Living and Dying in Balance

Founder, Finding Balance in a Medical Life

I have been teaching physician well-being for many years, and the majority of my work has been in the area of life balance. Unfortunately for most physicians, the evidence (overload and high burnout rates) points to a life out of balance.

The personality of the physician can be a mismatch with the world in which we are trained and work. For example, we have a need for control, yet we live in the world of medicine, where control is not always ours. This creates stress.

We live in a neuro-imaginal world, created by our family belief structure, our societal beliefs, and the belief structure learned in our training. When this internal world doesn’t mesh with our external reality, the result is stress. Fortunately, we have the opportunity to change this internal world to meet reality and create greater enjoyment with our work and a greater sense of life balance.

Recently, the benefit of life balance has been very real for me. This year, I was diagnosed with metastatic cancer. Even though I have been teaching it for many years, I was shocked to find I had no anxiety or fear upon diagnosis, even when faced with a 10% five-year survival. In essence, I was ready to enjoy life and face treatment full force.

The final line in my book about life balance for physicians is, “Balance is knowing that today is a good day to die; that you have lived fully, lovingly, and without remorse.” I have taught the notion that today should be a good day to die, yet what you say and do when the “rubber hits the road” might be different. When I was diagnosed with a “bad” cancer, it was, in fact, a good day to die.

I began asking myself: “Why wasn’t I afraid? Was I deluding myself with New Age-sounding spiritual BS? Was I in denial about my own mortality? Or was it real?” Over the next week, as I dove into being the “cancer guy,” I realized this wasn’t delusion, BS, or denial. I really was OK with it all.

The next question for myself was: “How did you get this way?” I was born an anxious guy from New Jersey and this mentality was not part of my upbringing, so I must have learned it. The teacher inside me got excited: Anything that can be learned can be taught.

So what are the magic ingredients that can be taught? As I sat with this question, two simple ingredients came to mind: gratitude and acceptance. Gratitude for the people, things, memories, emotions, and events of your life. And acceptance that we really have little control over most of it. (For example, I can do my chemo, radiation, acupuncture and supplements, yet I have no choice as to whether I live or die).

While gratitude is easy for most physicians, acceptance or even surrender to lack of control is difficult for most physicians. We can control the “small stuff,” but we truly don’t know the “big picture.”