Latest / The Hidden Load: For the educators and leaders in medicine who hold everyone up. / The Milestone Trap: Reframing Time, Aging, and Expectations
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. And I just crossed another milestone. I had a birthday. And if you're anything like me, or I would say like most high achieving healthcare professionals, educators, and leaders, birthdays and other major calendar milestones do not just come and go quietly. Not necessarily because of celebration. But because they carry a very specific, unquantified, and heavy hidden load. Now, in the weeks leading up to a milestone birthday, an anniversary, or even the end of an academic year, there is often a quiet background process that starts running in our minds. This process is an internal audit. You might find yourself looking at your calendar, at your CVE, at your career timeline and that unwritten or even written life checklist that you have been carrying around since your twenties. And the hard questions start creeping in. Those questions might include, am I where I thought I would be by now? Or am I achieving enough? Or am I steering this ship, this department, this clinic, or even this life fast enough? And the one that causes me the most anxiety. Shouldn't I have figured this out by now? Now in medicine, we are systematically conditioned from a very young age to measure human progress in rigid, relentless, and linear increments. Think about the conveyor belts that we step onto. There is pre-med time in undergrad or in our post-back time. Then there's the MCAT, then there's med school, then there's step one or complex one, step two or complex two, followed by match day, then intern year, then all of residency, followed by senior resident. And then if you choose to do a fellowship, there's fellowship. Then there's board certification. Yay, you finally made it. And then if you're an academic like me, there is climbing of the professorship ladder, going from assistant professor to associate professor, and for some, full professor, division chief and chair. This is a pretty direct pathway, and we spend decades living entirely by someone else's pre packaged schedule. We follow this path that somebody else says is the right path to follow. Each of these milestones is defined for us, truly, by an external board, a committee, or a standardized exam. We learn to evaluate our worth based on how fast we can check off those boxes against an imaginary hyper-optimized timeline. And so when a personal milestone like a birthday approaches, Our automatic default reflex might be to run that exact same clinical diagnostic on our personal and professional lives. And so some of us, definitely me included, carry the silent anxiety of the pre-birthday audit. We worry about getting older, not because of the cosmetic number, and probably not because of a few gray hairs, though I don't love when those show, but because we carry a deep seated fear that time is slipping away before we've been able to fix every broken clinical system. Or before we have saved every struggling learner, or before we have published that next paper, or reached that elusive mythical state of complete operational control. For each of us, that might be a different thing. That might be achieving a certain position. That might be having a certain number of publications, that might be achieving a certain rank. So let's look at what that pre-birth and anxiety actually sounds like in real life. It is sitting in your office at the end of a long day looking at a stack of unread journals or incomplete administrative tasks, that checklist that just isn't done, and feeling a sudden surge of quiet panic. It's comparing your career trajectory at age 30 to a 60-year-old colleague who just landed a major grant, or at age 40 or 50 to a different colleague who just stepped into a dean's role. And now feeling like you are somehow behind. We can turn these celebrations of life, unfortunately, into an administrative performance review. Some of us judge our current, complex human realities against the static blueprint that we drafted when we were so much younger, maybe just 25 years old, and knew almost nothing about how the real world works. But then the day actually arrives. The candles are blown out, the messages are answered, the cupcake is eaten, and you wake up the morning after. And if you are kind enough to yourself to give yourself the grace to stop running for just a moment, if you take a quiet breath before opening your email, then perhaps A profound diagnostic realization can set in. Nothing catastrophic shifted overnight just because of the birthday or the anniversary. But suddenly everything can look a little clearer. Looking back at my own reflection this birthday, I have realized something fundamental about the way we view aging and longevity as leaders in healthcare. We spend an enormous amount of mental and emotional energy mourning the passage of time or dreading the physical and cognitive toll of getting older. But we rarely pause to acknowledge the immense unshakable sovereignty that comes with experience. Getting older in this profession is not just about accumulating mileage or adding lines to your bio. It is about accumulating pattern recognition. It is about the experience. So let's talk about pattern recognition. In your early career, it's high speed and low context. Your threat defense system is hyperactive, and every friction point feels like an existential crisis. And that means that you react with speed, panic, and often personal overfunctioning. But then you move on to ultimately senior leadership, where you hopefully have high wisdom and the macro context. By that point, your threat defense system is calibrated. It recognizes organizational cycles and institutional inertia. And you're able to respond with pause, perspective, and strategic boundary setting. I want you to think about the things that would have sent you into an absolutely long internal tailspin even five or ten years ago. Perhaps a sharp critical email from a division chief or dean. Perhaps a rejected curriculum proposal or grant application, or even a tense confrontational committee meeting where people disagreed with you. Maybe a sudden, disruptive institutional mandate passed down from health system leadership. Early in our careers, those moments will feel like existential threats to our identity. They trigger our fight or flight response. They made us stay up until two AM drafting multi page defensive emails or over preparing our slides because we believed that if we were not flawless, then our entire career would collapse. But when you have been through enough academic cycles, when you've been through enough July resets, enough accreditation visits, and enough organizational restructures, your brain is able to build a deep library of pattern recognition. And then you're able to realize three major truths. First, most institutional emergencies are simply poor planning by someone. Second, most organizational crises are temporary, cyclical storms that will ultimately pass. And third, your value as a leader is not measured by how fast you react, but how calm you remain while everyone else is panicking. The post-birthday or post-anniversary clarity is about realizing that time is not an enemy that you are desperately racing against. Instead, time is the raw material of your wisdom. You are no longer guessing your way through the dark. You are navigating a room you have walked through a hundred times before. And if you were earlier in your career and have not yet reached that wisdom, I just want to reassure you that for you, it too will come. So how do we actively put down the hidden load of milestone anxiety? And how do we stop holding ourselves hostage to an imaginary timeline and step fully into the sovereignty and clarity of getting older, both in age and also in our career? Well, we have to shift our relationship with time using three concrete coaching reframes. The first reframe is to burn the imaginary checklist. I love a good checklist. So this one feels hard. But I want you to stop evaluating your current season against a twenty-five year old's naive blueprint. We grow and change as the seasons of our lives and careers change. And so what it is that we need to accomplish should look different today than it did when he first started out. Reframe number two is to trade urgency for equity. This allows you to shift from that high-speed biological hustle. those immediate responses that are often coming from flight or flight to deep macro strategic wisdom. You don't have to be the first one to answer, or you don't have to answer within two minutes. It is reasonable to pause and think about what is truly the next best step. The urgency isn't always going to help you. And then the third reframe is to reclaim your personal horizon. It's important to remember that your career is what you do, not who you are. It is really important to your everyday life, don't get me wrong, but it is not all of you. Let's go back to each of these reframes a little bit. So, reframe number one, burn that imaginary checklist. Let's be completely honest about who that 25-year-old was. That version of you was hardworking, ambitious, and well-intentioned. Unfortunately, they understood almost nothing about the systemic friction, institutional inertia, healthcare economics, or The real reality of human relationships. They drew a straight line from point A to point B because they didn't want the detour and had never experienced it. So holding an older, more experienced you to a naive checklist written by that 25 year old is a form of self-sabotage. And so as I mentioned, because the seasons of life of our lives and our career changes. I want you to give yourself explicit permission today to update, edit, or even completely burn that old checklist. Measure your success not by the number of arbitrary boxes checked, but by the depth of your integrity, the quality of your relationships, and also the boundaries that you hold. Going back to reframe number two of trading urgency for equity. Early in our clinical and academic careers, we survive by trading our biological energy for immediate validation. We run fast because we think speed equals competence. We answer our emails instantly, we accept every committee invitation, and we hustle because we feel that we have to prove we belong in the room. But as you age into mid-career and senior leadership, your primary value Is no longer about the speed. It is about the depth and the equity. And your equity lies in your ability to pause, to step back, and see the macro picture, all while protecting your team from the reactionary panic. When an emergency hits your department, a junior leader is going to sprint around trying to fix everything at once and all by themselves. A senior, a seasoned leader, excuse me, is going to sit back. Ask three quiet questions, isolate the root of the problem, and guide the team with steady authority. So stop trying to outrun your younger colleagues. Start outthinking them. And start outthinking the friction using the wisdom that you have earned with experience. And then finally, your personal horizon. A milestone birthday or calendar marker. Is an urgent reminder of a fundamental truth. Your life is not an institutional asset. Your medical degree, your academic title, your clinical schedule, and your administrative role are components of what you do. They are not who you are. Healthcare institutions are magnificent necessary structures, but they do not have a soul. They will replace your clinical slots within weeks of your departure. Aging gracefully in leadership means recognizing that your highest duty is not to burn out for an organization that can't love you back. Your highest duty is to build a rich, meaningful, sustainable life that honors your humanity, your family, your passions, and your health long after that white coat is hung up for the final time. And you can do all of that while still enjoying the work that you love. So here is your Monday morning challenge for this week. Whether your birthday was six months ago or is coming up six weeks from now, I want you to take five minutes before you dive into your inbox or start your morning clinical block to conduct a milestone audit. Sit with your tea or coffee, open a notepad, and ask yourself the single diagnostic question. What is the one expectation or timeline I am holding on to simply because I thought I should have accomplished it by now? Identify it. Look at the data objectively without drama or self-judgment. And ask yourself, is this metric actually meaningful to who I am today? Or is it just an old ghost from an outdated checklist? If it no longer serves your purpose, give yourself explicit formal permission to cross it off and drop it off your shoulders today. You do not need to outperform your age. You do not race, and you certainly do not need to race against an imaginary clock. You do not need to prove your worth through endless overfunctioning. You just need to show up as the seasoned, wise, grounded leader that you have already become. Thank you for joining me today for this episode of The Hidden Load. If this milestone reflection spoke to you today, I hope you will share it with a colleague, a mentor, or a friend who might be carrying a bit too much weight about their own career timeline right now. Let's lo let's lighten that load together. And if you need help thinking through this or want to re-establish your goals, If you're listening to this episode in the month of August, I am running a birthday special. Send me an email and I will give you the code so that you can get a discount on any of my coaching packages. I would love to help you. I am 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 to. And I'll see you next time.