Otolaryngologists Outside the Office

It’s a bit ironic that the man who established the first full-time, sleep-in medical residency system also advised doctors to spend time pursuing hobbies and personal interests (Michigan Medicine. https://tinyurl.com/53b77ds8).

But Sir William Osler, MD, the Father of Modern Medicine, understood that medicine requires intense focus and concentration— and that physicians need rest and rejuvenation to be at their best. He personally enjoyed book collecting, reading, and practical jokes, and encouraged other physicians to engage in activities that brought them joy and satisfaction. In 1909, in the pages of the British Medical Journal, Dr. Osler advised young doctors to “look about early for an avocation, a pastime, that will take him away from patients, pills, and potions,” writing that “no one is really happy or safe without one” (BMJ. doi.org/10.1136/bmj.2.2544.925).

In 1920, in Aequanimitas, he wrote, “Begin at once the cultivation of some interest other than the purely professional” (Aequanimitas. https:// tinyurl.com/4tttxnux).

The advice is sound—and perhaps more important than ever as physicians struggle with burnout and work/ life balance. As you know, only too well, medicine is a highly demanding profession that can devour your time and energy if you let it.

That’s a lesson some doctors learn too late. Julie Wei, MD, director of the division of otolaryngology at Akron Children’s Hospital in Ohio, experienced serious physical injury and burnout after years spent caring for patients, helping families, and climbing the academic ranks. Three years after the onset of her injury—which worsened despite intervention and made it nearly impossible to work as a surgeon—Dr. Wei stepped away from clinical and surgical practice to pursue healing.

“It shouldn’t have taken me hitting rock bottom,” said Dr. Wei, while acknowledging the pressures physicians feel to prioritize their careers. Academic physicians must research, publish, and teach, in addition to maintaining clinical practices. Time spent serving on committees, traveling to conferences, and giving presentations adds up. Saying “no” to professional opportunities may seem unwise or selfish, but saying “yes” comes at a cost.

Making time for yourself is not selfish; it’s essential. These four otolaryngologists have each carved out space for activities that fuel their curiosity, creativity, and well-being— and their stories offer insight into how personal passions can strengthen professional purpose.

Viengsouk Phommachanh, MD— Comic doc

Like most kids of the ‘70s and ‘80s, “Vien” Phommachanh grew up watching comedy on television—prime-time sitcoms, late-night TV shows, and stand-up comics like George Carlin and Eddie Murphy. And like most children of immigrant parents, Dr. Phommachanh channeled his energy and ambition in an academic direction, graduating with a degree in medicine and embarking on a career in otolaryngology. By age 40, he was section chief of otolaryngology at his local hospital and at the top of his professional mountain.

“My practice was going really strong, but I got bored,” he said. That’s when comedy “popped back into” his heart, and he signed up for a comedy class.

“My motivation was, one, to scratch it off my bucket list and, two, to be a better speaker,” Dr. Phommachanh said. But when his first stand-up set—delivered in front of about 250 people at a local club, after just three class sessions—was a success, Dr. Phommachanh was hooked. Today, he is the #1-ranked Laotian ear, nose, and throat doctor/comedian in Southwest Florida (probably) (Comicdoc.com). He performs two to three shows a week, tours nationally and internationally (Australia, Canada, the Bahamas, and more), and has recorded a Dry Bar comedy special (“Open Up & Say HAH!”) that’s racked up well over four million views.

He’s also still a practicing otolaryngologist in Sarasota, Fla.—and a better, more balanced physician than he was early in his career.

“Comedy cleanses my palate,” Dr. Phommachanh said. “As soon as I hit the comedy stage, I’m a different person. You can’t go on stage with a negative mindset, so I’m forced to leave that behind and enter the stage with good humor.”

Performing also hones his relational skills. “In both comedy and medicine, you have to read the room,” Dr. Phommachanh said. Physicians and comics alike must build rapport, develop trust, and communicate clearly. And although Dr. Phommachanh first worried that his patients might think less of him as a physician when they discover he performs stand-up, he’s learned the opposite is true.

“They love it, “he said. “It makes me more approachable because they know there’s a human side to me and that’s what they want—a doctor who is human.”

To make space in his life for comedy, Dr. Phommachanh eliminated activities that did not serve his needs and interests.

“I took away the things that were killing me. I stopped taking call at the hospital, cut my hours, and stopped doing surgeries that were physically impairing me,” he said. “Now, I operate as much as my body tolerates, and when I feel healthy. Most weeks, I only work Monday through Thursday; I may work half a day Friday if I don’t have a show or only have a local show.”

Of course, not all physicians can afford to cut their work hours. But focusing exclusively on your career comes at a cost, too, and Dr. Phommachanh has no regrets about reorienting his life.

“If you allow one thing to consume your life, it could destroy you,” he said. “I decided to put a value on my personal freedom and creative goals.”

Alessandra Colaianni, MD, MPhil—Writer physician

Dr. Colaianni was a writer before she was a physician.

“I was a big book nerd as a kid,” she said. “I started writing little poems and stories when I was in middle school and just kept doing that.”

In medical school, she pivoted to creative nonfiction. “I realized that the things I was inventing were so much less interesting than what I was experiencing as a med student and seeing on the wards,” she said. Writing helped her process these experiences, and she enrolled in an elective reflective writing seminar co-led by a pediatrician and writer.

Finding time to write during residency was a bit more difficult. And yet, Dr. Colaianni managed to publish her first article, “Terra Nova”, in the New England Journal of Medicine at that time.

“It’s about Antarctic exploration and makes some parallels to surgical residency,” she said, noting that the 2018 article “was pretty controversial.”

In it, she directly addressed the competing demands for physicians’ time and energy, writing:

“There is value in self-sacrifice—and there is value in naming residency as the sacrifice that it is—but obviously not to the point of injury … there is also the inconvenient fact that the worst nights I’ve had on call—waves of consults from the emergency department, that feeling of being the only person in the hospital, airway disasters … are the nights I’ve learned the most …. Reconciling these truths is not a trifling exercise: I’m torn between envying my friends with vibrant lives outside the hospital and being disappointed in myself for not studying harder, working longer, committing more.”

For a while, the demands of medicine won out. Joining a monthly writing group sponsored by Brigham and Women’s Hospital helped “rekindle” her interest in writing, Dr. Colaianni said. It was still difficult to find time to create, but “once I did, I felt so much better,” she said.

Since then, she’s published essays in The New York Times, Harper’s Magazine, The New Yorker, Guernica, Ars Medica, and other top outlets. Although her capacity to write ebbs and flows with the demands of her life and profession, Dr. Colaianni continues to nurture her outside interests.

“I am very protective of my free time and interests,” she said. So, while she’s currently unable to commit to acting in local theater productions—another passion of Dr. Colaianni’s—she now occasionally meets with friends to do a one-night reading of a new play. “That way, I can still be involved and invested and enjoy that part of who I am,” she said.

She encourages other physicians to make time for personal pursuits as well. “If there are things that you do that make you happy, you should do them. We have one life.”

John Schneider, MD, MA— Physician philosopher

What does a rhinologist with a degree in economics do for fun? Read philosophy and ponder the meaning of life.

John Schneider, MD, MA, was working as a research assistant at the United States Federal Reserve when “medicine somehow became my dream,” he said. He transitioned careers, earning both a master’s degree in public policy and a medical degree; today, Dr. Schneider serves as the division chief of rhinology and assistant dean for faculty coaching at Washington University in St. Louis. He’s also an outdoors enthusiast who enjoys traveling with his wife and two teenage children.

Quiet time, reading philosophy and psychology feeds his mind and soul.

“What’s fascinating to me is learning what it is about our experience as humans—and as physicians and surgeons—that elevates us above the technical aspects of what we do,” Dr. Schneider said.

While today’s discussions of physician burnout often focus on external factors—electronic medical records, administrative burdens, the ever-present pressure to do more in less time—Dr. Schneider chooses to study philosophy for another perspective.

“We human beings have been discussing these ideas since prior to the Roman Empire: What is it about our lives that we control, and what don’t we control?” he said. “The answers are in philosophies, in understanding ourselves better and gaining perspective on how we think and feel as physicians.”

There are no simple answers, but much to be gained from studying and appreciating different philosophies. “The ideas about how we should live are vast. The truth lies somewhere among the varying philosophical traditions. If you don’t read all of it, you risk a biased view of the world,” Dr. Schneider said.

Spending time immersed in philosophy and psychology also strengthens Dr. Schneider’s self-knowledge and ability to connect with patients and colleagues.

“As scientific as medicine is, it is still a human endeavor,” he said. “Reading and taking time out of a very busy life to find the peaceful moments and explore life philosophically helps me remember that the people I work with are human too and not just numbers.”

(Perhaps that’s why Dr. Osler advised young physicians to “start at once a bedside library and spend the last half hour of the day in communion with the saints of humanity” (Proc [Baylor University Medical Center]. https://tinyurl.com/4eccbkvh).

Finding time to enjoy and explore life beyond medicine isn’t always easy. “There’s truly never enough time,” Dr. Schneider said. But he rejects simple solutions.

“In the same way that we want mechanistic, logical steps to our work, we often want mechanistic, logical steps to managing our time,” he said. “But when we are cognitively or emotionally invested in what we’re doing, we’ve got to let go of time a bit. It’s going to take the time it takes to do it well. If I want to spend time with my children so we can have a good conversation, it takes the time that it takes. If I want to read a book, it takes the time it takes.”

Interruptions, of course, happen. “That’s life,” Dr. Schneider said. Toggling back to your original activity, instead of abandoning it in favor of something less urgent, can help you protect your well-being.

Julie Wei, MD, MMM—Back from burnout

For decades, Dr. Wei channeled almost all of her time and energy toward her passion: improving children’s health.

She saw patients, performed surgeries, served as president of both the American Society of Pediatric Otolaryngology and the Society of Ear, Nose, and Throat Advancement of Children, wrote and published two books aimed at parents (Acid Reflux in Children: How Healthy Eating Can Fix Your Child’s Asthma, Allergies, Obesity, Nasal Congestion, Cough, and Croup and A Healthier Wei: Reclaiming Health for Misdiagnosed and Overmedicated Children), and created online resources (drjuliewei.com) to help parents support kids’ healthy development.

She played tennis weekly (“my absolute joy,” Dr. Wei said) until injury made that impossible. When that same injury ultimately made work impossible, Dr. Wei embarked on a hiatus that ultimately led to a reorganization of her priorities—and a new book designed to support other physicians in their quest for balance.

“During the time I didn’t work, my time was mine. That was the biggest gift,” Dr. Wei said. She learned it was essential to make space for activities that support her personal priorities as well.

In her most recent book, Safeguarding Physician Wellbeing: Using Checklists for Personal, Professional, and Psychological Safety, Dr. Wei wrote, “Physicians are trained not to acknowledge their fundamental needs as a human being … [but] to live one’s life and career in ‘scarcity of time and life, feeling ‘robbed’ of being fully available to self and loved ones, is a tragedy and perhaps unnecessary.”

Today, Dr. Wei prioritizes family and fun. “We recently hosted three couples from our neighborhood on Saturday. Our college-aged daughter is spending the summer here, so I’m intentional about things like, Let’s go see a minor league game,” she said. “I also took a Tuesday off and went to a 10 a.m. movie with my sister and eight-year-old niece.”

She’s back to work full-time but hikes often with her husband at nearby Cuyahoga Valley National Park. She cooks five nights a week, both to nourish her family and to feed her soul. She plans family vacations, in part because she likes “looking at the beautiful photos of resorts and considering where to go,” Dr. Wei said.

She’s learned—and now tells other physicians—to step back from the grind.

“We have to not judge ourselves so harshly and truly give ourselves permission to say, ‘Enough is enough,’” Dr. Wei said. “We all cognitively know we need time away from work, but it will never feel natural. It’s okay to embrace the ‘discomfort’ that comes with prioritizing self over patients and work demands sometimes.”

Jennifer Fink is a freelance medical writer based in Wisconsin.