March 31, 2017, an auspicious day for two reasons
First and foremost, I was celebrating my fifty-fourth revolution around the sun. Yes, boys and girls, it was my birthday, my absolute most favorite day of the year.
Secondly, I had the privilege of delivering the keynote speech to a group of physician educators affiliated with the University of Arizona College of Medicine. The setting was the Club Room at the beautiful Arizona football stadium. We had a perfect backdrop of the entire football field through an enormous wall of picture windows.
I looked around and envied the wealthy season ticket holders whom I imagined lounged in this space eating gourmet hot dogs and sipping vintage wines while they watched the Wildcats play. I couldn’t help but wonder if I would ever actually join them one day from this vantage point on the fifty-yard-line watching my boy play. I could hear the cheers from the crowd as the band played the fight song. Touchdown!
Yes, my friends, it was a spectacular spring day in most every respect here in Tucson. And it was the perfect day to deliver a rousing and impactful talk.
Burnout in Physicians- A Ticking Time Bomb!
I had been preparing for months, creating and deleting slides, selecting the perfect quotations from wise historical figures that I had never heard of before, editing and rehearsing dialogue. I worked on my vocal tonality and stage presence. I even had a soundtrack that ranged from Beyoncé for an uplifting vibe to a dramatic operatic composition to set the tone for the emotional apocalypse of burnout. Nothing says utter despair like “Fortuna Imperatrix Mundi.” Google it. You’ve heard it countless times in movies and commercials. You’ll understand what I mean.
I awoke early that morning to give myself plenty of time to get into a peak state. First, I hydrated with lemon water mixed with a heaping dose of Alpha Brain. Then I did ancient yogic breathing exercises, gratitude meditation and of course– visualization. I blasted my favorite motivational playlist. Eminem shook the walls with “Not Afraid” while I rebounded on my mini trampoline to get the blood pumping and lymphatics flowing. I topped it off with a cold shower for an even more radical change in state. I checked myself in the mirror, fresh haircut and all decked out in power black. I looked ready to kick ass, but I had lingering doubts as to whether or not I could pull this off.
You see my friends–these were learned doctors, medical students, residents, skilled surgeons, and other esteemed colleagues I was psyched-up to impress and inspire.
Come game day; I was mentally prepared– psychologically primed, but there was one little problem.
I wasn’t sure I could speak
I must confess that I overdid it the weekend prior. I had just spent several twelve to sixteen-hour-days at an Unleash the Power Within event with 10,000 raving Tony Robbins fans to get inspired for my talk, and one of those infectious fire walkers got me sick. To be perfectly honest, screaming at the top of my lungs for four straight days didn’t help much either.
I spent the night before my extra special birthday talk coughing my lungs out. Despite the all night vigil of breathing treatments, hot steam inhalations and doses of corticosteroids– by the time I shut off my alarm at 5:00 am my voice was pretty much toast. The squeaking and creaking that came from my poor inflamed vocal cords was anything but impactful or inspiring. But it was impressive– impressively pathetic. Cue “Fortuna Imperatrix Mundi.”
Yes, brothers and sisters, I had laryngitis, which is mildly ironic considering the whole super-important speech thing.
But I had three things going for me
One, the talk wasn’t scheduled until 1:00 pm. Two, I’m an ear, nose and throat doctor. And three– Tony Robbins completely brainwashed me, so I was still all jacked up on the three H’s– hot coals, hive-fives, and hugs. Don’t roll your eyes. If you want to be a master, then you must learn from a master. And I guzzled that Koolaid.
I channeled my inner Tony
I call him, Little Tony. Think Danny from The Shining talking to his imaginary friend, also named Tony, but way creepier.
“Little Tony,” I asked, “What should I do? I have no voice. Should I cancel?” I heard a faint voice in the back of my mind. The voice grew louder, a cross between Yoda and Tony from The Shining with a hint of Little Nicky thrown in. So I guess it sounded exactly like Tony Robbins, “Where focus goes, energy flows,” said Little Tony, “Visualize and feel it happening.” “But I can’t do it.”
“If you can’t, then you must. And if you must, then you can,” said Little Tony.
I pictured myself in front of a riveted and inspired audience slowly rising to their feet for a standing ovation. The Chief of the Department was wiping tears from his eyes as The Queen Bee’s “Halo” played in the background. I felt encouraged again.
“Little Tony, I can do it. I will do it. I must do it!”
“Then make your move!” commanded Little Tony.
“Yes! Yes! Yes!” I weakly barked as I pumped my fist into the air. I was beginning to put myself into what Big Tony calls a “peak state.”
Unfortunately, my voice was still in a markedly suboptimal state, but fortunately, I still had about 6 hours before I had to speak. With the clock ticking I then pulled out every conventional and alternative treatment for laryngitis in my armamentarium– nebulizers, steroids, eucalyptus steams, gargles, herbal teas, medicinal mushrooms and more nebulizers. Most importantly, I rested my voice. Not wanting to waste an ounce of vocal power before the moment it was needed.
Fast forward– show time
I waited anxiously in the restroom, rehearsing silently in the mirror. I was trying to get mentally focused, but I was doubtful my voice would be there. “Get yourself into a peak state. Get ready to rip this shit open!,” ordered Little Tony. I made my power move and jumped up and down like a quarterback getting ready to go for the win. The frenetic beat of the instrumental trance mix, “Sandstorm,” boomed from the loudspeakers signifying that ready-or-not it’s game on. I heard my cue, “And now ladies and gentleman Dr. Michael Bays!”
I sprinted out onto the stage like a linebacker going in for the sack as my wide-eyed colleagues caught onto the tongue-in-cheek entrance. They danced around and cheered me on like a rock star. The Chief of the Department joined in on the fun. He bounded around and pumped his hands in the air like he was at a rave. I did a double take. He had some impressive airtime.
The music quieted as my colleagues laughed and settled into their seats. Here goes nothing. I mustered all the intensity and passion that I had, took a deep breath, and the words came out, “Ladies and Gentlemen, thank you so much for that warm welcome. Let’s talk about burnout.”
And so there you have it. My voice leveled out at about 70%, but definitely enough to deliver the message on burnout based on Dr. Viktor Frankl’s book, Man’s Search for Meaning.
Dr. Viktor Frankl was an Austrian neurologist and psychiatrist as well as a Holocaust survivor. Dr. Frankl survived four concentration camps including Auschwitz and Dachau by sheer will and incredible luck down to the very last days before liberation. He lived to the ripe old age of ninety-two. Upon release, he founded a form of psychotherapy known as logotherapy. Logos translates to meaning or wisdom. Not surprisingly, Tony Robbins is a fan of Dr. Frankl’s. He often refers to his work in his talks.
The three keys to preventing burnout
1. Choose your attitude.
“Everything can be taken from a man but one thing: the last of human freedoms — to choose one’s attitude in any given set of circumstances, to choose one’s own way.” Dr. Viktor Frankl
In the concentration camp, attitude could be the difference between life and death. The prisoners, physically sick, exhausted and starved, who understandably gave up would lie on their bunks, refusing to get up. They would enjoy one last cigarette and would predictably be dead within a day or two.
It takes a subtle shift in perception to realize that happiness and fulfillment in our lives do not depend on external factors. It’s a choice, a mental state of choosing one’s attitude.
2. Be Grateful
“Gratitude is the solution to anger and fear.”– Tony Robbins
Unbelievably, even in the concentration camp Dr. Frankl found something to be thankful for– a few more peas in his watery soup or a beautiful sunset at the end of the day of hard labor in the bitter cold.
When we are grateful, we tend to sleep better, feel more energetic, get sick less, live happier and healthier lives and live longer. Trust me on this. I’m a doctor.
3. Have a Vision
“Those who have a ‘why’ to live, can bear with almost any ‘how.’” –Nietzsche
Dr. Frankl wrote, “It is a peculiarity of man that he can only live by looking to the future — sub specie aeternitatis. And this is his salvation in the most difficult moments of his existence, although he sometimes has to force his mind to the task.”
A vision gives us something to hold onto and inspires us to keep moving forward no matter how badly we are suffering. A vision gives us our ‘why.’
Even when he was miserable with pain, fatigue, bitter cold and starvation, Dr. Frankl got himself through the grueling hours of forced hard labor with his vision. He wrote, “I saw myself standing on the platform of a well-lit, warm and pleasant lecture room. In front of me sat an attentive audience on comfortable upholstered seats. I was giving a lecture on the psychology of the concentration camp!”
What is our excuse for burnout?
My question to my colleagues at the conclusion of my talk on burnout was, “If Dr. Frankl was able to find meaning and not succumb to the horrendous circumstances of life in a concentration camp, then what is our excuse as physicians for being burned out?”
So there you have it, my friends. Did my colleagues give me a tearful standing ovation? Not exactly, but they appreciated the effort and more importantly– they got the message.
On the other hand, Little Tony tearfully proclaimed, “Outstanding! Three high fives and a hug– sniff.”
A final few words of wisdom
First, be patient. We can all make significant and profound changes in our lives, but it doesn’t happen overnight. It’s a skill– like surgery or learning a musical instrument. We are conducting the symphony of our lives.
Second, I encourage you all to read or listen to ”Man’s Search for Meaning.” Don’t worry. Dr. Frankl intentionally spared most of the gruesome details, and the book may change how you look at life.
Third, Did you notice that I didn’t take any antibiotics for a viral upper respiratory infection? Don’t do it– not even a Z-Pak. They won’t work and just create antibiotic resistance.
Integrative medical practitioner, Andrew Weil, M.D. warns us in his new book, Mind Over Meds, “We are coming to the end of the antibiotic era, as bacteria have now developed resistance to our latest and strongest drugs.” Trust him on this. He’s a Harvard-trained doctor.
And finally, answer the phone.
Uncle Michael
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