Combating Burnout by Finding Heart, Part 1

Transcript of a Sage Hill Live Fully Podcast conversation with Dr. Chip Dodd. Lightly edited for readability; speaker labels omitted.

Hi. This is Stephen James with the Sage Hill Podcast. We have a special edition of the Sage Hill Podcast today coming from the Sage Hill studio. We have our first podcast guest, doctor Sean Jones. He's gonna tell a little bit of his story, and Chip's gonna talk to him about an issue that's been around for a long time, but is just now getting some of the attention it needs, professional burnout. So stay tuned, and welcome back to the Sage Hill podcast. So I'd I'd tell you what, doctor Jones officially and doctor Sean Jones officially, but Sean to us, I'm so glad to get to talk to you. Thrilled about it. And I want us to start by talking about the the book that just recently came out called Finding Heart in Art, a Surgeon's Renaissance Approach to Healing Modern Medical Burnout, which has really become a sort of a a big passion of your heart. I'm so interested in talking to you and other professionals, other spouses, doctors hearing about this too. I've I've had the privilege of working with physicians for thirty years. I love you guys. My heart breaks for you guys in so many ways. I respect what y'all do. So, Sean, you just start out introducing yourself, how you came to this book and what the book's about. We'll just go from there. Well, I appreciate being here first of all, Chip, and you, inviting me here.

I think it's been, as you said, a passion of mine, sort of in the model of AA. You know, if you feel like you get something out of treatment, then you want to go tell other people about it. Yeah. And so it's really been something that's been on my my heart for a while. But I found myself in a place, and actually Evelyn found me. I think she sort of dragged me up out of the ditch. The spouse of Sean? Yes. And, that was my wife. And, I tell the story in the first chapter of the book how, you know, she thought, because we're both physicians, she initially thought, oh, he's got a brain tumor. Yeah. And so she actually sent me to my internist and said, you demand to get a CT scan. Yeah. And so he said, well, why do you need a CT scan? And I said, well, Evelyn said I need one. You know? That's that's why that's what any good husband would say. And he goes, well, how do I code for that? You know? And so I said, well, I've got Spouse spouse diagnosis. The worst headache I've ever had in my life because I knew that was something that would get paid for. And so the CT, of course, was negative, but the point of that was it was sort of her recognition that I had become emotionally numb and not present Mhmm. Which is actually something that I had come to the conclusion of while shaving one morning. It just all of it occurred to me. It's like, I'm not feeling anything. Wow. How long had you been in practice? How long had you been married at that point? How old are you now, in fact, start with the start? I'm 58 years old. 58 years old. I had been, this was about six or seven years ago. So it was after I'd been in practice about, twenty years. Right. And my children were all sort of in high school, middle school. And in practice as as a very successful ENT surgeon. Correct? I've been successful. Started my own practice. I mean, nobody really wants to say, you know, like, I'm a good tennis player. It's hard to

say. I'm really smart. I'm really tough. I'm really talented. I've done a great job. But but you really had. You had you had carried the profession with dignity. You had cared for for patients with methodically, with with integrity, overseeing patient care, attempting to raise a family, attempting to do the right thing, being a a good religious man. I mean, you were doing all the right things, were you not? I was checking the boxes Yeah. And, somehow in in the midst of all that, the, the tragedy or tragic nature of life had sort of gotten me to a point where I'd shut down and I I didn't recognize it as it was happening. Mhmm. And so that, that's when serendipitously or if you believe, as a result of of God's providence, then I came in contact with Stephen James at Sage Hill and CPE, and and so we underwent some initial marriage counseling. Yeah. And so after a couple of, visits in fact, I think it was like one couple and then one with Evelyn and one with me. Mhmm. At the end of But at this point, do you you're saying to to yourself, something's off for sure, and I don't know what it is, and it's not physical. I don't have any idea what it is, but I've already When Evelyn sees it, she's aware that something's I mean, I can run five miles. I can do I'm still working at the hospital. No seminal events. Nothing's affecting your work. Your work's just as good as it's been. So I thought, I think it's better now as it was up to being a whole human being. Yes, sir. So, Stephen said, hey. I think I know what the problem is. I want you to meet somebody. And so he takes me into your office, actually, and that's the first time I meet you. And and, you know, you are like this, you know, sort of vibrant big bird in the room because you were just all over the place. And and I'll never forget you leaned down and you said, listen, we can help you become who you were made to be Yeah. So you can go out and do what you were made to do. Yeah. And the the idea of that just somehow touched me in a place that's hard to even explain. Yes. But I knew that that was true, and I wanted it. Eighteen inches below your forehead.

Yeah. Yeah. The place that got that gets forgotten along the way. But lost so many of you guys that are professionals, especially physicians. It's just so strong in the brain. You know? So but go ahead. Yeah. Yeah. So, you said, well, I tell you what. You need to come in for a three day evaluation. Yeah. It's like three days. I mean Three days of losing what? You know, the idea of, like, getting three days off for a vacation was impossible. But to take three days off and what that meant as far as rearranging patients and and the schedule, I'd actually just been, about, I think, maybe three or four months before that, elected president of the Kentucky Medical Association. So that was gonna start in about six months because I was president-elect.

And and what were you doing that for? Why why did you do that? It's I know it's a wise an accusation, but come in. Give me your defense for having done that even though it's great. Right. Well, I I think you're already very busy. Right? I'm very busy. You're already sort of tired Tired. And you're not feeling exhausted. Did you think the next maybe I need to achieve something else or have a difference in the world? Or I think that was part of it. Yeah. But I think also there was that idea that, you know, I've been given so much that I wanna give back, and somebody's gotta do the difficult work Yes. To be able to talk to Yeah. People in Frankfurt, you know, which is the capital of Kentucky about

how what the decisions they make are gonna affect medicine Yes. Patient care. And And you had enough wisdom and experience in the profession now that you really I felt like I could provide something in that regard. And my father-in-law had actually been, really involved in KMA and was a mentor for me in that regard. He was legacy responsibility too and It was a combination of things, but I think it all kinda came together. So there are doctors everywhere? There there are. Okay. Absolutely. Yeah. And, so three days, I was like, you know, Evelyn and I talked about it and she's like, it's your decision, you know, but I'm I'm really supporting you in whatever you wanna do. I want you to to get better, you know, and so Can I let me ask you a question? Sure. You're you're describing, and I think a lot of professionals relate to this. In fact, recently, I had a, a physician friend that I know who knows what I do in terms of people coming into treatment, and he said, do you mind if I ask you something just privately? And the the answer was course. And, he said, how do your people how do they end up going to treatment for three months? How do they pull that off? Because I would love to go on a a a sabbatical, and I not because I need treatment, but because I want to do something with my son. And, the impossible nature of that when I said you can do it. You could just simply organize it and do it. But so many of you guys are literally like living on a fast moving train, and it's going from destination to destination, and there's no getting off unless you're thrown off or jump off, and that's almost certainly in y'all's minds gonna cause extreme bodily harm. You know? So it's like it's like an impossible thing, a three day time period to actually get an examination, a consideration for something's off, that your life is sort of sinking though your achievements are still increasing. And the idea of three days for you was just overwhelming. It felt impossible. And I think so many so many doctors, even the young ones who are demanding that time still are scared to take it. But, yeah, so you're on this train. Three days keep going. Right. And I think one of the other issues there is is the awareness

that it takes to recognize that there is a problem. Most people are not going to recognize emotional exhaustion because we've been trained to ignore it. Yeah. You don't have that. Right. Moe you know, it's like a Navy Seal being in cold water. It's just the way it is. Now do other people in in y'all's training, are other people do they have emotional exhaustion, but you don't? Is that kinda how that works? Or do y'all even take the time to I don't know that I would have seen it in anyone. Most of the time, if I saw one a a colleague who was acting out or something of that nature, I would have probably seen the same issue that he saw and said, well, that was

appropriate. I would have probably acted out in that situation as well. Yeah. But the emotional exhaustion either was something that's made up, doesn't exist, or is maybe a weakness perhaps? A weakness. A weakness. Yeah. I think it probably would have been a And you're trained not to have it. So not only is it a weakness, but you're trained not to have it. One of my general surgery, mentors, one of my chief residents went into him and said, you know, I'm having trouble with my marriage. I need a day or two off so I can try to put things together. And he said, listen. I've had three wives. None of them have been a problem. I suspect that you'd be easier to replace one of those in a general surgery residency, so I suspect you ought to get back to work. That that story is very familiar. If you want a spouse, if you want a friend, get a dog. I mean, that So Yeah. So It's just, you know, that that ignoring self care and needs was sort of drilled. Mhmm. Everything else comes first in that regard. I think that's sort of the way the training was. And hopefully, that's changing a little bit, though obviously, it's not changing as quickly or as well as it should Yeah. In terms of the way we're training people. But So go back to that three day evaluation. So the three day evaluation yeah. So I get back and I just said, okay. We're we're we're just gonna somehow make it happen and talk to people. I've found the weekend that worked, and, it happened to be a weekend before I had a week of vacation scheduled. So I thought it'd be easier to just take, you know, the time in the middle of that. So I went in, and it was really interesting because And, oh, wait. I don't wanna get so you took your vacation

to do your evaluation. Is that correct? I actually extended my vacation. I I had I had a couple of days on the beginning of my vacation. So So you take the evaluation, do your use your vacation to get better and get back to work, so possibilities. Right. Yeah. Okay. Right. But it actually gave me a week to sort of think about what happened. Yeah. And to talk to Evelyn in, you know, a sort of more casual way about, okay, what are we gonna do about Yeah. What happened. Yeah. And so I think that was also, very providential in terms of my being able to come to terms with what that meant. So we're at the three day evaluation, and, I'll never forget meeting, you know, someone who's become a really good friend. Almost everyone there was either a physician or a dentist or a professional Yeah. For sure. And there were 10 at the time, I think, in in treatment. And when you're sitting around at night talking about everyone's issues and and things come up, it it was like, well, well, why are you here? Yeah. Like, well, I'm really, you know, I'm depressed, and I'm this, and I'm that, and I don't feel like I'm not sure I want to be a doctor anymore. And I was like, I've always loved being a physician. I'm not sure what's going on. I was like, well, what drug are you using? Well, I'm not I'm not using a drug. Well, you know, that's all you that's the whole reason. Like, there's no way that I would do that. And so I didn't know it at the time, but they sort of, like, took bets on whether or not I would be back Yeah. At the end because you recommended six weeks of, you know, outpatient psychotherapy at the end of the three days. And so Evelyn and I went on vacation with our children. We actually went to Vero Beach, Disney World, Vero Beach in Florida. Had a great time. She's a dermatologist, so we never took beach vacations and our kids finally just had a riot and said, listen, we're gonna do a beach, you know, we'll do the sunscreen, we'll do long, you know. You stay at the end of the day. Yeah. Exactly. So we did that and and had a great time. But during that time, I was like, look. I have gotten a taste of life that I really think I don't wanna do one day a week or one hour a week for the next five years. Yeah. If they think I can get better quicker,

it's like, I don't wanna wait. Right. So Stephen Stephen supported it. I definitely supported it. Phil Herndon, who you are very good friends with and care about, You decide to come into the Center for Professional Excellence. And, you know, you you, Sean, and I know you've done so much work on burnout, which we'll get to. It started out with, you know, depression, codependency, alexithymia, dysthymia, upbringing, family of origin, and what's so amazing is CPE was built to do two things. One is recovery from whatever ails you, whether it's depression or addiction, so you can have recovery of your life. And, you got a taste of that. You got a a scent of that. Like, you've never seen the ocean, you've heard about it, you could smell it, so you kept being drawn to it. And I love that. And it's it's so sad that so many people have to get to that that next place that they're saying, why are you here? Right. When, actually, you had all the you'd earned your club membership into treatment. And, can you speak to, the guys around you and yourself? You guys are health care professionals, professionals generally speaking. You guys are really smart, and you're really tough. Like you say, a Navy SEAL with cold water vacations are for weaklings. Emotional exhaustion can't happen to me that somehow your your willpower you're you're smart, you have plenty of willpower, you're tough as nails, and that becomes a form of have to. You've got to be like that. Also, you especially physicians, and I think all professionals, but all people in general, but you're also very concerned. You're you're driven by concern or morality. So you have these three primary characteristics, and along the way, you're sort of trained to become a a caretaker, people pleaser, approval seeker, and achievement, even become going into being the president of the KMA, Kentucky Medical Association, at the point of being on the edge of the precipice of of darkness, exhaustion. It's amazing how you guys, in all of your achievement and all of the things that make you successful, they become tools that also destroy you. You know, because you lose heart. You lose emotional capacity, whereas you lose the ability to feel your feelings, tell the truth, and give it to the process. So Right. You come to treatment, you you do it. And in fact,

the studies have shown that as a cohort, those that because you might say, well, physicians are set up to fail because of who they are Yeah. When they're enter the process. Yeah. But studies show that people who become medical students are actually more well adjusted, less likely to become depressed, more, you know, overall intelligence and adaptability than their peers. Vetted. And then by the third year of medical school, they are lower than their peers in every one of those rankings. Somehow within just a couple of years, we have been able organizationally, institutionally, however you wanna put it, to sort of beat that out of them. Yeah. So this this this direction, mission, sort of a a mission of the heart in the beginning, sort of, like, gets translated up into the head. And by that point, so the heart starts to get lost a little bit?

I I think that it has to be, and then it's all about achievement and and making sure you get the right score, the right test, the right residency, the right and it goes on and on and on and on. And it's And then you're also seeing that your choices have real life consequences in terms of death and lawsuits, in terms of trauma, and even, I guess even, I've heard so often that once a physician moves into practice, they've, by ten years through residency and then maybe another two years in the practice, they are they've been, wounded by trauma. They've seen so much loss. At the same time, they're starting to see this experience called boredom. You're seeing the same thing over and over again. At the same time, you're carrying trauma. So you're It's not shocking anymore. Yeah. And the post traumatic stress disorder related depression, which as you know, I was diagnosed with,

is the same sort of thing that returning veterans have Yes. From the battlefield. And Yeah. In many respects, we see some of the same things in a different context. Do you think is that is that generally so for physicians? I think based upon your research and your research I think it is. I think that people who have elements of PTSD are more likely to suffer burnout than people who don't according to an Israeli study. Yeah. You know, the difference between burnout and post traumatic stress disorder, depression, anxiety, all of those start to co mingle. Yeah. And it's difficult to figure out where somebody actually entered the pipe, but it all ends up looking the same. Yeah. You know, addiction, codependency. Yeah. Let's let's jump to that then. So going back just for a moment, we know that, physicians don't all they don't all carry post traumatic stress disorder. Not all physicians are depressed. Not all physicians have anxiety disorders, but those are very real, real issues and very common to the health care professional. Agreed? Absolutely. And, addiction, huge. At the same time, y'all have, very minimal permission to have these problems.

Well, I I think if, you know, you look at the, the boards that regulate physicians, their primary purpose is to protect the patients, which arguably is is tantamount for them and and should be. And so I think it creates this barrier to physicians being able or willing to admit any weakness or impetus or likelihood that they have Yeah. Any of those chinks in their armor. Thanks for listening to the Sage Hill podcast. For the rest of this conversation between Dr. Chip Dodd and doctor Sean Jones, come back for next week's episode.