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The Mindset of Invincibility


Kajal Khanna, MD, JD, FAAP
September 19, 2019

A little while back, I was reading an opinion article about the shocking early retirement of the Indianapolis Colts’ quarterback, Andrew Luck. I was struck by the similarities of the critiques of his actions and the profession of medicine. One former quarterback stated, “He owes it to his team” to keep playing despite his injuries. Luck, the author stated, “had violated the cardinal norm of sports – playing through the pain after a career of fidelity to it.”

‘Owing it to the team’ is something I hear frequently in medicine. Just as in sports, we don’t want to let our fellow team players down. Stories abound through my residency, fellowship, and attending life. The resident, attached to their IV pole while waiting for surgery, coming  to present at morning report. The attending who had a pneumothorax, rounding with Pleur-evac in tow. The fellow with gastroenteritis running to the farthest bathroom from the Emergency Department to vomit and then returning to their shift. The attending with the burst appendix lying down in the middle of rounds, insisting that they were “just fine’.  

But it doesn’t just involve working while ill. Doctors are mythologized for their ability to overextend. I recently attended the third in-person meeting of the Women’s Wellness Through Equity and Leadership project and listened for the number of times physicians were described as warriors. I lost count after a while.

Dr. Kajal Khanna says a culture of invincibility among physicians is unhealthy for providers and their patients. #AAPvoices #WIMMonth

Our professional cardinal norm may not be to play through the pain, but it definitely involves soldiering on despite personal or professional roadblocks. We seek to never burden others in our department, practice or residency. To do so, would be letting down our “team.”  

The physician-warrior
Fight for your patient, schedule multiple meetings after overnight call, work weeks without taking a day off, work sick, being available 24/7, take the shortest amount of parental leave.…I could go on for paragraphs. We have a culture where we revere those who are a warrior at work. Be it that they may have a commanding presence, they are never unsettled by microaggressions or bias, grinding through to finish their fellowship grant, running to soccer practice to watch their children, stepping on the Peleton bike at midnight and answering emails at 3:00 a.m.--all while post-call from their shift.  

Being indestructible, never failing has become the rallying cry amongst physicians. And this slogan is killing us. We aren’t unique as an industry to have this appreciation of those who can ‘do it all.’ But we owe it to society to understand the value of disconnecting. To realize that we can’t, shouldn’t and aren’t expected to do it all.

We have to change the mindset that boundaries and limits imply weakness and failure. Rather, those same boundaries will allow us to succeed and flourish and encourage our young patients to join this noble profession.”


If we, as physicians, those who feel they can never leave their patients, workplaces, research, departments can find a meaningful way to take a pause and place actual boundaries on our work lives, then other industries can follow in our footsteps. We owe it to ourselves, our patients and “our team” to take the time to check in with ourselves.

We have to change the mindset that boundaries and limits imply weakness and failure. Rather, those same boundaries will allow us to succeed and flourish and encourage our young patients to join this noble profession. Our patients want their physicians to be authentic, not the super-humans that the field of medicine has groomed us to be.

I believe we can be stronger, more impactful and more approachable leaders if we move away from this mindset of invincibility. Perhaps we can learn from this new generation of football players who are “unlearning those masculine ‘truths’ about hardened self-sacrifice and the nobility of suffering.”
 
I, for one, did not enter the field of medicine to be a warrior. I want to be a healer, leader, and advocate. As physicians, we have plenty of grit. Let’s try to lead from a place of grace as well.  


* The views expressed in this article are those of the author, and not necessarily those of the American Academy of Pediatrics.


About the Author


Kajal Khanna MD, JD, FAAP, is a member of the inaugural Women’s Wellness though Equity and Leadership Cohort. She holds a faculty appointment as Clinical Assistant Professor of Emergency Medicine at Stanford University and is a pediatric emergency medicine physician who focuses her academic work on equity in the emergency care for children globally. She is the founding Director of the Pediatric Emergency Medicine Fellowship at Stanford University and the Director of the Global Pediatric Emergency Equity Lab at Stanford. She is eager to integrate innovations in well-being in how we train and practice emergency medicine and has lectured nationally on integrative nutrition and technology-based approaches to stress reduction.








Additional Information 

Project aims to support female physicians in wellness, equity, leadership (AAP News)
Physician Health and Wellness (AAP.org)
Missing Persons: Minorities in the Health Professions
Action Collaborative on Clinician Well-Being and Resilience (this National Academy of Medicine initiative is hosting a Twitter Chat on the role of gender in clinician burnout, September 25 1-2 pm. Share your personal stories and provide input about how systems-level interventions can improve well-being. Join by following @theNAMedicine and #GenderinClinicianBurnout.)