Coming Home and Losing the Veneer

When we go home, we feel comfortable and transparent.

Posted Jul 13, 2019

Wavebreakmedia/Shutterstock
Source: Wavebreakmedia/Shutterstock

I spent the past 48 hours with the society that I have come to understand is my professional home and happy place, the Pediatric Orthopaedic Society of North America (POSNA). These are surgeons who have dedicated their lives to fixing children—children who break their bones, children who are born with crooked bones and spines, vulnerable little beings who cannot advocate for themselves. 

My pediatric orthopaedic family exists to support each other, to build each other up and pick each other up. Dr. Steve Frick, the outgoing president of POSNA, said something today from the podium that resonated fully with me. It went something like this, but I cannot do it justice. My clumsy paraphrasing of his words are as follows: This society is here to take care of its members so that the surgeons can take care of the children, their patients, in the best way possible.  

Two years ago, POSNA committed to embracing the work of wellness for pediatric orthopaedists. I had the honor of working with two of my heroes, Dr. Hank Chambers and Dr. Michael Goldberg, to spearhead this work. In the spirit of my own wellness, as I was overextended at that time, I asked for someone else to lead the WTF, as our Wellness Task Force was unfortunately named. That someone else has since joined the ranks of my heroes. Dr. Vish Talwalkar has a quick smile, humility, brilliance, and the kind of sense of humor required for this work. We started with a short seminar last year. We wrote a call to action, published in the Journal of Pediatric Orthopaedics. And yesterday Dr. Brian Scannell chaired a half-day course on wellness that overwhelmed me with gratitude. My POSNA family showed up, learned, contributed, and did the hard work of questioning our own vulnerability.  

I had an “aha” moment as I planned the talks I would give during this session. In my quest for physician advocacy in the interest of wellness, and in my fierce battle calling attention to the moral injury that some call burnout in physicians, I have traveled to speak, written articles at night and on weekends, and had countless conversations with struggling physicians. I have always advised my mentees, my friends, my family, and my children to say yes to the things that bring joy and stir passion. So saying yes to all things related to this work has rolled over me like a Mack truck. My "aha" moment came from the podium. I began my talk with the disclosure that I have shifted to an edgy place. I’m not talking about the wellness of yoga mats and organic vegan food. I spoke about the abyss that is growing between doctors and patients. About the loss of peer interaction. About the loss of respect for physicians, as evidenced by the #doctorsareassholes and #stayinyourlane viral movements. About the systemic challenges of the electronic medical record, sleep deprivation, loss of autonomy, and inability to have the support to function at the scope that we have trained so hard to achieve. And as I moved through my talk, I shifted from edgy to angry. Angry about what has happened to my beloved profession.  

My kids go through their days at school and sports and friends and dance, keeping it together mostly as model citizens. Frequently they get home to me and lose it, with an ensuing hot mess of tears or rage. The sense of family, of warmth, of support, brings up the feelings they have bottled up all day long. This is what I felt as I came home to my POSNA family yesterday. I felt the support around me that enabled me to lose my veneer and show the crack in my armor.  

I have left the beginner and intermediate slopes of this physician advocacy work I have assigned to myself. I feel like I am at the top of a steep and icy mogul field. There is no alternate route for me. I have committed, and I am pointing my skis down this mountain. I’m not sure if I will wipe out and fail, or whether I will book down the mountain with good form and confidence. So stay tuned.