In my recent GUTS podcast interview with Joe Sherman, MD, one of the topics we spoke about was what I call the “suck it up” philosophy.
The following is the transcription of the segment. If you’d like to listen to the podcast in its entirety, you can do so here.
Let’s jump in …
JOEY: You mentioned earlier all of these social obligations. I think especially as men, we have different ones. And what I found, as a man and a husband, there’s kind of like this suck it up attitude, right? Which is what appears to be put upon doctors. Just suck it up.
You were saying earlier, which is on par with this concept, that if something’s not working right, you would just put more time into it without really dealing with how you were doing emotionally or cognitively.
And I’m really glad you shared that your wife came with you to a therapy appointment, so she could shed some light on how she saw you struggling. Going to therapy, and bringing your wife into the discussion about your mental and emotional health, probably wan’t the easiest thing to do — but it is such a brave, healthy choice, as opposed to continuing to suck it up.
I think one of the concepts we’ve danced around a little bit is this kind of shame. Like men or doctors might feel shame that they need help, but what they forget is that we’re all human beings.
And there is no shame in getting that help, just like the patients come to you for help. And that was a big lesson for me when my wife got sick. It was kind of all hands on deck. Take care of our two sons. Take care of my wife, and take care of my clients (I run a small marketing firm). And I did nothing for myself until I got to a point where I almost became an alcoholic, and was falling apart.
So for me, was like, all right, you know what? I needed to step back and assess what do I need to do to be OK …
For me it was therapy, joining a men’s group, and it was trying out different solutions — trial and error — like you had mentioned earlier to determine what works and what doesn’t work for self-care.
And I think, you as a doctor know this better than anybody. If someone comes in to your office and says, “hey, here’s my problem,” and they just want you to hand them a pill, that’s not the answer.
JOE: Yeah, I mean, there’s so many different things that you mentioned. To start, it depends on your upbringing. For me, there was, I was the youngest of this large family. There was this philosophy of get out there, get to work, earn your living.
And the whole concept of suck it up, just deal with it, was present … you have to keep going. And then the whole culture of medical training just goes along with that. Everything that we’re taught in medical school and residency is, look, if you can’t hack it, then get out … just keep going.
Don’t deal with your emotions, just suck it up and go.
And, just like you say, being a male in our society, being raised with that type of mentality, and then having the culture of medicine kind of superimpose itself. What ends up happening is any other way that we knew about processing our emotions, even acknowledging our emotions, kind of gets pushed to the sideline to where we forget — if they were ever there.
I think that this is one of the reasons why women in medicine now, there will be in the future a majority of women in medicine, and yet still in medicine today it’s a male dominated culture. And that goes along with the societal expectations of male and female.
So with my clients now, it’s the same process I had to go through to acknowledge — to be able to recognize — when I am suffering. To recognize when I need my own self-compassion, when I need to acknowledge how my emotions are being expressed physically in my body. All of these things were so brand new to me at a very advanced age in my life. And these are things that many other people deal with much earlier in life.
For my clients now, I have to kind of get in there and meet them where they are in this whole suck it up, buttercup, mentality and then try to say, okay, let’s look at another alternative way of looking at this. What’s really happening to you physically, emotionally, spiritually? Because this is the space where you can talk about those things. It’s okay to talk about it. There is no shame in it. It’s called being a human being. It’s called humanity. That’s what we are.
We’re not these superheroes, we’re not superhuman. So all of these things are shifts in the culture and shifts in the mindset that I think especially male physicians need to make eventually in their lives. There are some that never come to that point. Many physicians never come to that point because they’re able to surround themselves with an environment that allows them to continue living this suck it up life. But I think eventually that catches up to you.
JOEY: Yeah, yeah, and it’s in a lot of ways it’s kind of like an unconscious life.
JOE: Exactly.
JOEY: The word human being is the combination of two words for a reason, right? And I think the suck it up mentality is part of this tapestry that humanity has made for whatever reason. And the beingness, whether we call it mindfulness, consciousness, presence — that higher self, that connection to spirit, kind of like you mentioned, gets pushed out of the frame.
So, what would you suggest a doctor do if they are in a situation where they are surrounded by this suck it up culture, but realize they kind of need to make this shift away from it?
JOE: I think first of all, you have to recognize within yourself what’s happening. And if you’re feeling this sense of dread when you go into work, if you’re feeling as if you’re really not being effective at treating your patients because everything else is getting in the way, and you feel like you’re really not a very good doctor — if you start to feel like you even resent having to take care of patients.
These are all symptoms and signs of burnout.
This can go on, and you can become increasingly anxious and even depressed, and feel yourself separated and isolated from everyone else. As you see this start to appear, the most important thing is to realize that you do need to reach out for help. It’s not shameful. I mean, there may be that sense or feeling of shame there. Shame, I also believe, is a normal human emotion. But also to realize that just like your patients need help, just like you refer patients to consultants, to therapists, to psychiatrists, to mental health providers — we need mental health providers. We need coaches, we need therapists, we need spiritual directors, we need everything. All of those supports.
Because the pressures and the constant stress placed upon physicians really call upon us to look outside and to get that type of help that we need, to then digest/internalize that, and to be able to put it into practice and to become a habit so that we can reach some balance in our lives.
Before, I would say when I first started as a pediatrician, I had the belief that this was going to be my life. My vocation. My stance was, “I will throw everything into it. And everybody else, if I find a life partner, they just have to kind of fit in somewhere. If I have children, they have to kind of fit in somewhere.” That was the way I looked at things before. And I think many physicians go into practice feeling that way. And they feel like there may be no other alternative.
There is an alternative.
There is a reality where you can reach a better balance, and that if you do take care of yourself, if you get the support you need, if you’re able to take a break, if you’re able to institute these small little practices that help you re-center yourself and reset yourself, then you can come at the practice of medicine with a whole new mindset — one that brings your authentic self to the forefront, giving your patients what they truly deserve, your full self, not just a piece of you.