“I was forced to put on a mask and pretend to be someone that I wasn’t.”
This sentence struck me hard as I was reading the outstanding essay by Dr. Manu Dua about his struggles with being a dentist and how a cancer diagnosis led him to realize that dentistry was not the right career for him.
Manu’s words are even more impactful because he never got a chance for a new start, as he passed away on March 14, 2021, at the age of 34.
We all stop short when we hear such devastating stories. But after some brief reflection and perhaps even less introspection, we go about our lives, often suppressing our very real fears and the fact that somewhere along the way, we forgot who we are.
The Loss of Self in the Pursuit of a Goal
“The dark but beautiful side of facing our mortality at an early age is that you realize that death is the only ever-present factor and it respects no boundaries,” Manu wrote.
Manu talked about embracing our inner selves, a concept central to yoga philosophy, where it is taught that taking the time to look inward is the key to understanding who we really are so, as he reminds us, we “can take advantage of the precious years we may have left.”
It is so easy to get lost in the pursuit of career aspirations and become so invested in the quest, we forget to stop, pause, observe, and listen to ourselves and not to everyone around us. The investment is both financial and personal, and soon we are in so deep, we think there is no way out, and our pride insinuates itself into the conversation.
We could never fathom chucking it all and making changes because we have already given so much of ourselves in the process and because the shame of what we think would be viewed as a failure is too much to bear.
For Manu, dentistry was a “professional pursuit of unhappiness.” When I was in high school and the question arose about possible careers, the three high-achiever options were medicine, dentistry, and law. “Just pick one” was the prevailing directive.
I know too many people who applied to all three programs and let their test scores dictate their future. It was akin to an arranged marriage, where people believed their love for the career would eventually grow. Or not.
Of course, many people may be thrilled with their chosen professions and would do it all over again if they were given the chance. Or would they? Would you?
Cancer thrust that option upon Manu. We should all learn from his story and take time to check in with ourselves about how we feel about what we do day in and day out, often on autopilot, before our resolve to make changes is completely eroded.
The Toolbox of Resilience Is Empty
A young dentist I mentor told me, soon after graduation, that the stresses of the career he and his classmates worked so hard to achieve was plaguing far too many of them.
“None of us have coping skills,” he said.
The packed curriculum of professional programs has never made room for teaching how to effectively communicate, handle adverse events, and, most importantly, look after ourselves. Slowly this conversation is changing, and steps are being taken to right the ship.
But the “suck it up” attitude still prevails, which can result in patients not getting the care they expect and deserve. Also, many no longer see feedback as being coached toward the best performance but as a personal attack. The ego then creates a veritable blockade between said feedback and the concern for the patient for whom the procedure was meant to help.
Our profession does have a lot to offer. But we are, as Manu discussed, bombarded with images of our colleagues living their best lives who don’t hesitate to tell us how well they are doing. Many of them, however, are not just lying to us but they most certainly are also lying to themselves.
Like Manu, I noticed several years ago that I had not become the person I wanted to be. A friend and colleague was both blunt and kind enough to tell me “You scare people.” I had reached what I call the angry part of my career.
I started to make some changes. But I did not have the resolve to recognize that, two ulcers in, I could not just tough it out and keep going.
Through yoga training and transitioning my practice life to something I could actually handle, it took several more years before I could get closer to being true to myself and in a position to help guide others to develop the skills to manage both the lows and even the highs of practice so they do not squander what our profession can provide.
Believe me, however, I am still a work in progress.
I sent Manu’s story to my good friend and fellow educator Dr. Vanessa Morenzi, who immediately wrote to tell me how she transitioned from her years in general practice to the specialty of orthodontics, which she “loves to this day.”
From private practice, Dr. Morenzi made another bold move and became director of an outstanding specialty training program, where she imparts her experience and wisdom to legions of future colleagues—and to me too.
“You must be willing to trust your own self-evaluations of your gifts, talents, and deficits in order to identify, and pursue, your best self,” she said.
It is about getting to know yourself and listening to yourself, because if you don’t, you may no longer recognize yourself.
In What Doctors Feel: How Emotions Affect the Practice of Medicine, Dr. Danielle Ofri recounts a less than stellar encounter with a senior resident over her management, or mismanagement, of a patient with diabetes in the emergency department.
Looking to prove her worth, Dr. Ofri, then a very green intern, eschewed the advice of a seasoned nurse, resulting in her patient requiring emergency intervention again! Years later, at the appointment for an ultrasound of her first child, she encountered her former attending in the waiting room, whom she realized quite likely had forgotten the whole event.
The entire episode again played out in her mind as if it had just happened. While she was watching the screen showing the outlines of her first child, she said that all she could think about was that fateful day when her actions could have compromised the life of her patient.
Nobody teaches us how to process these traumas, which we encounter on a daily basis, from the angry protestations of a patient to the failure of one of our treatments.
Mentors
Uomo avvisato mezzo salvato.
My study of Italian has revealed so many great idiomatic phrases. The man that is warned is half-saved. Finding the right mentors before we make a career choice is an imperative so one is not left defeated, thinking that “this is not what I signed up for.”
We need to learn who we are and that it is a sign of strength, not weakness, to know when to make changes that allow us to perform at our best, or just walk away. We need many different mentors for both our professional and personal lives to help guide and advise so that we can face life’s challenges, aware and prepared, come what may.
Dr. Freeman is the director of patient experience for dentalcorp, helping dentists across Canada achieve clinical success that results in the best experience for their patients. He is an honors graduate of University of Toronto (U of T). He completed the Advanced Education in General Dentistry program at the Eastman Dental Center in Rochester and returned to U of T to complete his Diploma in Orthodontics and his Master of Science degree in the field of temporomandibular disorders and orofacial pain. He is also co-director of the Facial Pain Unit at Mount Sinai Hospital and lectures internationally on clinical orthodontics, facial pain, patient experience, and virtual surgical planning. Bruce is a certified yoga instructor with additional training in breathing techniques, meditation, and trauma informed movement. He directs the Wellness Program for Hospital Dental Residents at Mt. Sinai Hospital, emphasizing how self-care leads to the best patient care. He can be reached at bruce@drbvf.com.
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