Physicians are trained to care for their patients. But when they need support themselves, it can be difficult to find help. Canadian Women in Medicine Conference (CWIM) was founded with a mission to support women in medicine throughout their careers and advocate for their well-being so they can thrive. Its latest fifth annual conference is the largest gathering of female physicians in North America. This year’s theme focused on wellness, and one of the most anticipated speakers was Jillian Horton, MD.
Her not-so-perfect world
An award-winning medical educator, writer, musician and podcaster, Dr. Horton obtained a master’s in English at the University of Western Ontario and did her medical training at the University of Toronto, where she has held the post of associate dean and associate chair of internal medicine. For two decades, she treated thousands of patients at an inner-city hospital, mentored hundreds of students and had three sons. Dr. Horton is currently a general internist who serves in multiple leadership positions at University of Manitoba’s Max Rady College of Medicine in Winnipeg.
Six years ago, Dr. Horton outwardly seemed at the peak of her career, but privately, she struggled with a crippling secret. “So often, the people who are really good at solving other people’s problems are not that good at solving their own,” she says.
“When I look back on that period of my life, I recognize now that I had been cycling in and out of burnout, probably for the better part of my professional career.”
An opportunity for personal reflection
Dr. Horton’s colleague suggested she attend a meditation retreat run by Dr. Mick Krasner, who had been working with burned-out physicians for 10 years, teaching them mindfulness, self-regulation and emotional self-awareness. At first reluctant, Dr. Horton realized that to continue in medicine, something had to change.
“I thought I’d learn something that would help my students, but in that journey, the person I actually learned to help was myself, and it was probably the single most important, healing thing I did,” she explains.
“I learned to talk through some of the things I had been carrying or blaming myself for throughout my entire career and to work with some of my stories differently. It was absolutely life-altering.”
Dr. Horton now teaches Dr. Krasner’s method to other doctors and leads the development of new programs related to physician wellness. A novel she had been working on for years instead became a bestselling memoir, We Are All Perfectly Fine: A Memoir of Love, Medicine and Healing . Published in 2021, the book reveals Dr. Horton’s experience as a caring doctor and mother on the brink of personal and professional collapse. It also offers a roadmap for other physicians to share their stories and take better care of themselves and ultimately, their patients.
We are not all perfectly fine
In her conference session, “We are not all perfectly fine: How telling our stories will transform our culture,” Dr. Horton focused on how the existing medical system — with its punishing training schedule, sleep deprivation, and unrelenting stress — shapes physicians who are never taught how to take care of themselves.
“In medicine, we value critical thinking, not emotional attunement. We’re conditioned to believe that double-blind randomized control trials are the only language we’re allowed to speak,” she says.
“We have to internalize the idea of other ways of knowing, and stop letting other people unilaterally define what professionalism is. We have to be ready to come to other conclusions about what has helped us and what has harmed us, and it takes a lot of strength to do that.”
A positive path toward change
One way to counteract physician burnout and suicide is pushing through the fear of judgement and sharing authentic experiences, Dr. Horton explains. Stories are powerful vehicles that enable healthcare practitioners to achieve personal, systemic and institutional change. By creating an environment of trust, support and empathy, physicians can transform the medical culture.
“Mindfulness, storytelling, self-regulation, and finding the courage to tell the true story about our own lives — all these things are deeply connected,” she adds.
“We’re wired to listen to stories; we experience emotional stimulation, oxytocin is released and we’re totally captivated. Then, we feel empathy, which changes our behaviour and changes our response.”
There’s already been a significant shift in how healthcare practitioners see their experiences and culture, she added. In 2021, Dr. Colin West — one of the leading voices on physician wellness –explored the critical use of stories, and how faculty could disclose their own mental health struggles during training to good effect.
“There are risks in telling our stories, but there are even bigger risks in not telling them,” Dr. Horton says.
Overcoming fear to share your truth begins with cultivating a supportive network, Dr. Horton told attendees. “Find your people, and then hold on to them for the rest of your life, because they will make it easier for you to metabolize those feelings, continue practicing the way you want to practice and be the person you always imagined yourself being.”
Every story makes a difference
Several years ago, Dr. Horton wrote a comic strip for her students to communicate her experiences.
“I talked about mental health struggles in medical school and residency, self-doubt, impostor syndrome and private grief. I had no idea if it would be impactful,” she recalls.
At that year’s graduation ceremony, the valedictorian shared highlights of medical school along with incidences of severe trauma, including thoughts of suicide. Later, she told Dr. Horton her comic book had given her the courage to tell her story, in the hopes it could help her peers.
“Our profession has a big problem with denying us meaningful opportunities to achieve work-life integration, and the best thing we can do is talk honestly and say yes, I’ve experienced burnout,” she says.
“The stories we don’t hear are even more important than the ones we do. That’s how we figure out what might have happened to the people we lost or ones who are too injured to tell their stories. We all have a story, and we really need to be willing to rewrite the end.”
- Learn the Skills to Take Charge of your Mental Health
- Preventing Professional Burnout: Tips for Doctors
- Chill Out Before You Burn Out: Stress-Relieving Tips for Medical Residents
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