Friday, May 23, 2014


Medical culture doesn't value rest. I've often heard other doctors speaking at length about their long hours and their many patient encounters. There is a physician I work with who routinely stays past 9pm caring for patients. His comments are greeted with half admiring, half commiserating responses from everyone else. We tell him he's working too hard but no one criticizes him or pressures him to change. We tacitly agree that this is appropriate behavior for a medical provider.

I've never heard a doctor say "Well, I sign out every day at 5pm no matter what in order to take care of myself and spend time with my family."  I'm not sure how such a comment would be greeted. Probably with quiet and then an awkward change of subject. Certainly with some internal jealousy on the part of the listeners, along with unverbalized scorn. Medical culture values hard work. The rule is that the harder you work, the more diagnostic puzzles you solve, the more patients you see, the better physician you are. It's as if everyone is competing for a "best doctor" medal that is never handed out. No wonder so many doctors are burned out.

I've often mourned my own needs for rest and sleep. Sometimes when talking to friends I'll say "I wish I could get by on 5 or 6 hours of sleep per night. I could get so much more done!" I always have a list of projects to be done, books to be read, lectures to be written that occupies the back of my mind. I consume more caffeine than is good for me so that I can manage on 7-8 hours and suffer the headaches and irritability that comes from sleep deprivation so I can get that little bit more taken care of. But I'm coming to realize that this is crazy.

I've been reading "The Seven Habits of Highly Effective People" by Steven Covey. One of the themes in the book is balancing between production and production capacity. Rest is part of the investment you make in production capacity, something you do in order to preserve your ability to keep on working. This is a concept I see people paying lip service to, but most people don't live it out. A friend recently posted a quote from the Dalai Lama that said, in essence, that he is surprised by human beings, because we sacrifice our health in order to make money and then spend money in order to restore health. That one hit home with me, because I definitely do this. And when you put it that way, you realize that it's pretty pointless.

Last weekend I attended a women's gathering at the church I am attending. The theme of the gathering was rest, and the central message was that G-D wants us to rest in him. He created us and adores us, not for what we do but for who we are. We don't need to check everything off on our to do list to be loved by G-D. That it is not only okay but is actually commanded that we stop, that we rest, that we spend time on a regular basis in quiet restoration. That rest isn't for when everything is done but that it is something that needs to be done no matter how many or how urgent our projects.

Honestly, I'm terrible at this. I will hear a message like this and start trying to rest more and then I crumple under the pressure of life. It takes discipline to rest; it takes saying no to certain things and it takes accepting my own limitations. It is painful to recognize that my personal to do list will never be completely checked off, that there are interests I won't be able to pursue. It's difficult to disappoint others by saying no to them. It's easier (although not wiser or healthier) to just go with the flow of saying yes and skimping on rest. However, I am coming to realize that it's not sustainable over a long period of time, and that saying a measured, reasonable "no" now will strengthen my ability to say "yes" far into the future. I'm not sure how to live this out. I don't know what that life of regular rest would look like. But I'm beginning to recognize that I might want that life, and that it is up to me to make the choices that would get me there.