A: Hey guys. Welcome back to the podcast. I am Amanda.
L: I'm Laura.
K: And I'm Kendra.
A: And today we are just gonna have an informal discussion on an equation that has made a big impact in my life. And the principle can be applied to so many things that we just wanted to share it with you and see if there's any areas in your life things are harder than it should be. The Equation- it's attributed to psychologist Kristin Neff. That's the best I could find on the interweb. So we're just gonna go with it. But she says suffering equals pain times resistance.
Pain X Resistance = Suffering
Okay. So in essence, what's that's trying to say is that we are all human beings. There are going to be painful things. We can't escape it. And even trying to pretend like some things aren't painful is toxic positivity, and our bodies just reject it. So there is pain. It's part of the human condition. There are gonna be sad times with your children, unfortunate circumstances, you know, things that come up. That is part of being human. That is unavoidable. But when we resist that, or when we think thoughts that aren't particularly helpful, that multiplies the pain and creates the suffering. And so, I know that sounds crazy, but we're gonna show you with some examples of how that looks.
And I'll start with how it looked in my life. For a brief period of time I went to all nights because I didn't want us to have a nanny. My husband's a full-time physician also, so I was part-time, and I was like, well, I can do all nights. I'm just part-time, you know, and that will be totally fine. That way I can get the kids to school. We won't have to have a nanny. And don't ask me why I didn't want a nanny. I just didn't. It's just a choice. But I would, you know, night shifts are rough, like your body's not really built for night shifts. And I would spend all day dreading going into those night shifts. About how terrible it was going to be, about why am I even doing this, about, you know, everything that was wrong with the medical system. And so, the night shift is painful enough. It is kind of rough on a circadian rhythm, although, you know, there are strategies for that. But me dreading it all day long when I wasn't even at work and resisting the fact that I had chosen to do this exponentially increased the amount of suffering that I was having with working all night shifts.
I've done it also with, you know, the frequent flyer that keeps signing in. Like, oh my gosh. Like, why are they doing this? It shouldn't be this way. Somebody should say they can't come here anymore. Well, no you can't. Yeah, but it shouldn't be like that. You see how the fact that the person's there again is, honestly isn't really that bad. But me having this whole scenario in my mind where things aren't as it “should be,” is just me resisting reality. And it was creating unnecessary suffering.
There's so many examples of this, and we see it in our clients all the time. And so I just wanted us to kind of have a discussion of how this looks so that you guys out there can start considering, wait, am I making a bad situation worse for myself?
It's never the circumstance that is the problem. It's what we think about the circumstance that creates the results for our lives. So do you guys have any examples that you've seen over and over or that it's come up in your life?
L: Yeah. Well, honestly, for a long…actually, I'm still resolving this for myself. I'm still entering emotional adulthood. I spent so much of my life thinking that other people should be different than they are. And I had a set of expectations and standards for myself, and I could not understand why other people didn't wanna do things the way I thought they should be. I remember one instance when I was in residency. When I had a patient come in with a COPD exacerbation, and I remember. Looking back on it, it was very simplistic thinking. But I would say, why do these people keep smoking? And I remember telling this patient, I'm like, you know why you're here. And I had this moment where he…he taught me. He said, dude, don't talk to me like that. Like telling me I was not being respectful of him, and I wasn't. And that was kind of one of my first lessons in that people get to be themselves.
Everyone's on their own journey and people get to choose the way they're gonna be. And if we don't like it. If we wish they were gonna be a different way and try to change them, we're really only causing suffering for ourselves. And this will come up in any number of different interpersonal relationship situations, whether it's our patients. Sure. We wish our patients wouldn't do a lot of things they do, but judging them isn't going to change that. And wishing that it would be different isn't gonna change it. You know, expressing kindness to them maybe, but probably not. So just accepting people the way they are is a big step in the direction of avoiding this unnecessary suffering.
A: Yeah. There's a whole lot of like- if you catch yourself saying “it should be,” or “I wish that,” or “if only.” If you catch yourself saying that, just notice what comes after that. If this is a helpful road to go down, or if you are just creating a bunch of mess for yourself.
Oh, I'll give another example. So in our town, they stopped having a drunk tank at the jail. And so if an officer or whatever went and found somebody drunk and passed out in a ditch, and they checked on him to make sure that he was breathing, and he woke up. Then they would bring him to the ER. And I'm like, why are you even doing that? Like there's no medical condition here. Like, what are you doing? And I would just lose my mind. Do you think I was writing the local legislators to try to change this policy? Do you think that I was being proactive? No. And so for me, if that had motivated me to make a change, then I would wanna keep that thought. Like, this isn't how it should be. However, for me, I had no interest in firing off emails or letters or whatever. So me just raging against the machine was waste of my energy. You only have a certain amount of energy each day. Right? Like, and I could have used it for something that served me better.
K: Yeah. That's funny. I, I hear you. I'm gonna second that. I definitely would go from zero to 60 when I would just hear the ruckus like, walk down the hall, you know. Like in Amanda and I’s shop, we have, the place where we work, but you can hear everything. And so when I would hear just a ruckus going down the hall and like multiple officers trailing, I just said multiple cuss words under my breath before I signed up on the track board and walked my happy butt in there, ready to take it out on just about anyone in the near vicinity.
And I realize that actually probably affected the care that I gave. You know, I, all of us, I know, have the intention of giving good care to every patient. But I'll tell you bluntly and honestly, it did affect my care. And if they could tell me their name, where they were, and how they got there, I was like, clear for confinement. See you later. And how many, like, subdurals did I let walk outta the ER, I don't know. Not to shoulda, coulda, woulda, but it's just one of those things that it really does kind of cloud your judgment and just not, you really just don't give good care anyways.
And it's like we, I think we've said this before. I mean, you like drink the poison and hope that it injures the other person. It doesn't make any sense because we're the ones experiencing the suffering and pain. I know I…any, any married people out there? Holler back at us. I absolutely caused a lot of pain and suffering because I wished my spouse was different. And there are many things…I don't have enough time in this podcast. But I realize that one of the things that was super important to me, I had never really expressed. And I know, I think we've talked about this before, but we have the manual, or we call it the prescription for people. We have expectations of how we think people should behave, and when they don't, we're, we're the ones that take the brunt. When it really has nothing to do with us. Our spouses hopefully are adults too, and they're allowed to behave however they want. And it wasn't until I, like thoroughly communicated, several times, about how that certain behavior affected me, that real change took place. But for years I just suffered and like, you know, fantasized about holding this pillow over the…
L: Right . Well, I think
K: Just briefly, so he saw Jesus and just like, oh can I do this?
A: My marriage is in the dumpster fire half the time. So yeah, well, and that's painful enough without me thinking that's not fair. It shouldn't be like this, you know? Exactly. That sort of thing. Exactly. Not helpful.
L: Well that, I think that's an important distinction to make there Kendra though. Cuz like we're, when we're saying resistance, we're talking about like, just like sulking about it. Just being mad about it and not actually doing anything. But setting healthy boundaries is a good thing. And that's not resistance, that's setting some boundaries.
A: That's being proactive.
L: That's being proactive.
K: Yeah. Well then I used the energy to actually set boundaries and just express how it made me feel. And once I made it about me, and I owned it. Like that really stresses me out or adds a level of stress when you do X or when you do Y. And is it a hundred percent every time now? No, but at least it felt better for me to say this behavior causes a lot of stress for me. Or I feel you don't respect my time or whatever, and made it about me. And then it was, it was like freeing because I was like, well, no longer do I need to sulk or be frustrated or be mad because now I've actually said it. I've set the boundary. And then ball’s in your court, dude.
A: Also, if we're, you know, talking about medical examples. I would do this to myself when I wished I had done something differently. I wished I had been smarter and picked up on the diagnosis sooner. I wish I would've called so-and-so first instead of so-and-so. You know, whatever. Like in retrospect, there are things, if I had to do it over again, I would have done it differently, but it's done.
L: Right. No time machine.
A: Right. And so I, I'm telling you, I could spend. I think we go into it in Unit Nine in our course, but I can spend months critiquing how I did it wrong. And it's okay to want to do things differently, but you have to watch, like, are you learning from this, or are you just berating yourself where you can't show up. Like, are you, are you using this to make yourself better or are you actually making yourself worse? Because of the way you're showing up to a situation. It happened yesterday. Kendra knows what I'm talking about. Like, I wish I would have been quicker. We work at a freestanding ER, and I wish I would've been quicker sending this. It was kind of a strange story. Well, the guy got to the right place. But I almost fell into old habits where like, if you just would've not been clouded by the original story, you would've acted sooner. And, but today I'm here to tell you, yes, I wish I would have managed that patient better, but I'm going to remember this and just do better next time. That's, that's a, that's big growth for me.
L: Yeah. And that is so huge because you're not shaming yourself.
A: A little…
L: You're not making it mean anything about your worth or how smart you are or how awesome you are as a physician. That is so important. That's one of the things that we, our, our clients, we love them so much, and we all struggle with this. We all struggle with shaming ourselves. Probably cuz we learned it in training for making mistakes that are natural and normal and are just part of the process of…there’s a reason it's called practicing medicine. It's not perfecting medicine.
A: Right. But nobody tells you that, you know? Like you're the only one who's not perfect. That's what it feels like. But that's so not right.
L: They're just hiding their own shame of their mistakes.
A: Well, and thats too. If we were allowed to be vulnerable, everyone feels this. And so, then you wouldn't have to be judgy of others because you also, in return, didn't feel judged. Yes. You know what I mean? It would be so much better, but again, that's not how it is this moment. And we can wish that it was a different way. But yes, I will be more vulnerable because I want to start moving that needle a little bit. And I also realize that not being absolutely perfect at my job does not affect my worth as a human being. I am going to do my very best every single time. But as a human being, sometimes I don't pick up on everything. Like sometimes my spidey sense fails me. You know?
K: So I think another thing which is important to remember is, you know, even so. I think, I have found that sometimes I do this. I'll find out I'll need to call a consultant. And I will find out who's on call, and as soon as I hear the name…mm-hmm… And if it's not ever a positive or fruitful conversation on the phone with this consultant, I will immediately just let out a huge sigh and cuss and be like, great. And I'm already like creating pain and suffering for myself because I absolutely don't want to talk to this person. I don't. No matter how, I could have everything wrapped up in the nice paper, the patient's got a pretty bow, like, here you go, Ma'am. And it will just never go well. There's just always something about the interaction with, you guys know, certain consultants that is so painful. But it doesn't matter because I used to think. My first thought was like, why do you have to be such a jerk on the phone? Like, and I would take it as a personal attack on the way I manage patients.
I have no idea what's going on in that consultant's life. I don't know how many calls he's just gotten from, I mean, we're a tertiary care center. I don't know what's going on in his life, but immediately I thought it was about me and the way I cared for the patient. Even if they were, you know, blah, blah, blah, everything teed up, ready to go. And I realized, once I flipped the script in my mind and said, I took care of this patient, did everything, hand it over. And it's, you know, if the interaction doesn’t go well, that's actually not on me. And whether or not the consultant on the other end of the line realizes the efficiency which the patient was taken care of. If they don't appreciate it to you right now, it probably is gonna be something down the road. So there's always the unseen, there's always things that we never appreciate because it's later down the road. Whether we were timely and efficient or whether we caught something that was a little bit of a backdoor diagnosis. You're like, oh gosh. Something like that.
There's also the unseen that we forget about, and so that also can be a thought. Like, I'm not sure what this guy's got going on, but you know what, I'm sure that that outcome's gonna be good because of my care. I just probably won't see that, but we can just like hope or whatever. We go to work wanting to do the very best job taking care of our patients in the most effective and efficient way. As long as we keep patient care at the forefront, you can't go wrong.
And so there's nothing that you should feel guilty, or anyone else should make you feel guilty if you didn't tee it up exactly how that consultant wanted. They can always find something that you didn't do in the ER. That's like, I feel like, part of their job as being a consultant.
L: Well, you know what one of my favorite things to now is? Is to set healthy boundaries with people like that. Like, I'm just at the point like, if, if any of them start talking to me in a way that is disrespectful, I just say, hey, hey, I'm sorry you're having a bad day, but you don't need to talk to me like that. Like, we're on the same team.
A: Yeah, like it's very disarming like, oh, wait a second. Like because here's what happens is when you come into a conversation like that with pre-judgment, it, it is a natural inclination to give right back to them the thing that you dislike that they're doing to you. And that's not your best self.
A: Right? So in the equation, when we move from resistance to acceptance, and you just decide that if you're getting the result you want, keep it. If you're not, then consider moving more towards acceptance and see how it is.
One of our clients was frustrated with her husband. He is always like grumpy and doesn't wanna do new things on vacation. And she's like, it ruins my vacation. Well that's impossible because he can't ruin your vacation. Like you have. It's your thoughts about it. But we were able to move towards: isn't it so cute, your little grumpy guy? He's like the ol’ man on Up. Like we love that about him. And you can just, if you let him be him, and not put all your energy in trying to change him, then you could put all of your energy into having fun on vacation. It's not dependent. He gets to be a little grumpy old man on Up. You love that guy.
L: Or you can, you can choose to still be mad about it if you want. You can keep it if you want. You can, either one.
A: But if your goal is to enjoy your vacation, then you need to really look at if this is helping you or if this is hurting you.
K: Yeah. I love the part about just getting to decide. You getting to decide. That just feels like you just get your power back. It's like when you get to decide how this situation's gonna unroll, it really is the fact that it empowers you and it almost just, like you said, Amanda, like you kind of deflect the hater and bring on the lover here.
So we are so excited that we just completed one of our webinars: “What's the ICD-10 Code for Injury Sustained in a Dumpster Fire?” We had a great time. If you missed it, scroll down now to the bottom of the show notes and click the link to watch the replay. And stay tuned because our next FREE class is coming up May 10th at 12:00 PM Central, and we are talking about Time Management.
Until next time, you are whole. You are a gift to medicine, and the work you do matters.