Why Physicians Struggle to Rest (And How to Make It Sustainable) | Ep34

Michael Hersh, MD

[00:00:00] Rest. Most physicians say they want more of it, but when they actually get the chance to slow down, they don't. They reach for their phone. They feel restless, uncomfortable, almost guilty. Because when you've been wired to be productive your entire life, rest doesn't feel relaxing. It feels unproductive.

There's nothing to show for it. No box checked, no sense of progress. And when you've spent your entire life earning your worth through your output, rest starts to feel like something you haven't earned yet. If any of that sounds familiar, stick around because that's what we're talking about today.

Well, hey everyone, and welcome back to the Better Physician Life Podcast. Thank you so much for being here today. So today we are talking [00:01:00] about rest. Not the Instagram version, not the take a vacation and everything will be fine version, but real rest. The kind that actually works and makes it feel like the rest of your life can be sustainable.

We’ll talk about why it's so hard for physicians, why we resist it, even when we're exhausted, and how to start building it back into your life in a way that's realistic and sustainable. Because rest doesn't always come naturally to people who were trained to never stop, to keep going, to push through, to never give up, even when they're completely exhausted.

How do I know? Because this sums up my life to a T. So, a few years ago, I decided it was time to figure this out. It [00:02:00] was time to take rest more seriously. I didn't just think about it, though. I actually planned for it. I gave myself one job for an entire month. Do nothing. That was the goal.

No projects. No to-do lists, no tasks. No plans to use my time well. Just rest, recharge, relax. Spend time with my family. Be more present for the day-to-day stuff. Read for pleasure, listen to music, and just slow down. And I would love to tell you that I succeeded. I would love to tell you I turned over a new leaf and everything shifted after that month, but that didn't happen.

I failed, not just a little bit, not one or two days. [00:03:00] I honestly could not do it, and it wasn't because something unexpected came up. It wasn't because work got outta hand. It wasn't because I didn't have the time. It was because every time I finally stopped moving, I didn't know what to do with myself. I'd sit down to rest and feel uneasy.

My brain would immediately start scanning for problems, for things that needed to get done. I'd reach for my phone, and without even thinking about it, I was scrolling. What I learned very quickly was this, I didn't just need rest. I needed to learn how to rest. And here's the thing. That realization was both frustrating and incredibly relieving.

Frustrating because I wanted rest to be simple and [00:04:00] relieving because it showed me exactly what I needed to be working on. It wasn't necessarily a personal failure; it was my conditioning. Medicine trains us to override signals. Fatigue becomes something to push through.

Discomfort becomes something to ignore. Rest becomes something you earn after the work is done. And let's be honest, the work is never really done. So rest just keeps getting postponed. Indefinitely. Over time, your nervous system adapts to that pace. Constant motion starts to feel normal, and stillness starts to feel wrong.

So when you do finally slow down, it's not calming, it's unsettling, not because rest is bad, but because you haven't practiced it in a very long [00:05:00] time. That's when I started rethinking what rest actually looks like. Because up until that point, I had a pretty narrow definition of rest. I thought rest meant doing nothing, sitting still, lying on the couch, turning everything off, and for me, that didn't work.

My body would stop moving, but my brain kept going. I'd sit there feeling restless, distracted, almost agitated. It didn't feel restorative. It felt wrong. What I eventually realized was that not all rest looks the same. There's passive rest, and there's active rest. Passive rest is what most of us picture, again, sitting, laying down, being still, and it's really important.

We need it. It's diastole for the systole of life. [00:06:00] But for a lot of physicians, especially those of us who have spent years running at full speed, passive rest is actually the hardest place to start. Active rest, on the other hand, was the gateway for me. Active rest still involves movement, but there's not always a measurable output, not a specific metric, or a goal to hit.

For me, that looked like going to the gym, not to get huge or hit a personal record. It was just to move to stay healthy, to work through stress. It can look like going for a walk without tracking steps or straightening up the yard, doing something physical without necessarily trying to accomplish anything.

And here's the part that I already knew, but that somewhat still surprised me. After active rest, passive rest becomes [00:07:00] more possible. Once I moved my body and burned off some of that stored stress and tension, sitting still didn't feel so uncomfortable; the mental noise quieted down. My whole system felt more settled.

Going to the gym isn't lying on the couch, but it is restorative, and afterwards sitting on the couch felt more doable. And that was a pretty big shift for me because it meant I didn't have to force myself into stillness right away. I could ease into rest instead of trying to flip a switch. And that idea alone, that there's more than one way to rest, made the whole thing feel more doable.

Once I started thinking about active rest, something else kind of clicked for me. It wasn't just about movement; it was about the intention behind the movement. I realized I didn't actually have to stop doing things to rest. I just had to stop using everything as a [00:08:00] means to an end. I could walk without trying to get somewhere, be outside without accomplishing anything.

Do things without turning them into another project. I started to think of this as doing things restfully. It's not about productivity. It's not about efficiency. It's about allowing the experience to be the point, and for someone used to operating in productivity outcomes and checklists, that takes practice because even when we rest, we try to optimize it.

We track it, we schedule it, we try to do it right, and when that happens, rest turns back into work. But rest isn't just a behavior, it's a skill. And like any skill, it has to be learned. If you spent decades training yourself to push, produce, and power through, your body doesn't just suddenly relax [00:09:00] because you decide it should.

It needs to be taught. It needs to be shown. It needs repetition and exposure. It needs small, consistent reps, which is where most physicians go wrong. We aim too big. We decided we're gonna finally slow down, take a full week off, take a day off, change everything. And when that doesn't work, we decide we're just bad at rest.

But that's not how skills are built. Skills are built in small increments, so instead of starting with an hour or a day or a vacation, start with five minutes. Five minutes with nothing to do, no phone, no task, no optimization. Some days it'll feel fine, and other days it will feel unbearable, and both are completely normal.

The [00:10:00] goal isn't to be good at resting. The goal is to practice. Because the more often you give your system permission to slow down, even briefly, the less foreign it starts to feel. And over time, what once felt uncomfortable starts to feel possible. And this is where a lot of physicians get stuck, not because they don't value rest, but because they don't know where to fit it into a life that never really stops.

Medicine doesn't just reward productivity. It quietly ties our productivity to our worth. From early on, most of us learned that praise followed performance. Good grades, good evaluations, good outcomes. Achievement felt good, not just professionally, but personally. So over time, it's easy to start believing that rest has to be earned, that you're allowed to slow down [00:11:00] only after you've done enough.

The problem is that enough is a moving target. There's always another patient, another chart, another thing you could be doing. So rest gets pushed to the margins, or it comes with guilt. If I rest, someone else has to pick up the slack. If I slow down, I'm falling behind. If I stop, I'm being selfish. And once guilt enters the picture, rest stops working.

You can be sitting still and still feel tense. You can be on vacation and still feel on edge because your body might be resting, but your mind is keeping the score. That's why so many physicians say, I took time off, and it didn't help. Or it helped, but it didn't last. It's not because rest doesn't matter.

It's because rest with guilt isn't rest. So here's the reminder. We all need [00:12:00] to hear over and over again. Rest isn't a reward for getting everything done. It's a requirement if you want to keep going. Think about a beating heart. Diastole is rest, and it's not optional. That resting phase is what allows the heart to fill and function, and when it doesn't happen properly, we call it diastolic dysfunction, and the heart isn't working optimally.

The same thing applies here. Rest isn't the opposite of productivity. It's what makes productivity sustainable. And when you stop treating rest as something you have to justify, it starts to do what it's supposed to do. For most physicians, the easiest place to start isn't a vacation. It's the transition between work and home.

Because if you're like most doctors, you don't actually leave work when you leave the building. Your body's in [00:13:00] the car, but your mind is still running the list. Replaying conversations, thinking about tomorrow, carrying the whole day with you. That transition doesn't happen automatically. It takes intention.

That's why I created the 5-minute Commute Reset for Physicians. It's a short guided audio and a simple worksheet designed to help you downshift, clear your head, and leave work where it belongs before you walk through the door at home. Not perfectly. Just intentionally. It's five minutes. 

You don't have to overhaul your mindset. Just a small, repeatable pause. A diastole built into a part of your day that already exists. You can download it for free at betterphysicianlife.com/commutereset . And I'll link it in the show notes. 

So let's come back to where we started: Rest. Most physicians say they want [00:14:00] more of it, but when the moment comes to slow down, they reach for their phone. They find something productive to do, not because they're doing it wrong, but because rest doesn't come with proof. There's nothing to show for it. No box checked, no sense of progress. But here's the shift.

Rest was never meant to be something you accomplish. It's something you practice. And like any skill, it starts small, imperfectly, repeatedly. Five minutes is enough. A pause between work and home is enough. Because rest isn't about stopping. It's about making the pace sustainable. You don't have to earn it. You don't have to justify it. You just have to let it happen. 

Thank you so much for being here and for listening, and I'll see you next time on the Better Physician Life Podcast.