Sustaining Our Joy in Practice
September 21, 2017
by Autumn Dawn Galbreath, MD, MBA
My eldest child left for college this fall, having chosen to attend school in Scotland. Yes, that’s right. Scotland. It’s a long way away. It’s also a place I had never previously visited. We went on a family trip to Scotland in March—partly to visit the school he now attends, and partly to have one last bang-up family vacation before we became a family that no longer lives under one roof. On that trip, we had not one, but two, flat tires on our rental car. A consequence of our struggles driving on the left side of the road, perhaps? The second flat tire occurred while I was alone in the car with the rest of my family divided between two different places. I had to have the car towed from the tiny little Scottish village where the flat tire occurred to the slightly-larger Scottish small town where the nearest garage was located. As I sat alone awaiting the tire repair, I overheard this conversation, all in thick Scottish brogue.
Garage Staffperson: When will you be leavin’ for the U.S.?
Customer: Two weeks more here, then I will be there for six months.
Staff: Every year you go?
Customer: Yea. Every year I am here for six months and over there for six months. The most difficult thing is changing driving to the other side of the road each time. (chuckle)
Staff: It’s different there, eh?
Customer: Oh, so different. Americans work so hard. They work so much. Do’ye know it’s standard to have two weeks holiday leave per year?
Staff: TWO WEEKS? I’ve never heard such.
Customer: Yes. Two weeks. It’s criminal, really. That’s why when you see the Americans over here they are always in such a rush. They work so hard for so long to earn their holiday. And then when they go on holiday, they are in a rush to enjoy every minute before they return to work another year for another holiday.
Staff: Shameful, it is!
Customer: Yea. You’re right about that, lass.
As I flipped through my magazine and listened to this conversation, I initially smiled to myself at the “caricature” of Americans: busy, harried, overworked, under-vacationed. But as I smugly pondered these thoughts, it occurred to me to reflect on what I had been thinking when this conversation began.
Me: How long can it possibly take to change a tire? I’ve been sitting here over an hour already. Not a single customer here, either. I’ve got things to do. It’s not like we’re in Scotland forever. Do they think I have all day to sit here waiting for them? We have so much more sightseeing to do before we leave.
Caricature? Maybe not so much. Maybe I am one of those busy, harried, overworked Americans rushing to “enjoy” every minute of a holiday before going back to the grind. Hmm. Food for thought.
This overheard conversation has flashed through my mind on a number of occasions since March. When I feel begrudging about getting ready for work on any given day. When I comment to my spouse or colleagues about how much I need a vacation. When I realize I am not taking joy in what I am doing from day to day, but that it often feels like a means to an end.
Am I alone in these feelings? I think not. Interestingly, there are articles on joy in medical practice (and its absence) in the secular literature. I’ve always considered joy a uniquely spiritual word, so it surprised me to find it used in purely secular articles. But it’s there.
- “Losing Your Joy?” is an article by a physician-turned-coach who advocates taking control of our daily lives in order to avoid burnout and rediscover the joy of practice.
- “Finding Joy in Practice” in Medical Economics offers various aspects of practice that may be robbing joy, with suggested changes to combat this.
- “In Search of Joy in Practice: A Site-visit Analysis of Twenty-three Highly Functional Primary Care Practices,” an ABIM white paper, examines 23 clinics judged to have good physician work-life balance, drawing lessons that other practices may emulate. One statement stands out to me: “To address the adult primary care workforce shortage, we must search for joy in work.”
Why the discussion of joy among non-spiritual writers? The dictionary defines joy as “the emotion evoked by wellbeing, success or good fortune or by the prospect of possessing what one desires: delight.” By that definition, I suppose it is a good fit for what so many physicians want and what these authors are trying to offer. However, I don’t typically hear the word joy being used in this context. Happiness, contentment and satisfaction are more common. Joy, in my experience, is a word typically used to describe a more transcendent emotion. A more spiritual experience. And, while surprising in the secular literature, it is a frequent word in Christian circles.
In fact, the most recent issue of Today’s Christian Doctor features an article entitled “Where Did My Joy Go…and How Do I Get it Back?” Unlike the secular articles on the topic which offer temporary solutions without diagnosing the root cause, Dr. Betsy Manor gets to the true heart of the matter: “I knew I did not want to spend one more day toiling without the strength and guidance of the Lord.” Therein lies the Source of Joy. Not in changing our daily routines, taking control of our own decision-making or emulating other practices’ work flows, though there may be value in those things for some of us. No, the Source of Joy is far beyond anything we accomplish in healthcare. The Source of Joy is in our own relationships with our Creator, through our faith in Christ.
In Surprised by Joy, C.S Lewis points out, “All Joy reminds. It is never a possession, always a desire for something longer ago or further away or still ‘about to be.’” He astutely muses, “I sometimes wonder whether all pleasures are not substitutes for joy.” In other words, true joy is not something a secular person can ever fully experience. True joy is the fullness of relationship with God. As Christian healthcare professionals, we have access to this joy, both for our own wellbeing and for the benefit of our patients. And, ultimately, isn’t that the reason we close the exam room door and enter into the private lives of patients every day? For their benefit? If, as Dr. Manor experienced, we are toiling without the strength and guidance of the Lord—without joy—what true benefit do we really offer?
David prayed, “Restore to me the joy of your salvation and grant me a willing spirit, to sustain me” (Psalm 51:12, NIV 1984). As healers who do so much to sustain others, isn’t this a prayer we need to pray on a daily basis?