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Use 'professional firewall' to manage stress.

The ancient Greeks struggled with the concept of a good or fulfilled life. In about 400 B.C., Hippocrates taught that the key to a healthy life was balancing the humors of the body. To do this, one paid attention to the spiritual, emotional, and physical interplay of forces in one's life.

George Sheehan has said that wisdom is the step beyond knowledge. Wisdom comes from the knowledge that a physician's purpose is to teach people to live the good life.

Asclepius was the Greek god of healing, and he taught that exercise, a healthy diet, and a rich family life were needed to develop the "good life." He carried a curved wooden staff with a serpent wrapped around it. This staff is the ancient symbol of combining body and soul, and also the caduceus that is the modern symbol of medicine. The Greeks had no word for stressful events to the body, but they had figured out the body-mind connection.

Hans Selye was the first to use the word stress in a medical sense. He borrowed the term from the engineering lexicon in which stress is described as the reaction of solid material to physical energy. Interesting and creative research has been done since Selye first proposed that uncontrolled and unmanaged stress could affect physical health.

In the mid-1950s, when immunology was in its infancy, he suggested that connections exist between stress, decreased immune response, and, subsequently, disease processes. He was roundly criticized and thought to be on the fringe of the scientific world by stating that physical diseases could be caused by mental stress.

People charged with taking care of others have a continuous type of stress. We form a unique bond with patients, and this bond is not broken until the patients are healed, become angry and leave us, or die. Fortunately, patients rarely die in our immediate care. So we're left in the position of being responsible for a large number of people for a long period of time.

We carry stress with us, and unless we figure out a way to decrease it, there will be serious consequences. One of those consequences is abject fatigue. Another is feeling ground down.

Until I retired, I was not aware that as a physician taking care of patients I was always on duty. This didn't mean I was always on call for my patients, but I carried a constant, low-grade consciousness of my responsibilities. It was something that produced stress in me.

For the first 2 or 3 months after I retired, I patted myself down every night looking for my beeper. The realization that I neither had nor needed one was quite enlightening. Achieving balance is something we need to do to manage the assault of stress on our lives, but finding that balance requires your energy, talents, time, and physical presence.

A professional life is demanding, insatiable, and fulfilling. A 10- to 12-hour workday is a huge dedication of energy to the professional life. Although we hate to admit it, professional life is sometimes more satisfying than family life. The high we get from a grateful patient makes the hassle of dealing with the moodiness of a teenager even more difficult.

Being aware of the elements in your life that you need to balance seems intuitive, but I found them difficult to sort out. For me work is one segment, family and friends a second segment, and leisure time a third. Giving weight to each of these elements is where you do the balancing act. Because our work is such a huge pull on our energy and time, I found I needed to do something to keep me away from my old habits. I found balance by creating a "professional firewall."

How can you create this firewall for yourself?

1. Arrange a schedule that does not impinge on family, friends, and leisure time. Make it irrefutable. Realize that your operative schedule isn't set in concrete. We don't have to start every day at 7:30 a.m.

2. On call time and leisure time do not mix. Being on call and carrying your beeper when you're going to your child's picnic doesn't work.

3. Remember that your workday should stop at a specific time.

Maybe the most important thing I've learned is that balance is ephemeral. It needs constant reevaluation. Stress is an ongoing issue, and you need to give your mind and body the chance to reduce the impact of stress. The human body has mechanisms to turn off the stress responses if you give it a chance.

One of the ways to turn off your stress response is to find a time-out spot or a "laughing place." I have several laughing places in my life that have helped me cope with stress. One I found when I volunteered at an orthopedic hospital in Tunisia for 6 weeks each year. It provided a change of pace that enabled me to slow down and get to know my family better.

Balance for me is finding purpose in my life by combining work, family and friends, and leisure time. Balance is learning from the past and letting it go. It's looking toward the future but not dwelling in it. Most importantly, balance is grabbing the calm and "laughing" moments in the present and making them your own.

DR. LUTTER is adjunct professor of orthopedic surgery at the University of Minnesota Medical School in Minneapolis.

BY LOWELL D. LUTTER, M.D.
COPYRIGHT 2006 International Medical News Group
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Copyright 2006 Gale, Cengage Learning. All rights reserved.

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Title Annotation:work life balance for stress managment
Author:Lutter, Lowell D.
Publication:Clinical Psychiatry News
Article Type:Editorial
Geographic Code:1USA
Date:Nov 1, 2006
Words:913
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