'Medicine Is My Calling'

For This FP, Faith and Family Life Help Stave Off Burnout

August 16, 2017 10:46 am Paula Haas

When Stephen Dudley, M.D., swims in Puget Sound year-round, he's not just swimming. As he slices through the water, he's also praying. Just as the Olympic Peninsula protects Puget Sound from the sometimes-violent weather of the Pacific, Dudley's faith and his family life help protect him from burnout. Dudley recently shared with AAFP News how faith has helped him chart the course of his life and be a balanced, productive physician.

[Stephen Dudley, M.D., on Greek Island]

Spending time with family is a must for Stephen Dudley, M.D., shown here during a trip he and his wife, Gabrielle, took to Turkey, the Greek islands and Spain in 2015. This particular island, Santorini, was known as Thera in ancient times and was the site of a catastrophic volcanic eruption during the mid-second millennium B.C.

Q. How have your religious beliefs and practices sustained you and helped you stave off burnout?

A. I grew up in an Episcopal home, and I've never not believed in God or felt religion wasn't important. But in the 1970s, at the height of the Jesus movement, my spiritual life reawakened. I realized it wasn't just a Sunday thing, but something that influences my entire life.

First and foremost, my faith grounds me and gives me perspective. When things are stressful at work, I know this isn't all there is in the world. I believe that life on earth is a training ground for an eternity spent with God, and if there's an unpleasantness along the way, it's calming and reassuring to know it's happening for a purpose. Is it to teach me something -- like patience and humility? I try to analyze my life and see if I can correct the way I behave.

Writing Offers Expressive Outlet

Family physician Stephen Dudley, M.D., of Shoreline, Wash., is arguably a true Renaissance man.

In addition to his strong religious faith, devotion to family and appreciation for the rigors of exercise, Dudley has a passion for the written word. Here are a few articles he's written for the Los Angeles Times:

I'm usually the first one up in my house, and I try to start each day reading my Bible and having a time of prayer and meditation. Some long stretches in the Bible don't speak to me, but other places I've read 20 times, often with something different jumping out at me because I've changed or I'm experiencing a new situation.

I believe that medicine is my calling, and when I read stories in the Bible about people with a strong sense of vocation and a calling, it inspires me. I get a lot of inspiration from Dr. Luke, a physician who was one of Jesus' closest associates.

I especially like the epistles of St. Paul, who I think was the deepest Christian thinker who ever lived. He was steeped in the Jewish faith and quite antagonistic toward Christians until he had a life-changing experience with Jesus on the Damascus road, and then he became the faith's strongest advocate. When I read his epistles, I get a sense of someone who is gifted in understanding of theology but who also has the most tender heart toward others.

And he was under tremendous stress. He wrote Philippians, the eleventh book in the New Testament, while in prison waiting to have his head lopped off by Nero. That's an amazing book -- he says, "I can do all things through Christ who strengthens me." It's hard to read St. Paul and not get something out of it.

I sometimes pray on my way to work, and when something stressful happens at work, I may pray silently. And then I pray while swimming in Puget Sound. I don't have to count laps and the motion is repetitive, one arm in front of the other, so I can get into a rhythm and pray.

[Stephen Dudley, M.D., and his wife, Gabrielle, on hiking trail]

Stephen and Gabrielle enjoy a hike along Snow Lake Trail near Snoqualmie Pass in the Cascades, about 50 miles east of Seattle. Snow Lake is the largest alpine lake in the region.

Religious traditions and church services also speak to me. I'm there with others from different walks of life, and we're all singing the same songs and coming together in unity.

Q. You've said that a rich family life is important to combating burnout.

A. It is indeed. I wanted to marry someone who shared my faith, and fortunately, I found that someone: Gabrielle. We'll have been married 35 years this fall. She helped support me through four years of college, four years of veterinary school, four years of medical school and three years of residency. I always let her know how much I appreciate her!

When I was in med school, we had two small children. I would sometimes leave labs early and pick up the kids, then study between their naps. During residency, when my days on call ended at noon or 1, I'd pick them up from school and spend time with them. I could have learned a little more in medical school and residency, but I wasn't going to grow up not knowing my kids. They're now 27 and 29 and seem to think I'm an OK guy, and my son is a fourth-year medical student.

I've long felt that the training process to become a physician is too onerous. You won't find any other career where the time demands are similar. Medicine selects for the test-takers and people who can remember arcane minutiae, and that doesn't necessarily translate into a good physician.  

I would love to see a system where residency training doesn't try to cram in so much information, and graduates go into practice with mentors for a few years. I had that after vet school, practicing with eight vets who were the most supportive professionals I've ever worked with. One in particular -- a dairy vet -- was the kindest, gentlest guy who didn't treat me like an idiot for asking questions. I remember him even after 25 years, and I emailed him recently to let him know I'm doing well.

Q. Have you ever experienced burnout?

[Stephen Dudley, M.D., and his son, Daniel, getting pedicures]

Stephen and his son, Daniel -- a fourth-year med student at the University of Washington -- share some quality time getting father-son pedicures, complete with painted toenails. The occasion was a Hawaii-themed birthday party for Gabrielle where a prize was offered for best nails. Stephen won, scoring a bottle of Maui pineapple wine.

A. I may have, early in my medical career. I was working all the time and had no control over my schedule or anything. I found I dreaded going to work each Monday, so I resigned and cobbled together some part-time urgent care jobs for a few years.

Then I joined a small independent practice for 11 years. Toward the end, it was increasingly challenging because of the extra burdens placed on private practices.

About that time, my wife was diagnosed with advanced ovarian cancer. Believe me, that reinforced the point that there is more to life than going to work! Happily, she's in remission right now, but it's been a roller coaster. I knew it would be hard to take time off if I needed to, so I left the practice and became an employed physician at the University of Washington Neighborhood Clinic, Ballard Urgent Care. I've given up some autonomy, but in return I'm working for an organization with better health insurance so we don't have to worry about untenable medical costs, and I have leave time I can access. That's a huge stress reliever.

Q. Do you have mentors in medicine who help you cope with stress and avoid burnout?

A. My wife is my greatest mentor and counselor. Unfortunately, there aren't key peers in medicine that I can go to when things get tough and I'm stressed. It's just not something that is discussed, which makes me sad. Even in my first practice, with Christian doctors as partners, we didn't really talk much. We focused on seeing patients, charting over the lunch hour and at day's end, then racing home to our family lives. No one got down and real about what they were going through in their lives.

Q. What advice would you have to help family physicians avoid burnout?

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A. If at all possible, establish your own internal barometer of what you're willing to put up with and how long you'll put up with it. Some people think that after residency, it will be smooth sailing. After residency, they think it will happen once the first five years in practice are done. And then they think it will happen when the house is paid off. But when you maintain a frenetic pace, you establish a pattern. So definitely cultivate some time for other interests. They're necessary!

It's important for your work to have purpose, because if work loses its significance, that quickly affects the spirit. I don't mind long days if I can use my skills appropriately. However, when simple tasks tend to dominate -- such as getting the minutiae of coding just right to satisfy the billers -- that can wear me down. I try to focus on the fact that I am about the Master's business. It's my calling. I don't work for the University of Washington, insurance companies or patients, but rather, I see myself as being in the service of the King. It gives gravitas to even the most mundane tasks.

If you've tucked your spiritual life away, unpack it and try it on again. Some people turn to meditation and yoga to avoid burnout, and those could help, but also try rediscovering your faith. It might be just what you need.

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