Bring Yourself to Work

As an intern, I developed an unconventional strategy for achieving work-life balance. My partner and I had matched into competitive residencies, and we were living together for the first time in an unfamiliar city. I was determined to get both our training and our relationship right.

According to my plan, work and life would remain in balance as long as we kept them separate. We would fulfill our service and educational obligations by day (and/or by night), enduring myriad physical, intellectual, and emotional stressors without complaint. Then we would come home and leave all the hardship behind. We would hang our white coats on hooks by the door, unwind while cooking dinner together, flop on the couch, and forget about work.

It didn't always go as planned. Often, some of the tension from the day would sour the stir fry. Stress didn't wilt like the greens. Instead, we devoted much of our energies to pretending. We pretended our home was a fortress, impregnable to the sorrows of “doctoring.” Unknowingly, we also excluded the joys.

My work life was similarly compartmentalized. In college, I majored in English and was drawn to medicine more by stories than by pathophysiology. But my nontraditional resume engendered an imposter complex, and I resolved to bury the part of my personality that delighted in modernist poetry. Approaching residency, I overcompensated. I would become a one-dimensional patient care machine.

The theologian James P. Carse wrote extensively about this tendency toward reductionism. According to Carse,¹ when we adhere dogmatically to rules and boundaries and compromise our values, health, and relationships in the pursuit of advancement, we are engaging in “finite games.” On the other hand, it is only when we set our sights beyond passing spoils—beyond trophies and credentials and quality metrics—and commit to fostering connection that we truly find fulfillment.

I spent much of residency playing (and winning) finite games. I had a great sense of accomplishment, but little sense of purpose. On the surface, I struggled to select a fellowship; underneath, I was searching for meaning.

Everything changed one afternoon while meeting with my mentor, in an office cluttered with photographs of her family. For the umpteenth time, I was weighing the virtues of one subspecialty against another, when Dr Z finally ran out of patience. “Gaetan,” she interrupted, “It does not sound like you want to do a fellowship. It sounds to me like you want to take care of patients, and you want to write.”

What a strange observation for an associate professor of medicine to make. Did she think that was an acceptable thing to want? She did . . . and she was exactly right.

I once heard passion defined as that dream you hold so dearly you are embarrassed to say it aloud. Fortunately, I had someone to speak for me.

What Dr Z gave me that day was not a career path or even a 5-year plan; it was the gift of permission. Permission to end an untenable charade, to stop viewing my work as role-play, to resolve the closeted humanist and the budding physician into a single, coherent identity.

Dr Z said, “It sounds like you want to write,” but she meant, “It sounds like you want to be yourself.” The moment I allowed this, it was like Technicolor transforming an old movie.

I have been trying to pay it forward ever since.

For several years, I have devoted a teaching round each month to an exercise I call “Bring Yourself to Work Day.” I gather my team of residents and medical students in a quiet space and invite them to reveal their personalities, anxieties, and ambitions by responding to a series of prompts. Describe a childhood experience that still influences you today. Name one thing in your life that goes unnoticed. Describe your best mistake, career or otherwise. These are some of the many illuminating questions I have gathered from prominent interviewers like Krista Tippett, Danielle LaPorte, and James Lipton.

The diversity of experiences and perspectives that converge at an academic medical center is astonishing. I have been privileged to work with a budding neurologist whose grandfather was imprisoned and tortured during the Chinese Cultural Revolution; a physician-scientist who for years ate only peanut butter and jelly sandwiches for lunch and dinner; an impassioned intern whose difficult childhood informed his advocacy for patients; those whose lives had been altered by illness, accidents, and/or kindness; heirs to long medical traditions; and others who felt the sting of discrimination. In the course of these conversations, I have been invited to a seaside cafe to eat tacos while watching waves break; to rural villages in India and Greece; and to an African immigrant kitchen where the aromas of thick soups and boiled yams mingle with a lively Yoruba melody. Most importantly, I have heard those disoriented by the rigors of training restake their claims within the wide-ranging landscape of medicine, reanimated by the language of dreams.

Among hundreds of residents and students, only a few have declined to answer a question. On “Bring Yourself to Work Day” defenses soften, boundaries between private and work lives dissolve, and the typical hierarchy of a teaching service gives way to a comfortable intimacy. Together, we affirm the power of the personal narrative and recommit to exploring the lives of our patients.

Often, I share recent photos of my wife (now a full-time pediatrician and mom) and daughters with my ward teams. I repeat more advice from Dr Z. “There is no such thing as work-life balance,” she would say. You have to bring your life to work, and marry your work with your life. Don't contort yourself to fit someone else's expectations. In medicine as in life, great mentors grant you permission to be the person you always wanted to be.