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The Physician Philosopher Podcast

TPP: 44: Be The Hero (Not the Victim) in Medicine

Larry Keller

 It is a big turning point for most doctors when they realize that leaving medicine isn’t the answer to feeling trapped in medicine.

The truth is you have all of the power you need, right now, in your current job to enjoy medicine again.

But first, you’ll have to deal with some hard truths. This article today, the hard truths we are going to dive into, are only for the brave and courageous.  If that’s you, let’s go.  

Today’s Thought 

Today’s thought is this:

When you position yourself as a victim, you remove all of the power you have to be who and what you want.  Only YOU can give this power away.  And only YOU can take it back.

Life is about shifting paradigms.  About changing the narrative of the story that we tell (often ourselves) about a situation. 

When you tell yourself a story in which you are the victim trapped in medicine, you believe that as the victim you have no control to change the situation. Your brain really begins to believe that leaving medicine is the only way out. 

But, what if that’s not true? What if inside of the victim, you could be the hero in your story?

I Use To Be The Victim 

For the past couple of years, I was positioning myself as a victim until pretty recently.  

You may or may not know my story of going through physician burnout in the midst of having a smoldering Grave’s disease diagnosis.

Of being on the golf course (one of my favorite places to be) when I had my first panic attack after the group behind us teed a ball off that flew right by my head. (It turns out that when your TSH is undetectable, handling these situations becomes a real challenge).

And then that ultimate moment when I got passed up for a leadership position in my department. It was a position that I had expressed interest in for years, and that I had been previously groomed to overtake. 

For the next year and a half I positioned myself as the victim of an unfair situation.

At the time, I didn’t have all of the facts, and so my brain did what all of our brains do, it filled in the gaps with the worst imaginable story to make sense of the situation. It filled in those gaps in order to protect me and make me feel better. 

It would take me the next two years to realize that the story my brain had come up with only positioned me as the victim of an unfair situation.  

I became bitter and angry. Disengaged at work in some of the things I had previously enjoyed. Practically leaving medicine. At least, thinking that leaving medicine was the only option. I reacted like the victim that my thoughts were making me out to be. My thoughts and actions were full of spite.  

The bitterness that raged inside of me for the better part of two years was set to consume me. It impacted my home life, work life, and just about everything else. 

The problem? I was disengaging from so many other things out of spite.  Out of bitterness.  Out of anger.  

Until I realized what I had been doing and  the thought model that changed my life.

The Transformation

One day, it all clicked that it was up to me how I responded. 

This realization came when something inspired me to realize that I was not showing up as the kind of person I want to be, and that deep down I knew I was. 

This inspiration came while I was getting coaching and reading a book. 

This book is old. It was originally published in 1989, but the truths in this book are timeless.

The book is The 7 Habits of Highly Effective People and when the author, Stephen Covey, gets to the chapter on proactivity he talks a lot about focusing more on “Being than Having.” Focusing on who we want to be rather than on what we need to do or what we want to have.

That was when it clicked.  

It is up to me to no longer place myself in the position of being a victim of an unfair situation, and, instead, to control what I can control. To show up as the man I know I am. As the husband and father that my family deserves.  

And that I can be the hero of my own story, no matter the situation. No matter the circumstance. 

The Hard Truth

It was a hard-truth to take on, but I had more power than I realized. 

And you do too. 

You have the power to choose what lens and perspective through which you view your reality. No matter the circumstances that happen around you, it is 100% completely up to you to determine how you will respond to situations, no matter how impossible that might seem.

Becoming bitter and angry is one option. Or you can choose to focus on who you are and who you want to be, even in the midst of the worst possible circumstances. (This is exactly what we teach our Alpha clients when we coach them.) 

There is a long standing idea from the time of Socrates, that some things are out of our control (in coaching we call these circumstances). These are things we have to accept, because we do not control them.

Other things are in our direct control, and are therefore things we can change. 

And one thing we can always control includes our thoughts, feelings, and actions in the midst of these uncontrollable external circumstances. 

Nelson Mandela is an excellent example of this concept. Despite being jailed during Apartheid in South Africa from 1962 until 1990, Mandela refused to give power over to his captors or to let them determine his self-worth, identity, or purpose. 

They could take his clothes. Force him to work. Emotionally and physically abused him,  but his mind was the one thing Mandela, and Mandela alone, could control.  

The Problem  

Ultimately, you have two choices when faced with circumstances that you see as unfair or unjust.  

You can do what most people do and choose to see yourself as a victim of the circumstances.  Or you can choose to position yourself as the hero of your own story. 

You can choose to be the victim and leave medicine. Or you can choose to be the hero, empowering yourself in ways that make how you practice medicine your choice. 

What do I mean?

Well, when you feel like you are trapped in medicine by moral injury, burnout, are unappreciated, unheard, or overworked. When you have no control over the administrators and insurance companies that seem to rule the world of medicine, you can choose to become bitter and angry.

You can choose to react with rage and ultimately leave medicine. 

But in doing this you have positioned yourself as the victim in your own mind. And medicine has lost someone it needs. 

And this, my friends, is the problem.  

When you choose the road of becoming a victim, you have not only lost emotionally, you have also lost control of your own thoughts, feelings, and, worst of all, the way you show up in this world.

You Have Two Choices 

Ultimately, you have two choices when faced with circumstances that seem unfair or unjust. You can choose to be miserable or you can choose to take control of the situation. You have the power to choose your response.

And that is what this is all about. It is about taking back your power by learning how to understand the way your mind and feelings interact. It’s about positioning yourself as the hero of your own story, not the victim. 

A hero who can triumph, despite great odds. Who can choose to rise above, no matter what is going on around you.  

Who can work to shift their paradigm and perspective. Who can pray for the serenity to accept the things you cannot change, courage to stand up for the things you can, and wisdom to know the difference.

Because medicine needs you.

If you want to learn how to always harness the power you have to enjoy medicine again without having to leave medicine, get on the interest list for our next enrollment of the Alpha Coaching Experience at thephysicianphilosopher.com/waitlist.

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It is a big turning point for most doctors when they realized that leaving medicine, isn't the answer to feeling trapped in medicine. You have all the power that you need right now in your current job to enjoy medicine again. But first you'll have to deal with some hard truths. This episode is only for the brave and the courageous. So I'll warn you, but if that's you keep listening, this is the physician philosopher podcast. I'm Dr. Jimmy Turner and anesthesiologist online entrepreneur creator of the alpha coaching experience. The physician lost for podcast teaches you how to create the life. You deserve one thought at a time, start before you're ready. Start by starting start now. And Hey everyone. Welcome to episode number 44 of the physician philosopher podcast. Last where we take an uncurated and unapologetic look into position, life, money and mindset. So today's thought is this.

When you have positioned yourself as a victim, you remove all of the power. You have to be who and what you want. Only you can give this power away and only you can take it back. So life is about shifting paradigms, right? It's about changing the narrative or the story that we tell ourselves about our situation. So let me tell you a story about a man on a subway, as told by Stephen Kobe to illustrate this point. So Kobe was on a subway one Sunday morning in New York, and people were sitting quietly, some reading newspapers, some lost in thought, some resting with their eyes closed, and it was a calm and peaceful scene. Then suddenly a man and his children entered the subway car. The children were so loud and rambunctious that instantly the whole climate changed. The man sat down next to him and closed his eyes.

Apparently oblivious to the situation. The children were yelling back and forth, throwing things, even grabbing people's newspapers. It was very disturbing. And yet the man sitting next to him did nothing. It was difficult not to feel irritated, and he could not believe that the dad could be so insensitive as to let the children run wild like that and do nothing about it. Taking no responsibility at all. It was easy to see that everyone else on the subway felt really irritated too. So finally, with what felt like was unusual patients and restraint, Coby turned to him and said, sir, your children are really disturbing. A lot of people. I wonder if you couldn't control them a little more. And the man lifted his gaze as if to come to a consciousness of the situation for the first time and said softly, oh, you're right. I guess I should do something about it.

We just came from the hospital where their mother died about an hour ago. I don't know what to think. And I guess they don't know how to handle it either. Can you imagine what Coby felt at that moment? His paradigm shifted. He said suddenly he saw things differently and because he saw things differently, he thought differently. He felt differently. He behaved differently. His irritation vanished. He didn't have to worry about controlling his attitude or because his heart was filled with this man's pain feelings of sympathy and compassion float freely. And he said, your wife just died. I'm so sorry. Can you tell me about it? I do. To help everything changed in an instant, it is a hard truth to take on, but we all have more power than we realize. We have the power to choose the lens and the perspective through which we view our reality and this paradigm shift at Kovi showed so well in that story, in the book that I'll tell you about later is just one great example of that.

That no matter the circumstances that happen around us, it is a hundred percent completely up to us to determine how we respond to situations no matter how impossible they might seem and how we respond is really under our control. No one else is. And it isn't the external situation that determines how your act. It's not the kids running a muck on the subway that determine how Koby felt initially, but our own internal choices and the thoughts and feelings that drive them that really fuel our response, right? So we can respond by becoming bitter and angry, you know, getting mad at the kids or running around, or we can choose to focus on who we are and who we want to be, even in the midst of the worst possible circumstances. And this is exactly what we teach our alpha clients when we coach them. Because you know, coaching's roots are really in stoicism and stoic philosophy.

So to give you an example of all of this, that really it's about our own internal decisions about external situations that we can't control that allow us to have that freedom that we're looking for. So many doctors come into ACE, really expecting to change jobs, change their life, find that freedom. And then they realize once they get inside the doors, that a lot of the freedom that they're looking for is already within their grasp. It's already within their ability to react and to be who they want to be in tough situations. And so epic T-TESS said this a long, long time ago and epic TD says the chief task in life is simply this to identify and separate matters so that I can say clearly to myself, which are externals, not under my control or external situations and which have to do with the choice I actually control where then do I look for good and evil, not to uncontrollable externals or situations around us, but within myself to the choices that are my own.

And Epictetus said this in his famous discourses. And we don't have to go back to 1 35 80 when hepatitis died to hear these sort of things. The same idea is captured in the serenity prayer. For example, in alcoholics anonymous, a lot of you probably familiar with that. You know, the one that says, God, grant me the serenity to accept the things that I cannot change, courage to change the things that I can and the wisdom to know the difference. So we do all have external situations that happen to us, but then we also have the opportunity to change certain things that are internal to us, and really that wisdom. That's the prayer to know the difference between the things that you can change inside of you and externally, and the things that you can't and having the serenity to deal with the things that you can't change and hidden both in the quote from Epictetus and the serenity prayer is the idea that some things we call them circumstances and coaching are out of our control.

These are things we have to accept they're facts. There are things that could be proven in the court of law because we don't control them. Their external circumstances, their externals, as Epictetus would say, they are the kids running around knocking newspaper papers out and yelling and being rambunctious on a subway. When you've been resting before they got on those are external things that are outside of your control. Other things that are in our direct control and are therefore things we can't control are the internals, the thoughts, the feelings, the actions, anyone of these things we can always control. And that includes those things, right? So we teach in coaching that the circumstances are not necessarily in your control. They're just facts, situations that happen around you. Things that people say, things that happen, but the thoughts, the feelings, the actions, the way that you show up in this world, those are controllable things.

And those are controllable things in the midst of uncontrollable, external circumstances. We have so many famous examples of this, right? And we've shared, you know, examples of famous boxers that in prior episodes that got thrown in jail for crimes, they didn't commit and yet refused to let the jailers control them. And even more probably famous example is Nelson Mandela, right? So he's an example of controlling his internal state, despite the external situations that were going on. So he got jailed in 1962 and was there until 1990. And yet he refused to give power over to the captors or to let them to determine his self worth his identity, his purpose, his mission in life. And during those years, he would go through some pretty crazy stuff. So he would be living in a seven foot by eight foot damp cell, had a straw mat on the floor and he'd get tuberculosis from the conditions.

His eyesight would actually get damaged because he was working on limestone. And the glare from the sun would damage his eyesight permanently. Even though we asked for sunglasses, he wasn't allowed to wear them and he would endure emotional abuse too. He wasn't allowed to really keep in touch with people. And during stents, when he was in jail, he would go as long as six months without having really correspondence from the outside world, he's missed his kids' funerals because they died while he was in jail, a couple of them, and he wasn't allowed to go. And so he had massive emotional and physical views and they could take his clothes. They could force him to work. They could make him miss things outside of prison, and they could drain him emotionally and physically abuse him. But his mind was the one thing that Mandela and Mandela alone could control.

So, you know, he did, he continued to study law. He continued to work on his mind and later in his imprisonment, he would even teach other prisoners lessons that he'd learned. And he continued to focus on his anti-apartheid efforts in South Africa, where the apartheid regime was leading to racist actions and situations that for many people made them really mad. And for many people who go through things like this, that's what happens. Their captors not only control them emotionally and physically, but they take over them mentally and spiritually. In fact, during the same time when Mandela was in jail, there's other group that was fighting the same fight. They were fighting the apartheid regime. They had similar goals, but the way they went about it was really different. It had a heart that was really fueled by anger and hatred and racism toward the apartheid government and those that were associated with it.

And this is understandable, right? The treatment that they had received in the whores, they witnessed were unconscionable. These were terrible things happening to their people. And so a lot of people would look at the situation and say, yeah, I'd be mad too. I'd be really upset. And you know, when they got in prison, they were angry. They were a lot more violent than Mandela's group. The reason why is because they harbored hatred in their heart, that the external situation that both of them were in it, that neither of them could control was the same, but their internal resolve and purpose and identity and mission, it was different because they chose different paths. So while this one group was fueled by hatred and anger and racism back towards the people that were doing the same to them, Mandela, didn't do that. Mandela continued his agenda of ending racism on all accounts, on both sides to have a multiracial South Africa that was at.

And so the point is that our external situation often not in our control, and that includes in medicine. And you might be wondering, Hey, like Jimmy, like, I love all these stories, you know, but this is a podcast for physicians. Why are you telling me all this stuff? Why are you talking about Nelson Mandela? And the reason why is because he's a great example of the truth that while your circumstances can be miserable, it is up to you and you alone to determine how you react to your situation. And we may not be, are you able to control the circumstances and situations around us, but we can't control how we respond to them, who we are and what we do when Tufts situations arise. So ultimately we have two choices, right? So when you're faced with circumstances like this or circumstances at work, we can do what most people do and choose to see ourselves victim of the circumstance, or we can choose to position ourselves as the hero of that story.

And so that's what I want to talk about in this episode. And what do I mean by that? When we feel like we are trapped in medicine and morally injured and burned out, or we feel unappreciated, unheard overworked, we have no control over our administrators or the pre-authorizations or insurance companies not paying for the treatments and modalities that we know our patients need, or they seem to rule our world or the charting that never ends. And non-competes and conflict of interests, that policies that seem unfair fair. These are all things that happen around us, external situations that we don't really have control over. And this is what I called being trapped in medicine, or feeling like trapped physician. If you feel like any of those things you've thought about going, part-time, you've thought about leaving medicine altogether because of those affirmation things, right? The maintenance of certification requirements, the online modules, like there's just so many reasons that doctors have around us to be upset and we can choose to become bitter and angry.

That is a choice to react with rage or to remove ourselves from the situation and in doing so. We have positioned ourselves selves as the victim. So no only in the workplace, but in our own mind. And that my friends is the problem. When we choose the road of becoming a victim, we have not only lost emotionally. We have also lost the most important thing. We have lost control of our own thoughts, our feelings, and the way that we show up in this world. And that all happens because we're the victim of something happening around us. It's not our fault that all these things are happening to us. They're not happening for us. And look at me, what was me? And I'm not saying that these things, aren't tough. I'm not saying they're not hard. And I'm also not saying this is going to be a popular idea.

There's gonna be a lot of people listening that are getting angry with the idea that I'm posing, which is that you have control over your thoughts and feelings so that you don't get too angry. I'm going to tell you a little bit about my story, right? Because this is not something that's unfamiliar to me. I'll get real with you for a moment here. For the last couple of years, I've been positioning myself as a victim up until pretty recently, actually many my story of going through burnout in the midst of having a smoldering graves' disease diagnosis in the background that I didn't know about. And when I was on the golf course, which is one of my favorite places to be when I had my first panic attack after the group behind us T to ball off that flew right by my buddy. And I's head, it turns out by the way, that when your TSH is undetectable handling, these situations becomes a real challenge.

I subsequently got depressed and burned out and really the penultimate situation and all this journey that I don't talk as much about is that I got passed up for a leadership position in my department. And it was a position that I had expressed a lot of interest in for years since I was in training. And that I had previously been groomed to overtake at some point, you know, I'm not going to get into the details here because honestly they're not really that important, but suffice it to say that me getting passed up had nothing to do with my age or being qualified for the position. That's not really, what's important. What is important is the story that created for the next year and a half as I positioned myself as the victim of an unfair situation. And at the time I didn't have all the facts.

And so my brain did what all of our brains do. It filled in the gaps with the worst imaginable story to make sense of the situation. And it's just like those blocks of words you see on the social media posts like on Facebook or Twitter, where they jumble up the words, like the words and the letters are wrong. Like they are rearranged. Sometimes the letters are missing, they're in the wrong order. And yet we can still read the paragraphs because our brain is very good at filling in the gaps. And that's what our brains do in tough situations too. And we don't have all the information is that we fill in the gaps with the most likely story. And it's usually not a very pretty one. And so my brain did the same thing. It filled in the gaps and did the other thing that our brains are wired to do, which is to protect us.

And so it sorted out this story by protecting my ego by protecting myself and by filling in the gaps with the story that made sense of the facts that I did have. And all the, while it would take me two years to realize that the story my brain had come up with that entire two years had positioned me as the victim of an unfair situation. And I became bitter. And honestly, I was angry. I started disengaging from things at work and some of those things were things that I priestly enjoyed. Why? Because I was angry in my mind, I checked all the boxes, I'd done everything right. And then I got passed up anyway, multiple times without much of a conversation about it. And because of this, I reacted like the victim of my thoughts. And they were making me out to be this person who had been done wrong.

My thoughts and actions were full of spite because of that. And I wasn't going to do anything that, wasn't what I wanted to do from here on out. And if it didn't fit my hell yes policy, which I love talking about, I wasn't gonna do it, period. I'm a big fan of Les policy and getting clear on what's important to you, but the motivation behind your hell yes, policy is just as important as the hell. Yes. Policy itself for two years, this whole yes' policy was just fueled by bitterness and rage for the better part of that time. And it was set really to consume me and impacted my home life. It impacted my work life and just about everything else. And so I did what most tight, three wing two Enneagrams do. That's, you know, the achiever I achieved, the next big accomplishment was going to make it all right.

I started suffering from a rival fallacy. I was mad at the world and bitter. And the next thing that I accomplished was going to show the people that decided to pass me up, that I was going to be really great. And then I was going to have impact and purpose in this world, whether they wanted me to, or not right from the ugly story that I was telling myself. And so what did I do? I poured myself into my business at the physician philosopher and in helping our clients in the alpha coaching experience. And fortunately, God has a funny way of doing things in life, but despite my spite and my anger in that situation and me being a victim, I really saw a lot of good come out of the situation with the alpha coaching experience and the doctors we've been able to help.

So the problem was that I realized later was that I was disengaging from so many other things out of spite, out of that bitterness out of anger. And I realized what I'd been doing, but it took time. It took time and really what made this click for me and what made me realize that I'd been telling myself that I was a victim this entire time was while I don't control these external situations. It was reading that book by Stephen Covey, seven habits to highly effective people. And that's where he talks about that story about the subway that's Sunday morning. And so I learned from Kobe and I learned from Epictetus and the serenity prayer and Nelson Mandela's example that it was up to me how I responded. And this realization came when something inspired me to realize that I was not showing up as the kind of person that I want it to be.

And honestly, the deep down, I know I am inspiration came from that book and hilariously was written in 1989. This is not a new book. I was four when it was published, I was born in 1985. But the truth is that these truths in this book are pretty timeless and that's seven habits of highly effective people gets to a chapter on proactivity. And he talks a lot about focusing more on being than having and on focusing more on who we want to be rather than on what needs to be done or what we want to have. And that is where I really started to get this insight and clarity when he shared that story of the subway and the paradigm shift he had when he realized the man and the children on the subway were reacting to the death of his wife and their mother.

That's when it clicked, it's up to me to no longer place myself in the position of being a victim of an unfair situation and to instead control what I can control to show up as the man that I know I am as the husband and father, that my family deserves and that I can be the hero of my own story, no matter the situation, no matter the circumstances and from all of these stories and illustrations from Epictetus and the serenity, prayer and Nelson Mandela, and the story on the subway. I hope you realize that you don't have to position yourself as a victim either. Instead, you can focus on who and what you want to be in many of the most impossible situations that medicine places us in each day. And so those situations may not be in your control, but your thoughts and your actions are.

So when we learned to focus more on who we are trying to be and less on what we cannot control the things outside of us, an amazing thing happens. I see this happen all the time in Africa and experience with clients who come and get coached and they're like this happened and that happened. And that's why I feel this way. And they skip that responsibility part, the hero part, where you can take responsibility for your own thoughts and feelings when they shift their paradigms to have a completely different feeling and understanding than they previously had. That's when the power comes. And that's what this episode is all about. It's about positioning yourself, not as a victim and handing all of the power over to the hospitals, clinics, insurance companies, so on and so forth that make us feel burned out and morally injured. But when you position yourself as the hero of your own story, a hero who can triumph despite great odds who can choose to rise above no matter what is going on around you, who can work to shift their paradigm and perspective who can pray for the serenity to accept things.

You cannot change the courage to stand up for the things you can. And the wisdom to know the difference today's thought is this. When you position yourself as a victim, you remove all of the power. You have to be who and what you want. Only you can give this power away and only you can take it back. So my friends, if you've been telling yourself that narrative, that story, that you were a victim of a bad situation, and that you have no control over how you feel. I highly encourage you to take a deep look inside. I highly encourage you to think about the paradigm and perspective that you're placing on things and to see if there's another way that you can be thinking about it by doing so, take back the power that is yours and yours alone. So until next time my friends start before you're ready. Start by starting start now. I'll see you next week.

My dad, Dr. Jimmy Turner is a physician first personal client. It's blogger. You know, I've coached for doc. However, he is not your physician or your life coach. You also, isn't a financial advisor, financial planner or accountant. Anything discussed in this podcast is for general education and entertainment purposes. I have coaching as our substitute for therapy, medicine, or medical treatment. However, if you are a doctor looking for a life coach, you can reach out to our, my [email protected]

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