Learning to Decompartmentalize as Self-Care

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As physicians, we learn to compartmentalize a lot of emotions–probably too often. We go from room to room and patient to patient, and we must display the best versions of ourselves, both physically and mentally.

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Marissa Flaherty, MD

We focus on the person in front of us and cannot let the emotions from the previous patient consume us. We put aside our own feelings to support someone else and we go to work sick so that others may be healthy. Our training reinforces compartmentalization skills in every stage of becoming a physician. Compartmentalization is important. If we can’t accomplish this skill, having a bad patient outcome may prevent us from saving the next people waiting for our care

Unfortunately, we do not train for de-compartmentalization to the same intensity as we do the other aspects of medicine. I have found that one of the traits that allows us to be truly humanistic physicians is being able to know the moments when we need to de-compartmentalize. These moments also allow for a better balance and understanding of our needs as a physician and a human.

It took me a long time to learn how to de-compartmentalize in a way that worked for me. It was through many moments and conversations with many mentors, friends, family, and colleagues that I developed the necessary skills to be present in each room I walked into. My family, colleagues, and even my patients have taught me that it’s okay to be vulnerable and it is okay to feel emotions and talk about them. This may not be immediately after a hard moment, but making space and time for talking about that hard moment is the important thing. This also looks different for everyone and finding out how it works for you early in your career can make a world of difference to your own health.

I often tell students, if it’s possible, take time before entering a patient’s room and think about what you’re bringing into the room, emotionally and physically. It’s a hard thing to do. For me, the simple task of allowing myself 10 seconds to take a deep breath before I meet with a patient, check where I am mentally and be aware of what I’m bringing into the room has helped me become a more compassionate physician and a healthier version of myself. I think about my loved ones, and I think about how I would want their doctor to be as present as possible. I call those 10 seconds my “mini decompartmentalizing.” While I am not processing the deep impact of the previous patient interactions of the day, I am taking a moment to breathe, center myself and realize what I am feeling so that when I enter that next patient’s world, I am present.

This practice also has helped me become more patient and more self-aware. We must meet the patient where they are and walk alongside them through their journey. It is not our job to tell a person what to do and wait for them to do it, but instead to help support them. I have found that by taking these 10 seconds, I am able to be more supportive and less paternalistic with patients. When I am overflowing with compartmentalized emotions, I fall into habits of paternalism, algorithmic medicine and only focus on the science of it all.

Self-care, humanism, and respect in medicine are just as important as the science. Often these are words on the page of our lectures or conversations we have with our patients, but do we say the same ones to ourselves? Everyone will have a different version of self-care, but we all should have the same level of respect for ourselves. Part of this journey is learning to have enough regard for yourself to take care of yourself. If I could talk to my MS1 version of myself I would say, “After the hard days, talk about it. After the rough shifts, reach out a hand to each other. After the great successes, celebrate. Treat your patient as their family would want them to be treated. And, most importantly, when you are lost with how to help a patient, take 10 seconds to breathe.”

Dr. Marissa Flaherty is a board-certified adult psychiatrist and an assistant dean in the Office of Student Affairs at the University of Maryland School of Medicine. Dr. Flaherty serves the students primarily in a mentoring, academic advising and career counseling role. She works with the other members of the office to create a warm and supportive environment for all students. Dr. Flaherty enjoys helping students learn to balance their personal and professional growth through medical school and beyond.

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The views and opinions expressed in this collection are those of the authors and do not necessarily reflect the positions of the Association of American Medical Colleges.