There are two things that I wish that I had known when going into medicine: the need to find a mentor and the importance of work-life integration.
I cannot stress the importance of mentorship enough. We go into medicine, into our chosen field with this determination: “I'm going to be the best X: I'm going to be the best surgeon, I'm going to be the best primary care doctor, I'm going to be the best psychiatrist.” That's what we want in our hearts. We go into medicine because we want to take care of patients.
But it's a really hard road; medicine is not easy, especially nowadays as there are definitely more unique challenges than we've seen in the past. It’s essential to have a mentor who can understand what you're going through as a physician and who can help you navigate your career path.
Picking a mentor can be tricky. Think about someone you admire or someone that has achieved a goal you would like to. Ultimately, your mentor should be someone that helps you show up as 100% authentically you as a physician and as a human being. This may be a former residency or fellowship director, like it was for me, or it may be someone in your department; think outside of the box.
I would recommend finding a mentor who’s outside of your leadership reporting structure to maintain the boundaries of performance management and mentorship. Can you identify someone that's going to have time to sit with you and talk with you and help you through some of the struggles that you might have as a new attending or even when you’re mid-career? Somebody that has some experience in where you want to go? Once you have identified someone, ask them to be your mentor.
For some people it will be that easy, just asking them directly to be your mentor. For a lot of people, it might be somebody who you interact with on a day-to-day basis or you work with frequently. Then it might be as simple as asking if they have a few minutes to talk and building a relationship from there. But it is important to identify to them that it is a mentor-mentee relationship so they’re aware of what their responsibility is as well.
Your mentor may also find you. That’s what happened with my current mentor. We were meeting briefly on an issue that was important to me and at the end, they asked if they could mentor me! It has been a wonderful experience and has been truly helpful in having someone to share my success and struggles in the day-to-day grind of medicine, to get advice on how to approach situations, and sometimes to just decompress. We meet regularly, and even though I don't always have my doctor or chief hat on, my mentor still helps me to be a better physician, to be a better leader. Mentorship is important in helping you better define where you want to go on your career path and how to get there. As a woman of color, having a mentor who understands the importance of sponsorship has been invaluable.
Whether you choose your mentor or they choose you, be on the lookout for someone to ask you to do the same for them. It's a great way to give back when you become that “attendier attending.” Continue to pay it forward in mentorship.
The second thing I wish I’d known is the importance of work-life integration. This is super important, but no one teaches us what it actually means or how to do it. Especially as a resident, it's work, work, work, work, work. You come home, you sleep, you repeat the day. It's the same in med school. Sometimes it's hard as an attending to get out of that mindset and not perpetuate that system.
When we talk about work-life integration, there's this misconception that it's always going to be 50-50. It won’t be, sometimes it's 90% work, 10% life and sometimes it's 90% life, 10% work. The question is, how do you make that work for you? How do you prioritize personal wellbeing so you can show up for your patients, show up for your colleagues? I’m hopeful that maybe this is changing a bit, but I wish more people talked about the importance of prioritizing your mental health. (I know, how ironic that a psychiatrist is talking about mental health!)
It's so important to know that if you’re not doing well, you have to prioritize your mental health. You have to put yourself first and that’s not being selfish. We talk about altruism and putting the patient first, but if you're struggling or hurting, you need to address that. If you had a broken leg, we wouldn't ask you to stand up and do surgery. If you had COVID, you would stay home. If you're not doing well in terms of your mental or physical health, then you need to be prioritized. That's OK, even as a physician. Maybe even more so as a physician; this work is really hard. You need to find those things that bring you joy when there doesn't seem to be any joy in the work that you do every single day. You need to find those passion projects that are going to re-energize you.
Sometimes prioritizing your mental health, making those decisions and doing what you need to do for yourself, can be scary. But you have to do it to be able to thrive. In 2014, with some encouragement from my husband and best friend, I decided to prioritize my mental health; that's how I wound up in California. I didn’t realize that’s what I was doing at the time, but it’s one of the best decisions I’ve ever made.
It's OK to check in with yourself, check in with your colleagues. We need to take care of each other, and we need to take care of ourselves and there's no shame in that. We need to take advantage of the resources available to us — EAP, outpatient mental health, etc. SSVMS also has the Joy of Medicine program, which features peer groups, an annual summit on wellness, and up to six counseling sessions for all physicians in Sacramento, Yolo, El Dorado, and Placer Counties regardless of membership status.
Your patients get the absolute best care when you're able to show up as 100% authentic you.
Because there’s no shame, I’d like to share a challenging time that I experienced. 2020 did its legitimate best to break me. I became chief right as the pandemic hit, which felt like drinking from a fire hose, learning all the operational things for my department and the quickly changing COVID landscape. I was also dealing with personal issues regarding my physical health. Then social justice issues hit hard that summer with the murder of George Floyd and the crazy political time we were in. And then in August of 2020, Chadwick Boseman died.
That. Broke. Me.
For whatever reason, that was the proverbial straw that broke my back. As I reflect back, I think it was because he always seemed to be the good guy in whatever movie he played. Especially after “Black Panther,” as an African-American person, having this positive role model for so many kids and even people my age was huge. When he died, it felt like this final light in the world had gone out in a time that felt very, very dark for me. I knew in that moment that something wasn't right and I was not OK. I felt safe with one of my colleagues and shared with her that I needed help and a couple weeks later, I started therapy. I can honestly say that it was a lifesaver.
Prioritizing my mental heath helped me to find better work-life integration. It helped me to put things in place to “protect” myself and recognize when I may need to check in with my therapist. It’s allowed me to be fully Christina without shame and without the mask that a lot of us wear every day. It’s allowed me to be a better wife, daughter, friend, and physician.
When I think about my journey and why I am sharing this with all of you, I realize that I had a mentor who demonstrated the importance of living as your full authentic self, my best friend Angie who passed away five years ago. About eight years ago, I thanked her for not being shy on sharing the struggles she’d had. She told me, “Chris, if I show someone else my scars, that person knows I am someone that can help them get through the same thing.” Her words continue to impact me today.
So to sum it up: find a strong mentor and look for a tenable work-life balance or work-life harmony. And if you’re not okay, don’t ignore it. It’s OK to not be OK. It’s OK to be vulnerable and ask for help. It’s OK to share your stories. It may change someone’s life. It could save somebody's life.
Email Christina Bilyeu, MD
