As Go Your Relationships, So Goes Your Resiliency

We hear a lot about how your work can affect your personal relationships, usually for the worse. In fact, I wrote about how cynicism at work can negatively affect your relationships at home in a recent column. This is a well-worn topic in emergency medicine, and there are a lot of strategies to deal with it. Go running. Practice mindfulness. Carve out space that is uninterrupted by work.

Something that is far less discussed, though, is when it goes the opposite direction. We talk a lot about the worst aspects of our job overflowing into our relationships, but how often do we stop to consider how our relationships may be affecting our work? Recently, I had the pleasure of hearing a talk on resiliency by Wayne M. Sotile, PhD, who has been studying health psychology and resiliency in physicians for almost 40 years. He said something that has stuck with me since: “As go your relationships, so goes your resilience.”

Resiliency, in Dr. Sotile’s words, is the opposite of burnout. And burnout, as we all know, is a crisis our profession is facing. Medscape’s annual reports of physician burnout have consistently shown that emergency physicians are at or near the top of the list when you break it down by specialty. Fifty-five percent of emergency physicians reported feeling burned out in 2016, tied in first place with critical care physicians and urologists. Fifty-five percent is an insanely high number. Imagine if it were only 40 percent or 20 percent. But that would still be one of five emergency physicians feeling burned out. It would still be a huge problem.

Focusing on your relationships could be the key to strengthening your resiliency. Dr. Sotile gave an example during his talk that was close to my heart. It concerned how our spouses can honor or dishonor our work. As emergency physicians, we are often working nights, weekends, and holidays. The likelihood that we will miss something important in our kids’ lives, whether it’s their bedtime routines, their recitals, or their big games, is high. Imagine if your spouse reacted to your kids’ disappointment by commiserating with them or saying they wished you would pay less attention to work and more attention to them. Incidents like these can be incredibly destructive to a physician’s resiliency.

My wife is also a physician, so honoring each other’s work goes both ways for us. We know how important supporting each other’s calling is to each other and our children. It’s not uncommon for my wife, an otolaryngologist who is also fellowship trained in laryngology, to be called in to the hospital unexpectedly. The most recent time it happened, our children, ages 5 and 2, started crying, saying that they missed her and didn’t want her to leave. I understood; it’s difficult to have a parent or spouse called away. But I talked to them about how she is doing an incredible and worthy job to care for other people who are sick and need her help. Honoring each other’s work helps us and our children to be proud of the roles we each have.

Another example of how my personal relationships have affected my work had to do with a colleague of mine, Tim Corvino, MD. Tim was my senior resident and good friend. His friendship was a big reason why I joined the same group as him after graduation. I knew he would give me advice based on my best interests.

He did just that when I was working as a traveling physician to fill gaps in our group’s coverage around the country. I was dating the woman I would later marry then, but she still had a few more years of residency, and I was often on the road. It was a serious strain on our relationship, and the question of whether we could really move our relationship forward came up. I spoke to Tim about it, and he arranged for me to move back to Columbus to spend more time with her, even though the company really needed more travelers. The rest is history, of course. We got married and now have two wonderful kids. And Tim is the godfather of our first child.

That personal relationship has had a profound impact on my work, life, and happiness. My capacity to stay resilient in the face of emergency medicine’s challenges is the direct result of the strength of relationships like those I have with my close friends at work and with my wife and family at home. That may seem obvious, but we take it for granted unless we pay attention. And, if we find our resiliency lagging in the emergency department, if burnout is creeping up on us, we may need to look to our relationships to get us through.

Editor’s note: this post was first published in EM News.