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How a first-gen doctor practices self-care

In recent years, burnout has been a widely concerned global health issue among members of the medical profession, even more so during the COVID-19. While burnout among physicians is a

long-standing issue, mounting stressors such as rising living costs, inflation, long working hours, bureaucratic healthcare systems, caring for terminally ill patients, were all magnified during the pandemic. Particularly for first gens, the first to pursue a medical career in their family, who face

unique challenges, the need to achieve a better work-life balance is more important than ever.

For this special article, our in-house writer, Jason, sat down with a first-gen physician, Alicia, to explore the importance of mental health and self-care among healthcare professionals. Please note that the names mentioned herein have been amended to protect the contributor’s anonymity and any similarities in stories and personal experience between the contributor and the reader are purely coincidental and unintended.

At the tender age of 19, Alicia (not her real name) left home to pursue a medical degree that would see her settling down in Australia decades later. Being the eldest child to an Asian family of 5, Alicia knew it was down to her to set an example to the rest of her siblings. When asked how she would describe herself in three words, she said - serious, dutiful to a fault and private. In fact, prior to the interview, she had joked about her suitability for the interview, much to our writer’s amusement.

“Haiyah (Oh god), I am the most boring person to interview. You should probably find someone else instead,” she joked in her Manglish (Malaysian English) colloquial accent, although she admits she tries to loosen up more these days. Now in her early 40s, Alicia has somewhat found contentment in her life. On her off days, she describes her ideal day as staying in, doing house chores, then serving a good ol’ bowl of egg noodles tossed in soy sauce with a hearty bowl of leafy greens.

“It’s all about the simple things in life,” she says.

Here’s the transcribed version of the interview:

J = Jason, A = Alicia

J: How did you get into Medicine?

A: During my time, many Asian families were considered prestigious if you had a doctor in the family. I suppose that’s what kickstarted the interest and the eventual pursuit of the career. There might have been a bit of an interest involved, and right after high school, us kids were expected to go straight into college and then university to pursue our tertiary education. Those days, there was no such thing as a gap year, or figuring yourself out. The expectation for the eldest child was that you were supposed to be independent right after graduation. If you were born into a well-to-do family, great, off to college and university you go. If you came from a poor or average family, well it’s either work or college. At that point, my parents had the financial means to fund my education and left with little time to figure things out, I decided Medicine would be the easiest choice and I went with it. 20+ years later, well here I am, working as a doctor in Australia.

J: Could you tell us a little bit about how life was for you starting from the time you entered university right up to your career?

A: Well, I can’t say much about where I currently work at, due to confidentiality reasons, but in a nutshell… I left home at 19 to pursue my degree in New Zealand. I spent 5-6 years studying and right after graduation, I waited for an additional year for housemanship. During my housemanship, I relocated to Australia for the exposure and following that, I moved around to several parts of the country and eventually settled down in Melbourne, where I’ve currently worked for at least 10 years.

J: Can you tell us how you feel about your job and if it affects you in any way? Psychologically or physically.

A: (Slight pause) You know, when you get to my age (laughs), you’ll realize a job is a job and I think you have to learn how to keep it separate from your private life. Some jobs demand a little more involvement, like mine. Now that a long time has passed, there are days where I question if the job is right for me. Sometimes I do feel like I’m stuck to the grind, and that this is a vicious cycle that continues to plague my life. But I always find that learning to find the purpose in your life and what you do gives you the momentum to press on in life. It’s all about finding a sense of belongingness to what you do, and to constantly remind yourself that you are contributing to the society in ways that you can.

J: At what point did you start to pay attention to your mental health?

A: Death and losses are common in the hospital, and there are simply days where you have witnessed too much to even go on, but you do so anyway because that’s the job. You would think after years of working in the industry that I would have an easier time coping with it, but the truth is, I find myself affected from time to time too. We’re humans after all, and it’s only human to feel and be emotional.

For me, the turning point came when I realized my patients’ wellbeing was significantly affecting mine. There are days when you have patients quitting their treatment and medication, and you feel helpless about it. Sometimes it really gets to you because then you start questioning your competency. In fact, there are times when the self-doubt is so strong, that it affects family relationships and my ability to practice self-care.

J: Could you tell us a little more about how your job affects your family relationships?

A: I’m very lucky in that my family was not financially dependent on me for support, and so I didn’t really have to worry much about money. How my job affected my family relationship is that when I am stressed out and I get on the call with my family members, I realized I was unintentionally lashing out at them. That was the wakeup call for me. When your mom FaceTimes you after a long day of work because she misses you and wants to know if you’re eating or sleeping well, and you start to raise your voice at her because you were affected by work, that was when I knew I was hurting the people around me. Or sometimes, when your brother comes to you for life advice, and you’re in no mood to listen and you start saying the wrong things which leads to heated arguments over text messages or phones, and it is detrimental to the relationship and mental health. I knew I needed to stop that.

Essentially, I was projecting and transfering my feelings to them, and I knew that wasn’t healthy at all. And that has a domino effect because your parents or siblings will take it in and lash at the next closest person in their lives. And lastly of course, what I felt in my job significantly impacted my performance and I needed to learn how to address that instead of wallowing in those emotions.

J: You mentioned stress also affects your ability to practice self-care. Let’s talk about that. Are you doing anything to care for yourself these days?

A: Absolutely. Eating, drinking and sleeping well are good ways to start. It doesn’t have to be a fancy meal, just something simple and nourishing that keeps the body going. When I come home from work, I cook simple meals that give me comfort. They also allow me to sit down to recharge and be human again. On days where I find it hard to do anything after a graveyard shift, I pop some leftovers into the steamer or microwave and eat. It’s not extravagant, but it gets the job done and comforts the mind and soul. I keep myself hydrated and I follow a strict bedtime routine.

I also recommend setting realistic goals at work. Understand where your threshold lies and determine if you’re able to take on more than your capacity. If there’s one thing I wished I knew earlier, it’s having the ability to say “No” when things get overwhelming at work. I also think actively communicating with your superiors at work gives them a sense of where you’re at in terms of work threshold, which allows them to actively support you.

During my rest days, I take the time to go run, meditate and volunteer. I practice transcendental meditation and I find that it helps me regulate my running thoughts. On the off chance, I listen to some podcasts on Buddhism. Volunteering at your local community also gives you the chance to ground yourself and open your eyes to the hardships around you. Volunteering teaches you to be grateful for the opportunities you have and anchors you to the now. Pre-COVID, I visit my family once every bi or tri-yearly. I go home, spend time with my loved ones, play with my dog, and really just take the moment to be happy to be home. Otherwise, I plan a trip to go hike somewhere. I’m quite an avid hiker and so being in touch with mother nature is an absolute blessing. Now that international traveling restrictions have eased up, I might do that too.

Another thing that I’ve been doing a lot more these days is unplugging from social media. I think soc med is cultivating this sense of FOMO in us and it’s really sending the wrong message to the younger generation about life and idealism. We see something on the internet and are led to believe that all that is the standard these days. Staying away from the distraction of the internet and having the time to self-reflect and think about my goals are great ways to keep me going too, I find.

J: Wow… that sounds great and I’m glad you’ve found your center in life. We’re nearing the end of our interview. For our last question - What is your advice for first gens, or the younger generation who are struggling with mental wellness?

A: Kindness and compassion are the two most important things that you can ever give to yourself, and I hope you’ll make a mental note to create that in your life 24/7. To people who are trying to figure out their lives and career, or battling with mental health issues, my advice to you is to take it one step at a time. I know it’s easier said than done, but know that there is no “expiration date” to your achievements and success in your life. We all have our own life paces to follow and you should never let anyone push you around. There’s no right or wrong choices in life, you just learn to live with the decisions you make and be comfortable with it. And if you feel like you need to start all over again, by all means, do it. It’s okay to have failures in life, to admit you are vulnerable and need help. It’s perfectly fine to reach out to people for support, and know that your loved ones will always be there for you.

J: Thank you so much for the input!

A: Not at all! I really hope I’ve helped shed light on what it means to be a first gen and taking care of my mental health. Like I said, I can be rather boring and unentertaining (laughs).

J: Not at all, thanks again Alicia. You take care!

A: You too!

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