Connecticut Children's Women in Surgery Episode 3: Maintaining a Sense of...

Wellness is the intentional things we do to live a life that is personally fulfilling and meaningful; the key word is intentional—wellness does not come to us, we must seek it out.

Wellness is a practice of working towards physical and mental well-being and happiness, intentionally shaping every day to live life to the fullest.

Wellness is being happy, which requires different things at different times—currently it means maintaining social relationships while functioning at work with direct patient care and academic activities.

Wellness is the intentional act of thinking about yourself during the day and giving yourself self-care, whether physical activity or mindful reflection, and understanding your priorities to make time for work and play.

After residency, the realization struck that hobbies had been lost during training; finding a new hobby became an intentional act to have self-care time away from work.

During medical training, there is a sense that all time should be for training; after training ends, one realizes this is the continuum from now on and must figure out how to balance.

Immediate patient care and parenting must take priority no matter what else is scheduled; you cannot take a break from them.

Those in the sandwich generation have the additional responsibility of caring for older parents and ensuring their safety, especially during the pandemic.

A psychology course taught a transition ritual: blasting heavy metal music in the car when leaving campus to turn off the work brain and transition to home life, preventing carrying patients' problems home.

In the executive vice president role, institutional priorities—pandemic response, financial crises—constantly elbow their way up, making it difficult to prioritize family and self-care time.

The pandemic forced everyone to be more honest about bandwidth limits; early anxiety led to supporting frontline colleagues but realizing there was not bandwidth for many other things.

Before the pandemic, it was common to have 6 or 7 children's activities on weekends after a busy on-call week; the pandemic shutdown prompted reflection on whether all those activities were necessary or if family time was more valuable.

An article suggested that parents being selfish and focusing on their own wellness is good for children; choosing activities parents enjoy (hiking, biking) so the family does them together combines socializing, physical activity, and enrichment.

The drive to be the best almost takes over and is prescriptive: publish one more paper, do one more case, stay late to see that operation—you can lose yourself in it.

The drive to be the best shows up in behaviors like checking Epic or email during vacation; the standard for responsiveness may be different for women than for men.

Epic beeps on the phone every time a patient sends a message, creating pressure to respond immediately; this is a double-edged sword of trying to harness drive.

Being prescriptive about vacation—putting up an away message and trying hard not to log into Epic—takes practice and does not always work, but it allows a mental break.

A documentary (The Social Dilemma) described the dopamine hit of social media and email checking; being intentional about phone notifications—turning off all except patient messages and calls—has been a lifesaver.

Women tend to be natural caregivers, and while society is shifting, this remains an expectation in many families and cultures, creating a challenge in balancing caregiving with other demands.

As the only woman in a surgical residency group, there was always an expectation that you would get tired or not be as strong or tenacious, creating a constant need to outwork or outperform male colleagues.

As an intern, after placing a chest tube that felt wrong but was dismissed by the chief resident, the tube was found malpositioned the next day; another resident advised never backing down or failing to advocate for yourself, because doing so would make people perceive you as weaker because you are female.

A chief resident who got pregnant during residency was talked about constantly, even though she was probably stronger than most residents because she had to feel terrible in the first trimester and still get through it.

Barriers for women in surgery include the perception that they may not have as much stamina as male counterparts, which feeds the drive to overdo it and be overenthusiastic—the 'I'll prove you wrong' syndrome.

Being first-generation in the family—first to go to college, graduate, and attend graduate school—creates an additional challenge: no reference or framework, and a chip on the shoulder to do it extra for everyone who set the path before.

Keeping a journal in the desk and writing in it during rough times or when not feeling like yourself provides a moment to get back into the present and reflect on feelings; reading old entries brings back the exact feelings from that time.

In moments of stress or feeling on edge, stepping back to separate emotions from circumstances, naming what is going on, and focusing on the next step forward helps until the day is done and thoughts can be collected.

Making boundaries—such as leaving the phone in another room from 5:30 to 7:30 PM unless on call—to be present with family during that time is helpful, though it does not always work.

Physical activity—swimming or running—with focus on breathing provides mindfulness; even 30 minutes to 1 hour makes things more clear afterward and allows everything else to be done better.

Connecticut Children's supported an Orange Theory program with a certain number of classes per week; this institutional support made it a priority when it would have otherwise felt selfish to take time away from children and other obligations.

The Women in Surgery group did kickboxing together; institutional framing made it a priority when individuals would not have gone to a strip mall to kickbox on their own.

After manager training on setting fiscal year 2021 goals, the idea arose that every team member at Connecticut Children's should set a wellness goal, similar to diversity goals, supported by the institution.

Wellness includes showing compassion to others and recognizing when someone needs a little extra—10 minutes to catch their breath, a cup of coffee, or a listening ear—because something is not going their way.

The OR environment at Connecticut Children's is very much a family; early in one surgeon's tenure, after a bad morning before a robotic case, Dorothy came around with a handwritten card, recognizing the bad day and providing support.

The OR feeds the soul—not only the creative soul and professional aspirations, but the people in the OR (techs, nurses, physicians, anesthesiologists) are like family and recognize when you are not yourself, providing support in worst and best times.