The Stoic Physician
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The radical alteration in the current flow of daily life does not spare anyone. For those working in the privileged healthcare arena, the front seat to the current spectacle demands an alteration in thinking to survive.
The adoption of a stoic mindset allows the application of ancient philosophy to modern times. Please do not confuse Stoicism with being stoic. A subtle shift in interpretation or labeling combined with a redirection of mindset can reinvigorate the soul, and Stoicism offers useful tools in the face of unprecedented challenges.
A few concepts to begin your journey.
Deo Valente
So much of the day-to-day working of a healthcare professional is beyond control. This uncertainty is readily apparent in the face of the COVID pandemic.
While the practitioner strives to do the best with the tools at hand, that is often not enough. Invoking the phrase “Deo Valente” or “God willing” provides a feeling of acceptance that many outcomes are already predetermined.
For those averse to Spiritual or religious references, the concept of reserve clause is similar.
A simple example:
We will successfully utilize goal-directed therapy with appropriate antibiotics, fluids, and vasopressors to manage the septic patient. May my knowledge and skill carry this patient to recovery and health, fate willing (deo valente).
You will fail but there is no fault.
Premeditado Malorum
Physicians, particularly those working on the front lines in critical care, are adept at predicting and preventing catastrophe.
The framework is simple. Think ahead to all the possible negative outcomes and understand that many are be beyond your control. Prepare and diligently analyze likely outcomes and options. You are premeditating on the negatives.
Through this process, a framework for making more informed decisions evolves. This technique can help steel one to unavoidable unpleasant outcomes and prepare for difficult future moments.
Preferred Indifference
The hands of fate are sealed in certain instances. The path of a healthcare career may not go as planned.
Having the character of strength to weather a lack of career promotions or rejections is a real-world application of this concept. A clear illustration of this is the Sufi tale of the farmer's judgment. Good thing, bad thing, don't know.
A simple releasing of attachment to a preferred or unpreferred outcome will unburden the mind and allow one to move past difficult events.
Memento Mori
"Remember you must die."
The rigors of life and medicine often leave physicians ignoring their own lives, family, and friends. Failing to honor your body and soul will hasten the end.
Father time catches us all. Remind yourself daily that you to could leave life right now. Let that be a framework for decision making. Learn to say “no” more often.
"Let us prepare our minds as if we'd come to the very end of life. Let us postpone nothing. Let us balance life's books each day. The one who puts the finishing touches on their life each day is never short of time." Seneca
A Good Death
Many a warrior has faced the battle with courage only to be carried home on a shield. There is no shame in this.
There will be a time when a new clan of younger warriors must carry the swords. Embrace the hands of time and do not find your last breath drawn slumped over a pile of charts. Use your incredible talents to find a new muse. The universe compels the sharing of gifts.
Before one can control the world around him, he must learn to control himself. Stoicism delivers concepts and offers the framework to accomplish this amidst the chaos of modern life.
Take a moment to pause. Get a gap. Use that small period between stimulus and response to decide based on the best version of yourself.
You cannot save all -do all -be all.
Ignoring self-care will hasten your end.
Celebrate a good day/shift/case.
Embrace love - family - friends.
Unplug -recharge -refuel.
You were put here to do this work, now get to it.
Further Reading:
https://ryanholiday.net/100-things-learned-10-years-100-reads-marcus-aureliuss-meditations/
https://donaldrobertson.name/2013/02/02/action-with-a-reserve-clause-in-marcus-aurelius/
https://jonathanvieker.com/premeditation-of-evils/
https://dailystoic.com/stoicism-indifference/
http://sovitpoudel.com.np/the-story-of-good-thing-bad-thing-who-knows/
https://link.medium.com/J0vgVwunE9
https://www.thestandupphilosophers.co.uk/the-stoic-approach-to-life-and-death/
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