Option Overload

When I was taking an English Literature class in college, I remember writing a paper titled:

"A Case Against Option Overload"

I still think about this idea all the time. 

See, my mother was a housewife. She did not work for a living. Well, she technically worked. A lot. Since she had 5 kids to raise and my father used to travel a lot. I meant to say she did not leave the house to get paid for a job, nor did she have a boss to answer to at the time. 

Somehow, because of this, she really wanted both of her girls to have a day job. It didn't matter what we did. As long as we left the home and had our own income, that is all she wished we would accomplish. 

I can't say that I grew up wanting to be a physician. 

If I'm being honest, I wanted to grow up to be a dancer! It sounds crazy, but it is true. Growing up in the post revolutionary Iran that might have been a stretch, but if you had asked me back then, that is what I wanted to do when I grew up. 

After high school, I joined a dancing program. As much as I loved it, it was clear to me that it was not how I wanted to spend my life or earn a living doing. 

Then if I could be anything I wanted to be, I wondered, what would I want to become? 

That is when the option overload idea first got started. I really had no idea what I wanted to do with myself. I loved science and while there was a time that I thought I'd pursue science and become a college professor, once in the PhD program, I realized that I was not into bench research. 

Medicine seemed much more appealing to me. I got to use my 'people skills' and still get to apply sciences that appealed to my brain somehow. Even though I chose to pursue medicine, I did wonder whether that was the right choice for me. How could I be sure?

I mean, 4 years of medical school, 3 plus years of residency and maybe a fellowship afterwards was quite a chunk of my life. If it was the wrong decision, I had no one to blame other than myself. It would be the life I had chosen so if it would end up feeling like a mistake, that would have been my own consequence.

Even choosing which medical school to go to was excruciating. What part of the country should I apply to? How many schools? Did I really want to go to state X? The choices never ended. I kept taking more and more steps to get deeper and deeper into my one path I had imagined may be the right one. 

When we are caught up in the middle of making hundreds of decisions, we are sometimes paralyzed and instead of choosing, we just pile them all on top of one another. Not only do we go deep in the direction we are heading, but we also pile high. 

From Option Overload to A Path of No Return. 

Instead of making decisions that are either/or, we end up making decisions that are this and that.

Well, that is what I was doing at least. 

May is Mental Health Awareness month. It has occured to me that as humans, especially as female physicians, we simply have never learned to say no. 

The only path forward has been to apply ourselves 100% and only feel rewarded when we are offered to do even more: Apply yourself more.

We have only learned to say:

Yes, of course I can do that.

Being a team player has been a blessing and a curse. 

I remember when I was working as a hospitalist. The first year they asked me if I was willing to sit on the Medicine Committee to represent the hospitalist program. One thing led to another and I ended up being the Chair of the Medicine Department within five years. One thing led to another and I eventually ended up being the elected Chief of Staff of my 350 bed hospital. I was told I was the youngest person to hold that position. 

This was while I was also the Director of Quality department as well as the Director of our inpatient and outpatient Palliative Care Program. I was literally working all the time. 

I had to run extra meetings in the evening to review physicians' code of conduct issues and recommend suspension for colleagues who were senior to me both in age as well as in experience. 

It was not an easy time.

I had to revoke some physicians' privileges and put an end to career of other physicians who were consistently noncompliant with our hospital's ethical codes. 

Being a stickler for rules and regulations, I held more feet to the fire than anyone else who had preceded me. The Executive Committee loved how I showed up in leadership settings and kept promoting me more and more. 

In retrospect, they kept piling up on my responsibilities and I could not say no.

Looking back, I actually loved all of it, and maybe somewhere deep inside, my ego was making all these successive promotions mean I am important somehow. I was forgetting that it kept me from having dinner with my family, but slowly but surely, I was starting to develop some awareness that maybe I needed to slow down.

I was starting to notice that I had boundary issues and my home life was suffering. Something had to give, and that something would invariably be my time spent at home with my own family. 

No wonder physicians snap. Physician suicide rate is more than twice the rate of that of any profession of similar caliber. Burnout is so common that more and more institutions and medical groups are incorporating physician wellness program as well as peer coaching as a routine benefit. 

We don't know how to ask for help.

When faced with more options to choose from, instead of a simple "No, thank you.", which is what I teach my daughters now, we keep sinking deeper and deeper in the quicksand of more responsibilities. 

Here is my permission slip for you. 

Not taking on that extra project does not mean that you are weak or incapable.

You are welcome to let others down (while holding yourself up).

It actually means you are strong and capable. It means you know what you want, and what you want is not doing more of what is asked of you. 

In my coaching program, I guide my clients to do just that. 

I wish I could tell you how it feels for them to say no to another Grand Round, or another commitment that they have been dreading. 

They say no, and no one bats an eye. 

"Was it always that easy?"

They ask me. Yes. It was. 

I realize that I have been practicing medicine for more than 20 years now. You may think that it is easier to say no because I have more experience. It is not true. You will be taken advantage of at any stage of your career. 

It will only stop when you make a conscious effort that it will stop.

One of my group coaching clients is just finishing her fellowship. She has accepted a job offer across the country. As she is getting ready to move, she realized that they have asked her to work on Saturdays at the last minute. 

She is not sure what to do. 

She can't say no, can she? She wonders.

It is a good thing she is in our group coaching program. All the women in the group, all different specialties and different ages and experiences, were very clear:

"You say no. It was not in your contract to begin with, so you say no."

This simple lesson is my gift to you.

You don't have to be part of my coaching program to benefit from the liberation of saying no and not feeling guilty about it. 

Otherwise, it is a rabbit hole. Every single time you say yes to more things that have been asked of you, you are chipping away a little bit of your own protected time. 

One day you wake up and you won't even know what it is that you want anymore. 

I tell my clients, when deciding to choose between options, it's either a "hell yes" or it's a "no!"

Above is a picture of a "hell yes" spontaneous decision which was going to stay at a luxury hotel for one day with my sister for a mother's day celebration to indulge in what matters to us:

Time spent resting. Time spent connecting. Making memories to feed our souls. Not owing an explanation to a single being as to why we need to relax and recenter. Why we choose to put ourselves first so we can fuel up and get back to the life that demands so much of us everyday.

Remember:

• Choose Love
• Choose Easy
• Choose Yourself 
  
  

With much love and Aloha to you. 

You can schedule a free 1:1 with me if you feel you could use some guidance as to how you may manage your mind around "Option Overloads" that plagues our lives.