Podcast Transcript: You Can't Pour From An Empty Cup: Wellness in ENT

[Gopi Shah MD]
So I wanted to first started out with you, Ash, and ask you, how did you get into wellness?

[Ashley Agan MD]
So that's a great question. I would say my interest in wellness stemmed from a experience of burnout when I was a resident. I guess I should just take us all the way back because for as long as I can remember, I have been burning the candle from both ends and saying yes to everything and spreading myself too thin and feeling like if I'm not being productive, that I'm being lazy. And so there was just this constant push to just be going, going, going, going, going, going. And it worked for a long time. And I did that when I was in grade school. I did that in college. I did that in medical school. And then I got into residency, and I was still going. And then my chief year in residency, it just all finally hit me. I was just burnt out. I was physically and emotionally exhausted, very depleted, just in a dark place. And I think having been through that, I didn't know it was a burnout back then. I just was like-

[Gopi Shah MD]
It's a buzzword, but it's hard to know exactly what it means.

[Ashley Agan MD]
I didn't know what wellness was. I knew it burnt out was. I just was like, ugh. And so now after having joined the faculty here at UT Southwestern and knowing everything we know about wellness, wellness is everywhere now, I just feel passionate about making sure that here at our residency program that we are doing everything we can to promote wellness and to make sure residents know what burnout is and what it looks like so that if they are headed that direction, they can recognize it and maybe reach out and get help and try to pull themselves out of it before it's as deep and dark as it was when I was there.

[Gopi Shah MD]
No, I think I had a very similar. So I had a little bit of time between residency and fellowships, where I think that kind of helped me breathe a little bit between that next stage in my life. And probably about four years into being staff is when I hit my burnout in the sense of every box is instantly being checked, you're starting to continue to one more notch under the belt or one more title, one more this or one more that. And at a certain point, that external stuff is not gratifying. It's exhausting. And you have to figure out who you are again and start choosing what you want to do and no more shoulds, no more external anything because, like you said, it's not sustainable.

So I think for me, it definitely became a priority when I was feeling that way in order for me to maintain a happy relationship with my family, myself, my patients, my friends. I needed to make some changes. So I think that's when wellness became important for me too. Wellness is, same thing, buzzword as the burnout. What do you think it really means? We say wellness, but what does that mean?

[Ashley Agan MD]
Yeah. What is wellness? I think wellness looks different for different people. And when I think about it, I think about just thriving, really being able to wake up every day and go spend your energy on something that you are truly passionate about. And we all enter medical school saying we're passionate about patient care. And then we get through medical school and residency and there are so many things that aren't patient care that just really can break you down. You spend so much time on other things, and sometimes you do have to do things that you're not passionate about. I think everybody has to do a little bit.

[Gopi Shah MD]
There's some peer-to-peer conversations for insurance approval you're just going to have to do.

[Ashley Agan MD]
But if you can be waking up every day and spending the majority of your time really doing something that lights you up and that you're excited about and feeling like you are looking forward to what you're doing, if you can organize your work and your life in such a way that allows you to have that, that's what I aspire to. And certainly, I have not figured it out yet, but that's what I'm working towards that. That's what I feel like wellness looks like and what I am hoping to do or trying to do every day.

[Gopi Shah MD]
Yeah. No, I think I like the thriving, that growth. I think there's a lot of introspection that comes along with trying to be well, which means taking some time to pause, breathe, think, get into yourself, but also get out of your head. And it's little baby steps and theory. It sounds very idealistic, but it's hard to sometimes make behavior changes to go along with what you feel you need to do about being well. I think, like you said, we're so used to burning the light at both ends when a lot of times that just is saying a lot of yeses to everything, and that's what gets drilled in terms of how to be successful in your training. Or what are the three A's right, accessibility, all that stuff, affability. Accessibility you're always available and on. But somebody very special had told me it's okay to say no to the things that you don't want to do so that you can actually say yes to the things that you do want to do. And so sometimes it's also-

[Ashley Agan MD]
I think that's great.

[Gopi Shah MD]
... behavior changes and making those things of saying it's okay to say no to that because it's okay that you don't want to do something because there are other things once you figure out what you are passionate about and take the time to enjoy. Every other little action will be a little bit more meaningful. But it is little steps, I think, day to day.

[Ashley Agan MD]
For sure. And it can change.

[Gopi Shah MD]
And it can change. What you think you want and what your goals are and what looks like thriving can change over time, and you can pivot.

[Ashley Agan MD]
And that's okay.

[Gopi Shah MD]
Yeah.

[Ashley Agan MD]
And that is totally fine.

[Gopi Shah MD]
I agree.