Latest / The Hidden Load: For the educators and leaders in medicine who hold everyone up. / The Vacation Firewall: Hustle Culture, Identity, and the Power of the Switch
Transcript
- Santina Wheat: Welcome to the hidden load for the educators and leaders in medicine who hold everyone up. We will tackle the hard topics and help you conquer your chaos and get to calm all by starting to acknowledge and remove that hidden load. This podcast is a space for us to name the things that are common, but not normal. Each week, we'll look at the invisible weight you're carrying and explore practical coaching-based tools to help you find more calm, better boundaries, and a sense of purpose that doesn't require you to run on empty. I'm so glad that you've carved time out for yourself today. Let's get into the episode. Welcome back to The Hidden Load. I am your host, Dr. Santina or Tina Wheat. I'm happy to share that I recently had an article published in SOMI Docs titled, I Had to Leave the Country to Stop Checking My Email. This article was born out of a moment on a family vacation that held up an uncomfortably clear mirror to how I and so many of us operate in medicine. Picture this. I was standing in the sweltering 90 degree summer heat of the Vatican. Our tour guide was giving us a historical breakdown of the habits of the modern papacy. As she pointed out the quirks that make the current recent Pope distinctly American, the list felt strikingly and almost painfully familiar. Cutting vacations short out of a compulsive need to get back to work. Installing a gym directly inside the living quarters to never miss a workout session, and an absolute unyielding assistance on blasted air conditioning. Now, standing in the room in heat, I was practically praying for the air conditioning. And so that felt real. But the other details struck a much deeper, more uncomfortable cord in my chest. The urge to install a gym in your residence so you can optimize every hour of your morning. This coupled with an inability to step away from the desk even when you were on leave, that spoke directly to the ethos we carry with us everywhere we go. Personally, I sat in the hospital room while I was getting ready to deliver my baby, catching up on charts and sending off. final emails. And I definitely do have a gym in my basement that I use to make sure I can do every hour of every day. And I definitely have a gym in my basement that I put there because of the additional time that it takes to get to a gym. All of this made me realize that what we experience in healthcare is not just a clinical problem. It is a deeply rooted American phenomenon. But is it a problem? Hustle culture permeates every single corner of our lives, right down to the way we vacation and to the way we raise our children. Even on a dream family trip in Italy. This beautiful historic place where the local rhythm practically begs you to slow down, our habits followed us. When locals heard we were from Chicago, we had these lovely, breezy conversations about what was our favorite deep dish pizza, or if we liked the same baseball team as the Pope. But beneath that small talk, our family's internal wiring was still humming with quiet anxiety. We were a few weeks out from the beginning of the school year, and so my children began asking relentless questions about that upcoming school year. Who were their teachers going to be? Did they have all their school supplies? Was their class schedule set yet? And could we see it? Some of it was standard back to school jitters, but much of it also stemmed from something more modern. They simply didn't know what to do with unscheduled time. Vacation had handed them empty, open hours, and their immediate instinct was to fill the void with preparation, planning, and worry. My husband and I found ourselves repeating, hey guys, we're on vacation. We're allowed to relax. Those problems will still be there when we get home. We can wait to worry about that until we get home. Yet as I said those words, I knew that I was also speaking to my former self, because I would have been doing the same thing not that long ago. In fact, let me tell you the honest unvarnished truth about my boundary setting just two years ago. It actually took my medical organization blocking network access from outside the country for me to stop checking emails while I was on leave. I eventually started intentionally choosing international travel, specifically because it gave me an institutional tech and forced excuse excuse to say I literally cannot log in, so I cannot be responsible for that. It took an overseas firewall to grant me the permission to rest. For a long time, I attributed this relentless drive strictly to the culture of medicine. Physicians are conditioned through decades of training to believe that hypervigilance is a virtue, and that stepping away comes at a catastrophic cost to our patients or to our colleagues. But standing in Rome, I realized that it is far bigger than medicine. It bleeds into everything, even our wellness routines. Think about how we approach wellness in healthcare today. Exercise becomes something to optimize and track. I am certainly guilty of that. Rest becomes a deliberate recovery strategy with heart rate variability metrics. And we turn our self-care into another task list to master installing virtual platforms, engaging mindfully with coaching, and tracking metrics to ensure our sanity remains intact. And yes, I know I'm saying this as I also tell you that I think that all of those things are good for you. We have commodified rest. We treat recovery like an administrative milestone that needs to be checked off so that we can get back to high volume production. That's something that I am certainly guilty of. And this leaves me wrestling with a question that I think many of us in healthcare leadership avoid asking out loud. Is the hustle mindset inherently toxic? Or have we just completely lost the ability to manage the switch? Lately, we are constantly being preached to that medicine should not be our identity. The prevailing wellness rhetoric insists that we must separate who we are from what we do, untangling our sense of self entirely from our white coats. But I find myself asking. Shouldn't something we have sacrificed decades for, bled for, and worked so fiercely to master be part of who we are? Why should we feel guilty for taking pride in a discipline that required so much of our youth to achieve? Medicine inevitably shapes us. The danger does not come from loving our work, or even as identifying as a doctor or a leader or a nurse, whatever that might be. The danger comes when it becomes our only identity. When the work consumes every single dimension of a person until there is nothing left outside of the hospital walls. Any disruption of the routine feels like an existential crisis. The goal shouldn't be to erase the physician or other professional in us. The goal should be to nurture the rest of who we are right alongside it. So that when we do step off the clock, we still know who we are sitting at the dinner table in Rome. The broader cultural narrative surrounding work has swung widely to the extreme, in my opinion. The phrase hustle culture is thrown around almost exclusively as an insult used to describe a dystopian trap of endless labor, burnout, and corporate exploitation. And to a degree, that critique is well earned. Glorifying 80-hour work weeks. Bragging about missed family dinners, skipping earned time off, and wearing exhaustion like a badge of honor are all a recipe for physical and emotional decay. Past a certain threshold, longer hours stop producing better output, and instead leave people impaired and depleted. Yet In our rush to condemn toxic overwork, I do wonder if we have swung too far in the opposite direction. Work life balance can sometimes become an umbrella excuse for a lack of urgency, accountability, or pride in craft. Having practiced in healthcare environments where the pace moved at a sluggish crawl. Where short clinic days, long breaks, and low patient volume meant patients waited months just to get initial consultation, I can tell you that an absolute absence of whole is definitely not charming. When you are a patient waiting on a biopsy result, a diagnosis, or a life-altering treatment plan, a lack of urgency carries devastating consequences. I also think that ambition has tremendous value. Taking pride in hard work, striving for efficiency, showing up on time, and demanding excellence from yourself and your institution are qualities that are worth preserving. Hustle, in its truest form, is what allows us to master a complex trade, build security, provide for our families. And fun the very passions and vacations we cherish. When I was younger and would ask my mom why she worked so hard, she always told me that she was hustling to make sure that I had a better life than she did. And I often feel the same. I hustle to make the world better for my girls. That doesn't mean that I need to ignore the relaxation, the recovery, and take advantage of the joy that I can have in those times. Now, if you aren't willing to manage the switch for yourself, I want you to look at this through the lens of a leadership and medical education. As educators, program directors, department chairs, and clinical supervisors, our behavior creates the cultural ceiling for everyone who walks behind us. Our learners, our residents, and our junior faculty are hyper-attuned to us. They don't just absorb the clinical guidelines that we teach on rounds. They absorb our relationship with time, boundaries, and work. If you are an attending who boasts about answering emails at 1 a.m., if you send non-urgent messages to residents on their day off, Or if you proudly admit that you checked your inbox throughout your entire vacation, you're sending a clear, terrifying message. To succeed here, you must give up your life. When we display that behavior, we do not build dedicated trainees. We build terrified perfectionists. We teach them that asking for time off is a sign of weakness, that unscheduled time is dangerous, and that their value as a physician is measured solely by their degree of exhaustion. Modeling the switch is an active and essential act of leadership. When you go on leave, put an out-of-office message on that explicitly says, I am away and completely disconnected to recharge. For urgent clinical matters, please contact coverage. And then actually stay off the network. When you walk into clinic on Monday after a vacation, Don't complain about how behind you are or brag about how much email you had to slog through over the weekend. Look at your residents in the eye and say, I had a fantastic week away with my family. I completely disconnected and I am so glad to be back with you today. And hopefully, if you have done the things that I mentioned and actually had coverage, you might actually feel that way. When you demonstrate that you can be a fiercely capable, high-performing clinician, and also someone who turns off the engine completely when you are off the clock, you give your learners a permission slip to survive in medicine. You show them that excellence does not require self-destruction. The trouble begins when hard work becomes synonymous with self-destruction. We start believing that proving our value requires destroying ourselves for our jobs, or we allow our professional drive to completely swallow our personal lives. So, how do we teach the next generation and also remind ourselves that deep professional pride and true personal rest can coexist? How do we honor the doctor or professional in us without letting them crowd out the person? Perhaps we don't need to plant ourselves firmly in either the hustle culture or anti-hustle culture camp. The middle ground is far less trendy on social media, but it is infinitely more sustainable and it can allow you to thrive. Work hard, be fiercely accountable. Let your career be a proud part of who you are. Get the job done with urgency and excellence. And then when the work is finished, close the laptop, step out of the clinic, and go home to live the rest of your life. And make sure you have systems that allow you to do so without guilt. Here is your Monday morning challenge for this week. I want you to look at your relationship with your work switch. Ask yourself, am I holding back my drive out of cynicism? Or am I overfunctioning out of guilt? Have I lost the ability to flip the switch off when I walk through my front door? If it takes an overseas firewall for you to stop checking your inbox, I want you to start small this week. Create a local firewall. Create a One hour time slot every evening where your phone goes into a drawer, the laptop is closed, and you sit at the table fully present as a spouse, a parent, a friend, an adventurer, or just for time for yourself. And if you lead a team, explicitly tell them this week that you expect them to turn off their work switch when they step off the clock. You do not have to surrender your ambition to find your peace. Thank you for joining me for this episode of The Hidden Load. If this reflection on hustle culture, leadership modeling, and vacation firewalls spoke to you today, please share it with a colleague or a trainee who might be checking their email on leave right now. And don't forget to go read my article, which I have Included in the show notes. Let's lighten the load together. I'm Dr. Santina Wheat, and I will see you next week. Thank you for listening to The Hidden Load. If today's conversation spoke to you, I would love for you to share it with a colleague who might need to hear it too. It's one of the simplest ways we can start shifting the culture of medicine together. And remember, your time spent reflecting here matters. You can earn free CME or CE credits for listening to today's episode through the Pinnacle app. You'll find that link in the show notes. If you are looking for one-on-one coaching support or want to dive deeper into the resources we discussed today, let's connect. You can find information on how to reach me in the show notes. don't forget to hit subscribe so that you never miss an episode ⁓ and leave me a rating so that others can find me too. and take care of yourself because you deserve to be held up too. And I'll see you next time.