One Step at a Time: A Personal Journey to Resident Wellness

by Nicole Phillips, MD (@DrNikkiPhillips)

I have previously described, in this forum, my experiences as a surgical intern during the Boston Marathon bombing. This year, I crossed the finish line as a runner in that same event.

Running a marathon had never played a role in my life plans—then again, neither had medicine, for a long time. And although running the marathon certainly helped me to honor many of the emotions inspired by the bombing, I can honestly admit that the thought of running the marathon never even crossed my mind in the immediate aftermath of that event. (At the time, I still thought that running a marathon sounded like a crazy thing that other people sometimes did.)

Most of the published articles on resident wellness have focused on issues such as the restriction of duty hours, resident sleep patterns, access to health resources, and mental health support. Unsurprisingly, most of these studies have focused on non-surgical specialties. After all, the phrase “resident wellness” is one that most likely incites groans from most surgeons; I’ve certainly been guilty of an eye roll or two when similar topics have been presented at our didactic forums. We didn’t sign up for this blindly, we say. We’re tough. After all, surgeons are a self-selecting crowd; we signed up for punishing hours, a notoriously brutal culture, and the sheer gutsiness that our daily actions require. Who needs to sleep, anyways?

But wellness has come to have a whole new meaning for me over the past several years. In the midst of my second year in training, I found myself—despite believing in the above sentiments hook, line, and sinker—feeling like there was something missing. Part of it was physical; I felt disconnected from my body, having trained myself to subsist on the peanut butter and graham crackers I could pilfer from the PACU between cases, to function on four hours of sleep a night, to living a life with no exercise beyond the occasional stairs taken during rounds. Even more of the disconnect was mental. I would repeat the same mantra to my friends and family: I just don’t have the emotional reserve to deal with this right now. I was checking out much more often than I was checking in.

One day, I found myself perusing websites for marathons that took place in far-off, tropical locations. I wasn’t sure that I really wanted to run a marathon… but I was sure that I wanted to visit Hawaii. I figured that if I could give myself a huge incentive, I could potentially convince myself to change some of the unhealthy patterns I had fallen into over the past few years. I didn’t know how or when I would find the time to make it happen, but I clicked the button to register anyways. And then, the next day, I laced up some sneakers and stepped out onto the road.

This is something I can do, was my first thought. No fancy gear required, no specific times or dates that I needed to be available.  I love being outside, and so I didn’t bother signing up for a gym membership—I would run the streets of Boston, at whatever time I could.

As the first few weeks of training went on, I realized that an amazing thing had happened: I had done much more than sign up for a race, in the hopes of justifying an expensive vacation to a beautiful place. I had given myself the gift of a few minutes every day, just to myself.

And so began my own relationship with “resident wellness.”

In a natural progression of the above, I began eating better and sleeping more. The fuel I gave myself became important enough that I began prepping food over the weekends; I would then pack up this food to bring to work throughout the week. I was initially concerned that all of the time I spent running and food prepping might take too much away from my time for reading and studying, but, in fact, the opposite proved true. Because I was taking better care of myself, I was more present and focused in the time that I did have for studying, making me much more efficient. I was also more present and available in my relationships with family and friends. (An added benefit of long runs was the great opportunity they presented to catch up with people by phone. I also nerded out listening to board prep lectures as the time for the in-service exam grew near!)

And so I ran Honolulu in 2014. And then Boston in 2016. With lots of shorter races in between and since, including a 10K I ran on Saturday after a brutal week at the hospital. I would never have considered myself a “runner” before; now, I can’t imagine life without it.


I’m incredibly wary of giving advice to others, and by no means am I suggesting that the only path to “wellness” is through running. But in keeping with the recent focus on wellness in our field and at the upcoming ASPS meeting, I wanted to share my story and humbly submit the following suggestions:

  1. Find what brings you back to yourself, whatever that might be. Devote some time to that practice every week, when possible– knowing that some weeks it just won’t be possible.
  2. Be mindful of the fuel you choose to carry you through the day/ night.
  3. (Most importantly) be kind to yourself and to those around you…. Although the reasons why each of us chose to pursue a career in medicine are endlessly varied, at the heart of it all is the impulse to take care of those who need our help. Sometimes that includes the healers.

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