Musonius Rufus:

• We have covered embracing voluntary discomfort. Yes it will “make you stronger.” But how does this actually work? William Irvine breaks down several stoic principles in his book A Guide to the Good Life. He gives 3 specific reasons to embrace discomfort (adapted from first century stoic philosopher Musonious Rufus): 
1. Voluntary Discomfort hardens us. If all we know is comfort, even the slightest discomfort will cause us distress. So some voluntary trouble can immunize us. 
2. #1 helps you tolerate hardship in the future, but embracing discomfort can help you in the presentby removing some anxiety. If you know you can handle minor doses of discomfort, you can be more confident that you can also withstand major stresses, and therefore do not have to worry about hypothetical bad fortune. 
3. Gratitude. If we periodically experience situations without our comforts, we step back into our normal environments appreciative of what we have. Irvine gives the great example of stepping outside in the cold to then return and marvel at how your furnace can insulate you from the 9 degree (today in Louisville) chill outside.  
Go do something difficult today, it hurts a little less each time. 

Happy MD:

• The Happy MD is not so happy with how the state of Massachusetts is working on the medicine burnout problem. He makes valid points in this critique. He worries that the authors do not place importance on BOTH individual and system wellness efforts. He pulls a direct quote: “Physicians don’t have time to consistently fit yoga and similar coping strategies into their routine.” Drummond also criticizes the instruction to support physicians after they have mental health diagnosis (they say very little about prevention). He doesn’t like the plan to at some point in the future to modify EMRs to be more user friendly. He wants change right now.
• It is refreshing that more and more organizations are developing similar consensus statements, and something is surely better than nothing. I always argue that promotion of wellness, salutogenesis, should be prioritized over addressing burnout.

Literature:

• Reading makes you a better doctor. Reading literary fiction actually seems to improve empathy, battling a very stubborn enemy: depersonalization. It is all about getting outside of your medical bubble, seeing what motivates and fulfills other people. 

“When compared to nonreaders, the relative risk of burnout for consistent readers—those who read at least one book per month—fell by 19 percent across the emotional exhaustion and 44 percent across the depersonalization domain.”
“In an unpublished study by Dr. Marchalik, more than 200 urology trainees were surveyed about work characteristics, as well as relaxation techniques. These included watching movies, meditation, yoga, reading and other ways of relaxing. Meditation, exercise and yoga were not protective against burnout— but reading was.”

Tight Traps:

• Science Daily summary of an odd but informative article on neck muscle strain and screen use. 125 students “scrunched” their necks for 30 seconds (with no instagram to watch) and 98% of them felt an average of 5/10 pain. 12 of the students had EMG studies showing increased tension in the trapezius muscle. The findings were a “total surprise” to most of the participants. Remember the 30 pound head, and do some chin tucks. 

Letter to a Young Female Physician: 

• Susan Koven is a dedicated physician writer who understands the hard work of creating. Her Letter to a Young Female Physicianappeared in NEJM in 2017. She briefly recounts her medical school and training, paying homage to James Jackson and Richard Selzer. Excellent advice for any young physician. Your empathy and motivation begin to falter at the end of intern year and especially beginning of second year. 
• Take her advice:
“My dear young colleague, you are not a fraud. You are a flawed and unique human being, with excellent training and an admirable sense of purpose. Your training and sense of purpose will serve you well. Your humanity will serve your patients even better.”

Quote:

“The problem is, homeostasis works to keep things as they are even if they aren’t very good.”
George Leonard
*Don’t let inertia prevent you from starting a healthy habit TODAY.