Soul-Sucking Emptiness

Although fictitious, dementors were inspired by a season of depression experienced by J.K. Rowling that she described as an, “absence of being able to envisage that you will ever be cheerful again. The absence of hope. That very deadened feeling, which is so very different from feeling sad.”  I think most of us can relate to moments like that especially in residency where you feel like every minute at work is slowly draining your soul & leaving you hollow.  And while there is increasing talk on mental health, wellness, and depression during residency, I believe there is a critical, missing piece of the discussion – Spiritual Wellness.  

Off the top of my head, there are definitely several reasons for its absence including the historic tension at the intersection of faith & medicine, our increasingly individualistic and diverse Western culture, and a scientistic worldview that dismisses any talk of spirituality as an area outside of knowledge.  And as one article points out, even defining spiritual wellness is difficult because its definition varies by culture and tradition, “but refer[s] to a common experience.”  At its core spiritual wellness is a phenomenon typically connected to, “our search for meaning and purpose in human existence.” 

Unfortunately, that search for meaning and purpose does not stop during intern year.  We cannot put our spiritual wellness on pause for 3-9 years and think nothing is going to happen.  If anything, our time in residency is our, “journey of faith, personal growth, and moral challenges.” It is how we, “come of professional age – acquiring the knowledge and skills of [our] specialties or subspecialties, forming professional identities, and developing habits, behaviors, attitudes, and values that last a professional lifetime.”  Our time in medical education is forming us into someone.  The question is who are we becoming?  And I think this is exactly what spiritual wellness is trying to address – who I am becoming in relation to myself, those around me, and the transcendent.  But unfortunately, the institution of medical education is not equipped to answer this question.  And while a definition of spiritual wellness remains elusive, I believe an accurate description of it as a phenomenon within the medical context for physicians can be understood on an adequate basis of thought and experience.  So here is my best attempt at a description & the paradigm I’m using for discussions on this podcast.  

Physician Spiritual Wellness is the journey for meaning and purpose amidst our day-to-day life as persons within medicine.  It is the interaction of the inner life with the “rough and rugged stretches” of our path, and its destination is the good physician.   

Some notes about this description.  First, it was influenced by The National Wellness Institute’s description of spiritual wellness.  Second, it is intentionally grounded as a phenomenon occurring within our social, embodied experience of being within “medicine” and oriented toward becoming a “good physician”.  Third, I’m letting you in on the ground floor for this.  I’ve thought about this for a few years now, and I expect to get some things wrong. This description of spiritual wellness within medicine will likely change with more thought & experience.  Which is why I need your help to challenge my individual perspective & elevate this concept beyond where I can take it on my own.  Finally, this concept is an open invitation for individuals to bring their full selves to the conversation.  I do hope to encounter a diversity of perspectives to challenge my own, and in return I hope others will be open to what my experience can bring to their lives as well.  

I’d imagine by this point some of y’all are skeptical of physician spiritual wellness as a concept, whether it exists, and – if it does – whether it is even important in the conversation.  No worries.  I’ve been wrestling with that same doubt for a few years now and here’s why I’d encourage you to continue tuning into this conversation (these are not necessarily the most important arguments.  They are just the ones I’ve been thinking about recently):

1. An increased focus on wellness and burnout hasn’t solved resident burnout.  Research on wellness is ongoing and evolving to point toward new solutions.  So it follows that wellness as it has been previously conceived and its current state is still missing part of the solution.
2. Meaning and purpose are important in the discussion of burnout.  However, “what should be our meaning and purpose within medicine?” is not a measurable scientific variable.  Which implies that some discussions on meaning & purpose amongst physicians must consider answers outside of “science”.
   

I do think exploring spiritual wellness will help us become better physicians.  And it may prove to be valuable as part of the solution for resident burnout, but that is yet to be tested.  But here’s the thing, if we are afraid to reflect on the questions that spiritual wellness is trying to address, we will never know if that inner-emptiness of burnout caused by the “ soul-sucking dementors” in our lives could be helped by considering residency’s impact on our spirit.

Also, a quick disclaimer here: By focusing on spiritual wellness, I am in no way making arguments against mental wellness.  While I can imagine there is some overlap & relationship between the two, I do not intend for our discussions on this podcast to replace seeking help for a diagnosable mental disorder.  If you are at risk of hurting or harming yourself or others please seek out the appropriate help.  You can call the National Suicide Prevention Lifeline at 1-800-273-8255 if you need help today.