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  • Sue MT

Cram It In?

Updated: Nov 2, 2019

Several years ago, around the new year and when my kids were small, I decided to choose an annual motto, something that would help guide me in the coming year and be based on the experiences and reflections of the past year. I recall thinking about how busy that particular year had been and how time had flown by. I had some regrets about working long hours, being on call so much, and missing out on a few of the girls' events and growing up moments. As a family, we have tried our hardest to serve weeknight meals around the table, find time to do family outings and certainly we have enjoyed some great vacations. However, that particular December, as I looked back on the busyness of the past year, my annual theme became clear to me, and I was not impressed. I had been following the “Cram it in” theme. I had experienced a “do everything you possibly can while trying to balance family, life and work, at the expense of your own well-being, kind of year!” Yikes, I was not pleased with myself. It was obvious that the motto for the coming year needed to be different.

So why had I experienced a “Cram it in” year? First of all, I had not been intentional about honoring my values. The thing I valued most in the world, especially my family, had been marginalized on many occasions. I had gone about my business, sitting on committees, working long hours and trying to be an efficient mom. Those closest to me, who I cared about the most, were receiving what was left of me at the end of the day. In medicine, so much of our best is given to our patients and often those closest to us receive the left-overs of our energy, time and love. I had also placed myself at the end of my receiving line. I was in the mindset of living life as a human “doing” rather than a human “being.” This is an easy cycle to get caught in. When one more thing is asked of you, it rolls around in your brain for a few moments, as you begin to multitask and think about how to fit it into your schedule. I had forgotten how to just rest in the moment, sit back and try not to immediately solve the dilemma in front of me. I needed to remember how to stop and reflect on whether this next task would even be honoring my values before deciding the action to take.

The next year was spent being intentional about my choices, thinking through what activities I would choose to do and why. Weighing every choice against my values, I learned how to reflect and respond rather than react and immediately solve what was being asked of me. I stepped back from several commitments and committees. I took time for me and to just refresh my brain. Does this mindful approach always work? By no means! I slip up all the time. I have asked my husband to hold me accountable when it seems there is too much on my plate. I have also had frank discussions with my girls, who are now young women, about how to identify their values and not forget how, in the busyness of life, to honor what is important to them.

Physicians are great at making long lists of tasks and prioritizing them, sometimes to the detriment of their own wellbeing. In my coaching experience, I have been impressed at how many docs enjoy list making and checking off items on that list as they maneuver through their day. The list goes something like this: see the patients, review the labs, write the notes, check the in-basket, plan for the committee meeting, repeat. We do this all while sipping cold coffee from a styrofoam cup, trying to fit in a bio break, paying our bills and arriving home late into the evening. Weirdly enough, this is what has been referred to as achieving work-life balance. Something about that particular phrase has always irritated me. When something is balanced, there is this nagging impression it could be easily tipped or spilled. It is like spinning plates in the air, they can always come crashing down. So, when I heard the term “work-life integration,” and it resonated with me a bit more. My work in medicine and my life are integrated, interwoven. Not that I always wish they were. My pager sits on my kitchen counter when I am on call, as I spend time with family. My kids can call me at work when they have a need and that changes my focus from work to them. Does the phrase work-life integration correctly describe what goes on in our lives? It might describe it, but it may not be the best approach for our own long-term wellbeing and resilience.

What we really need to strive for in medicine is work-life-self Integration, and maybe that word order isn’t not even correct. I propose it should be Life-Self-Work integration. The steps then become: 1) figure out life, who you are and what you value, 2) prioritize who you are in your own world 3) integrate all the work and "giving of you" together with who you are in a way that allows your gifts to shine and benefit others.

This Life-Self-Work approach affords you the opportunity to not get caught up in the "Cram it in” life theme that seems all to common in our profession. This new phrase serves as a powerful reminder of what your priorities can be, when you mindfully, intentionally choose to honor yourself. Perhaps this is the best annual motto going forward into this next year and forever.

Best wishes “decramming” and trying out the Life-Self-Work Integration approach. For more information on how to identify your values and make mindfulness a priority in the busyness of medicine, drop me an email at

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