Resilience is the buzzword that everyone in the world of wellness seems to use. It is something everyone possesses in varying quantities and pivotal for wellness. We talk and talk about ways to increase resilience and even make it an integral part of wellness models for health systems because, well, burnout is out of control. (Medscape National Physician Burnout & Suicide Report 2021. Jan. 22, 2021; https://wb.md/3ImhJLQ.) Maybe, the thinking goes, you would not burn out if you were more resilient.
But if we take a moment to truly consider what resilience is, we can unpack some problems with making this the central focus of personal well-being. Resilience as a function of personal well-being means the ability to become strong, healthy, or successful again after something bad happens.
Read that definition again and really think through what it means. Resilience is becoming strong again after something bad happens. If resilience is central to hospital wellness efforts, can we assume that working in hospitals is bad for us? That's a grim idea for the future of medicine.
If lifestyle medicine has taught me one thing, it is that medicine focuses too much on what we do after things happen. By design, through our medical training, we are healers of illnesses that have occurred. We are not naturally inclined to be forward-looking healers. Preventive medicine doesn't carry the same glamour that critical care does. We should know; EPs do both.
Resilience, however, is a backward-looking trait. Something bad happened to me, like being on the front line during a terrible once-in-a-century pandemic, and I have survived it so far. What offers a more forward-looking approach? I posit that courage is pivotal to why all of us are still involved in emergency medicine after being beaten down for two years.
Courage is forward-looking; it is the mental or moral strength to venture into, persevere, and withstand danger, fear, or difficulty. Courage is what you need to head into something unknown that is likely dangerous. Everyone knows what it was like in March 2020. We all had courage, an unbelievable amount of it. We had no idea what was about to happen to us. As the days went on, resilience started to kick in, but if you really think back to what we went through, the predominant characteristic we had to possess to keep coming to work was courage.
Courage and resilience are not opposites but exist on a fluid continuum. We have endured a lot, but we also keep showing up. Celebrate that courage that makes you keep showing up. Support and celebrate your colleagues. As new well-being models start to take hold and the focus lies more and more on the mindset of physicians, reflect on your own courage and encourage others. (Mayo Clin Proc. 2021;96:2682; https://bit.ly/3IhjtFZ.)
Think through what gives you courage to walk in the door when the waiting room is packed and the pandemic is still happening. Meditate on that. Share it. Your source of courage likely has more to offer you than you have given it time for. Stress reduction and social connection are pivotal pillars of lifestyle medicine. (American College of Lifestyle Medicine. https://bit.ly/3dmtwfg.) Spending time thinking through your courage and where your mental fortitude comes from will reduce stress and allow you to share and connect with others.
Courage can blossom from many different sources. Like a Marine charging into a combat zone, there is something that makes it all worth doing. Courage can stem from values, ideals, family, friends, nature, motivational quotes or books, and faith, anything deeply personal that makes you you.
This is often something that connects us to something that we identify as bigger than ourselves. It may help you identify your source of courage if you consider what gives your life meaning and purpose, items critical to success in positive psychology. (Seligman M. Flourish: A Visionary New Understanding of Happiness and Well-being; Sydney: William Heinamann; 2011.)
I keep a prayer card in the overhead visor of my car that my mom sent me as the pandemic was starting. It is a tactile reminder for me of what provides me courage: my faith and my family's unwavering support. Yes, build resilience, but don't forget to celebrate your courage and spend more intentional time with your sources of courage.
Dr. Harrisonis board-certified in emergency medicine and lifestyle medicine, and practices emergency medicine at Bridgeport Hospital-Yale New Haven Health. Learn more about the intersection of emergency medicine and lifestyle medicine by visiting her website atwww.acute2root.com. Find more information on the American College of Lifestyle Medicine athttps://www.lifestylemedicine.org. Follow her on Twitter@acute2root.