Podcast Episode 38 | The Importance of Physician Mental Health

Michael Myers: 00:00 They were just terrified of what this could mean in terms of their licensure or their disability insurance or things like that. That is tragic.

Intro: 00:12 From Spaugh Damron Tenny, it's the Prosperous Doc podcast, real stories, real inspiration, real growth, a show for doctors who are ready to improve their overall wellness in every aspect of life. Now here's your host, Shane Tenny.

Shane Tenny: 00:30 On the Prosperous Doc podcast, if you are a longtime listener, you know that we talk about all aspects of wellness, whether it's physical wellness, like the interview we did with Colin Zhu a couple episodes ago, talking about culinary medicine, whether it's relational or financial wellness. Today, we're talking about emotional wellness and mental health. We all know there is a mental health crisis in our country. Certainly, it's been exacerbated by the global pandemic and it's taking a disproportionate toll on our health care providers. Grateful to have as my guest today someone who can bring some experience, some authenticity, some compassion to the topic, Dr. Michael Myers is often referred to as the doctor's doctor.

Shane Tenny: 01:20 He's devoted his career to the mental health and well-being of his fellow physicians, of you, your colleagues around the country. Dr. Myers is a professor of clinical psychiatry at SUNY in New York Downstate Health Sciences University in Brooklyn. He's authored numerous books, including Why Physicians Die by Suicide, the handbook of physicians' health. Doctors, marriages and most recently, we're going to talk about today, his recent book, A Memoir: Becoming a Doctor's Doctor, where he offers his inside look at the struggles physicians face as they shoulder the social and emotional cost of serving the community. I'm excited for our conversation today. We're going to talk about his new book. We're going to talk about his work with physicians, definitely COVID and the stigma around doctors' mental health. Dr. Myers, thanks so much for being with us today.

Michael Myers: 02:12 Thank you for having me, Shane. I'm happy to be here.

Shane Tenny: 02:15 Well, we appreciate it. It's certainly, I think, some topics that are timely and the more airtime we can give them, I think the better it is for everyone. Let's start at the beginning or maybe your beginning. There was a time, I think a couple of decades ago, when you were a freshly minted undergrad with the world as your oyster and the eagerness to go to medical school and all of the medical specialties in front of you. I'm curious, what drew you to the field of mental health in the first place and maybe some of the story about what's led to your life's work and serving your colleagues and mental health.

Michael Myers: 02:49 Thanks a lot, Shane, for that question. Yes, it has been a couple of decades. I studied medicine in the '60s. When I graduated from medical school, psychiatry as a specialty wasn't on my radar, actually. I was a little bit late coming into the field of psychiatry, largely because of events that had occurred. I look back now, I lost one of my roommates to suicide when I was a first-year medical student. You can imagine that what that was like. He was a medical student as well and that was in 1962. The stigma associated with ill health or suicide in the medical profession, back in those days, was unbelievable. In fact, there was no response, actually, from our medical school. It was really, I don't know if you'd call it covered up, but there was no discussion. It was as if Bill never existed. So we just buried ourselves in our studies, as you know from doing this work, how easy that is to do.

Michael Myers: 03:52 But yet, of course, my thoughts or memories of him never really went away. So after that, I did a rotating internship in Los Angeles. I started internal medicine residency and one of the things that I noticed too, between those two things working as an emergency physician in Detroit, Michigan, was my exposure to suicide. It was really quite profound, doing the medical surgical end of things, when people have made very serious suicide attempts. It was through that, that I got this thinking that I would like to attempt to be involved in people's lives before they reach that desperate point. So then my segue way into psychiatry, and then during my training, I had this unusual experience of actually looking after some physicians, a doctor's wife, a doctor's child, and then off I went.

Shane Tenny: 04:49 As your work in the field of psychiatry and your compassion for mental health, based on what you've seen, that's just led to this work of whether it's writing or speaking or authoring journals or just one-on-one work, which I want to talk with you about in a couple of minutes here. It's just been a calling and from what I know of you and have observed, I think it's just been a blessing to the field. Is that overstating the work that you've tried to do?

Michael Myers: 05:16 Yeah, I'm passionate about it. There's no doubt about it. I think it is rooted in so many of those things that I just mentioned a couple of minutes ago.

Shane Tenny: 05:26 Now, looking at just the landscape around us right now, we're recording this in early 2021. There's been a pandemic with us the last year. COVID is everywhere and people are locked in and shut down and socially distanced and it's taking its toll. Now physicians deal with illness and loss among their patients all the time, but this is unique. What's your read on the state of the medical community right now?

Michael Myers: 05:52 You're so right, Shane. This has been a very, very stressful time. The calling of physicians and the work that doctors do really is to serve the humankind, the rest of the public. But yet, the messaging that those of us who work in the field of physician health have been trying to really get out there right from the get-go when New York City was the epicenter, so our doctors on the front lines were working so hard, so busy with self-care that they had to make sure, though, that they took time away to just rest and recoup. In those days, of course, there was such a fear of contagion, we knew nothing about the virus, catastrophic fears that they could become ill themselves and transmit it to their loved ones or each other.

Michael Myers: 06:38 What we did at SUNY Downstate, a fellow psychiatrist and I, Dr. Viswanathan, we started support groups. Basically, when Governor Cuomo declared our hospital, the University Hospital of Brooklyn as COVID-only, we really sprang into gear because we knew that frontline physicians were going to need that. So we did that for the hospitalists, the critical care physicians, the anesthesiologists, all of the trainees, as well as the emergency physicians too, because they were dealing with so much, right in the emergency room. Making these decisions about whether you admit or not, the volume of sick people and the volume of death in those early weeks was just overwhelming for the doctors. We just kept doing things like that and the outreach that they had for each other was, and has been, unbelievable.

Michael Myers: 07:27 There's been collegiality between and among physicians that I've never seen. In fact, I remember one of the physicians saying, "I was so burned out before this pandemic. Not anymore, I'm doing work that, yes, it's hard. It's painful at times, but this is what I was trained for." We're not having to worry with so many of these, what they would call the systemic issues having to do with the way people are reimbursed and managed care and things like that. We really felt vital, so therefore, at 7:00, when people were making noise out on their balconies cheering for all of the front line workers across the city or across the nation, that meant a lot. But it's so interesting. There's a certain modesty in physicians to say, "I really don't like being called a hero." They're so grateful. They've got to call you something. So you just keep your modesty and just accept that. They really had tremendous respect for all of what you people are doing.

Shane Tenny: 08:39 You've had the closest optics to the physicians around you in New York. How are they fairing now? Are these groups, the ability to talk about not just their patients, but talk about themselves, are they hanging in there? Are we seeing that, just the weight and the cloud that, in some ways, the country's feeling. Is it heaviest there or are they faring well and that sort of thing?

Michael Myers: 09:00 That's a great question, Shane, because these things are regional as you know. This kind of moved West and South and so everybody knows about that. Now that we've got the vaccine coming, things like that, there's a little more hope. But yet, of course, I think the term is one that so many people, stakeholders who use it, is cautiously optimistic. Anthony Fauci is saying things like that as well. We still can't let down our guard, et cetera, et cetera. What we're trying to do, because all of those groups are on pause, but what we're doing, we're continuing to do the one-on-one counseling. There is, indeed, a fear in doctors that, "Oh my gosh, I hope that we don't get big surges like we had before." That kind of thing. We know more about but the viruses. We've got a bit of a toolkit now and not as many patients are dying as before. But of course, I'm sure you know this, and what everybody's worried about are the long-term consequences of this virus.

Michael Myers: 09:56 We're still learning about it, these long haulers they're called, who are developing neuropsychiatric complications and the cardiovascular problems, things like that, that it's all new. So there's a lot of research going on. A lot of doctors are paying very close attention to this, of course. That's in the workplace. The other thing, though, is that this has made profound changes in doctors' practices as well. So many of them are redeployed. Sometimes they got to let staff go and doing virtual primary care and other care as well. That's also kind of getting back slowly, that sort of thing, but we're still in the early stages of what I would call recovery. But once again, I would still say though, that there's so much hope out. The applications to medical school have shot up even higher than they were before, so people want to do something. They're not running away from this virus.

Shane Tenny: 10:55 In general, even before COVID, we know, I think since the statistics have started being tracked over the last couple of decades, I'm thinking of a conversation I had with Dr. Dyke Drummond a couple months ago. The rate of depression and suicide among physicians, among medical school, is higher than the general population. Why is that?

Michael Myers: 11:20 So it's COVID. We certainly don't have those data, for instance, suddenly everybody's concerned about that. Could the rates of suicide go up? There's a lot of research going on, but it's still too early, substance use. Before all of this, though, it's what we know and what attention is being paid to, though, is that the work with physicians is, indeed, stressful. I think for too long, there's been this sense that most doctors are tough, they're work horses. Just give them more work, pile it on and they can do it. But we've known them for a couple of decades or longer that that's not healthy. It can't be sustained.

Michael Myers: 12:02 That's where the term burnout come in, or the terms, moral injury come in. There are doctors who are saying, "Look, we're human too," and that was the whole thesis, and we'll probably come to that in a little bit, of my memoir that the messages I wanted to get out to everyone is doctors are humans too. They can become ill, but they could also recover really, really nicely and get healthy again and get back out there. So it's that as well as just maybe personal vulnerability, but yet, we all have our own personal giving, our families of origin, how we grew up, stresses in our lives, things like that.

Shane Tenny: 12:40 The challenge I've heard from other physicians and folks I've interviewed, there's just the internal pressure of, "I have knowledge, which is unique and special and healing, or lifesaving in some cases, and if I don't do this, who will? There's a line of patients out the ED that would need to be seen. I can't just, 'I'm sorry, I'm tired.'" But there's that just the challenge of reconciling the fact of, "I got to take care of myself to care for you, but you need care acutely," and that's not always easy to tease out, is it?

Michael Myers: 13:15 It isn't, Shane. I can remember hearing that three decades ago. If I had to put a doctor on medical leave because her or his depression wasn't quite far along yet for them to return to the workplace, oh my God. They said, "You can't. I have to work. I've got to get back out there. My colleagues, they're overworked," that sense of responsibility and guilt. I said, "I'm sorry, but this is what we have to do because I'm just worried about your safety right now. I don't want you making errors." I said, "You've got so much on your plate already, the last thing you need is a complaint from a patient or a lawsuit. So give me a few more weeks to work with you, get you better. Get you back part-time," that sort of thing.

Shane Tenny: 13:59 Talk a little bit more about just the stigma around seeking help for mental health or seeking help for depression or burnout or those sorts of things.

Michael Myers: 14:10 Shane, and I always like to break this down into both what we call internalized stigma and external stigma. So the internalized stuff, the interior stigma, is what we do to ourselves. We tend to be perfectionists in medicine and then we're kind of at one level, rewarded for that, because if you're not somewhat perfectionistic, you're not even going to get into medical school or dental school or something like that. Then once you get in, it's "Okay. Now you can relax." So you can only relax so much because you got to keep up with your knowledge. There's a lot of information that's packed into the four years, that these are lifelong learning specialties in medicine and dentistry, et cetera, et cetera. So there's all of that. So we can be hard on ourselves and so therefore, when you begin to develop some symptoms and stuff, you use this tendency of feeling weak or flawed or inadequate or less than. So that's the internalized stuff and we beat ourselves up.

Michael Myers: 15:06 That external stuff is actual discrimination where individuals suffering from or recovering from a mental illness or whatever, are discriminated against when it comes to it. This is the part that so many of us in the physician health movement have been fighting. These are the questions that are asked on medical and dental licensing applications, in renewals, malpractice insurance, credentialing applications to hospitals, medical sets, malpractice insurance, things like that. Basically, what we're saying is that do not ask any questions unless they have something to do with impairment, not with illness, and those questions have to be about current things, not past things, current things.

Shane Tenny: 15:51 With that said, that's been the historical stigma that just, in some ways, requires or has resulted in physicians not disclosing or not talking or things like that. There are trends taking place, correct me if I'm wrong here, but in some states and with some medical boards to help open up the opportunity for physicians to be more vulnerable or those sorts of things. That's taking place now, isn't it?

Michael Myers: 16:14 Absolutely. Yes, and that's the very hopeful piece. Basically, the national licensing boards have been looking at these questions. Here in the state of New York, for instance, when we take out a license, there are no questions asked about our health at all, but I think only about a dozen states like that, but the Federation of State Medical Boards that was looking at this nationally. What we've been recommending is a template something like this: Are you currently suffering from any illness that's affecting your ability to practice safe and competent medicine? If so, please explain. So that's the part of CTA. It touches on impairment and it doesn't partition off substance use disorders or other mental health and from things like diabetes, multiple sclerosis, cancer or any things like that, so it's all kind of under your health.

Michael Myers: 17:03 So as that improves, that's going to make it easier. Shane, I'll just mention one other thing where I saw this in a tragic way was the research that I did to put together the book on physician suicide where I interviewed family members of doctors who had taken their lives, I can tell you, there was at least 15 to 20% of these families that I interviewed where their deceased loved one, or actually loved one, died by suicide without a consultation. They did not go to a primary care physician, to a psychiatrist, to a psychologist, to the clergy, anybody, because they were just terrified of what this could mean in terms of their licensure or the disability insurance or things like that and that, that is tragic. Absolutely tragic.

Shane Tenny: 17:53 Yeah, it is. At the risk of asking you too personal a question, I'm struck by the fact that thankfully, there's more dialogue around these topics now, but knowledge doesn't mean that we're immune from them. I guess I'm just curious, in your many decades of service, have there been times where you've struggled with depression or anxiety or those sorts of things and how did you work through those or how's that going?

Michael Myers: 18:17 Yeah. Very good question. I can do that in two parts. Certainly, when I went through training, when I was having just stressful things, I got some therapy then, very helpful. Also, at other times through my career as well, then stressful things, family and then as I mentioned in the book, way down in my life course, when my marriage was ending and I was coming out as a gay man, I was 64 years old at that time. I was also in therapy at that point as well. That was extremely helpful because I was transitioning. I was not only leaving a 40-year marriage, but I obviously had concerns about my wife as well as my adult children. It's like this, it a major transition, and my career, things like that. The therapist I had was so helpful and just so reasonable and so hopeful.

Shane Tenny: 19:12 That's a great example. I'm grateful for you to bring it out because I think it's an element of, "Look, we need to practice what we preach." Just listening to a podcast on mental health doesn't mean you're immune from it. It means here's an opportunity to take action to care for yourself, even the experts do. I appreciate you sharing that. I want to take a quick break here and then come back and talk a little bit more about your book and some of the one-on-one work that you've done.

Shane Tenny: 19:41 Do you have a financial junk drawer? Even before I describe it, you probably know what I'm talking about. Just like that proverbial drawer in your kitchen or laundry room. You know, the one filled with pens and pencils, screws and duct tape, matches, chopsticks, maybe even an old sock, the drawer filled with things that you didn't know where else they belong. Well, many of us as we go through life accumulate a financial junk drawer filled with an insurance policy we bought from a college roommate after graduation, an old 401k that we never moved from an earlier job or bank accounts that we opened to get a car loan or mortgage, even though we don't bank with that institution.

Shane Tenny: 20:24 The more products, accounts and policies you have, the harder it is to create a centralized vision and progress towards the goals that you have, whether you're working with a professional financial planner or trying to tackle these things by yourself, the more organized you can be, the more effective you'll be at making the changes and monitoring the results towards the goals that you have. If you need help in this regard, click on the show notes below and download our free guide, Five Steps to Organize Your Finances. I can't say it's a fun way to spend a weekend, but you'll be amazed at the progress you can make if you'll just start cleaning out your financial junk drawer.

Shane Tenny: 21:11 All right. So Dr. Michael Myers, thanks so much for just helping us dive through this topic of mental health. I know one of the things you talk about in your latest book, the memoir on Becoming a Doctor's Doctor, is the work around just couples' therapy. Not a lot of psychiatrists work with couples, but you have. What are some of the unique challenges that doctors' couples have that might be different from the average married couple?

Michael Myers: 21:36 Yeah. Thank you, Shane, for asking that because you're right. Psychiatrists generally don't do couples work. There's been a few of us over the years. I didn't get any training in it, in my residency, but then my practice, by the way, it's always been half-time and then half-time academic work. So in those early years of practice, I was seeing so many individuals with marital difficulties and I just felt handicapped. I felt that it couldn't offer enough except quote-unquote support. So I went and got some training. So then what I did then, and I practiced [inaudible 00:22:06] basically until I retired. So basically again, I said the same thing that doctors are like everybody else. We, too, can have stresses and strains on our marriages.

Michael Myers: 22:15 One thing I did notice, and it depends on whether it was a more traditional doctor's marriage or perhaps you do a dual career or a dual doctor marriage, but that certainly evolved over the decades in my work as well. But it's so often the time that they really didn't set enough time just for plain, old-fashioned communication. So, so much of the work I was doing with physicians was really making sure that they protected that quality time for each other as a couple and then, of course, as a family as well, because marriages of very busy physicians have also worked over the years, this sort of thing. So there's been a template for that. So I really just need it to help doctors who are in that respect. I put some, I think, four or five different disguise case examples in that chapter.

Michael Myers: 23:03 One of the ones that I think people have been quite surprised about, there was a couple in their middle years with a growing kid, a dual doctor couple. The chief complaint, I'll never forget, it was uttered by the woman who said, "Our problem is mopping up after the affair." So quite traditionally, you'd tend to look at the man and think that he's had the affair, but in this case, it was her. What I was able to tease out very early in that first visit is that this affair was rooted in the fact that she has an undiagnosed, low-level hypomania of bipolar illness that hadn't been diagnosed. She had a very postpartum depression after one of her children, but then everything was under the radar.

Michael Myers: 23:47 But anyway, what my point about all of this was, was that I was able then to make the diagnosis, treat her appropriately for her illness. Her husband was not surprised about this because he was worried about her as well. He just felt her judgment was really off. She agreed. What he had to help her with, of course, as you can imagine, was the shame. Oh my God, that poor woman, she just felt dreadful about something like this. That was the last thing in the world that she would've ever thought would occur in her life. He was a prince of a man. They were both lovely, lovely people, as were their adult kids. I got to meet them as well. It's such a good news story in terms of a very happy ending.

Shane Tenny: 24:30 I know that you also write in your book about just the work that you've done has taught you humility. What do you mean by that?

Michael Myers: 24:38 That's when I decided to put a chapter in the book called, What My Physician-Patients Taught Me. There's two parts to this. I think there's a tendency in all of us in medicine, many will become sub-specialized and especially as a doctor's doctor, to get a swollen ego, a big head. "I must be good if doctors are coming to me, that they trust me and they think that I do good work." That can just feed into some sort of narcissism or arrogance or whatever, that sort of thing. I had to fight a lot of that thinking that looked at what's most important is that I do good work. I got to set the bar high, et cetera, et cetera, that sort of thing. So you're looking after people who are brought to their knees with the difficulties that they're having. [inaudible 00:25:27] with professionals in their personal life, in their marital life, you can't help but be humbled by that.

Michael Myers: 25:32 Then as you also know, [inaudible 00:25:34] suicide, threats of suicide all through the book as well, losing patients. But then I also put in that chapter a touching story of a high-functioning woman in our hospital who insisted on being treated on a teaching unit. She wasn't a psychiatrist. She was in another branch of medicine because I was going to have a colleague look after her in another medical center so she can have some privacy, et cetera. She said, "No, I want to be treated here." And that woman, she helped my medical students and residents with their own humility and the admin thought they had such admiration for her and she'd just accept it. "Yes, I'm a physician, but I'm a very depressed woman right now at this time." Again, another one of these lovely stories where I guess, when or if our time comes, I hope that will have the dignity to encourage [inaudible 00:26:36].

Shane Tenny: 26:39 You've done a lot of research and dealt with, over your career, suicide. It's hard to understand. I know there are many folks that you've worked with that you've counseled that have had thoughts of suicide and, of course, haven't acted on it. What should people better understand about suicide?

Michael Myers: 26:56 It comes back to that same thing that, "Look, we're human too. This can happen to us as well," because see, that's the paradox of all of this. I come from a completely non-medical family. When I started working in this area my brother, for instance, couldn't wrap his head around it. So that, " A doctor? Why did that doctor die by suicide? You guys got everything going for you, higher education, status, money, et cetera, et cetera." So I had to explain about psychiatric illness. Sometimes you can be very elusive, the doctor himself or herself doesn't quite feel it.

Michael Myers: 27:30 The family may not notice, so I do so much education on those things to watch for, red flags, making sure that you can kind of bust that stigma so that the doctor can just get help because it breaks my heart when I see people, including physicians, dying by suicide, a treatable illnesses. So because this doesn't happen in other branches of medicine. I have a lot of friends who are oncologists. I said, "You never heard of a doctor dying of cancer who didn't go to an oncologist at least once?" He said, "No, I haven't. I said, "Well, we certainly see it in my branch of medicine. So there's those sorts of things because these things can be treated.

Michael Myers: 28:08 There's so much research going on. By the way, I will just mention this because we were talking about COVID. When Dr. Lorna Breen, emergency physician, who her suicide to reached national attention. She was the chair of emergency medicine at Allan Columbia University Hospital here in New York City. Her tragic death, after she herself developed COVID, really galvanized the nation. There is so much that has come out of that horrible loss. Her sister, Jennifer and her brother-in-law, Corey, are doing amazing work with Congress.

Michael Myers: 28:47 They have a bill before Congress, the Dr. Lorna Breen Healthcare Workers Initiative, something like that. Tim Kaine has put that before Congress. It's to bring us out of the closet, to make a difference, to promote more research, to make sure that we keep fighting the stigma so that doctors don't have to be ashamed. That's what she was struggling with and it was so painful to listen to them describe the fear that she had about losing everything because she got ill.

Shane Tenny: 29:20 On the chance that there's somebody listening to our conversation today, who is either struggling with depression or acknowledges they've had thoughts of suicide or just wish it was over or they've got a family member or a friend, and there is the fear. What's going to happen? If I seek a therapist, then are they going to be obligated to notify the medical board? Are they going to have to notify my hospital? Those sorts of things, what happens? Somebody raises their hand and says, "I'm struggling. Can you help me out?" What happens?

Michael Myers: 29:49 That's such a good question. That's the other thing too, that I'm often asked. My line is always the same, "Whatever you do, do something." Then, so that might mean, because there's been a reason sometimes where they kind of muttered this out to you or whatever, or you might approach them. But the point of this is that you have a one-on-one confidential, personal conversation with that individual. You can be in any walk of life. You don't have to be a medical person or whatever, to try to just sort out, any way you can, how serious this might be at this time. Then the next thing, of course, is then to gauge all of that about getting help.

Michael Myers: 30:25 The one thing I always tell individuals who are reaching out to a fellow physician is when you appraise them with the resources, because you know that want them to see someone, that they should. I learned this from a videotape, I did it years ago on physician suicide, was this, it's not enough to just give them a couple of names or a phone number of resources, call and call her or whatever. That sort of thing, when you're so ill that you can't make those phone calls, or if you can, it's just crushing because your self-esteem is in the toilet somewhere. You've got no energy. You feel like you're bothering people.

Michael Myers: 31:00 So I always say, "You set that up for them." Say, "Okay, let me help you with this. I'll make the phone call." I always say it. If they insist though, because they feel you're being kind of infantilized or whatever, I said, "Okay, give them 24 hours or something and check back with them because if they haven't done that, you do have to do that," because once they get into care, then I think they'll realize, "Woo. I do need to be here." I've just seen that so many, many times with my ailing doctor patients themselves. They are so relieved to be there. Then you get going on making the correct diagnosis and proper treatment and you can try for that, so it's that human connection.

Michael Myers: 31:39 When you use the first person plural as well, "We are going to get you through this. Let me help you with this," or, "I'm going to help you with this," or whatever. If it's too much of, "You do this. You do that. You're really depressed, you need to do this." That can feel alienating, something like that and this gets, we come full circle, Shane, to what we've been talking about. Because with COVID-19, again, I've seen such outreach between and among physicians caring for each other. Doctors are openly talking about their feelings these days. It's more acceptable. They're talking about your feelings with your trainees, which is healthy, normal, good.

Shane Tenny: 32:20 It is. COVID is such a recipe for disaster to the degree that loneliness and isolation is a common denominator among suicide.

Michael Myers: 32:30 Yes. Yeah.

Shane Tenny: 32:31 Social distancing and COVID has only exacerbated that, but in the midst of that crucible, the resistance, and as you're talking about whether it's on a national scale or legislative or things of, "No, we are not going to be sucked down this. We are going to start a conversation we never would have had the pressure to have to have before."

Michael Myers: 32:51 [inaudible 00:32:51] an amazing and important word there loneliness because that's a feeling state that until a little while ago, a lot of people had trouble saying, "I just feel so lonely," because they thought, "I don't want to sound pathetic." But nowadays, both men and women are using that, "I feel so lonely with this isolation, that I can't hug anyone. I haven't seen my grandchildren. Zoom is fine, but I can't wait to see the person, even if I have to use social distancing or back when we can touch, we connect. So those are big factors that we're really looking at in terms of how that's making people feel depressed, perhaps suicidal, things like that.

Shane Tenny: 33:36 As you look over your career, you've authored a number of books. You've authored a number of papers. You've done a ton of work. What's been the biggest challenge for you?

Michael Myers: 33:45 I would say the biggest challenge is, I hate to sound hackneyed, but it is stigma. Even if we didn't really always call it stigma, it could be that resistance, though, to speaking to someone bearing so much alone, sharing that with someone which eases it. There's the stigma piece, but there's also something else I think in medicine which has to do with ruggedness or something or individualized something and so, it's like, "I'm tough." In surgery, they used the term, grit. You got to get grit. But yes, it is great to have grit, but yet, sometimes our grit is going to be a small G and not a capital G, this sort of thing.

Michael Myers: 34:27 So when we can realize that this is why the word resilience has become kind of a tough word. We use it in medicine a lot. You never want to use it to negate somebody like you don't seem to have much resilience. I'll tell you, you can take the most resilient physician during the midst of some type of major illness or trauma in their life, they're not going to feel very resilient. They will, but that's going to take a little time. So it's that kind of stuff, Shane, I think that I've seen big changes in. I'm so hopeful about everything. I just feel that despite all of this and what we're going through, in the world, I think, of physician health, we're making big strides.

Shane Tenny: 35:13 On the trajectory that we are on in this aspect of medicine, hopefully our healthcare providers are headed for a healthier future than ever before.

Michael Myers: 35:24 Yes, and we owe it to those we've lost, because we have.

Shane Tenny: 35:29 Michael, thanks so much for being with us today. I really appreciate your insight.

Michael Myers: 35:34 Thank you, Shane.

Shane Tenny: 35:34 So thank you for joining us for this conversation. If you want to explore Michael's books, his background further, you can find a link to his website in the show notes. Again, his book is A Memoir: Becoming a Doctor's Doctor. You can track that down and as always, we appreciate you being here. If you have suggestions for topics or guests that you'd like for me to chase down and interview, by all means, you can just email me directly, shane@whitecoatwell.com. Thanks so much for joining us. We'll see you back here next time.

Outro: 36:08 This episode of the Prosperous Doc podcast is over, but you're not alone on your journey. Spaugh Damron Tenny has been helping physicians and dentists prosper through financial planning for over 60 years. To connect with us, visit sdtplanning.com today and take your financial wellness to new levels. Join us on the next episode of the Prosperous Doc podcast.