Welcome to 2021! Although we are not celebrating a miraculous, groundbreaking transition into the New Year, this transition from 2020 nevertheless offers us the promise of a renewed beginning. This year, we can look towards the bright spots of a COVID-19 vaccine, a refreshed presidential administration, and our continued dedication to SGIM’s vision of “a just system of care in which all people can achieve optimal health.”
New Year’s resolutions, a four millennia old tradition, may be viewed as “unrealistic pledges” of behavior change,1 perhaps because of the transition’s similarly unrealistic sense of renewal. However, the last year was unlike no other in recent memory. Renewal and even resolutions may be just the prescriptions we need right now. The events of 2020 highlighted for us as individuals and communities numerous options for change, especially towards SGIM’s vision as of 2018. I offer a few considerations as we set out to craft and commit to our own resolutions, especially those within our loci of control to help one another but especially ourselves.
Concerns about burnout, (loss of) professional satisfaction, and joy of physicians at their daily work have been steadily growing. The exhaustion, chronic distress, and uncertainties of responding to a pandemic have likely led to an acute-on-chronic problem: poorer well-being and mental health of front-line workers and healthcare professionals, including physicians, clinicians, and trainees for these disciplines. There is no question that system change at all levels is needed to address the many thorny and deeply rooted contributing factors to poorer physician well-being, including those brought on by the still ongoing pandemic. As one of my collaborators wisely said, “If construction workers have universal safety precautions against mortal physical injuries, then physicians need universal safety precautions against mortal mental health injuries.”2
In organized medicine, our societies and associations can resolve, on behalf of members, to publish and amplify essential policy or position statements to address vital issues of our time. In parallel to advocating for destigmatizing physician help seeking for poor mental health, researching the factors contributing to physician dissatisfaction and cynicism, launching interventions to mitigate these consequences, and more, small changes and shifts in perspective still are valuable. One Belgian group lightheartedly calls moments of human connection mangomoments, named after the kind of connection created by a journalist who asks a critical care patient, who reflected on her experiences after awakening from a coma, what she can do to make her happy. The patient replies, “I would really like to taste a mango again,” and the journalist responds by literally bringing her a mango.3 This reminded me of a past essay on a related concept, micro-moments of positivity resonance, or a feeling of “love,” characterized primarily by a flood of positive emotions, shared in connection with any other person.4 Readily identifying these profound moments of connection may be much easier to recognize in encounters with patients than with colleagues, especially because of the nature of physician training and work.
Tuning in to potential connections with peers and colleagues may be especially beneficial for both involved. Recently, I listened to a podcast episode that described the concept of a double tap when checking in with another.5 The first tap: ask someone, “How are you?” and listen; don’t use the question only as a greeting. The second tap: if the person responds, “I’m fine” or “Okay,” a potentially reflexive greeting in response, ask again, “Really, how are you?” or “Are you sure you’re okay?” Checking in with each other, as I hope that we have come to do more often in the last year, seems like a worthwhile resolution to carry into this New Year. However, these check-ins, mangomoments, micro-moments of positivity resonance—whatever we wish to call them!—need also to be practiced for ourselves.
Offering others grace and empathy seem so much easier than offering the same in the form of self-compassion to ourselves. I lost a dear friend before COVID-19 was declared a pandemic, and that loss, combined with pandemic-related shifts in routine and mindset soon after, prompted me to seek help. Working with a psychosocial therapist, dissecting key moments in my acute responses to my friend’s death, I reflected on that initial question again: What did I need? Then, if I were to see someone like me in that position, how would I offer them help?
This pandemic has unearthed such feelings in all who lost patients, friends, loved ones, and others along the way. Stopping long enough to recognize and respond to one’s own needs is vital to our health and well-being and the long-term sustainability of our individual and collective pursuits. In “a just system of care in which all people can achieve optimal health,” physicians are a part of the system and also are deserving of optimal health alongside and as patients also. As 2021 begins, let us resolve, reinforce, and re-commit to our existing resolutions and to promote our health and that of our colleagues, even if only one mangomoment at a time.