Michael: Hey everyone, and welcome to another episode of Doctors Living Deliberately. So happy to have you here with us today. Welcome as always to my co-host, Dr. Arpita Gupta DePalma . How are you? 

Arpita: I am amazing. How are you? 

Michael: Doing Great. And you know, we took the summer off from recording podcast. So some of our listeners may have noticed that when some of the episodes were airing, we were talking about things that maybe weren't timely for the season. That's just an example of how we are trying to live by what we preach, right? So we are doctors living deliberately. And so we just decided we weren't gonna record podcast episodes over the summer. And so here we are getting back into recording. And I think as you and I were coming together to do these recordings today, I think we both had a little bit of dread about getting back into this after taking the summer off. Am I wrong?

Arpita: I would say that I missed your face and I missed your voice and I missed chit chatting with you, but I definitely was in a different space of whether or not I wanted to record today. Yeah. Leave it at that. 

Michael: And what's interesting is I think we both really love doing this podcast. I think it's been so much fun, more fun and a lot more work than either one of us had imagined when we set out to do this. Yet it's weird that I was feeling a little bit of dread before we started recording today. And so 

Arpita: Sorry. And so what? See what I mean? We're off. This is it. This is why we're dreading it, because we're like, we're out of practice. We haven't done it in three months. Holy shit. Right? 

Michael: And so. And so, what is dread arpita? 

Arpita: Oh my God. Dread is this feeling of like apprehension of fear, of reluctance, of just like this weight on you that I just don't wanna do X, Y, and Z for whatever reason. And for me it's partially like I haven't had to do this in a couple of months and it's been nice not having appointments in the late evening, afternoon or on the weekends and I can just kind of be lazy or restful. We talk about that too, but, and so having to be committed and being accountable for the commitment I've made came with a little bit of dread. Yeah. As I think it happens for a lot of people. 

Michael: Absolutely. Yeah. And for me, one place that I always before coaching noted that dread was coming up for me was when it came to work. I would spend my entire Sunday dreading the upcoming work week and then even sometimes I would get to work in the morning and I'd park my car and I'd just sit in my car dreading the start of another day. And so even if you had never heard the term work dread before, you have certainly experienced that kind of sensation in the pit of your stomach, which just makes you feel like, ugh, I just don't wanna do this right now. And it's normal. I think we all get it from time to time. And so, you know, for me, I think a lot of the work dread was coming up because there were aspects of my day that I just didn't want to do. I think that that is pretty normal also. Do you have a similar experience with work dread or is it other things that you feel like have come up for you? 

Arpita: I'm giving Michael Hersh are you kidding me face right now for those of you who are not watching this, because if you've heard my story, you know how much I say I hate working at the office, like in in an admin role, right? So the dread is always there and the the problem is when we dread work and we don't show up, the shit piles up. Right? And it gets worse, and then the dread increases. And so it's becomes this vicious loop that we don't do the work, it gets more overbearing or overwhelming, and then the dread increases. And then it puts us in the cycle of, of again, staying stagnant, not moving forward. And so that's kind of what I've found for myself, where I just kind of have to hunker down and push through sometimes. Take that dread along with me because it is actually very prohibitive. If you succumb to it all the time.

Michael: Yeah. Yeah. I think for me I got, so you know you were just calling succumbing to the dread. I think I was doing that for such a long time that I really started to vilify medicine and kind of idealize retirement. Right? Idealize getting out of medicine and when that was happening, when I was allowing myself to succumb to the work dread, I was working so much harder, I was doing everything I could to facilitate this escape where I just knew that once I could escape, I could finally be happy. And what ended up happening is anybody who's been listening to this knows is that that just precipitated my burnout that much more quickly. It was the fact that I wasn't recognizing the work dread. I wasn't recognizing all of the aspects of my day that I didn't want to be doing that kind of facilitated this thinking. Because the truth is, is we've already discussed here in this podcast, there is not better than here. Retirement is not better than working every day. There are always going to be other things that come up that maybe you are less enthralled with, that you don't love. And really it's about taking a moment to figure out, why is this coming up? Why am I feeling this way? And trying to uncover a little bit more of the awareness and the details of the situation. 

Arpita: Yeah, I think that is kind of a key point here. Like what am I dreading so much? And a lot of times what I've found is the dread is I feel overwhelmed. Like this stuff has gone on for so long, or this person has been in charge of this and it's a hot mess, and now I have to go in and clean it up. Or there's 20 patients on my schedule and I have charting still not done from the day before. So again, piling up, there are so many different reasons why. So that is key, is figuring out why am I actually having this heaviness about going in and completing the work or whatever other task it is. And I think from there, I, I mentioned it, I think in one of the other podcasts, is like really starting to divide it up with regards to how you're gonna address it. You know, that's gonna be the next step. What I realized is when problems come up or challenges come up for me, one go-to thought that I've now adopted for myself is I always make things work out, right? Because when I find myself spinning in the, oh shit, now what? What if? You know, I can't believe this is happening. It just spirals you further into this dread and this sinkhole of not wanting to move forward. So I have to really catch myself when I'm going in that place and say, you know, I always make it work out. Shit's happening again. Why wouldn't shit be happening? This is what happens when you own a business. This is what happens when we are physicians. It's expected. That's how I kind of get myself checked and move out of it. I think the next step from there then is really starting to decide and being intentional with how you wanna show up with the exact situation. So maybe speak a little bit about that, about maybe do you have a thought that you kind of go to when you catch yourself going in that funk? 

Michael: It's interesting. I was just gonna pause and say I, I love that you identified overwhelm as a major source for your dread. For me it's frustration, right? So frustration about things that are not gonna go the way that I want them to go. Frustration over not getting, you know, a medication approved for a patient that I want them to take, frustration over a prior authorization or over, you know, somebody being late or things along those lines. And I think for me, just like you, it was coming to terms with the fact of, well, of course you're frustrated. It's not trying to get around the frustration, it's not trying to get around the overwhelm. It's more of an acceptance of most people would feel the exact same way in the exact same situation. Yeah. And once you can identify and become aware of, okay, well this is what is driving the dread and this is why and kind of normalize it for yourself. It doesn't necessarily make it better. We're not talking toxic positivity, like, yay, I'm frustrated. What we're talking about is just coming to terms with the fact that it's normal, most people would feel this way, and there are so many other aspects of my day that I truly enjoy and like, and I can choose to focus on all of the things that bring me frustration. Or I can just remember that the frustration is just part of all of the things that I get to enjoy about my day. 

Arpita: Right? And I think that key there is like you said, recognizing that, focusing on the good, but sometimes you just have to push through it. I mean, there's a shit that you gotta deal with, right? This comes with the responsibility of being an adult, and we chose these careers, we chose what we're doing with whatever roles you have in your life, and it's gonna come with the good and the bad. So, part of it is recognizing you push through it and then you actually get a little bit of a dopa hit at the end of, Hey, I actually did it. I got it done. Thank God that's over. Right? Those things do come with positivity at the end that is well deserved and earned. So I think that's one way to definitely work through it. Another way, I've kind of started to approach things pretty regularly when shit hits the fan or things are just not good, is kind of a little bit of a threefold, dividing it out, right? Is this something I can bag completely? I don't need to deal with it. I'm really making more of it than it needs to be. Can I just drop it completely from my life. Is this something I can barter? Can I hire somebody to do this shit because I hate it so much, it drives me crazy. I'm not able to show up as my full potential with my full potential as my best self here. Or is there a way that I can better the shitty situation, right? Because I'm gonna have to do it. I don't love doing it. But how can I make this so that there is a little bit of a win, a little bit of a light at the end of the tunnel. So I feel good about it at the end. And you know, it takes the intentionality of pausing sometimes when you're in that dread to separate it into those three categories and figure out which way you're gonna go. But when you give yourself the time to do it, sometimes that's just the extra little push you need to be able to get through. 

Michael: Yeah. And what you're highlighting here is, is sitting in your power and knowing that you have choices, right? So you, you know, you mentioned earlier saying, you know, we chose to be physicians, and so that was a choice. And you said that in past tense. But the the truth is we choose to be physicians. We choose to, you know, get on a phone call and do a prior authorization so that a patient can get a imaging test or a medication that they want. You can choose not to do that, and that's okay too. You get to choose. And when you can sit in that power and then decide what are the things that I want to continue doing versus what are the things that maybe somebody else can do for me versus what are the things I'm just not gonna do? You reclaim your power and that some of that is an antidote to the dread because when you know, well, I'm just not gonna do that, then you don't have to dread it anymore.

Arpita: Right. Right. I, I think that is super important too, because your brain is worried about something. I mean, and use this as a cue for yourself, right? If I am constantly dreading every single day doing X, Y, and Z, do I need to reassess and burn all the shit down and start over, right? Sometimes we have to do that, and we're scared of doing that because of the repercussions or the responsibilities that we have, et cetera, et cetera, and it makes sense. But if you get to a point where it's always like that as well, you have to decide, do I wanna continue the rest of my life this way? Or if I can't do the bag, barter, better do I burn it down and start over again? We have to stay in choice, and it makes, I'm not trying to diminish it or make it sound like it's easier said than done, or just not put any weight on the responsibilities that we carry. We all have financial expenses, et cetera, et cetera. But the point is, what is the ultimate goal that you have in your life? 

Michael: Yeah. And then also not losing sight of the fact that there is a lot about the stuff that we do that brings us a lot of fulfillment. And life is too short, time is too limited to spend all of our days dreading the next day. And so taking a moment, our brain is always gonna go to the negative stuff, the parts of our jobs, the parts of our life that we don't want to do. And taking a moment to remember the parts of your day that you actually enjoy, the interactions that you have with patients or with your colleagues, the people that you work with and around. You know, all of that. Also, you know, when we're talking about next steps to kind of overcoming the dread is seeing a lot of the positive. And again, we're not talking toxic positivity. We're not talking about, yay. Everything is fantastic. We're just talking about focusing on the parts of of your day that actually do light you up, fill your cup, bring you joy, all the things.

Arpita: Do you do a gratitude practice or anything like that? Like how do you do that for yourself each day? 

Michael: Yeah. You know, I would love to say that I have a daily gratitude practice. I would love to, to kinda integrate that into my routine. 

Arpita: Okay. I'm gonna teach you right now, then I'm gonna cut your ass off and teach you how to practice what we preach. Okay. 

Michael: Let's do it. Let's do it. 

Arpita: What you're gonna do in the morning. I want you to put a sticky note on your bathroom mirror. Okay? And I have to do it 'cause I need the visual to remind me. In the morning I want you to put on there what am I thankful for and why. that's your gratitude practice. And typically when I do that question in the morning, I'm brushing my teeth, I can't do anything else. It's really hard to not have the toothpaste go flying everywhere. So I'm stuck there. So I might as well be intentional with what I'm thinking about. So the why is important because it holds you in that space of gratitude. It holds you in a good space, a positive space rather than a negative space. And then I do the same damn thing at night when I'm brushing my teeth, but instead I ask myself; what are three wins I had today, or what are three things that went well today? Right? We're shifting the brain to look at the positive because as you've said, and as we all know, our brain always seeks out the negative because it's trying to keep us safe from all the dangers that we perceive in the world. So you have to really spend the time being positive. So are you gonna do this? Are you gonna do it Michael Hersh? 

Michael: Yes, I am. And I think, I love that this doesn't have to be complicated. Because I feel like sometimes I overcomplicate things in my life, so I love that. That is something simple. You've talked before about habit stacking, right? So, so lining up a habit with something that you are gonna be doing anyway, you already have a habit to do. So I know I'm gonna be brushing my teeth at least twice a day in the morning before going to work and in the evening before going to bed. And so being able to do this, these gratitude practices and focus on some of the good stuff that happened during the day. I think that this is very doable for me. And the next time you ask me about my gratitude practice, I'm gonna be able to say, yes.

Arpita: You better be doing it. You better be doing it. No, I, I think that actually brought up something for me. When you're saying that, you know, if I look back at my journey over the past three years, there have been so many different tools and nuggets and tidbits that I've been offered, and some of 'em I take on and some of them stuck and some of 'em didn't. But I will say, the one thing that has stuck is this practice, and I'm not perfect with it. When I go on vacation, the sticky note is not visible and inevitably I always forget and I come back and I see it. I'm like, oh yeah, right? So part of this is just recognizing that it doesn't have to be intense and labor intensive and long-winded and extensive. It's very simple, but I notice a huge shift in my ability to look and seek the good throughout the day because of this little practice that I've installed. And it does not take that much time, but it makes a huge difference. 

Michael: Yeah. That's awesome. 

Arpita: What else? What tips do you have for me? Have you implemented anything that you feel has really made a difference for you?

Michael: I think we talked a little bit about the thought download and I, you know, for me that is one of my best ways of figuring out what's going on for me when I can't quite figure it out. And when we're talking about dread, you know, starting with what's going on, why is this happening, where is this coming from? And creating awareness around why you're feeling the way that you're feeling. This is a tool. It's such a simple tool and and it's one of those things like, why did I not know about this before? And so if you've heard me talk about it a million times, this is exactly why, because it has become so useful in my life in terms of figuring out kind of what's going on and why am I showing up the way that I'm showing up in all of these different situations, including with my work dread.

Arpita: Yes. Awesome. Well, I appreciate your sharing this topic 'cause we all deal with it. We all have it in some area of our life. And I think this has been very helpful with regards to how do we tackle it? You know, we've given a lot of tools today, I think that will help others. So I hope you guys have enjoyed it. Do you have any other final words Michael Hersh? 

Michael: I mean, I think also just remembering that everything is a choice, right? And you know, you don't have to suffer in the dread. You don't have to succumb to the dread like we were talking about earlier. You always have a choice. And just reminding yourself that you can make the decisions along the way can help so much with dread in, in every aspect of our life.

Arpita: Totally, totally. Remain in choice. That's your choice. So, all right guys. Well, thanks so much for joining us today. We've had a fun conversation, a little bit of livelihood of explaining how things have actually transpired over the summer, but we look forward to you hearing from us soon at the next episode. Take care. 

Michael: Thanks guys. Take care.

Arpita: Bye 

Michael: Bye.