Ode to Joy
It’s much in vogue these days to talk about “bringing back joy” to the practice of medicine. I think that’s great, but it does raise a question: where did joy go in the first place? Medicine has always had more than its share of pain and tragedy, but we never used to think of it as joyless. It isn’t the human toll of sadness and loss that robbed our profession of joy--it’s the daily grind.
When I started my career over thirty years ago, the hours were long and the work was hard, but most of it seemed like work worth doing. Charting was minimal, inboxes were modest, and we spent most of the day face-to-face with other human beings. These days, for every hour we spend seeing patients, we generate two hours of charting and paperwork. No wonder our joy skipped town.
Little by little, some systems are addressing these trends that threaten to turn doctors into paperwork monkeys. Medical scribes are becoming more and more common, staff members are cleaning up inboxes, and some organizations are tracking how much time their providers spend charting from home in the wee hours of the morning. But while all these measures are helpful and absolutely necessary, they won’t, by themselves, bring back joy. That’s up to us.
In her book The Power of Fun, Catherine Price describes three components of fun, and contends that the more you have of each, the more likely you are to experience joy.
The first fun-factor is playfulness. This means doing something with no practical purpose, simply because it tickles you. At first, playfulness seems a bit incongruous in a medical setting, but it turns out that even a little goes a long way. I make it a habit to ask my patients one question each visit that has nothing to do with medicine. Whenever possible, I try to choose one that will make them laugh. And when we plan a retreat for our clinic staff, we always include something silly and fun. We’ve had chili cook-offs, team dance contests, talent shows, and karaoke parties. We’ve played Zombie Tag, taped a Harlem Shake video and had a Gangnam Style dance lesson. Medicine is often serious business, but that doesn’t mean it has to be grim.
The second component of fun is connection. Joy is contagious, and when we experience it with others, there’s a multiplier effect. One of the biggest mistakes a healthcare organization can make is to boost efficiency or patient access by disrupting continuity and relationships. Humans are the ultimate social animal, and the joy we get from our connection to one another isn’t achievable any other way. If we’re serious about bringing joy back to our practice, we have to make lasting, trusting, thriving connections with our patients and with each other.
The third element of fun is flow. That’s the state you experience when you’re completely absorbed in a challenging, engaging task. There is much in medicine that conspires against flow: the 15-minute appointments, the constant interruptions, the unexpected emergencies. And yet, on those days when we’re using our skills and helping others in significant, tangible ways, flow is a real possibility. The trick is to stay in that state, despite the million other things that compete for our attention. Just as it is for an athlete or an artist, flow for a physician comes when the moment-to-moment tasks become second nature, and we connect to the work on a higher plane. It comes when we see the bigger picture, and not just the grind.
All of these things--playfulness, connection, and flow--are available to us multiple times a day. They’re out there in plain sight, right beside the little frustrations and hassles that take up so much of our conscious minds. But we can’t have them unless we first see them.
Laurie Santos, a Yale professor who studies and teaches the science of happiness, has a practice that she uses to harvest these opportunities for joy. At least once a day, she makes it a point to notice something that delights her. It might be a sound or a word or an act of grace or kindness. It might be a certain color or quality of light. It might be the smell of fresh bread or the hint of a breeze against her skin. Whatever it is, whenever she notices it, she raises her finger as if to make a check mark in the air, and whispers the word: “Delight.”
Try it. You’ll find that, as soon as you’ve done it once, you start noticing more opportunities for delight all around you. Suddenly they’re everywhere.
There’s a long road ahead if we really want to bring joy back to medicine. Systems need to be overhauled. Organizations need to evolve. Certain EHRs should probably be burnt to the ground. But while we fight to make that happen, we have work to do ourselves, and there’s no better place to start than here and now.
With delight.
