Episode 67 of the Hope4Med podcast features Dr. Jamal Dixon, an internal medicine physician from Atlanta, Georgia. He graduated from Meharry Medical College and completed his residency at Morehouse School of Medicine. Dr. Dixon is a cancer survivor who was diagnosed during his final year of residency and now uses his perspective as a patient to help patients and caregivers through his program, The Caregivers Sanctuary. He shares his experience with burnout while working in an outpatient setting and how he overcame this period of burnout. We discuss the importance of putting yourself first, because no one is going to do it for you! We need to take care of ourselves first if we are going to keep taking care of others.

Transcript:
[00:00:00] Dr. JB: Welcome to Hope4Med.

[00:00:04] Hi everyone. Welcome to the Hope4Med my podcast. I am your host, Dr. JB and today’s featured guest is Dr. Jamal Dixon. He is an internal medicine physician from Atlanta, Georgia. He is a graduate of Meharry Medical College and completed his residency at Morehouse School of Medicine. Welcome to the show, Dr. Dixon.

[00:00:23] Dr. Dixon: Thank you. Thank you. Glad to be here.

[00:00:26] Dr. JB: Let’s go ahead and start from the beginning. Please share with my audience your origin story.

[00:00:34] Dr. Dixon: So, well, we can go through the K through 12, but going to Meharry, which is one of the few all black medical, dental schools, it was really a great experience just to be around so many people that are representative of you, of your culture, and seeing that you guys can actually make it and thrive in this field, this very demanding field. So it was a great experience. Met a lot of great people, lifelong friends, lifelong colleagues from there. And then after going to Meharry, transitioning into Morehouse School of Medicine residency, which lands in my hometown, and it was really a great experience. Just really being in one of the major flight trauma, busiest hospitals in America with Grady and just getting so much of a rich experience there.

[00:01:28] Now what happened during that time, during residency, actually, that was my last year of residency and, when we as physicians are going through our last year, we’re fielding job offers, like, we’re making travel plans, like, we’re almost at the finish line, so we’re so excited to be there. And, I remember in August, this is 2017 at the time, I’m at the Cav Medical, I’m going through internal medicine rotation, and I just start to get these small-at-the-time symptoms but in a physician’s mind, they’re really big. And so I noticed that all of a sudden, I just, I couldn’t eat as much and I would get full really quickly. So anyone in the healthcare field kind of knows, okay, if you stop eating or if you get full quickly, that it ends up being like a very big alarms symptom.

[00:02:25] And part of me was in denial, not going to lie, and I put it off, just so I could finish up the rotation so I can make sure I get my hours in so I could graduate from residency on time, cause that was the important thing. Then September came and it just got worse and so I went into the hospital in September 3rd, asked for CT, gave ’em a rundown, and ED doctor, really nice guy, we do the scan, he comes back an hour later and he comes with the “I have bad news” face. And as a physician, you knew that face because you’ve given it before to some of the patients and families that you’ve seen, so already knew, okay, this is bad, right? And then he says, well, I hate to inform you, but I mean, what we suspected has come true and you have a massive cancer going on in your abdomen now. Well, show me, like I got to see that cause I’m like in shock now and I feel my body just go numb in disbelief because at this time, I’m 31 and no one in my family, mother, father, had cancer like this, so it was just alarming of where this was coming from because I’ve been healthy up until that point. You know, I felt fine outside of this one symptom, had no pain and nothing else, except I just got full quick.

[00:03:54] So after dealing with like the fallout, like the weight, the severity of this, it really changes your whole life path. You know, I figured at the time I was just going to hospital medicine and, you know, just to be a doctor two, three decades and retire like most people do in this field, but after going through three surgeries, two month hospital stay, five months in rehab after, you learn so much about what it is to really be a patient. And in healthcare, we get a lot of good training on bedside manner, right? And so, a lot of us, at least millennials, gen Z, we’re coming in the era of having the bedside manner, right? But there’s just something different about actually having lived that experience and being able to like I know what it’s like, I know where things can go wrong in the hospital. I know where you got complications from things and you stay longer and all the horror stories that can happen to you in a hospital. Most of those I experienced, even though they knew I was a physician, right?

[00:05:10] So coming out of that and dealing with family and friends who were taking care of me the entire time, I just started to learn about the patient and caregiver interaction. And it just opened my eyes to a whole new sector. A whole new niche group of people within healthcare that aren’t actually being served, that are overlooked and it’s not intentional, but it’s just because of how healthcare is set up to treat patients, which it should. And because of that focus on healing patients and making patients well, we actually neglect the people around the patient, right? And I would notice that during all my visits, I’m having visits with oncology, I’m having visits with surgery I’m having visits with wound care, and visits with infectious disease doctors, all these visits, all these follow ups, and mental health was never addressed. Family was never addressed. And it just shows you that blind spot in healthcare that we’ve missed.

[00:06:18] So after all those months, I came back in February of 2018, and I’m still recovering from surgery. I still have tubes in me like, but I just had to get back to work. I had to get done with residency. I needed that return to normalcy. And so I finished residency in December 2018. After that, I did outpatient until the pandemic started actually, and when that hit, it just shifted healthcare even further because you could see the people panic, you can see healthcare workers panic ’cause nobody really knew what was going on. This is something we had never seen before in terms of a pandemic, something that you can’t see because there’s a virus, something that doesn’t present the same in everybody. Some people, it was fatal. Some people, they had no symptoms. Some people there in the middle, and it was just a lot of chaos during that time. And during the pandemic, you know, actually I stepped away from outpatient medicine because of how stressful it was, the burnout, even before the pandemic.

[00:07:30] And then once you get into it [the pandemic], and you’re seeing 28, 30 people a day, and you don’t have protective equipment and people are just looking for answers and you just realize, okay, this system is abusive to us, and where can I–

[00:07:47] Dr. JB: Sorry just for a quick second, so you mentioned something about burnout before the pandemic. Can you elaborate on that a little bit? What do you mean by that?

[00:07:56] Dr. Dixon: So a lot of times for us, especially physicians, there is a lot of work that is not medical in nature. So, when we do outpatient medicine, for example, the basic rule is that for every patient, you have two hours of paperwork to do, right? Or two hours of electronic paperwork to accomplish. So, if you’re seeing 20 people a day, 24 people a day, that adds up and then that correlates to around an 18 hour work day just to get through everything and stay up to date. So, I was really overwhelmed just by the load of work that came with seeing the people. Seeing the people was great, but following up with insurance companies, you got to call labs, see why the lab wasn’t done at the facility. You got to call back for results, you’re calling pharmacy to make sure medications are being filled. If not, why is it not in the formulary, why did insurance company reject it?

[00:09:00] There’s so many administrative and bureaucratic tasks that you’re burdened with on a day-to-day basis. And you take a lot of that work home with you. And in a lot of other sectors, when you do your job and you clock out, job is done. You don’t go home and do more work, like your job is done. With healthcare, it’s not really set up that way, especially on an outpatient primary care basis. And you work through it in the beginning because you want to care for the people, that’s what you signed up for, right? You went to school for it, you took on debt for it, you did all these things to care for people ’cause that was your passion. But then you have all of these other tasks that are added on top of that, that you never went to school for, that you really shouldn’t be doing, but you’re forced to do in order to take care of the patients. Over time, it adds up.

[00:09:53] You know, when you’re on vacation and you’re still doing charts and you’re still calling in imaging and you’re still having to talk with patients and you’re supposed to be on vacation. So over time when you don’t get rest, eventually you start to become fatigued mentally, physically, emotionally. And that’s where the burnout factor comes in for a lot of people in healthcare. And especially during a pandemic, it got worse for a lot of physicians that were just overwhelmed by just the sheer amount of people and the lack of resources given to help people. So burnout is a serious thing within healthcare. And a lot of times we’re not really told about how to manage it. We’re not taught how to deal with it. We’re basically told, Hey, this is what you signed up for, deal. Or Hey, you guys make such and such salary, you should be okay with that. That salary makes it okay. Like, there’s that culture of you should just put up with it and sacrifice your wellbeing in order to continue the job. And then the burnout gets worse because you feel like you’re not really appreciated.

[00:11:06] You feel like insurance companies are against you. The CEO, CEOs are against you. When you can’t take care of all the patients or give every patient the time they need, then you’re frustrated by that. And if you really feel like you’re fighting against the system by yourself and that no one understands. And so, that’s where the emotional and mental toll just starts to wear on you and then you have burnout.

[00:11:31] Dr. JB: And have you found that there are places where you can go ahead and have conversations like this, about your experiences, where people can understand what you’re talking about?

[00:11:41] Dr. Dixon: So when I was having the burnout– see my burnout period, I had a little bit in residency, which that seems to be the culture across the board cause you’re working 80 hour weeks, and sometimes more, but you don’t report it, but during my time in outpatient, when I was doing it, I didn’t have a space to actually talk about it. I really didn’t. And I think that’s a big issue because there weren’t, there weren’t systems in place for healthcare workers to talk about the problems with their position. They weren’t able to talk about the problems that were going on, there wasn’t a safe space for them to actually express their grievances, to just actually vent, to actually process some of the things they’ve seen.

[00:12:30] Because when you think about health care, a lot of us get in at an early age or, we’re here in our twenties, thirties, and we’re seeing a lot of sickness. We’re seeing a lot of death, right? And I don’t, we’re not really told to think about it that way. Like we have to compartmentalize so much on a day-to-day basis, but when you really think about it, these are people in their twenties and they’re seeing death. Right? And usually no one really saw death that early, except for police officers, firemen, military if they were at war, but we’re seeing this and that can be traumatizing, but you’re told, Hey, you still have 16 more patients on your census to see in the hospital today, you got to compartmentalize it. You got to tuck that over here so that you can take care of the other patients you have. And so no matter the cause of it or whether you knew if they were in hospice or you knew it was coming, still leave a mark on you.

[00:13:31] And when you don’t have spaces to talk about it, that kind of thing builds on you. Anyway, if you have family, if you have a spouse that are not in the field, they can only empathize so much, unfortunately. So that’s why I think it’s important to have spaces like this, like spaces, like Hope4Med and what you’re doing because you’re allowing people to know that, Hey, it’s okay to talk. Hey, if you’re a healthcare professional, it’s okay to admit that you’re having difficulty on the job, that you’re having these struggles, that mentally, emotionally, you’re starting to break down because we don’t have it. No one has that space. We don’t have it at work. I’ve never been across a job that offered it. That’s just is a thing in the healthcare culture. And it’s something that has to be talked about because the rate of suicide, physician suicide has gone up since the pandemic and it was already rising before March 2020. So I never found that space, to be honest with you. I didn’t have it. And that’s why my burnout really got so bad because I didn’t know that there was a space. I didn’t even know I was dealing with burnout until it was too late and I was already suffering.

[00:14:42] And a lot of times in healthcare, we, we function with burnout. We function through burnout, like we’re functionally unwell, but we still get up every day to do our job. So yeah, that’s how I’d answer that, there wasn’t anything I’ve seen honestly, it’s the first real podcast actually brings that to light and actually talks about burnout ,ways to cope with, you know, avoid it, whatever it may be. This is really the first space that gives that, that I’ve seen.

[00:15:15] Dr. JB: Yeah. So that was my impression also, and it was so needed because like you’ve mentioned suicide amongst physicians is high. It’s been high for years and years and years. And it’s something that we don’t talk about. 300 to 400 of physicians are dying, a med school class dies every single year and these were pre COVID numbers, not post. Pre. So, going back to your story of feeling symptoms of burnout, but not realizing it, could you put words to what you were experiencing?

[00:15:53] Dr. Dixon: So, irritability was one. Disturbing my sleep patterns. It was just, it was hard to get a good night’s sleep. Appetite, it would go up and down. And just really feeling fatigued. I was really tired, even when I did get good sleep, I was tired. You just feel tired. You have this sort of brain fog where mentally you’re moving slower and you’re just unhappy. And you try to place this feeling on so many other things like, oh, it was just a bad day. Oh, it’s just the nature of the job. You’ll get better. You sort of do these mental acrobatics, you know, to find another reason for it because no one ever told you, Hey, this thing called burnout is real.

[00:16:37] And this is not anything against the system. I just think the system was behind in recognizing that, Hey, our workers are dealing with mental and emotional traumas and struggles because usually we just stay silent about it, right? Because we put so much in taking care of the patients and the families and the people we see, that we just keep it silent.

[00:17:02] And as long as we stay silent about it, no one in terms of the general public knows about. And then we don’t get to support. And I think that’s just been going on for decades. And we’re just now getting to the point where, our generation and gen Z are saying, Hey, no, we’re not going to sit silent anymore. We’re going to discuss this because it’s only going to get worse. So I think that’s kind of, where it was. A lot of fatigue, brain fog, your brain’s sluggish, you can’t process information as quickly, you’re irritable, your sleep patterns are off. You’re really just miserable and you just try to find reasons and excuses as to what it is. I think, well, I just needed a day off and of course you feel better on a day off, but you don’t get enough days off in a row for it to matter. And so then you’re right back in. And so it just becomes that cycle of you feel these symptoms, you blame something else, and then you keep it moving. So those were the real symptoms I had. It was really a mental, emotional thing more so than physical for me.

[00:18:09] Dr. JB: So what happened when everything came to a head?

[00:18:13] Dr. Dixon: So the biggest part when everything hit me, outside of cancer of course, and it was outpatient and is when I was on vacation, actually. I was in Vegas. I was off all week and I was charting every day. I charted for at least a couple of hours and that’s when it just hit me like, wow, like I’m really miserable. And I’m really frustrated. I’m really on vacation and I’m not even enjoying it to the fullest. This is not what I picture my life in this field to be and usually when physicians say that, they get pushback from the general public about, well, you knew what you signed up for. Why are you complaining? They don’t really see the behind the scenes issues that you deal with.

[00:19:07] And for me, it came to a point where I just say, I need to take life into my own hands cause no one is going to protect my mental, no one’s going to protect my emotional well-being, no one’s going to ensure I have work life balance. I have to do it for myself. And if I don’t empower myself to do it, I’m going to stay in this pattern. And I feel like a lot of healthcare workers were just trained to stay in that pattern. We’re not trained to actually address burnout, the reasons behind it. We’re not told to take our career into our own hands. We’re not really told to put ourselves first. Right? Because that’s seen as, oh, well, you’re selfish if you do that.

[00:19:48] But that’s what happened when it came to me, it was like an epiphany. It’s like, I can’t keep living like this. Like I can’t keep waking up dreading going to work. That’s not a life I want to live. I can’t be off work and still doing work. That’s not the life I want to live in. I had to really address where’s the frustration coming from. It’s this job. And although it’s a great job, it’s, you know, it’s got prestige, it provides a lot of comfort. You have to realize, or at least I realized I have to break free from this. I can’t continue to stay here and be healthy from a overall holistic standpoint, right?

[00:20:32] So by the time the pandemic hit and then I had to separate from that, it was just the freedom I felt. And once you get a taste of freedom, like you just, you can’t go back,. And when I felt, I was like, wow, this is even though it’s uncertain because of in-between positions and the pandemics about a start. This is the most peace that ever felt in years.

[00:21:01] Dr. JB: So what do you mean by the freedom? What happened, did you quit your job, or…?

[00:21:08] Dr. Dixon: And so it was mutual, I mean, on both sides because as medicine is a business. So there, when the pandemic hit, they lost 60% of foot traffic and 60% of their revenue. And so they’re already on pace to replace most of us with NPs anyway, this kind of sped that up. And so usually when you go through that process of, okay, you got your contract but we’re going to move in another direction, I’m going to let you go, usually you feel angry, right? Usually just for everyone, you just want to keep the job. It was peace for me. It was peace. I didn’t like it, but I knew I would feel peace.

[00:21:52] And then the first day after, I just felt relief because I didn’t have those burdens anymore. I didn’t wake up thinking oh, I need to make sure I call in this result. I need to make sure they actually get this lab done, or if their insurance rejects this, now I’ve got to spend an hour talking with the insurance company about why this patient needs this. I didn’t have to do any of these tests anymore. And it allowed me to actually process the things I’d seen, things I’ve gone through my career up to that point. And it led to me finding a passion that I enjoy and other methods of working in healthcare that I enjoy a lot more and give me a better work-life balance.

[00:22:35] So of course, there’s going to be that fear when you go from school to residency, to a job that’s secure and then you have to leave or you get fired or you got to move, or you’re so burnt out that you just have to put in your two weeks notice and go. There’s always going to be that uncertainty, but it’s better on the other side, when you address your burnout, when you move to something that gives you a better quality of life.

[00:23:04] And as physicians, we just don’t get told that. Well, usually it’s, at least in internal medicine, we’re basically led into two paths, right? Outpatient, hospitals, or nocturnists. They don’t tell you about any other way. So you just feel trapped. You feel like, well, this is all medicine is going to be for me. It’s going to be a lot of stress. It’s going to be a lot of hours. It’s going to be getting hit from all sides. It’s misery. And that’s what you’re given. Unless someone tells you again, there is a way out. There’s a way to deal with burnout. There’s a way to pivot. But for me, going back to your question, it was a feeling of peace, a feeling of rest, of knowing I didn’t have to wake up and deal with these sorts of burdens again. And just that feeling of knowing I’m not going to be stressed out in this field anymore. It outweighed all the burnout I had before.

[00:24:05] Dr. JB: But you took some time to process and reassess and think about your past, your present, and your future. You would not necessarily be where you are right now if you were like, okay, fine, I’ll just get another job, and then just found the next thing. I think that’s what it was.

[00:24:26] Dr. Dixon: Yeah. So I think something that would be helpful for a lot of people entering this field or currently in this field or people struggling with burnout, is you have to overcome that fear. You have to overcome that uncomfortable feeling of just not having that salary job next to you, right? Because clinging to that position, it really keeps you hostage. It keeps you in bondage. When I took that time off, I mean, of course I made sure I had enough money saved anyway, so that wasn’t an issue, if you know how to invest things and all that, you give yourself enough time and that’s something we don’t have a lot of as physicians, we don’t give ourselves enough time to figure out what am I really passionate about? What do I really want to do to serve patients? What do I really want to do with my life? What do I want to do with my family, with what I want to do in terms of figuring out how the rest of my life looks. We don’t really get time to sit down and think about that before we make our next move. Like you said, we just go from position to another position to another position because I feel comfortable there. I feel secure there. I can control what goes on there.

[00:25:44] So for me, I knew I needed the time off because I hadn’t taken that many vacations anyway. So, I said, let me just take some months off. I mean, we’re in the middle of the pandemic, let me just take some months off and see what I really want to do. See how I want to approach the rest of my career. And then that’s when I came into locums work. That’s when I came into processing my experience as a cancer survivor and having talked with caregivers as a doctor, and then using all those experiences to start another career path along with my locums, in terms of counseling patients and counseling caregivers, providing care for them. That time was just necessary and, on the outside, looking in it can be scary, because it’s, well, how you going to live? You’re not making any money on this new job and you’re just sitting there and… it’s kind of a, it’s kind of this false notion that taking rest isn’t productive. Which is absolutely false, but that’s just how we’re trained as physicians, where we just go in work, work, work, work, work. Can’t rest, got to study, study, study, study, study, study. And we never really get that mindset of rest is productive. Figuring out what you, what you really want to do is productive.

[00:27:04] So when I took that time off, I took seven months off to really start moving in different directions. And it was the best thing I could’ve ever done, but I had to overcome that uncomfortable feeling of, okay I went from a secure job to no job and I didn’t immediately jump back in. And it’s just that uncomfortable period that you have to overcome because you’re going to feel that there’s no getting around that, but if you have the right things in place, you have that’s this place you saved up enough money. And you actually take the time to sit and rest just mentally rest, emotionally rest. You’ll find out where your purpose is and you’ll find things that align with that. And then you’ll end up where you need to be and not where you were forced to be.

[00:27:56] Because when I burned out, I was questioning like, is medicine really where I’m supposed to be, because I didn’t think it would be like this. And so, I feel like a lot of times we have to question, we have that question session with ourselves, so we have that come to Jesus moment, so to speak, of is this really what I want to do? And if it’s not, how can I find a medicine position that fits that aligns with me that allows me to do the things I want to do within the healthcare system. And you need time to find that it’s not something you find easy, but if you don’t give yourself the time, you’ll never be there. You’ll never get free from the business of medicine.

[00:28:39] And that’s really what the problem is. Medicine is such a business now that it’s taken humanity out and we’re left to suffer as patients, as providers, we’re all left to suffer the consequences of that. So, if you don’t take that time to deal with burnout, to figure out where you want your career to go, you’re always, I feel you’re always going to deal with it. It’s just letting physicians know, Hey, when you, you’re dealing with burnout or you suspect it, you need to take that time off. For some reason that’s just something that’s looked down upon, if you take time off for that reason. But I think everyone in healthcare should be doing it.

[00:29:21] Dr. JB: Like a sabbatical.

[00:29:22] Dr. Dixon: Yeah, you have to. You know, we don’t really put ourselves first and that’s a problem. We don’t really make our own wellbeing a priority. And how can you serve the community? How can you serve the population? How can you serve your patients if you’re not at your best? It was just going to be a cascade of bad patient outcomes. So, you have to take care of yourself. That’s just as important. And no one’s going to do it for you. No one’s going to come to save you. So, you have to take it upon yourself to engage in wellness, however that looks for you. Whether that’s meditation, whether that’s fasting, whether that’s yoga, whether it’s traveling, whether it’s being with your family, whatever works for you, whether it’s therapy, find that and engage in that often because no one’s going to force you to do it. No one’s going to do it for you.

[00:30:15] And the way healthcare is now, they’re going to let you suffer. They’re going to let suffer ‘cause they know you will. They know you’ll just deal with it. You’ll just push through. And you’ll do the best you can while carrying this massive burden. So, I would say you need to care for yourself if you’re feeling those symptoms of burnout, take that sabbatical. Take the time off. Don’t worry about how management looks at it and how people are going to look at it. You have to care for yourself, because medicine has become a business of being a martyr in a shift. And so, we have to stop being martyred and start actually making ourselves well there’s a lot of us are working in health care. We’re not well. We’re not well. We’re functioning. We get the job done. We help and save lives and cure people. And we worked through this pandemic and, getting things under control. We did all that, but we weren’t well, if you were to really ask, we weren’t well. We hid it from a lot of people. We pretended like we were fine, but overall, we weren’t. And it shouldn’t be that way. So, I say, take the time for yourself, prioritize yourself a little bit more and see how much better you feel then.

[00:31:33] Dr. JB: That’s fantastic advice. I couldn’t agree with you more.

[00:31:38] Dr. Dixon: Yeah.

[00:31:40] Dr. JB: So to pivot just a little bit, could we spend some time talking about what you are doing now in terms of the focus on both the patient and the caregivers of the patient?

[00:31:53] Dr. Dixon: Yeah. So, when I was– in the pandemic I finally had time to process what I had gone through, as a patient. I mean, at this point, I was still getting CTS every three months. I’m taking oral chemotherapy, four weeks on, two weeks off, side effects, dealing with all these new things. But you know, this is 2020. All of the surgeries and diagnosis happened in 2017. I had been functioning with that trauma the entire time and just tucking it away. And I never actually went through day by day. I even kept a journal and I just never went back to read. So now that I had the time I met with my mentor that was spiritual advising. We just went through the story. And as I was going through the story, the things I was realizing, I started to understand why I did the things I did at that time. And that told me that, okay, this is what patients are thinking mentally. This is what they’re thinking emotionally. This is why they’re doing what they’re doing, because you have to have been through that to understand why.

[00:33:04] And as a physician we had that bias, right? We just, we always had that bias of patients don’t know anything. They don’t know the science, they don’t have the knowledge. They’re ignorant of a lot of things. So this is why they act irrationally. That’s kind of the culture that’s put on you that because you went to school and you took these tests And, you know, algorithms and codes and you can remember the Krebs cycle, that you automatically know what’s best. And that if a patient or a family member acts irrationally, it’s because of lack of knowledge. And it’s just not true. And that’s what I knew from my experience, because I was defiant a lot as a patient, but I knew what was going on. I could explain all the things. But there were just different reasons and different scenarios as to why I didn’t want to do it. And I had full knowledge of the consequences, I had full knowledge of the risks, and I did it anyway.

[00:34:02] And so going back to those kinds of stories, that’s when it hit me like, okay, these are the things that everyone who’s not a patient should know. And these are things that caregivers should know because most of the time caregivers either spouse, family members or like really close friends. Right. It’s really kind of rare that a caregiver is actually someone who’s licensed and trained because you have to go through insurance. You have to go through all these hoops to even get one, right? So we have people who aren’t medically trained that are suddenly thrust into a role and out of love, they’re operating. There’s going to be a lot of things and miscommunications and misunderstandings that happen because of what the patient is going through and what the patient is experiencing. And a lot of it’s not going to be logical. So when you’re healthy, you’re operating in logic. When you’re in a lot of pain or you go to a lot of suffering, logic isn’t really there.

[00:35:06] And so it was learning that through my experience, there were a lot of times where I had to stop and bridge the gap between my family and my friends to get them to understand where I’m coming from and for me to understand where they were coming from. And once I realized that, I went back through my experience as a physician where I saw families split apart. I saw marriages fracture because illness really does tear some families apart. And I don’t feel like it has to. And I feel like a lot of it comes from just misunderstanding of both sides. And it’s kind of like the patient side and the caregiver side, they oppose each other unintentionally instead of coming together as a team. And it’s really a lot of misunderstandings on both sides.

[00:35:55] I’ll go back to my experiences that are similar to a lot of people’s right when I was diagnosed and only told one person until the day before surgery. And I knew September 3rd, that’s when I was diagnosed, surgeries on September 13th, and I didn’t even tell my parents, I didn’t tell them until the night before September 12th. That’s when I told him. And at the time I thought I was completely right in withholding that information, that I had this massive tumor that could kill me when I had the surgery, and I know a lot of parents probably losing their minds right now because they can envision being a mother or father and your child tells you the night before, Hey, I’ve known this for about two weeks. I’m just now telling you.

[00:36:40] And then people can go into their memories of when they had loved ones or they had spouses that were terminal and they waited until the end to say something about it. And then the questions come, well, why didn’t they tell me? Did they not trust me? Did they not love me? Did they not think I could handle? Like what, where did this come? Why couldn’t they just tell me? Right? And that’s where part of the misunderstanding comes in because as a patient, when you get that news, You already know it’s going to hurt the people around you that you love, that love you. And so out of love, we try to minimize the pain or we try to keep the pain away from our loved ones as long as possible. So it comes from a good place. We just execute it really bad. And at the time I felt, if I could just give my parents 12 days of not having to feel bad about it, I will have done my job and I, no one could have convinced me I was wrong in doing that now, looking back at it.

[00:37:45] Yeah. I have said something the day of, but it’s little things like that where we have good intentions, but the way we act them out is just not done well and to someone who’s a caregiver, it can be interpreted entirely differently. And that’s where I like to bridge that gap of guiding people through the process of being sick, because as physicians, we guide you through physically, and that’s the easy part you fall out of the rhythms, you do labs, imaging, you find out which treatments work, the best you follow the steps you do followups, and then you go and proceed as planned. But when you’re dealing with aspect of illness, when you’re dealing with the emotional aspects of illness, when you’re dealing with the trauma that’s behind after going through any kind of illness, whether you recover or regardless of the outcome, there’s trauma, every step of the way that can happen, depending on if you got something to go wrong in hospital. The sounds, being unable to sleep, traumatic procedures, all kinds of things that can leave trauma once you leave the hospital building. Right?

[00:38:57] So when I went through my experience, I had to look and say, okay, these are all the things I was dealing with. This is why I was doing these things. These are the things as a patient that I wish caregivers knew. These are things that caregivers wish their loved ones. And then it was putting it together. And then it was studying the caregivers. I had come across and as outpatient in hospital and then going through questions that I would see needing to be asked how you feeling about your quality of life? Do you feel like your life has gotten more? Do you feel guilty when you take time for yourself? Do you feel like you’re the only one taking care of you? All these questions that a lot of them haven’t considered because they’re working so hard, they’re trying to do everything possible out of love. And they’re burning themselves out on the caregiver tribes.

[00:39:53] I think that’s the one thing that we’re good at, we can stop burnout cause we’re used to it. So we can see it in anybody, I could see burnout in cop, I could see burnout in a civilian, I could see burnout in a clerk, you could see burnout in anybody, cause you’re so used to seeing it and felt it before. It was easy to recognize. And just looking at it from a caregiver standpoint, taking care of a grown adult, managing a lot of their affairs, you’re carrying the emotional trauma of seeing them suffer. Then you have the self neglect that comes with. And it was just a big blind spot. And I knew that something had to be done to care for them as well. We can’t leave them behind because eventually the patient gets better or if they don’t, there’s still life after that, there’s life after the diagnosis. For the caregiver what’s that like? Why is no one focused on it? Because making sure they’re well, improves patient outcomes. That’s studied and that’s known.

[00:41:00] So in order to really connect with people and have people understand, this is what my loved one is going through, or being able to vent, it had to be someone that’s gone through it that can tell you, I know why they’re doing this because I do about everything wrong you can do as patient. I did that. So being in that position of saying, Hey, this is what’s going on. This is how you work around. Or being able to tell them, Hey, I know you feel like you have to do everything, but certain things you have to let the other members of the care team do their job. You can’t be the physician. You can’t be the wound care nurse. You can’t be the, the oncology NP. You can’t be all of these roles and that’s not what they need from you, because even in my situation, I didn’t need them to be another set of healthcare workers, I didn’t need that, because I could do that. I just needed mental and emotional support. But because out of love, you want to do everything you can. And a lot of times you become Superman or Superwoman, and then you burn yourself out as a caregiver, thinking that everything’s going to fall apart if you don’t have your hands in control of everything.

[00:42:12] And so that’s really what the purpose is now. Outside of doing locums work, which is basically travel, is the doctor’s version of travel nursing basically, to make it simple. But outside of that, I’m now engaged with The Caregivers Sanctuary that I started to actually care for the caregivers, cause they’re really left behind. So to make sure that they’re seen, make sure that they’re heard, make sure that they get intangible benefits of the counseling and guiding them through their loved one’s medical process, but actually giving them the tangible tools, giving them resources because lot of times navigating healthcare is very confusing. Even doing it for myself as a physician, it’s a lot of hoops. It’s a lot of phone calls. It’s a lot, dealing with insurance getting prior authorization. It’s a lot to deal with. And so giving people the tools of, Hey, this is where you go for equipment. This is what you need to go to get supplies where you can get funding depending on the state to care for, all these things. These are the things to look for in a nursing home or an acute rehab facility. These are things if you want to file complaints of.

[00:43:27] Just giving them the tools to make their experience as a caregiver better and then help them transition out of that role when the time. So that’s really what I’m involved in now, just using my experience with cancer, my experience that I had with my family, with my friends, to help other caregivers make it through and help their families and their friends to stay intact through illness, because the illness is going to happen, but it doesn’t have to destroy your family. Doesn’t have to destroy your friendships. It doesn’t have to leave you worse off than you were before.

[00:44:07] Dr. JB: So, this is such an amazing initiative and, I, I give you props for, for starting it and, for really using your life experiences to really create something that is beneficial to so many other people. If my audience wanted to find out more about The Caregiver Sanctuary, how could they do that?

[00:44:32] Dr. Dixon: Well, uh, they can start with my website www.thecaregiverssanctuary.com. And you can also follow me on social media. I’m on Facebook, I’m on Instagram as thecaregivingdoc. I’m also on Twitter, same hashtag. So website first and then all social media profiles in terms of Instagram, Facebook and TikTok. But the website is going to be the main way to find me and see the things that I’m doing. Seeing the blog posts, seeing the video seminars I’m doing, just to see a lot of the lessons and things that, I’m giving out and then to actually find a resources tab and see the things they need from there as well. And so that’s where they can look and see if they need my services as they want to schedule. Booking sessions with me to have these one-on-one counseling sessions, just to see if it’s something that would fit them, if this is something that they need, because the way I look at it, this thing with caregiving, however long it lasts, it needs to be as pain-free as we can possibly make it. And so for me, it’s to help you through that process and then you graduate from, right? Because eventually when that time comes, when they get back healthy, now I need to help you transition out of being caregiver and back to normalcy, and then you go about your life. And so www.thecaregiverssanctuary.com, thecaregivingdoc on all social media platforms. And that’s where they can find me.

[00:46:10] Dr. JB: And in closing, do you have any pearls of wisdom for my audience?

[00:46:17] Dr. Dixon: So a couple. So the main one is something I said before. If you’re under health care in any capacity, especially physicians, especially physicians, take care of yourself. We have to get out of that hero complex that we have, we have to get out of that savior complex. We have to get out of that guilt when we do something for ourselves, we have to get out of there. We have to stop that. So take care of yourself first, because as you said, these suicide rates among physicians, it’s steadily increasing, and it’s only be– a lot of it is from the stress of everything that’s going on. And a lot of it is from not being able to prioritize your self. Like life would be better, things will be better if you weren’t here, and that’s such a horrible place to be in. And a lot of times, a lot of us as physicians don’t seek the help, we’re not even granted access to help. There are a lot of outlets that provide help. So take time for yourself. Protect your mental space, protect your emotional space, and prioritize your wellbeing over your career. So many of us as physicians prioritize our careers so much that we neglect ourselves, our family, our friends, everything. So prioritize yourself and really make sure that this is what you want to do. And if it’s not, consider a pivot. You don’t have to stay and suffer. You don’t.

[00:47:59] Those would be the two biggest ones ’cause that’s what I see so much from my colleagues, suffering and feeling like “well, there is no other way, this is just what medicine is.” And it doesn’t have to be ,so take care of yourself first. Don’t feel guilty for prioritizing yourself. Don’t let these big companies use your hero complex against you. Don’t let them use the Hippocratic oath against you to make you deal with really bad working conditions, because that’s something that just happens a lot. We were in substandard working conditions that are hazardous to us. There hazardous to the patients and we just deal with it because we feel like patient care is going to go down if we, if we just up and leave, right. ?And we have to just get out of that where we allow ourselves to be used up and miserable. So prioritize yourself.

[00:49:00] Dr. JB: Who says a doc can’t rap? D O C T O R J B. The greatest doctor to ever touch the mic. The greatest podcast ever broadcasted or prerecorded. Come learn some. Each one, teach one. I’m done.