AAP Voices Blog

A little while back, I was reading an opinion article about the shocking early retirement of the Indianapolis Colts’ quarterback, Andrew Luck. I was struck by the similarities of the critiques of his actions and the profession of medicine. One former quarterback stated, “He owes it to his team” to keep playing despite his injuries. Luck, the author stated, “had violated the cardinal norm of sports – playing through the pain after a career of fidelity to it.”

‘Owing it to the team’ is something I hear frequently in medicine. Just as in sports, we don’t want to let our fellow team players down. Stories abound through my residency, fellowship, and attending life. The resident, attached to their IV pole while waiting for surgery, coming to present at morning report. The attending who had a pneumothorax, rounding with Pleur-evac in tow. The fellow with gastroenteritis running to the farthest bathroom from the Emergency Department to vomit and then returning to their shift. The attending with the burst appendix lying down in the middle of rounds, insisting that they were “just fine’.

But it doesn’t just involve working while ill. Doctors are mythologized for their ability to overextend. I recently attended the third in-person meeting of the Women’s Wellness Through Equity and Leadership project and listened for the number of times physicians were described as warriors. I lost count after a while.

Our professional cardinal norm may not be to play through the pain, but it definitely involves soldiering on despite personal or professional roadblocks. We seek to never burden others in our department, practice or residency. To do so, would be letting down our “team.”

The physician-warrior

Fight for your patient, schedule multiple meetings after overnight call, work weeks without taking a day off, work sick, being available 24/7, take the shortest amount of parental leave.…I could go on for paragraphs. We have a culture where we revere those who are a warrior at work. Be it that they may have a commanding presence, they are never unsettled by microaggressions or bias, grinding through to finish their fellowship grant, running to soccer practice to watch their children, stepping on the Peleton bike at midnight and answering emails at 3:00 a.m.--all while post-call from their shift.

Being indestructible, never failing has become the rallying cry amongst physicians. And this slogan is killing us. We aren’t unique as an industry to have this appreciation of those who can ‘do it all.’ But we owe it to society to understand the value of disconnecting. To realize that we can’t, shouldn’t and aren’t expected to do it all.

“We have to change the mindset that boundaries and limits imply weakness and failure. Rather, those same boundaries will allow us to succeed and flourish and encourage our young patients to join this noble profession.”

If we, as physicians, those who feel they can never leave their patients, workplaces, research, departments can find a meaningful way to take a pause and place actual boundaries on our work lives, then other industries can follow in our footsteps. We owe it to ourselves, our patients and “our team” to take the time to check in with ourselves.

We have to change the mindset that boundaries and limits imply weakness and failure. Rather, those same boundaries will allow us to succeed and flourish and encourage our young patients to join this noble profession. Our patients want their physicians to be authentic, not the super-humans that the field of medicine has groomed us to be.

I believe we can be stronger, more impactful and more approachable leaders if we move away from this mindset of invincibility. Perhaps we can learn from this new generation of football players who are “unlearning those masculine ‘truths’ about hardened self-sacrifice and the nobility of suffering.”

I, for one, did not enter the field of medicine to be a warrior. I want to be a healer, leader, and advocate. As physicians, we have plenty of grit. Let’s try to lead from a place of grace as well.