Eva’s Excerpt August 2019

To Be of Use by Marge Piercy

The people I love the best
jump into work head first
without dallying in the shallows
and swim off with sure strokes almost out of sight.
They seem to become natives of that element,
the black sleek heads of seals
bouncing like half-submerged balls.

I love people who harness themselves, an ox to a heavy cart,
who pull like water buffalo, with massive patience,
who strain in the mud and the muck to move things forward,
who do what has to be done, again and again.

I want to be with people who submerge
in the task, who go into the fields to harvest
and work in a row and pass the bags along,
who are not parlor generals and field deserters
but move in a common rhythm
when the food must come in or the fire be put out.

The work of the world is common as mud.
Botched, it smears the hands, crumbles to dust.
But the thing worth doing well done
has a shape that satisfies, clean and evident.
Greek amphoras for wine or oil,
Hopi vases that held corn, are put in museums
but you know they were made to be used.
The pitcher cries for water to carry
and a person for work that is real.

I came across this poem this week. It resonated for me around the theme that has permeated the last few months- wellness and resilience. We are all striving in some way toward wellness, resilience, and purpose. Many have come to think about wellness in the context of Maslow’s Hierarchy of Needs:

For me, this is a compelling way to think about it because it provides a strategic framework through which to approach the epidemic of burnout in American medicine today. Because it is a hierarchy, it implies that in order to achieve the highest levels, the lowest levels – basic needs- must be met. Things like ensuring adequate sleep, access to and time to eat, work security, and physical health are all foundational to being well. Next comes psychological needs- things like feeling a part of a community, feeling valued and cared for, are critical to overall wellness. Finally, at the pinnacle is the goal of autonomy and purpose in your work- fulfillment. This, of course, is what the poem speaks to for me.

We have much to do in the area of wellness, like all other medical schools and health systems in the US. In the Office of Education and more broadly there are several initiatives I want to draw your attention to. In undergraduate medical education, the initiative for scholarships announced in April is about addressing the basic need of financial security. In that initiative, I failed to account for the needs of our current students and I am actively working to address this to the extent that I can. Our medical student academic societies have been working hard on building community through a series of dinners, events, and the creation of a Society Cup, a friendly competition with multiple events throughout the year. Our students, led by Griffin Plattner WUMS4, have also developed a wellness webpage with information about a variety of wellness resources and information to help address common anxieties our students face as they progress through medical school. We already have an exceptional physical and mental health program for our students under the leadership of Dr. Karen Winters. Of course, our entire Offices of Medical Student Education and Student Affairs are focused on supporting our students to be able to reach self-actualization. There are several aspects of the new curriculum that will directly and intentionally focus on this domain as well.

At the Graduate Medical Education level, the team has been working for over a year to develop a strategy to address the mental health, wellbeing and community needs of our residents. Much already exists within specific departments and programs, but central resources have been limited to date. One new initiative in this domain is the funding of a new GME Wellness Program. Dr. Jennifer Duncan will be taking the lead on this initiative. Soon we will hire two fulltime psychologists and a part-time psychiatrist to support our residents and fellows. We will also offer self-screening tools and 24-hour crisis management in addition to the existing programs through EAP and health insurance.  Dr. Duncan will work closely with the GME offices and Program Directors to develop a menu of items to support the enhanced wellness of our residents. Preliminary data suggests we have some work to do in addressing the basic needs of our housestaff.

Wellness and resilience are equally important topics for our faculty and staff. It will be the focus of the Larry Lewis 3rd Annual Health Policy Symposium held in EPNEC on August 6th from 8-1. Information and registration can be found here. The keynote speaker is Colin West, MD, PhD of Mayo Clinic, an internationally renowned researcher and leader in physician burnout, wellness and resiliency. A number of departments have also held recent visiting speakers, workshops and programs on these topics. A way forward is not yet clear, but at least the conversations have begun.

Much, much work to do! My wish for you all as we enter this next academic year is simply this- that we each strive for meaning, fulfillment and joy in our work – rewarding and satisfying work that feels like a job well done!