Rica, and Belize. The trips bonded us, and the memories are rich and alive in my mind. I have given my kids experiences I never had the opportunity to have when I was young. That has helped me. That has helped us. That has helped sustain my career. Each trip, I was able to unload a bit of my own burden and returned refreshed and ready to take on someone else’s again.
I urge you to find a way to truly disconnect and become intentional with your time. Maybe it’s adventure travel with your family. Maybe it’s fishing or marathons. Maybe it’s just setting time aside each night to read or take a walk outside. And when you are working, learn to share the burden, say no, and hand the ball off. You are not a machine. Don’t be afraid to lean on your teammates and let go. And when you do, find something outside of work that leaves you refreshed, fulfilled, and happy. I so admire the lengths to which my colleagues go to take care of patients, but you also need to stay connected to your purpose while taking care of yourselves and your families.
Now that I am in an administrative role, as well as taking care of patients, I realize how hard health care leadership works to support and provide balance for our teams. This is an issue we need to tackle together as a profession, as people with shared goals and a common purpose. Our large, multispecialty practice now employs a team of people working on provider wellness, including a dedicated physician leader. We are trying to help our doctors understand that medicine is a team sport and senior leadership is dedicating significant resources to supporting the work of this team as a strategic imperative for the system. Back to oncology: with nearly 17 million cancer survivors now alive, I’d argue that the burdens are now too high for even the most dedicated oncologist to bear the weight without the necessary practice, administrative, and hospital support.
Thank you for your time. If you ever want some advice on places to go for an adventure, please reach out. I have some great recommendations.
Dr. Flora is the executive medical director of oncology at St. Elizabeth Healthcare. Follow him on Twitter @DougFloraMD. Disclosure.