As physicians, self-care typically sits at the bottom of our priorities list. We have been socialized, trained, and habituated to put the patient first. While we've come to see this as virtuous, if we continue down this path we will find ourselves increasingly empty and tired. It is not only important to care for others, but equally as important to do so for ourselves, as this will enable us to continue to care for others without feeling depleted.
For women, it's not only social pressure that tells us we must be nurturers, providers, and peacekeepers for those around us at home or work. We put pressure on ourselves when we start believing using time for ourselves would be selfish or ignore the nagging need for self-care. Our plate is too full, our to-do list too long, and we're likely already running behind.
Much of our neglect of self-care -- and the suffering that results -- comes from the way our thoughts become "truths" we tell ourselves. Eventually, we cannot conceive an alternative. Our brain scans our external and internal environments to find "proof" to match the verity of the thought we are holding on to.
We begin to think that if we do not prioritize the patient at all hours of the day, evening, or weekend, it would be selfish or would go against our duty toward the patient; we eventually come to believe this is our only option. Any other use of time -- such as for resting, recharging, or eating -- becomes almost unthinkable. If a patient needs us, we will drop our own doctor's appointments, skip our kid's recitals, or cancel our family dinner.
We rarely stop to question if all these beliefs about priorities and responsibilities are actually true. But what if we do start to poke holes in our beliefs? What if we stop and ask ourselves, "Is that really the only option?"
If we take a minute to consider an alternative -- that it is not selfish to put ourselves first -- something almost magical will happen. The thoughts that were holding us back, keeping us stuck in our misery and neglecting self-care, begin to release their grip. We begin to realize our options and actions don't have to be set in stone after all.
Unfortunately, we are not taught to think this way in medical school or training. We are taught to think critically about external information -- but what about our internal monologue?
Once we start questioning the status quo, we will begin to see there may be an alternative. It doesn't mean we are not caring, loving, or dedicated to our patients. It's about reframing what care means -- and these characteristics (care, love, and dedication) are the ones we need to own for ourselves too. To truly care for others, we need to care for ourselves. We need to prioritize time for resting, exercising, and creating the version of ourselves we want to become, not the version we are told we should be.
Living only to meet others' expectations, whether it is a spouse, work, or society in general, might make you agreeable and superficially pleasant, but internally you will desert your own spirit.
So, when you begin to head down a path of thinking self-care is selfish and that you don't have enough time, stop and question whether that's really true. This will take reflection, discomfort, and vulnerability. It will go against beliefs embedded in our culture that say you should be doing things a certain way.
Rocking the boat to live on your terms may be unpopular. Spending time on your self-care may mean others have to step up and take on tasks you had routinely handled in the past. It may mean others will need to respect new boundaries or become more self-reliant since they'd expected you would take care of things as the nurturer, provider, or peacekeeper.
Change is not easy. The transition from an old to a new identity means shedding the person you were. There is no manual or set of rules. As social beings, it can be uncomfortable to deviate from the pack or change the status quo. But like every sandstorm, although we feel discomfort and need to close our eyes, the sand always settles with time.
So, step into discomfort and question your "truths" of what is holding you back from prioritizing yourself. Demystify your objections to your self-care. You are the most important person. Your future self and your patients will thank you later. Hold on to that truth.
Diana Londoño, MD, is a board certified urologist in Los Angeles and one of the 0.5% of urologists that are both female and Latina.