Brené Brown’s book, The Gifts of Imperfection, has recently been re-released with a new cover and subtitle: 10th Anniversary edition, Including New Tools to Make the Work Your Own.  I’ve had my original paperback copy for 8 years. It’s dog-eared, highlighted in three different colors, with lots of hot pink Post-It notes sticking out of all sides. Brené has published five other books, yet The Gifts of Imperfection continues to be her biggest seller.

I haven’t bought the new edition, but I’ve learned the “tools to make the work your own” in my training and experience as a Certified Daring Way™ Facilitator, a certification that took a year to complete. Prior to COVID-19, I led small groups of women (would be great stuff for men also) through the curriculum which focuses on self-empowerment through authenticity, vulnerability, and shame resilience. The work is deep, powerful, liberating. I’ve witnessed firsthand how the exercises and discussions positively heal and change lives, including my own.

The new cover of The Gifts of Imperfection is without the original main subtitle, Let Go of Who You Think You’re Supposed to Be and Embrace Who You Are, and the other, more subtle subtitle, Your Guide to a Wholehearted Life. This caught my attention because I’ve looked to the book, Brené, her podcasts, interviews, TED talks, and course manuals, to get me one of those “wholehearted” lives.

What’s a wholehearted life? It’s one defined by having the courage to live and love with your whole heart. It’s not a destination or goal in itself but rather, a journey. A process. A practice. At the root of all of it is having the courage, compassion, and connection to do soul work and take action steps to show up as yourself in everything you do, even doing so imperfectly.

The book presents ten guideposts for cultivating a wholehearted life:

1. Cultivating Authenticity: Letting Go of What People Think
2. Cultivating Self-compassion: Letting Go of Perfectionism
3. Cultivating a Resilient Spirit: Letting Go of Numbing and Powerlessness
4. Cultivating Gratitude and Joy: Letting Go of Scarcity and Fear of the Dark
5. Cultivating Intuition and Trusting Faith: Letting Go of the Need for Certainty
6. Cultivating Creativity: Letting Go of Comparison
7. Cultivating Play and Rest: Letting Go of Exhaustion as a Status Symbol and Productivity as Self-Worth
8. Cultivating Calm and Stillness: Letting Go of Anxiety as a Lifestyle
9. Cultivating Meaningful Work: Letting Go of Self-Doubt and “Supposed to”
10. Cultivating Laughter, Song, and Dance: Letting Go of Being Cool and “Always in Control”

While I ravenously devoured all things Brené to share with others, I kept coming up against a vague, silent barrier. I could define a wholehearted life, but I couldn’t live it. I’m not afraid of a challenge, so I kept at it, digging and searching. My seeking and reading turned into an aching, a yearning for that wholehearted feeling. I knew exactly what I wanted, what it would look like, how it would feel to embody it like a warm blanket, but it was out of reach.

I realized that the small groups I’d been leading were with women who weren’t in medicine. I found myself relating to the others in every way I could outside of my career. I could discuss struggles with parenting, family, money, marriage, stress, but I avoided central topics like perfectionism, numbing, and powerlessness. I was really stymied by Guidepost #9: Cultivating Meaningful work. I also wondered why Brené had taken her research findings to Silicon Valley, Pixar, NASA, and the corporate world with her Dare to Lead book and training but hadn’t come near the medical community with her wisdom, even though she’s married to a pediatrician.

Finally, I had to ask myself, is it possible to have a wholehearted life and be a doctor?

I’ve been asking myself this question for years and have recently started asking others in the healthcare space. While many embrace the concept, few admitted to having the freedom to let go of exhaustion as a status symbol. Most couldn’t even imagine letting go of anxiety as a lifestyle. None could fathom what it would be like to let go of productivity as self-worth. Many outright said perfectionism is expected in medicine, and it’s a binding commitment doctors make way before receiving a degree.

To those reading, you know that burnout is emotional exhaustion. You know you’re a human with needs of your own. You know you deserve a wholehearted life, and Lord knows you want one. So, what gives?

As it stands in 2020, pre-COVID-19 and today, physicians can’t live wholehearted lives because we don’t have self-compassion, and we don’t set boundaries. We know how to give, sacrifice, people-please, perfect, follow directions, enforce protocols, manage time, and bury our own feelings and needs. We moan and groan as EPIC, Powerscribe, PACS, Big Pharma, administrators, insurance companies, patients, and our lives outside of medicine add more to our plates, but we keep showing up obediently, even if sick or disgruntled, no matter what.

I’m sure you remember feeling despondent before the pandemic. Now, there are no words to describe the overwhelm except “help.”

I believe doctors don’t have wholehearted lives because they can’t remember having one or haven’t ever experienced it. Deprivation has become a default setting. We keep getting the short end of the stick because we don’t speak up for our own needs or establish conditions of what is and is not ok.

As the pandemic rages on, old paradigms are fracturing in every arena. Medicine used to be a spiritual practice. It used to be a wholehearted vocation of deep fulfillment. Is this really our hour of darkness, or is it an opportunity?

As society’s “best and brightest,” can we be bold enough to stand up for ourselves? Can we walk away from the status, money, and unspoken social agreements long enough to establish new working conditions and save our self-respect?

I believe we can.  I want wholehearted lives for all of us. Every wholehearted life radiates out like sunbeams and warms all who witness it, healing and restoring everything in its path. We’d be exemplars of what health and wellness actually look like. We’d be models, not martyrs. Wholeheartedness is sustainable, self-perpetuating, and infectious. That’s a kind of contagion I could get on board with. No PPE required.

Tracey O’Connell is an educator and coach who fosters positive self-worth, psychological safety, emotional intelligence, and shame resilience among physicians, teens, and LGBTQ+ individuals. She is a certified facilitator of expressive writing programs and Brené Brown’s research. Her change of direction came after many years of feeling “not enough” as a person, physician, parent, or partner. Tracey has found that expressive writing allows us to access our true selves, helps us gain self-trust and self-compassion, and ultimately leads to a more authentic and wholehearted way of belonging in the world. She is also an advocate for universal, affordable, fair, safe, and equitable medical access, education, and practice. Since 1992, she has lived in Durham/Chapel Hill, NC, where she began her medical career in radiology and musculoskeletal imaging, training at UNC-Chapel Hill and Duke University.

She can be reached on her website, LinkedIn, Facebook, Instagram @fertile__soul, and YouTube.

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