3. Choosing Our Secret Lives
Of course, maintaining dual—or triple or quadruple—identities is no small task. The prospect of burnout stalks every identity and is often disguised as noble sacrifice. So how can we stay sane while managing the paradoxes of being a modern rheumatologist?
One strategy is to call out the myth of efficiency. The belief that we can do more with less indefinitely has seduced much of our profession. We install productivity-enhancing apps, sign up for documentation accelerators, and now, increasingly, turn to artificial intelligence to manage our messages and even draft our notes. These tools may appear superficially to be useful, but they risk reinforcing the most dangerous idea that with enough efficiency, we can assume infinite identities in a finite world.2
In fact, the only identity that rheumatologists do not embrace, whether at work or at home, is that of a robot. Rheumatologists, on the whole, are repulsed by the notion of being a cog in the machine. We are built to reflect on mortality, to wrestle with dangerous truths and to relieve the pain of others. The more we chase perfect productivity, the more we risk embracing a secret life that is deadly to everything that animates us.
More to the point, a culture of intentionality is needed to manage the secret identities we call our own and the ones we would seek to avoid. The poet Mary Oliver wrote that “attention is the beginning of devotion.” In rheumatology, the act of attending to our secret identities, tending to them and providing them the resources to grow in concert with one another, is the first step toward devoting ourselves to well-being.3
Intentionality also means building a culture of collegiality. It is only when we recognize that our secret identities are not secret but shared that we initiate sharing these identities and the burdens that come alongside them. When we share our lives with one another, including our frustrations, our joys, our pet peeves about EHRs, we let others into our secrets and foster a sense of professional collegiality. There becomes no room for a sociopathic Dexter Morgan.
4. Coalescing Our Secret Selves
Needless to say, keeping secret identities is exhausting. There are things, though, that we can do as individuals to help relieve that burden. First, we have to embrace a shift in mindset.
One approach I recommend is creating done lists rather than just to-do lists. These reflective inventories help illuminate accomplishments that otherwise disappear into the background noise of our busyness. They expose the accomplishments of our hidden selves to others. They openly celebrate the many roles we perform each day rather than hide them away. By honoring what we’ve done, whether it’s making a tough diagnosis, offering reassurance to a struggling patient, or cooking dinner with our family, we reconcile our secret identities into a wholesome singularity.
