July 23, 2024 • 30 mins
What happens when a driven physician realizes that years of hard work and dedication still leave her feeling inadequate? Join us as Dr. Megan Melo shares her journey through medical school, residency, and beyond, shedding light on the hidden struggles of perfectionism and burnout that many in her profession face. Through candid storytelling, Dr. Melo reveals the toll that relentless pressure and systemic issues in healthcare take on those who dedicate their lives to helping others.
In our conversation, Dr. Melo discusses the critical, yet often overlooked, topic of self-care in the medical field. She recounts the sacrifices made during her 20s and the unrealistic expectations that can lead to disillusionment with the profession. Importantly, she shares her strategies for prioritizing mental and emotional health, such as setting personal boundaries and seeking life coaching. By advocating for self-care, Dr. Melo hopes to inspire fellow physicians to prioritize their well-being and contribute to systemic change that benefits everyone in the healthcare industry.
Navigating emotions and setting boundaries are essential for healthcare providers, and Dr. Melo provides valuable insights into these complex challenges. She discusses the ethical dilemmas of patient demands and the importance of acknowledging and processing negative emotions rather than suppressing them. By reframing thoughts and understanding that one's worth isn't tied to pleasing others, Dr. Melo offers a pathway to maintaining both professional integrity and personal well-being. This episode is a must-listen for anyone in healthcare looking to foster healthier emotional well-being and establish stronger professional boundaries.
What You'll Learn:
- The importance of self-care
- The importance of boundaries
- Feel the feelings and why it is important
Connect with Dr. Melo:
Though I am a physician, this is not medical advice. This is only a tool that physicians can use to get ideas on how to deal with burnout and/or know they are not alone. If you are in need of medical assistance talk to your physician.
Learn more about female physicians' journey through burnout to thriving!
https://www.theworthyphysician.com/books
Let's connect for speaking opportunities!
https://www.theworthyphysician.com/dr-shahhaque-md-as-a-speaker
Check out the free resources from The Worthy Physician:
https://www.theworthyphysician.com/freebie-downloads
Battle of the Boxes
21 Day Self Focus Journal
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Dr. Shah-Haque, MD (00:00):
Welcome to another episode of the Worthy
Physician.
I'm your host, Dr SapnaShah-Haque, reigniting your
humanity and passion formedicine.
Today I have Dr Megan Melo, sothank you very much for your
time and being here.
Dr. Melo, MD (00:15):
Yeah, thank you so much for having me.
I'm excited to talk more withyou.
Dr. Shah-Haque, MD (00:19):
I appreciate that.
So what has your journey ofbeing a physician look like?
Dr. Melo, MD (00:26):
Yeah, I'm somebody who went straight through.
So I went from college tomedical school and followed what
I thought was the quote unquoteright.
Looking back, I can.
Part of the work that I do nowinvolves people pleading
imperfectionism and working withphysicians around that.
Looking back, I can very muchreflect how early those two
(00:47):
habits got started in me.
They definitely supported myjourney all along that path,
right when I told people Iwanted to be a physician great,
you'll be helping so many peopleand just a lot of reinforcement
.
I think that's true for manypeople.
But I think it's important thatwe really recognize it.
But again, followed thattraditional path and went
(01:07):
straight through, didn't have areal job or a real youth before
going to medical school andlater found out that many of my
colleagues had been out doinglife stuff not just to help with
, but got into Stanley Medicinefor my residency and did that
three-year program and thenstayed at the institution where
(01:28):
I was surrounded by a lot ofmodel of physicians who had been
in one place for a very longtime in their career.
From the outside, I appeared tobe very happy and content with
what they were doing.
Yet I saw them working verylong hours.
I saw them not spending a lotof time with family.
I found it really hard to putin those long hours and to feel
(01:51):
like I was doing enough.
I kept searching for a timewhen I could feel that I was
enough, I had done enough, thatI had gotten to a place where I
was good enough and I could takea break.
What I found is that never camethat sensation of being good
enough in I could take a break.
What I found is that never camethat sensation of being good
enough in my job.
Never came that break I waslooking for and I think a lot of
(02:11):
us are searching for that timeright where we feel like we have
accomplished enough and we canfinally feel good about the work
that we, you know, have done.
I see this, as you know,something that many of us
struggle with, and we could talkmore about that, but it's a
real limitation.
So it's a really important partof my journey just to come out
of really struggling to feellike a worthy physician.
Dr. Shah-Haque, MD (02:33):
Yeah, it's one of those things where the
arrival fell asleep.
I've arrived at being anattending.
Dr. Melo, MD (02:39):
Now what?
This felt good for a hot minute.
Now what?
Yeah?
Dr. Shah-Haque, MD (02:43):
exactly.
How did you deal with that?
Dr. Melo, MD (02:46):
Yeah, not well for a while.
To be honest, I think I wouldcome into periods of burnout and
just feel really overwhelmed,really exhausted, really down.
Sometimes I would take a break.
I ended up taking a leave ofabsence, for it was about a
month at one point in 2019.
But every time I would comethrough a period like that, my
(03:08):
response was always to armor up.
As Brene Brown says, right totry and get harder.
I just need to stop caringabout resting and stop thinking
that I or stop trying to be sosoft, right, like I should just
love the work so much.
That's enough.
That didn't work.
It didn't solve the problem,because that's just not how
(03:28):
humans operate.
We need a balance of work thatengages us and rest.
Yes, there's, of course, acertain amount of putting in
work time that we don't love,but we also have to choose at
some point to value ourselves,to decide okay, I need a
boundary here, I'm going to takesome time off, I'm going to not
(03:49):
respond to my phone, I'm goingto really disengage and rest.
Those lessons, I would say, aremuch more recent in my journey,
but what really made adifference for me was a few
years ago, in learning some ofthe coaching tools that I use
now and really learning howimportant it is to be aware of
my thoughts and how thatinfluences the emotions that I
(04:13):
have, the action that I take.
That really made the mostdifference for me in recognizing
how I was contributing to myburnout.
Dr. Shah-Haque, MD (04:22):
You dive into that a little bit more.
You're a life coach, correct?
That's correct.
How did you make that choice tobecome a life coach and what
have you learned from being alife coach that maybe has added
more of different lenses to lifeand medicine?
Dr. Melo, MD (04:40):
Yeah, I came into life coaching like many of us
thinking I wanted help formyself.
But often I think we asphysicians with high achievers
not enough to get help.
We have to decide we like thetool or like a framework, and
we're going to get certified andteach it.
I'm certified in the work ofRenee Brown.
(05:02):
I'm a Daring Way facilitator inher work.
I launched into that trainingnever having actually done the
work on my own, so that's athing that I grew up with and I
find that a lot in people, inother physicians that I talk to.
But the tools that I learned ingetting trained as a life coach
(05:28):
made a really big difference inmy life, in not feeling like a
victim anymore, in learning tosee how conditioned ways of
thinking led to the experiencethat I was having.
And I don't take the healthcaresystem off the hook.
The healthcare system that wework in, the insurance companies
, the employers, the way thatAmerican healthcare in
particular is structured, wasvery toxic to the humans doing
(05:49):
the work.
I would argue that in Americanmedicine and probably other
things, that the business ofmedicine profits off us being
hardworking, driven people whonever feel like we're enough
Because we will always go thatextra mile.
It's very easy for us to tosome extent, be manipulated, but
Mrs Jones is here.
She really looks like she needshelp, but no one's looking at
(06:11):
my specialty and I have acompletely full day.
They're just tapping into thatempathy part of myself, making
me feel like a bad person if Ican't squeeze her in and
intervene every other human.
So we don't have to let thissystem off the hook and decide
that the system is not also aproblem.
But naturally, as part of ourtraining, many of us learn
(06:34):
perfectionist andpeople-pleasing habits that get
reinforced over and over again,keeping us feeling like we're
not enough, and so then we'realways striving to do more.
When I learned the coachingtools, when I started to apply
that in my own life, I could seethe impact of that.
I could see how I wascontributing to my own suffering
and I was able to look at thesituation that I was in very
(06:55):
differently and see okay, ifthis is the circumstances that
I'm working in, if I have thismany patients to see, if I have
these responsibilities, how do Ineed to start setting
boundaries?
How do I need to start takingcare of myself?
How do I need to start thinkingabout this differently so that
my experience can be better.
I can stay in this workundergrad, it's not just taking
(07:27):
the rigorous course schedule itis trying to do research or
trying to get hands-onexperience.
Dr. Shah-Haque, MD (07:30):
That's like an 18, 19, 20-year-old and
really you're asking them to sayokay, what are you going to
dedicate the rest of your lifeto?
And then we get into medicalschool and we're at a very
impressionable age yeah, 22, 23,24, maybe there are some of the
nontraditional students thatmaybe have a better grasp, but
(07:50):
we typically give up our 20s inorder to do what we're doing,
not knowing that the way thatwe're structured and conditioned
is completely different thanthe actual world of medicine.
Dr. Melo, MD (08:03):
Yeah, so many of us give up our 20s with this
idea that the promise of our 30sand 40s isn't so much better.
I definitely gave up my 20s andthen, like I had my 30s, when I
started having kids and I wasattending, like where did that
decade go?
That decade was completely inservice, right my patients, my
(08:25):
kids, my family, and there wasvery little in my 30s that was
for me.
I'm just, I'm not just.
I'm almost 43.
Right, so I'm solidly in my 40snow.
But trying to figure out now,okay, how do I create space for
me in my life where, yes, I cantake care of patients.
Dr. Shah-Haque, MD (08:55):
Yes, I can work with my physician clients.
That I.
I appreciate that, again, we'rejust conditioned to put
ourselves last, especially withthe theory of being the all
smiling, never upset female.
Then our male counterpartsdon't always have to face the
double standards.
(09:16):
The label that we get if we'renot nice and I'm going to wear
that crown because that helps mekeep boundaries and if that
helps me just going back to,let's go circle back to.
You really distinctly pointedout the system in which we
operate, in which we practicemedicine, is the driver of the
(09:39):
burnout and the overwhelm.
Why do you think it's importantfor physicians to look inward?
Dr. Melo, MD (09:47):
Yeah, for many years I was working on trying to
change the system from withinthe system it was operating in.
I was given the title ofwellness champion and before
that I was working on aresilience curriculum with our
residents.
I was always very, verydesirous right to change the way
that we take care of ourselves,but at that time I was very
(10:11):
focused on the external.
I was very focused on thesystem needs to be better so
that I feel better.
I still believe that the systemhas significant impact on us.
I think that it has significantresponsibility to change the
way that it operates.
But I can see now that theentire business model of
American healthcare is reallybuilt on cramming as many
(10:33):
patients as possible for lesstime and more challenge.
Until that business model isdifferent the kind of
traditional fee-for service Idon't see the systems relieving
the pressure on physicians thatare healthcare professionals, so
I see that as a huge behemoth.
It's still a problem and Ifully acknowledge it, but I
(10:56):
don't want anyone out therewho's experiencing suffering,
who is finding themselvesoverwhelmed and burned out, to
wait until the system getsbetter.
I want them to see the systemfor one day, to see that we have
the ability to choose to staywithin the system or not, but
that if we're going to choose tostay in the system, we're going
(11:17):
to need to take care ofourselves because the system is
not going to do it.
Again, I think we give up our20s and we have this idea that
one time an attending they'llstart taking care of me.
I won't have to do 80 hourweeks anymore there's actually
no rule against that asattendings and we can very
easily find ourselves insituations working that much but
(11:38):
we also have more agency todecide what's okay, what's not
okay for us.
I decided very early thatworking full-time, full-time
clinical practice was nevergoing to be okay for me.
The way that I am, the way thatI my introverted self, the way
that I take care of patients,the way that I listen to them,
try to be present as a human, Icannot do that for 40 hours a
(12:00):
week.
But that's me choosing to say Itake care of myself by never
working full-time clinicallybecause the system is not going
to figure that out.
How many of us are working inplaces that?
And they would love us all towork at least 40 hours a week
because we're the reason why themoney comes in what's us
drunken to build?
It does.
So.
I want to work with people tounderstand what is it that you
(12:24):
need, what is it that was theright balance for you to
practice in this kind of setting?
Or, if you're choosing tochange your setting, how do we
help you still get really clearon boundaries and self-care so
that you are in a betterposition, no matter where you go
?
A lot of people have thisfantasy right of it's just this
(12:44):
place, it's just this employer.
Right, that makes me work thisway.
But I'll promise you, if youhop to another system, right,
even if you're working foryourself, you're really good at
overworking and hustling andyou'll keep doing it, just in a
different place, unless isn't itUnlearning those habits that
(13:05):
were protective in order to getthrough pre-med school.
I want to help people now ratherthan spending my time hoping
and wishing and dreaming thateverything was different.
Because if I take good care ofmyself now and other people do
(13:32):
the same, then we have theopportunity to change the system
collectively by saying we'renot doing things the way that
they have been done before.
We deserve to go on vacationand really be on vacation and
not come back to 380 portalmessages.
The reality is real.
The reality is real.
The reality is real.
It's real.
It's painful and people areupset at us and we feel all
(13:54):
things.
Dr. Shah-Haque, MD (13:55):
Yeah, that's one thing that being able to.
You want to be able to workwith colleagues that will help
you, will cover for you, becausewhen they're out, you're going
to be doing the same for themyeah.
Well, we'll cover for you,because when they're out, you're
going to be doing the same forthem.
Yeah, and it's the fear ofgoing back to the office to an
ungodly amount of tasks ormessages is that should not
happen.
Dr. Melo, MD (14:15):
That dread is real and that buildup of maybe I
should need to go on vacation.
You know that's the bit of ahit term, not the right answer,
but it's unlikely that thesystem is automatically going to
make a change for us.
We might have to start havingthose conversations and really
deciding.
Vacation is important to us andthe way that we take care of
(14:38):
ourselves and each other is thatwe do things in this way.
But those conversations don'thappen without somebody having
an intention around it, right,mm-hmm?
Dr. Shah-Haque, MD (14:46):
But those conversations don't happen
without somebody having anintention around it, Right when
you work with your coachingclients.
Dr. Melo, MD (14:54):
Do you ever get any pushback with some sort of
advice, absolutely, absolutely.
And it comes in a variety ofplaces.
But I'll tell you, those of uswho have struggled with
boundaries, it's not that we'venever tried, it's not that we've
never tried to set a boundary,but what happens right not that
we've never tried, it's not thatwe've never tried to set a
boundary but what happens rightis that somebody gives us we say
we don't have time to talkabout all the things on your
(15:14):
list, we're going to talk aboutthese too, but I came in to talk
to you about all these 20things.
Yeah, then we might.
Okay, let's see what we canmanage.
Or we maybe will say no, Ican't, I can't take a walk in
today, I've got to leave.
Well, no one else can say andthey're your patient, you should
learn to help them.
We've encountered so manysituations where we may have
(15:36):
tried boundaries a little bitand then we've gotten pushed
back and we felt bad, we feltuncomfortable in some way, and
we decided to make that meanthat boundaries are just not for
us Right.
But what I push people to seeis that when you have boundaries
, you're simmering in chronicfrustration and resentment.
Much of the time, you mightalso be judging yourself for
(15:58):
feeling that way.
Right, because shouldn't youwant to take care of everybody?
Shouldn't you want to beavailable 24-7?
Right, if I set a boundary, Ifeel uncomfortable.
When somebody gives me pushback, I am the opportunity to choose
that discomfort as analternative to my chronic
frustration or resentment,because I don't get a world
where I don't have either.
(16:18):
If I'm not used to settingboundaries, I'm going to be
uncomfortable, especially for awhile while it's new.
But the benefit is that I nolonger feel frustrated that
people are constantly asking meto do things, expecting that
I'll do them, but I just don'thave the time or capacity.
Dr. Shah-Haque, MD (16:34):
I love the fact that you're bringing that
up because it's difficult Again,going back to the people
pleasing, and we can be easilyguilt-tripped, but then, at the
same time, it's a matter ofreframing, of which one do I
want to feel If?
Dr. Melo, MD (16:49):
I say yes to you, I'm saying no to something else,
and a lot of the time that noto something else is me.
That's no to me.
No, you don't get to eat lunch.
No, you don't get to go to yourson's soccer game.
No, you don't have time andenergy to do anything else.
Know, your feelings are notimportant.
We've done that to ourselvesfor a lot of years many of us
(17:11):
but we have to expect thatthere's going to be discomfort
and that's okay.
Nothing has gone wrong.
Dr. Shah-Haque, MD (17:16):
Yeah, usually there are other systems
in place to maybe which thatwalk-in can go, because many
times it's five minutes beforethe office closes or it's on the
weekend when you're heading outto the car.
Hey, I just need to talk to youfor a minute those are real
scenarios yeah and it's.
Can you just call in something,an antibiotic for in my head
(17:37):
cold?
Dr. Melo, MD (17:38):
it's not that easy .
It's not that easy, yeah, orjust yesterday this happened a
lot in our clinic.
People will call and be like myhands hurted, can I just get an
x-ray?
My answer is always no, that'sbad care.
I need to talk to you, I needto examine you, I need to figure
out is this something that'sgoing to be x-rayable?
Because if I just order anx-ray and I don't know the story
(17:59):
, it turns out you've got a red,swollen hand, something else.
I'm going to tell you the x-rayis normal, right, because it
wasn't the right test with theright evaluation.
Dr. Shah-Haque, MD (18:11):
But like we have to decide, yeah, I'm taking
the risk of disappointing thisperson, but not that simple.
They don't know that.
I think that's where we need totrust our training and the.
I'm not a fan of patientsatisfaction scores, because
this is not a restaurant, it'snot a hotel.
There's a difference betweenthe patient expects and then the
(18:32):
standard of care, and we haveto remember to stick to the
standard of care and stick toour training.
It's okay to say no, it's goingto ruffle somebody's feathers.
At the end of the day, you canlook at yourself in the mirror
and say I know that by mytraining and because I have
confidence in myself, that wasthe right thing to do.
(18:52):
But it seems like a lot oftimes, with the way the medicine
is, I'm even I myself havestruggled with.
Yeah, I made the patient upsetbecause I wouldn't order what
they wanted or I wouldn't ordera medication.
How do you teach your clientsto deal with that?
Dr. Melo, MD (19:16):
Yeah, I think it sounds a little counterintuitive
, but we need to be better aboutjust acknowledging the emotions
that we're having and in mywork I teach people kind of the
relationship between theirthoughts and their feelings.
So we have an emotion that weoften can recognize that we're
pretty good about squishingthose feelings down or
pretending that we're notfeeling numb.
Like I said, we might stillhave judgment, like I shouldn't
feel angry at a patient.
What a terrible person.
(19:37):
I'm a terrible doctor forfeeling that way.
But if I let's say, somebodycalls and they want an
antibiotic because they've hadthe sniffles for three days and
I say no, they tell the frontdesk person I'm never coming
back here again.
I can't believe that they.
I always get it, I always get aZ-Pak.
(19:59):
I have the opportunity to sitand notice that I'm feeling some
kind of way right, I'm feelingI might be feeling guilty at
that moment.
I'm feeling guilty because I'mhaving a thought that I should
take care of the patient, theirneeds.
It's a common thought that wemake now.
Right, I should be doingeverything I can to take care of
the patient.
My brain is interpreting theirupsetness as me not taking care
(20:20):
of them.
But I have the opportunity toreframe that and think is that
really helpful?
Do I really want, every timesomebody wants an inappropriate
antibiotic, to think that I'mnot doing a good job?
Or do I want to think, no, I'mproviding safe and appropriate
care?
I don't control whether they goto Zoom care or some other doc
in a box clinic and get whatthey want, because there's much
(20:41):
more of a customer service pushright without that relationship,
right in these quick clinicsthat have popped up.
I don't control that.
But what I do control is my ownintegrity.
I can check in with my emotions.
I can sit with them.
It's really normal that I feelthis way.
A lot of people would feelguilty or annoyed or upset in a
situation.
That's okay.
But I value my integrity ofcare.
(21:03):
I value the quality of care.
I value that I prescribe veryfew antibiotics because I really
use the guidelines and I don'thave to compare with everybody
else.
I can decide what's okay for meand what's not okay.
But it is a promise that I'msitting with that and choosing.
Today I'm willing to disappointthat patient, not because I'm a
jerk, but because I know thatthe quality of the care that I'm
(21:26):
providing is this.
Not everybody's going to likethat.
Sometimes people just want tobe able to order us around.
That's okay.
I can let that person go.
I'm not going to be the rightperson for them.
Dr. Shah-Haque, MD (21:35):
No, and I think that's the reason why I
bring that up is that that'svery common, but we can really
apply that to so many differentareas, such as the books, the
triple books, the walk-ins,being on call, ungodly amount of
hours.
Again, it goes back toboundaries and knowing what
you're willing to do, notwilling to do.
But I think the biggest thingis and that I know, up until
(21:58):
about a couple years ago I wasnot very good is sitting with
those feelings and figuring outwhy am I feeling this way?
Yeah, because it's veryuncomfortable.
Dr. Melo, MD (22:10):
Yeah, because we want to just make the feeling go
away and we might turn tosocial media, we might turn to
ice cream or alcohol or anyother thing to make the feeling
go away.
I don't like feeling this way.
If we notice the feeling, if wename the feeling, I'm feeling
angry, right feeling.
I'm feeling angry right now.
I'm feeling resentful right now.
We can get curious about it,even for a minute or two.
(22:31):
Why am I feeling this way?
I'm feeling this way becausethis patient came in.
They requested something Ididn't think was appropriate and
I said no and they got reallymad because I wasn't meeting
their expectations.
Okay, that doesn't feel good,but on the other hand, I feel
good about the decision I made.
I don't control their emotionsor expectations.
(22:53):
It's okay for me to feel thisway.
When we can reframe it intolike a second experience, you
can realize that our negativeemotions that don't feel good to
feel they're very temporary.
They're there to tell ussomething.
It's okay for me to replay thatconversation, decide that I'm
good with the integrity of mychoice and that I'm not
(23:17):
responsible for other people'sfeelings or expectations.
Dr. Shah-Haque, MD (23:20):
I think that's key because we tend to
internalize and try to ownthings that don't belong to us.
Going back to the feel betterRight, but just going back to
the people pleasing, my worth isreflected on how people see me.
Dr. Melo, MD (23:37):
Yeah, if I'm making you upset, there's
something wrong with me, and Iimagine that you might reflect
on this as well.
That parenting is another place, obviously, where this comes up
.
What I see in physicians andhigh achievers, who we work a
lot, we do important work andoften carry around this layer of
guilt about not being moreavailable to our children or not
(24:01):
being available to go to theschool events or some things
like that, and therefore beingmore permissive and being more,
more desirous to fix theirfeelings too if they're upset
with us and therefore also nothaving good boundaries with our
kids.
There's this like doublespillover.
Again.
We can come back to thisprocess, like when I'm having a
thought like I'm not a good momwith our kids.
(24:21):
There's this like doublespillover.
Again.
We can come back to thisprocess, like when I'm having a
thought like I'm not a good mombecause my kids are upset with
me.
Again, I can sit there anddecide do I really think that my
decision was wrong?
Do I really think that shouldhave gone differently?
I don't control their emotionsand of course, I do make
mistakes right, so I can ownthat.
I don't want to act like Idon't control their emotions and
of course I do make mistakesright, so I can own that.
I don't want to act like, Idon't want to show up that way.
Dr. Shah-Haque, MD (24:43):
I'm sorry that I yelled, but knowing that
that people-queasing triggercomes up in our parenting
journey as well, and beingreally aware of that, so how did
you get to the place where youare now, with working less than
40 hours a week, maintainingboundaries with patients and
(25:04):
life coaching, along with yourpersonal life?
Dr. Melo, MD (25:07):
Yeah, I'll tell you very honestly that it's
always been a work in progressand it always will be, because I
have a tendency to overwork andto say yes to too much.
I was reminded of that again inthis month of November, where I
very ambitiously reached out toa lot of people such as
yourself let's record a toolkit,let's exchange podcast episodes
(25:29):
, do things and I overbookedmyself because I'm again, I'm
very good at being yes, let'sget some energy going.
I had to sit with that.
When I looked at my calendarfor November and thought how
many things were on my schedule,I said you know what?
I've done it again.
Okay, I can see that I've gottoo much on here.
How am I going to, you know,shuffle and make adjustments?
(25:51):
How am I going to take care ofmyself there?
I didn't beat myself up aboutit, which is something that we
definitely would have done inthe past, but I also looked at
that and really just appreciatedthe lesson, because we can do
the same things no matter wherewe are, because the habits are
in us.
So I'm working all the time onbeing intentional about how many
(26:14):
, what's my balance of patientcare and how long do I spend
with notes and inbox and all ofthat kind of stuff.
How many hours am I availablefor coaching?
How am I organizing things sothat my podcast goes out on time
and some of thoseresponsibilities?
How am I doing with spendingtime with my kids?
Dr. Shah-Haque, MD (26:31):
and my husband.
Dr. Melo, MD (26:31):
It's always shifting right Because life is
just different and differentseason.
But I try and just really keepmy eyes on that and tuning in
with myself, like how does itfeel?
I realized a week or two intoNovember when things were so
busy.
I'm like, ooh, this feels liketoo much.
This feels when I've been sooverwhelmed in the past.
I just want to lay down and nothave anybody talk to me for too
(26:53):
long.
Yeah, okay, this is no longer myemployer's thing.
I've done this to myself.
How am I going to remind myselfnot to do this again?
How am I going to take care ofmyself in this moment and stay
true to the things that arereally important to me?
Learn to shift some thingsaround, learn to really
appreciate that lesson, and I'mgoing to carry that with me as I
(27:14):
move forward.
But we're constantly learningas we go.
There is no arrival, just likethere's no arrival to this
magical place in medicine.
There's no arrival to thisplace where we've learned all
the lessons, we're perfectlyboundaried and everything feels
great and the kids are allsmiling and happy.
No, it's all just a journey.
Dr. Shah-Haque, MD (27:34):
Thank you for pointing that out.
To recap that it's an ongoingprocess, even though it's not
related to clinical work.
In medicine, we can easilypigeonhole ourselves into being
overstretched in other areas.
We have to really beintentional with what we're
doing.
Bring the seasons of change,just changing with the seasons,
(28:01):
that what worked six months agomay not work now because of
where we're at in life.
It's okay to acknowledge thatand with that, be frustrated
with that, feel your feelingsand figure it out.
And with that pushingboundaries.
The boundaries tend to changedepending on which kid is
pushing that button.
I have one that really teststhose boundaries and she'll make
a great adult someday, butshe's a great kid, or my
four-year-old.
But it's acknowledging that andbeing resourceful and mindful
(28:25):
of our time and energy.
So where can the listener findyou and your podcast?
Dr. Melo, MD (28:32):
yeah, my chain, yeah, my podcast is ending.
Physician overwhelmed availableon all the major players, and
my website iswwwhealthierforgoodcom.
There's information about myone-on-one coaching, as well as
my group coaching programs forwomen physicians.
Dr. Shah-Haque, MD (28:49):
So that's where people can find me.
I appreciate that and that willbe in the show notes.
What is one last pearl ofwisdom you would leave our
listeners?
Dr. Melo, MD (28:59):
Yeah, I think, coming back to what we were
talking about before, ofchoosing to see your emotions as
data that you can get curiousabout.
We'd all like to have this lifewhere we feel happy and joyful
all the time, but that's justnot reality.
No, humans are actually likethat.
(29:20):
But how can I see my negativeemotions when they pop up as
something that's trying to tellme, something that I can get
curious about?
Because when we can just acceptthat they're there, when we can
name them, get curious aboutthem, we will process them in a
much healthier way and we willmove through them instead of
(29:42):
what we've been taught, which isoften to suppress, shut them
down, pretend they're not there.
I think many of us have had theexperience and bernie brown
writes extensively about that.
It does not work when we dothat.
They don't.
That's not a benign thing thatthey just exit through our toes
of trepidation down right now.
They store up inside of us.
They manifest as other thingsinsomnia, disabling anxiety or
(30:06):
depression, chronic headaches,all sorts of things.
Let's take the moment torecognize that we are human,
that we do have negativeemotions, and they can be there
to tell us something, oftencuing us to have an opportunity
to learn ourselves a little bitbetter I appreciate that and I,
the listener listeners honoryourselves by sitting with your
(30:31):
emotions and figuring out wherethey're coming from.
Dr. Shah-Haque, MD (30:33):
A lot of times, I can, if you feel like
you're feeling something overand over again, listen to it.
A lot of times you need toreevaluate what's triggering me.
By by reevaluating that andmaybe reframing that and
addressing that, you can shedsome light and some freedom into
your life.
So, megan, thank you so muchfor your time and your words of
wisdom.
Dr. Melo, MD (30:51):
Yeah, thank you so much for having me.
It's been a great conversation.
Dr. Shah-Haque, MD (30:55):
Absolutely.
Welcome to another episode of the Worthy
Physician.
I'm your host, Dr SapnaShah-Haque, reigniting your
humanity and passion formedicine.
Today I have Dr Megan Melo, sothank you very much for your
time and being here.
Dr. Melo, MD (00:15):
Yeah, thank you so much for having me.
I'm excited to talk more withyou.
Dr. Shah-Haque, MD (00:19):
I appreciate that.
So what has your journey ofbeing a physician look like?
Dr. Melo, MD (00:26):
Yeah, I'm somebody who went straight through.
So I went from college tomedical school and followed what
I thought was the quote unquoteright.
Looking back, I can.
Part of the work that I do nowinvolves people pleading
imperfectionism and working withphysicians around that.
Looking back, I can very muchreflect how early those two
(00:47):
habits got started in me.
They definitely supported myjourney all along that path,
right when I told people Iwanted to be a physician great,
you'll be helping so many peopleand just a lot of reinforcement
.
I think that's true for manypeople.
But I think it's important thatwe really recognize it.
But again, followed thattraditional path and went
(01:07):
straight through, didn't have areal job or a real youth before
going to medical school andlater found out that many of my
colleagues had been out doinglife stuff not just to help with
, but got into Stanley Medicinefor my residency and did that
three-year program and thenstayed at the institution where
(01:28):
I was surrounded by a lot ofmodel of physicians who had been
in one place for a very longtime in their career.
From the outside, I appeared tobe very happy and content with
what they were doing.
Yet I saw them working verylong hours.
I saw them not spending a lotof time with family.
I found it really hard to putin those long hours and to feel
(01:51):
like I was doing enough.
I kept searching for a timewhen I could feel that I was
enough, I had done enough, thatI had gotten to a place where I
was good enough and I could takea break.
What I found is that never camethat sensation of being good
enough in I could take a break.
What I found is that never camethat sensation of being good
enough in my job.
Never came that break I waslooking for and I think a lot of
(02:11):
us are searching for that timeright where we feel like we have
accomplished enough and we canfinally feel good about the work
that we, you know, have done.
I see this, as you know,something that many of us
struggle with, and we could talkmore about that, but it's a
real limitation.
So it's a really important partof my journey just to come out
of really struggling to feellike a worthy physician.
Dr. Shah-Haque, MD (02:33):
Yeah, it's one of those things where the
arrival fell asleep.
I've arrived at being anattending.
Dr. Melo, MD (02:39):
Now what?
This felt good for a hot minute.
Now what?
Yeah?
Dr. Shah-Haque, MD (02:43):
exactly.
How did you deal with that?
Dr. Melo, MD (02:46):
Yeah, not well for a while.
To be honest, I think I wouldcome into periods of burnout and
just feel really overwhelmed,really exhausted, really down.
Sometimes I would take a break.
I ended up taking a leave ofabsence, for it was about a
month at one point in 2019.
But every time I would comethrough a period like that, my
(03:08):
response was always to armor up.
As Brene Brown says, right totry and get harder.
I just need to stop caringabout resting and stop thinking
that I or stop trying to be sosoft, right, like I should just
love the work so much.
That's enough.
That didn't work.
It didn't solve the problem,because that's just not how
(03:28):
humans operate.
We need a balance of work thatengages us and rest.
Yes, there's, of course, acertain amount of putting in
work time that we don't love,but we also have to choose at
some point to value ourselves,to decide okay, I need a
boundary here, I'm going to takesome time off, I'm going to not
(03:49):
respond to my phone, I'm goingto really disengage and rest.
Those lessons, I would say, aremuch more recent in my journey,
but what really made adifference for me was a few
years ago, in learning some ofthe coaching tools that I use
now and really learning howimportant it is to be aware of
my thoughts and how thatinfluences the emotions that I
(04:13):
have, the action that I take.
That really made the mostdifference for me in recognizing
how I was contributing to myburnout.
Dr. Shah-Haque, MD (04:22):
You dive into that a little bit more.
You're a life coach, correct?
That's correct.
How did you make that choice tobecome a life coach and what
have you learned from being alife coach that maybe has added
more of different lenses to lifeand medicine?
Dr. Melo, MD (04:40):
Yeah, I came into life coaching like many of us
thinking I wanted help formyself.
But often I think we asphysicians with high achievers
not enough to get help.
We have to decide we like thetool or like a framework, and
we're going to get certified andteach it.
I'm certified in the work ofRenee Brown.
(05:02):
I'm a Daring Way facilitator inher work.
I launched into that trainingnever having actually done the
work on my own, so that's athing that I grew up with and I
find that a lot in people, inother physicians that I talk to.
But the tools that I learned ingetting trained as a life coach
(05:28):
made a really big difference inmy life, in not feeling like a
victim anymore, in learning tosee how conditioned ways of
thinking led to the experiencethat I was having.
And I don't take the healthcaresystem off the hook.
The healthcare system that wework in, the insurance companies
, the employers, the way thatAmerican healthcare in
particular is structured, wasvery toxic to the humans doing
(05:49):
the work.
I would argue that in Americanmedicine and probably other
things, that the business ofmedicine profits off us being
hardworking, driven people whonever feel like we're enough
Because we will always go thatextra mile.
It's very easy for us to tosome extent, be manipulated, but
Mrs Jones is here.
She really looks like she needshelp, but no one's looking at
(06:11):
my specialty and I have acompletely full day.
They're just tapping into thatempathy part of myself, making
me feel like a bad person if Ican't squeeze her in and
intervene every other human.
So we don't have to let thissystem off the hook and decide
that the system is not also aproblem.
But naturally, as part of ourtraining, many of us learn
(06:34):
perfectionist andpeople-pleasing habits that get
reinforced over and over again,keeping us feeling like we're
not enough, and so then we'realways striving to do more.
When I learned the coachingtools, when I started to apply
that in my own life, I could seethe impact of that.
I could see how I wascontributing to my own suffering
and I was able to look at thesituation that I was in very
(06:55):
differently and see okay, ifthis is the circumstances that
I'm working in, if I have thismany patients to see, if I have
these responsibilities, how do Ineed to start setting
boundaries?
How do I need to start takingcare of myself?
How do I need to start thinkingabout this differently so that
my experience can be better.
I can stay in this workundergrad, it's not just taking
(07:27):
the rigorous course schedule itis trying to do research or
trying to get hands-onexperience.
Dr. Shah-Haque, MD (07:30):
That's like an 18, 19, 20-year-old and
really you're asking them to sayokay, what are you going to
dedicate the rest of your lifeto?
And then we get into medicalschool and we're at a very
impressionable age yeah, 22, 23,24, maybe there are some of the
nontraditional students thatmaybe have a better grasp, but
(07:50):
we typically give up our 20s inorder to do what we're doing,
not knowing that the way thatwe're structured and conditioned
is completely different thanthe actual world of medicine.
Dr. Melo, MD (08:03):
Yeah, so many of us give up our 20s with this
idea that the promise of our 30sand 40s isn't so much better.
I definitely gave up my 20s andthen, like I had my 30s, when I
started having kids and I wasattending, like where did that
decade go?
That decade was completely inservice, right my patients, my
(08:25):
kids, my family, and there wasvery little in my 30s that was
for me.
I'm just, I'm not just.
I'm almost 43.
Right, so I'm solidly in my 40snow.
But trying to figure out now,okay, how do I create space for
me in my life where, yes, I cantake care of patients.
Dr. Shah-Haque, MD (08:55):
Yes, I can work with my physician clients.
That I.
I appreciate that, again, we'rejust conditioned to put
ourselves last, especially withthe theory of being the all
smiling, never upset female.
Then our male counterpartsdon't always have to face the
double standards.
(09:16):
The label that we get if we'renot nice and I'm going to wear
that crown because that helps mekeep boundaries and if that
helps me just going back to,let's go circle back to.
You really distinctly pointedout the system in which we
operate, in which we practicemedicine, is the driver of the
(09:39):
burnout and the overwhelm.
Why do you think it's importantfor physicians to look inward?
Dr. Melo, MD (09:47):
Yeah, for many years I was working on trying to
change the system from withinthe system it was operating in.
I was given the title ofwellness champion and before
that I was working on aresilience curriculum with our
residents.
I was always very, verydesirous right to change the way
that we take care of ourselves,but at that time I was very
(10:11):
focused on the external.
I was very focused on thesystem needs to be better so
that I feel better.
I still believe that the systemhas significant impact on us.
I think that it has significantresponsibility to change the
way that it operates.
But I can see now that theentire business model of
American healthcare is reallybuilt on cramming as many
(10:33):
patients as possible for lesstime and more challenge.
Until that business model isdifferent the kind of
traditional fee-for service Idon't see the systems relieving
the pressure on physicians thatare healthcare professionals, so
I see that as a huge behemoth.
It's still a problem and Ifully acknowledge it, but I
(10:56):
don't want anyone out therewho's experiencing suffering,
who is finding themselvesoverwhelmed and burned out, to
wait until the system getsbetter.
I want them to see the systemfor one day, to see that we have
the ability to choose to staywithin the system or not, but
that if we're going to choose tostay in the system, we're going
(11:17):
to need to take care ofourselves because the system is
not going to do it.
Again, I think we give up our20s and we have this idea that
one time an attending they'llstart taking care of me.
I won't have to do 80 hourweeks anymore there's actually
no rule against that asattendings and we can very
easily find ourselves insituations working that much but
(11:38):
we also have more agency todecide what's okay, what's not
okay for us.
I decided very early thatworking full-time, full-time
clinical practice was nevergoing to be okay for me.
The way that I am, the way thatI my introverted self, the way
that I take care of patients,the way that I listen to them,
try to be present as a human, Icannot do that for 40 hours a
(12:00):
week.
But that's me choosing to say Itake care of myself by never
working full-time clinicallybecause the system is not going
to figure that out.
How many of us are working inplaces that?
And they would love us all towork at least 40 hours a week
because we're the reason why themoney comes in what's us
drunken to build?
It does.
So.
I want to work with people tounderstand what is it that you
(12:24):
need, what is it that was theright balance for you to
practice in this kind of setting?
Or, if you're choosing tochange your setting, how do we
help you still get really clearon boundaries and self-care so
that you are in a betterposition, no matter where you go
?
A lot of people have thisfantasy right of it's just this
(12:44):
place, it's just this employer.
Right, that makes me work thisway.
But I'll promise you, if youhop to another system, right,
even if you're working foryourself, you're really good at
overworking and hustling andyou'll keep doing it, just in a
different place, unless isn't itUnlearning those habits that
(13:05):
were protective in order to getthrough pre-med school.
I want to help people now ratherthan spending my time hoping
and wishing and dreaming thateverything was different.
Because if I take good care ofmyself now and other people do
(13:32):
the same, then we have theopportunity to change the system
collectively by saying we'renot doing things the way that
they have been done before.
We deserve to go on vacationand really be on vacation and
not come back to 380 portalmessages.
The reality is real.
The reality is real.
The reality is real.
It's real.
It's painful and people areupset at us and we feel all
(13:54):
things.
Dr. Shah-Haque, MD (13:55):
Yeah, that's one thing that being able to.
You want to be able to workwith colleagues that will help
you, will cover for you, becausewhen they're out, you're going
to be doing the same for themyeah.
Well, we'll cover for you,because when they're out, you're
going to be doing the same forthem.
Yeah, and it's the fear ofgoing back to the office to an
ungodly amount of tasks ormessages is that should not
happen.
Dr. Melo, MD (14:15):
That dread is real and that buildup of maybe I
should need to go on vacation.
You know that's the bit of ahit term, not the right answer,
but it's unlikely that thesystem is automatically going to
make a change for us.
We might have to start havingthose conversations and really
deciding.
Vacation is important to us andthe way that we take care of
(14:38):
ourselves and each other is thatwe do things in this way.
But those conversations don'thappen without somebody having
an intention around it, right,mm-hmm?
Dr. Shah-Haque, MD (14:46):
But those conversations don't happen
without somebody having anintention around it, Right when
you work with your coachingclients.
Dr. Melo, MD (14:54):
Do you ever get any pushback with some sort of
advice, absolutely, absolutely.
And it comes in a variety ofplaces.
But I'll tell you, those of uswho have struggled with
boundaries, it's not that we'venever tried, it's not that we've
never tried to set a boundary,but what happens right not that
we've never tried, it's not thatwe've never tried to set a
boundary but what happens rightis that somebody gives us we say
we don't have time to talkabout all the things on your
(15:14):
list, we're going to talk aboutthese too, but I came in to talk
to you about all these 20things.
Yeah, then we might.
Okay, let's see what we canmanage.
Or we maybe will say no, Ican't, I can't take a walk in
today, I've got to leave.
Well, no one else can say andthey're your patient, you should
learn to help them.
We've encountered so manysituations where we may have
(15:36):
tried boundaries a little bitand then we've gotten pushed
back and we felt bad, we feltuncomfortable in some way, and
we decided to make that meanthat boundaries are just not for
us Right.
But what I push people to seeis that when you have boundaries
, you're simmering in chronicfrustration and resentment.
Much of the time, you mightalso be judging yourself for
(15:58):
feeling that way.
Right, because shouldn't youwant to take care of everybody?
Shouldn't you want to beavailable 24-7?
Right, if I set a boundary, Ifeel uncomfortable.
When somebody gives me pushback, I am the opportunity to choose
that discomfort as analternative to my chronic
frustration or resentment,because I don't get a world
where I don't have either.
(16:18):
If I'm not used to settingboundaries, I'm going to be
uncomfortable, especially for awhile while it's new.
But the benefit is that I nolonger feel frustrated that
people are constantly asking meto do things, expecting that
I'll do them, but I just don'thave the time or capacity.
Dr. Shah-Haque, MD (16:34):
I love the fact that you're bringing that
up because it's difficult Again,going back to the people
pleasing, and we can be easilyguilt-tripped, but then, at the
same time, it's a matter ofreframing, of which one do I
want to feel If?
Dr. Melo, MD (16:49):
I say yes to you, I'm saying no to something else,
and a lot of the time that noto something else is me.
That's no to me.
No, you don't get to eat lunch.
No, you don't get to go to yourson's soccer game.
No, you don't have time andenergy to do anything else.
Know, your feelings are notimportant.
We've done that to ourselvesfor a lot of years many of us
(17:11):
but we have to expect thatthere's going to be discomfort
and that's okay.
Nothing has gone wrong.
Dr. Shah-Haque, MD (17:16):
Yeah, usually there are other systems
in place to maybe which thatwalk-in can go, because many
times it's five minutes beforethe office closes or it's on the
weekend when you're heading outto the car.
Hey, I just need to talk to youfor a minute those are real
scenarios yeah and it's.
Can you just call in something,an antibiotic for in my head
(17:37):
cold?
Dr. Melo, MD (17:38):
it's not that easy .
It's not that easy, yeah, orjust yesterday this happened a
lot in our clinic.
People will call and be like myhands hurted, can I just get an
x-ray?
My answer is always no, that'sbad care.
I need to talk to you, I needto examine you, I need to figure
out is this something that'sgoing to be x-rayable?
Because if I just order anx-ray and I don't know the story
(17:59):
, it turns out you've got a red,swollen hand, something else.
I'm going to tell you the x-rayis normal, right, because it
wasn't the right test with theright evaluation.
Dr. Shah-Haque, MD (18:11):
But like we have to decide, yeah, I'm taking
the risk of disappointing thisperson, but not that simple.
They don't know that.
I think that's where we need totrust our training and the.
I'm not a fan of patientsatisfaction scores, because
this is not a restaurant, it'snot a hotel.
There's a difference betweenthe patient expects and then the
(18:32):
standard of care, and we haveto remember to stick to the
standard of care and stick toour training.
It's okay to say no, it's goingto ruffle somebody's feathers.
At the end of the day, you canlook at yourself in the mirror
and say I know that by mytraining and because I have
confidence in myself, that wasthe right thing to do.
(18:52):
But it seems like a lot oftimes, with the way the medicine
is, I'm even I myself havestruggled with.
Yeah, I made the patient upsetbecause I wouldn't order what
they wanted or I wouldn't ordera medication.
How do you teach your clientsto deal with that?
Dr. Melo, MD (19:16):
Yeah, I think it sounds a little counterintuitive
, but we need to be better aboutjust acknowledging the emotions
that we're having and in mywork I teach people kind of the
relationship between theirthoughts and their feelings.
So we have an emotion that weoften can recognize that we're
pretty good about squishingthose feelings down or
pretending that we're notfeeling numb.
Like I said, we might stillhave judgment, like I shouldn't
feel angry at a patient.
What a terrible person.
(19:37):
I'm a terrible doctor forfeeling that way.
But if I let's say, somebodycalls and they want an
antibiotic because they've hadthe sniffles for three days and
I say no, they tell the frontdesk person I'm never coming
back here again.
I can't believe that they.
I always get it, I always get aZ-Pak.
(19:59):
I have the opportunity to sitand notice that I'm feeling some
kind of way right, I'm feelingI might be feeling guilty at
that moment.
I'm feeling guilty because I'mhaving a thought that I should
take care of the patient, theirneeds.
It's a common thought that wemake now.
Right, I should be doingeverything I can to take care of
the patient.
My brain is interpreting theirupsetness as me not taking care
(20:20):
of them.
But I have the opportunity toreframe that and think is that
really helpful?
Do I really want, every timesomebody wants an inappropriate
antibiotic, to think that I'mnot doing a good job?
Or do I want to think, no, I'mproviding safe and appropriate
care?
I don't control whether they goto Zoom care or some other doc
in a box clinic and get whatthey want, because there's much
(20:41):
more of a customer service pushright without that relationship,
right in these quick clinicsthat have popped up.
I don't control that.
But what I do control is my ownintegrity.
I can check in with my emotions.
I can sit with them.
It's really normal that I feelthis way.
A lot of people would feelguilty or annoyed or upset in a
situation.
That's okay.
But I value my integrity ofcare.
(21:03):
I value the quality of care.
I value that I prescribe veryfew antibiotics because I really
use the guidelines and I don'thave to compare with everybody
else.
I can decide what's okay for meand what's not okay.
But it is a promise that I'msitting with that and choosing.
Today I'm willing to disappointthat patient, not because I'm a
jerk, but because I know thatthe quality of the care that I'm
(21:26):
providing is this.
Not everybody's going to likethat.
Sometimes people just want tobe able to order us around.
That's okay.
I can let that person go.
I'm not going to be the rightperson for them.
Dr. Shah-Haque, MD (21:35):
No, and I think that's the reason why I
bring that up is that that'svery common, but we can really
apply that to so many differentareas, such as the books, the
triple books, the walk-ins,being on call, ungodly amount of
hours.
Again, it goes back toboundaries and knowing what
you're willing to do, notwilling to do.
But I think the biggest thingis and that I know, up until
(21:58):
about a couple years ago I wasnot very good is sitting with
those feelings and figuring outwhy am I feeling this way?
Yeah, because it's veryuncomfortable.
Dr. Melo, MD (22:10):
Yeah, because we want to just make the feeling go
away and we might turn tosocial media, we might turn to
ice cream or alcohol or anyother thing to make the feeling
go away.
I don't like feeling this way.
If we notice the feeling, if wename the feeling, I'm feeling
angry, right feeling.
I'm feeling angry right now.
I'm feeling resentful right now.
We can get curious about it,even for a minute or two.
(22:31):
Why am I feeling this way?
I'm feeling this way becausethis patient came in.
They requested something Ididn't think was appropriate and
I said no and they got reallymad because I wasn't meeting
their expectations.
Okay, that doesn't feel good,but on the other hand, I feel
good about the decision I made.
I don't control their emotionsor expectations.
(22:53):
It's okay for me to feel thisway.
When we can reframe it intolike a second experience, you
can realize that our negativeemotions that don't feel good to
feel they're very temporary.
They're there to tell ussomething.
It's okay for me to replay thatconversation, decide that I'm
good with the integrity of mychoice and that I'm not
(23:17):
responsible for other people'sfeelings or expectations.
Dr. Shah-Haque, MD (23:20):
I think that's key because we tend to
internalize and try to ownthings that don't belong to us.
Going back to the feel betterRight, but just going back to
the people pleasing, my worth isreflected on how people see me.
Dr. Melo, MD (23:37):
Yeah, if I'm making you upset, there's
something wrong with me, and Iimagine that you might reflect
on this as well.
That parenting is another place, obviously, where this comes up
.
What I see in physicians andhigh achievers, who we work a
lot, we do important work andoften carry around this layer of
guilt about not being moreavailable to our children or not
(24:01):
being available to go to theschool events or some things
like that, and therefore beingmore permissive and being more,
more desirous to fix theirfeelings too if they're upset
with us and therefore also nothaving good boundaries with our
kids.
There's this like doublespillover.
Again.
We can come back to thisprocess, like when I'm having a
thought like I'm not a good momwith our kids.
(24:21):
There's this like doublespillover.
Again.
We can come back to thisprocess, like when I'm having a
thought like I'm not a good mombecause my kids are upset with
me.
Again, I can sit there anddecide do I really think that my
decision was wrong?
Do I really think that shouldhave gone differently?
I don't control their emotionsand of course, I do make
mistakes right, so I can ownthat.
I don't want to act like Idon't control their emotions and
of course I do make mistakesright, so I can own that.
I don't want to act like, Idon't want to show up that way.
Dr. Shah-Haque, MD (24:43):
I'm sorry that I yelled, but knowing that
that people-queasing triggercomes up in our parenting
journey as well, and beingreally aware of that, so how did
you get to the place where youare now, with working less than
40 hours a week, maintainingboundaries with patients and
(25:04):
life coaching, along with yourpersonal life?
Dr. Melo, MD (25:07):
Yeah, I'll tell you very honestly that it's
always been a work in progressand it always will be, because I
have a tendency to overwork andto say yes to too much.
I was reminded of that again inthis month of November, where I
very ambitiously reached out toa lot of people such as
yourself let's record a toolkit,let's exchange podcast episodes
(25:29):
, do things and I overbookedmyself because I'm again, I'm
very good at being yes, let'sget some energy going.
I had to sit with that.
When I looked at my calendarfor November and thought how
many things were on my schedule,I said you know what?
I've done it again.
Okay, I can see that I've gottoo much on here.
How am I going to, you know,shuffle and make adjustments?
(25:51):
How am I going to take care ofmyself there?
I didn't beat myself up aboutit, which is something that we
definitely would have done inthe past, but I also looked at
that and really just appreciatedthe lesson, because we can do
the same things no matter wherewe are, because the habits are
in us.
So I'm working all the time onbeing intentional about how many
(26:14):
, what's my balance of patientcare and how long do I spend
with notes and inbox and all ofthat kind of stuff.
How many hours am I availablefor coaching?
How am I organizing things sothat my podcast goes out on time
and some of thoseresponsibilities?
How am I doing with spendingtime with my kids?
Dr. Shah-Haque, MD (26:31):
and my husband.
Dr. Melo, MD (26:31):
It's always shifting right Because life is
just different and differentseason.
But I try and just really keepmy eyes on that and tuning in
with myself, like how does itfeel?
I realized a week or two intoNovember when things were so
busy.
I'm like, ooh, this feels liketoo much.
This feels when I've been sooverwhelmed in the past.
I just want to lay down and nothave anybody talk to me for too
(26:53):
long.
Yeah, okay, this is no longer myemployer's thing.
I've done this to myself.
How am I going to remind myselfnot to do this again?
How am I going to take care ofmyself in this moment and stay
true to the things that arereally important to me?
Learn to shift some thingsaround, learn to really
appreciate that lesson, and I'mgoing to carry that with me as I
(27:14):
move forward.
But we're constantly learningas we go.
There is no arrival, just likethere's no arrival to this
magical place in medicine.
There's no arrival to thisplace where we've learned all
the lessons, we're perfectlyboundaried and everything feels
great and the kids are allsmiling and happy.
No, it's all just a journey.
Dr. Shah-Haque, MD (27:34):
Thank you for pointing that out.
To recap that it's an ongoingprocess, even though it's not
related to clinical work.
In medicine, we can easilypigeonhole ourselves into being
overstretched in other areas.
We have to really beintentional with what we're
doing.
Bring the seasons of change,just changing with the seasons,
(28:01):
that what worked six months agomay not work now because of
where we're at in life.
It's okay to acknowledge thatand with that, be frustrated
with that, feel your feelingsand figure it out.
And with that pushingboundaries.
The boundaries tend to changedepending on which kid is
pushing that button.
I have one that really teststhose boundaries and she'll make
a great adult someday, butshe's a great kid, or my
four-year-old.
But it's acknowledging that andbeing resourceful and mindful
(28:25):
of our time and energy.
So where can the listener findyou and your podcast?
Dr. Melo, MD (28:32):
yeah, my chain, yeah, my podcast is ending.
Physician overwhelmed availableon all the major players, and
my website iswwwhealthierforgoodcom.
There's information about myone-on-one coaching, as well as
my group coaching programs forwomen physicians.
Dr. Shah-Haque, MD (28:49):
So that's where people can find me.
I appreciate that and that willbe in the show notes.
What is one last pearl ofwisdom you would leave our
listeners?
Dr. Melo, MD (28:59):
Yeah, I think, coming back to what we were
talking about before, ofchoosing to see your emotions as
data that you can get curiousabout.
We'd all like to have this lifewhere we feel happy and joyful
all the time, but that's justnot reality.
No, humans are actually likethat.
(29:20):
But how can I see my negativeemotions when they pop up as
something that's trying to tellme, something that I can get
curious about?
Because when we can just acceptthat they're there, when we can
name them, get curious aboutthem, we will process them in a
much healthier way and we willmove through them instead of
(29:42):
what we've been taught, which isoften to suppress, shut them
down, pretend they're not there.
I think many of us have had theexperience and bernie brown
writes extensively about that.
It does not work when we dothat.
They don't.
That's not a benign thing thatthey just exit through our toes
of trepidation down right now.
They store up inside of us.
They manifest as other thingsinsomnia, disabling anxiety or
(30:06):
depression, chronic headaches,all sorts of things.
Let's take the moment torecognize that we are human,
that we do have negativeemotions, and they can be there
to tell us something, oftencuing us to have an opportunity
to learn ourselves a little bitbetter I appreciate that and I,
the listener listeners honoryourselves by sitting with your
(30:31):
emotions and figuring out wherethey're coming from.
Dr. Shah-Haque, MD (30:33):
A lot of times, I can, if you feel like
you're feeling something overand over again, listen to it.
A lot of times you need toreevaluate what's triggering me.
By by reevaluating that andmaybe reframing that and
addressing that, you can shedsome light and some freedom into
your life.
So, megan, thank you so muchfor your time and your words of
wisdom.
Dr. Melo, MD (30:51):
Yeah, thank you so much for having me.
It's been a great conversation.
Dr. Shah-Haque, MD (30:55):
Absolutely.
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