Take ownership of your healing

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The sickness role is a psychological concept that we give to patients to help them recognize the fact that they are NOT to blame for having an illness. Being ill is NOT something to be ashamed of, something to apologize for, and they are certainly not responsible for being sick.

Unfortunately, some people have misunderstood this concept to mean that they have no role in their healing, that “others” should be entirely responsible for their care and recovery, and they avoid taking ownership of the fact that their actions DO matter in how their healing journey will go.

So yes, none of us are responsible for having an illness AND at the same time, we absolutely DO have a responsibility to take ownership of the healing process.

A good example that I often see at the ED are patients who are coming in due to various ailments, none of which are significantly impairing or acute, because they would like a formal diagnosis or a second opinion for their condition. These ailments are often things like chronic pain, tension headaches, mood instability, ongoing relational issues, etc. Many of these conditions have already been looked at by (often multiple times) a specialist/ consultant, diagnosed, and treatments have been offered. Yet, many patients come to the ED looking for another diagnosis, a different “sick role” that they feel would explain their condition better. While it is completely understandable that an individual would want a better understanding of their condition, I am often surprised at how many of these patients believe that their recovery is entirely dependent on receiving the “correct” diagnosis and meeting the “right” specialist.

There is a huge societal role in this as well – we are often bombarded with images of patients coming to the hospital to be “taken care of”, where they are tucked into the bed and nurtured like a child, while taking a completely passive role in their recovery. This cannot be further from the truth. Best care is delivered when the patient takes an active role in and ownership of their own healing journey; when they take steps to best serve their body and mind. I wonder what changes we would see in our society if we start sending this message that patients ARE capable of and SHOULD be taking charge of their own health.

For example, someone with chronically depressed mood that have unfortunately shown poor response to conventional treatments can become angry at the health care system and the doctors for failing them, and this would be completely fair. AND, at the same time, they can take ownership of their healing process, and start actively engaging in psychotherapy, exercise regularly, set up a sleep schedule, explore their spirituality, tap into their social resources, and make a commitment everyday to heal.

One can use this for patients who have terminal illnesses as well. Palliative care is a large part of our training. It is incredible how patients with months left to live can make a commitment to do the best that they can every morning that they are alive. When they could walk, they would take a stroll around their neighborhood daily. When they couldn’t anymore, they got on a wheelchair and sat by the window every morning. When they were too unwell to be on a wheelchair, they listened to audiobooks and enriched their mind.

We can all take responsibility and ownership of our own wellness, and make a commitment. Us health professionals depend on our patients to work as a central piece of the healing journey. Without the patient’s commitment, there is only so much we can do.

As a witch and a spiritual person in general, I deeply believe that we are an active agent of change in our lives and the lives around us. Our will, actions, and energy DO have an impact in our life journey. Just like the spells we cast and the intentions we put forward, our everyday commitment and actions to heal from whatever ailment, physical or non-physical, WILL direct us towards our highest good.

Stay safe, my friends, and be well.

Culture of incompetence

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Culture of incompetence is a phrase that us, as resident doctors, came up to describe certain hospitals that have a culture that encourages a passive form of incompetence by discouraging productive change.

This does not mean that they encourage residents to make mistakes or to be incompetent in a general sense. Rather, it means that we are encouraged, either directly or indirectly, to abide by unspoken rules that are prohibitive of increased efficiency or innovative approaches to patient care. To give an example that I had mentioned in my previous posts, I had once worked in a hospital where working fast to speed up patient care was seen as putting pressure on the team and being a bad learner. Other residents had similar experiences in this hospital, where they were asked to adjust to the team’s pace, even when it was clear that there were areas of improvement needed to make the team more efficient. The hospital had set up an unspoken rule that it was happy with the status quo, despite the fact that it was no longer serving the giant and ever growing population of patients, resulting in months or even year long backlogs of patients to see, and patients waiting in the emergency department for days just waiting for a bed to become available in one of the inpatient units.

How does a culture of incompetence form? I believe that it starts from a seed of “leaders” that believe that what they are doing is near perfect, if not perfect, and that there is no room for improvement. Any attempts at productive change is seen as stirring up trouble or even being a bad learner. This kind of culture in turn produces an environment where those who agree with this worldview are the ones who decide to stay after their mandatory rotation ends, and the saga continues.

This kind of workplace culture can cause traumatic moral injury in young and motivated learners, possibly making them lose that spark that keeps them wanting to innovate and improve. Perhaps the reason why healthcare has seen so few innovative changes in the past many years is because this culture is pervasive in medicine. As residents, we get placed in a lottery system that inevitably lands us at a hospital with such a culture at some point during our training. While I wish I could say that most of us come out of the experience with our eagerness and dreams of a better future intact, it often marks the beginnings of becoming a bitter and burnt out physician.

I noticed this change in myself more recently when I pulled out a garnet bracelet from my jewelry drawer for work today. One of my daily rituals as a witch includes picking out a gemstone to support me at work and to set intentions for the day. Garnet, besides from being a protective stone, also encourages vitality, leadership, and positive growth. Since being burned by this culture of incompetence and many months afterwards, I was afraid to wear this to work in case it would push me to stand out more than a resident “should”, attracting negative attention and criticism. Today, for the first time in almost a year, I took out this bracelet for me to wear to work, feeling finally ready to return to my old self again.

If you feel that a productive and growth-oriented behavior that is appreciated by patients or clients is being met with resistance and even animosity in a new environment, I implore you to take a pause and to evaluate the environment before changing yourself. If you could find a way to hold onto that spark inside of you to ignite torches of positive change, a day will come when you are free to light up the world as you are meant to do.

Stay strong, my friends. Better days are just around the corner.