SGO Wellness: The Peace and Calm of Surgery in Gynecologic Oncology | William M. Burke, MD

William M. Burke, MD

It is that wonderful, magical time of year again! Thanksgiving has passed and the joyful chaos of the looming holidays surrounds us. The coming weeks are filled with travel plans, holiday parties, family obligations, religious observances, and personal hopes and dreams (I am not going to gain weight this holiday season). But wait— what about the other me, the gynecologic oncologist, during this frenetic time? What about the MOC, abstract deadlines, meeting planning, patient care, and the surgical crunch before everyone’s deductibles reset? Don’t forget the chemotherapy complications, end of life discussions, and family meetings. Oops…I forgot the EMR, billing and coding, administrative tasks, committee calls, and manuscript reviews.

Take a deep breath. Take a moment. That is a lot.

It is this time of year when we are all pulled in so many directions that has made me pause to consider how we as gynecologic oncologists can find ways to practice mindfully and to avoid burnout. How can we develop strategies to maintain a surgical practice filled with daily clarity, resolve, compassion, and wisdom? How can we maintain personal well-being both at home and in the workplace?

It is silly to think that there is one easy remedy; however, I was reminded of one strategy while at the Fellows Forum this year in Denver, CO. During a mentorship talk, we were all asked the question, “What has been the most difficult stage of your career? The beginning, the middle, or the end?” There was a lively discussion and a host of differing answers; however, the one common theme, regardless of the answer, was the personal and professional stressors experienced every day by gynecologic oncologists. More specifically, the anxiety created by a sense of not having control over all aspects of home life and career. It was at that moment I realized one constant throughout our careers is our presence in the operating room. Many articles, blogs, and essays highlight the operating room as a major source of anxiety for surgeons and a large contributor to burn out and personal dissatisfaction with medicine. After speaking to colleagues about this constant in our life, contrary to what many believe, I have come to understand that the operating room and surgical ritual can serve as a source of peace and calmness that can positively impact our overall wellness.

Rituals or daily practices that come to mind and remind me of my days in the operating room are shamatha, a well-known Buddhist practice that focuses on developing calmness, clarity, and equanimity and the yoga practice of the sun salutation that is designed to combine movement, breath, and traditional mantras in order to draw vital energy into the mind, body, and soul. The ritualistic preparation and completion of a surgery among the chaos that is the operating room allows us to focus, breathe, take stock of our surroundings, visualize the procedure and outcome, soak in some music (if desired), and hear and see nothing but the moment. The rhythm of the surgery enables us to compartmentalize our personal and professional stressors to another part of our mind and to momentarily achieve a stillness difficult to duplicate by other means. On days I can achieve a sense of stillness in the operating room, it is rare that I do not feel more energized and more at peace than I did at the beginning of the day.

William M. Burke, MD, is the Director of Gynecologic Oncology at Stony Brook Medicine in Stony Brook, NY.