Reflections on Resilience

Patricia Lindholm, MD,
2010-2011 MMA President

Originally Posted April 7, 2011

We have watched with awe and horror as events unfolded recently in Japan.  A massive earthquake, a devastating tsunami and then nuclear plants close to meltdown.   To a resident of Japan these events must have felt like the beginning of the end of the world.  Yet there were many acts of heroism including workers risking death by radiation poisoning to save their families and neighbors.  The Japanese are well known for their resilience.  I have no doubt that they will rebuild and work to make their country even more protected from natural disasters.

Resilience is the key to carrying on with life in spite of the pain, obstacles and other challenges that we face.  Every medical student must have resilience.  The brightest in college are now average students in medical school.  They must reframe their self-assessment and continue in a medical education.  As residents we continue to be trainees but assume more responsibility for the care and safety of our patients.  During residency a mistake can do very real harm.  The resilient resident confides in and relies on her fellow trainees as well as her faculty.   If we learn well, we discover that providing health care is indeed a team sport. 

I can recall a number of devastating experiences during residency having to do with poor outcomes for patients.  As we tend to be perfectionists, I am sure that you understand that I punished myself multiple times, feeling that I was not worthy of the profession, feeling that I had let someone down.  I felt like a fraud, an imposter.  I have had similar feelings as an attending physician.  In talking with close colleagues, I know that I am not alone in having these feelings. 

In moments of professional distress, we need each other.  We need to support and provide a reality check for a colleague who did their best and yet had a poor outcome.  The reality in the vast majority of cases is that our colleague is a good, caring physician.  We would do well to remind our colleagues of this again and again.  All of us have thought, “There but for the grace of God go I.”  The wounded healer feels alone and isolated and believes that he is constantly being judged by colleagues and other members of the health care team.  Sometimes the belief is well founded, which is an indictment of us all. 

In the 25 years in practice after residency, I have become more humble.  I have stepped off the pedestal I had built for myself over years of striving and pretending to be all-knowing, all-competent.  I remember once praying for humility some years ago, and then feeling afraid of what would logically happen if my prayer were fulfilled:  humiliation.  Well, that has happened but life did not end. 

Many things contribute to our resiliency, such as the love and support of our families, friends, and colleagues, and the appreciation of patients and their families.  Sometimes we also need professional help and therapy to get back on our feet.  I believe that reaching out for help is a sign of strength and wisdom.  Receiving care may feel unfamiliar to us but it is part of the complete human experience.  Try it sometime.