A physician’s journey to walk again and how she learned self-compassion [PODCAST]

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“Suffering something similar in my career, I know the detrimental impact of not having a voice or being heard in the medical community. Medical professionals do not want to appear weak, so they continue until something breaks.

As a pain physician, I understand where the frontline health care workers are coming from. The intense pain and suffering that they are experiencing. I want to help those that feel this pain before it becomes too much. In my writings, I reveal my own personal journey from burnt out to balanced life in medicine and the advice that helped me. I hope it will help you too.

You are not alone.”

Olivia Ong is a pain and rehabilitation medicine physician in Australia.

She shares her story and discusses her KevinMD article, “The unspoken pandemic in frontline health care workers.”

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Hosted by Kevin Pho, MD, The Podcast by KevinMD shares the stories of the many who intersect with our health care system but are rarely heard from.

Transcript

Kevin Pho: Hi, and welcome to the show, where we share the stories of the many who intersect with our health care system but are rarely heard from. My name is Kevin Pho, founder and editor of KevinMD. Today on the show we have Olivia Ong. She is a pain and rehabilitation physician in Australia, and she wrote the KevinMD article “The unspoken pandemic in frontline health care workers.” Olivia, welcome to the show.

Olivia Ong: Thank you, Kevin. Thank you for having me.

Kevin Pho: We’ll get into your article in a little bit, but first off, can you share your story and journey to where you are today?

Olivia Ong: So I graduated from the University of Melbourne here in Australia in 2004, and I started my internship at a regional Victorian hospital. I entered the rehabilitation medicine training program as a resident in 2007. But in 2008 my life changed forever. I was walking to work when I was hit by a car at high speed in the hospital car park that I worked in, and as you can imagine, it changed everything.

And you see, a few years earlier, in my late 20s, when I was a resident, you know, I had ticked all the success boxes. I was working as a resident doctor in a reputable hospital. I was happily married, still happily married. I had my own house and car, and I had a great network of friends. But in reality, at that time, I didn’t feel fulfilled at all. I lacked self-worth. I was feeling quite burnt out, and we’re hearing this more and more lately. Like so many people who seemingly have it all, I just lacked self-worth. I was about to go on a journey of discovery.

But first of all, I had to deal with my injury at that time. Because of the car accident, I had a spinal cord injury. I lost the ability to walk, and being a patient on the other side of the health care system, you know, the days in the hospital were challenging and an eye-opener for me. It was really different being a patient. I finally understood what my patients had to go through. I felt like a pincushion, you know: drips on my arms, I had a catheter and a feeding tube up my nose. I felt quite vulnerable. And I think the most confronting thing I had to deal with was that I was told by doctors that I’ll never walk again. So I was on the other side of the health care system.

I had emergency spinal surgery to stabilize my spine. I basically had an L1 and L2 dislocation with a smashed L2 vertebra, so I had emergency spinal fusion surgery that night. And I remember, you know, the days in the hospital: Every day I tried to move my legs. I was in spinal shock at that time. I just couldn’t. So I used all my willpower, you know, day in, day out, and tried my best to move my legs when I could. I just felt so defeated, very broken and helpless, and I finally understood, “Yeah, this is what my patients had to go through.” That’s not a nice feeling.

And I felt such intense grief and loss following my injury, because I asked all these questions running through my head day in, day out, like, “Will I be able to walk again? Will I ever be a doctor?” Because that was all I knew. That was my identity. You know, I felt like a burden to my husband, like, “Will he just leave me? And will I ever have children?” If anyone has suffered a loss or been through a traumatic event, it’s quite easy to blame yourself, and certainly that’s what I did. I blamed myself for everything I went through. I felt that everyone was looking at me with pity, basically. I wasn’t being self-compassionate, and my self-worth, which was already low at that point when I was a resident, pre-injury, plummeted to the bottom.

And the good news is I eventually learned to walk again, against all odds. In fact, I traveled to the United States, to San Diego, to learn to walk again. I spent a couple of years there, and I really had an awesome time in the U.S., hanging out with spinal cord injury survivors. They took me to watch football games, and we had tailgate parties, so I got to know all that stuff, and Thanksgiving.

My journey to walk again taught me a very important life lesson: self-compassion. You see, my experience of learning to walk again was the exact opposite of my life as a resident doctor. Instead of being on autopilot, wishing that I had a catheter to not think about going to the bathroom, yeah, that’s how dramatic it was. When I was a resident, I wished I had a catheter so that I wouldn’t have to go to the bathroom. As we know, ward rounds are really very tight in terms of time, and we have to do our charts and everything. And I had to be mindful of each step I took. I had to learn to crawl again, stand again, like a baby, and eventually walk again.

And instead of being alone, a lone ranger, struggling to seek help, like doctors do, I connected with fellow spinal cord injury survivors. We were bound together by our common humanity and our common suffering, being spinal cord injury. And I guess most important of all, instead of being a perfectionist, beating myself up for every mistake I made, I learned to accept myself for who I was.

And the three pillars of self-compassion, which I tell all my colleagues and I teach all my clients, you know, it’s, in essence, mindfulness, common humanity, and self-acceptance. These are the three pillars, and these were the things that gave me self-worth. And actually there’s been research to show that self-compassion can help us become more productive. In fact, not only does it allow us to remain calm in the face of failure, rejection, and criticism, you know, we experience higher well-being and become more productive and successful, it also reduces our stress levels, as it activates our soothing system. You know, we just feel a lot greater well-being.

And then, as I learned to apply self-compassion not only in my personal life but in my professional life, I started getting my self-worth back. I went on to pass two board exams, in rehabilitation medicine and pain medicine. I did end up having two children, very beautiful kids. I really adore them very much. And I essentially built a beautiful life from something that was really traumatic and sad. I became a formidable force in the lives of my family and friends and became more influential around my medical colleagues. They were initially very skeptical of me, because I took time off from my work, and they thought my medical knowledge had dropped. And, you know, us doctors unfortunately can be quite judgmental toward each other. But they learned to respect me in the end, and I think the most important life lesson was that I learned to respect myself.

And now every day I, you know, embody self-compassion in my clinical practice and also in my, well, because now I’m a life coach for doctors who are burnt out. So I try to teach them what self-compassion can do to help them recover from burnout.

Kevin Pho: Well, that’s certainly an incredible story. And during that journey, who did you have to mentor you or guide you? How did you learn to have self-compassion? Was there someone who mentored you? Was this something that you had to find out on your own? How did you learn how to do this?

Olivia Ong: That’s a good question to ask, Kevin, because it was mainly a journey of self-discovery. There was no one to mentor me. I felt very isolated from my medical colleagues. I felt quite rejected and discriminated against, because now I have a disability and I’m working in a hospital like them. And there were many instances where, you know, I remember one of my bosses made it really difficult for me when I was back at work. I started part-time, and even though the other supervisors were pretty happy with my work performance, he told me off and said, “You know, I think your knowledge, there’s a big gap now, and I don’t think you’re competent enough to perform your duties.” That’s what he told me, face to face. And that’s when I knew that there’s a lot of unconscious bias in our medical profession toward doctors with a disability and doctors with chronic illnesses.

And I think eventually I got a life coach for myself, and that really helped me kind of overcome all the mental roadblocks I had. And certainly the spinal cord injury survivors that I connected with were kind of like my gurus and mentors and peers at the same time. So we leaned in on each other very much, and quite a number of them are still, I mean, they’re in the U.S., and we still stay connected up to this day, because it’s a common bond that binds us forever, in a way.

Kevin Pho: Now, for those other clinicians who have a chronic illness or disability, what would you say is your number one tip that you could share with them?

Olivia Ong: Pre-injury, I was programmed like a lone ranger, and I thought self-compassion was a really fluffy and meaningless concept to even, I guess, embody. And having found the strength and power in self-compassion, which leads to balance and fulfillment, that’s probably why I want, that’s, you know, the lesson that I want to kind of teach your audience: that it’s not fluffy. It’s something within us that we can tap into.

And especially with doctors who have, you know, chronic illnesses and disabilities: Everyday work in medicine is already quite a high clinical load and very stressful. Add a chronic illness or disability on top of that, and you can imagine what it can do to, I guess, your mental health and your well-being. And certainly I experienced burnout. Probably in 2019 I experienced full burnout from having to deal with my injury. I think I had board exams at that time. I had a toddler. Yeah, it was really a lot to juggle, and I experienced a very severe burnout, where I had to take two months off work.

So my message is that self-compassion is not one of those things that is really easy to practice. It’s intellectually easy to understand but hard to practice. And I really want to tell doctors in a similar position to me that, with my own experience, it was really difficult and scary, because it’s like giving ourselves love, right? Sometimes we remember all the conditions under which we were unloved, and when we open to our pain, feelings we’ve repressed for a lifetime can rise up and overwhelm us. And certainly as doctors we repress our emotions big time.

And I remember Chris Germer, from the Mindful Self-Compassion Center, said, you know, these difficult feelings that arise during a self-compassion practice are called backdraft. Think about it. It’s a firefighting term. You know, when you throw open the doors of a house on fire, the oxygen rushes in and the flames rush out. Similarly, when we open our hearts and the love rushes in, our past trauma, pain, and insecurity may rush out. Backdraft isn’t a problem.

So I just want, you know, the doctors in a similar position to myself to know it’s not a problem. It’s a sign that the healing process has begun. And certainly, when I learned to walk again, that was actually when the healing process began. I can safely say that my healing process started in America. That’s why America has a very special place in my heart.

And self-compassion can certainly help doctors, not only those with disabilities and chronic illnesses, but doctors from around the world who are facing burnout at the moment, which unfortunately has been compounded by the pandemic, to heal from their emotional pain, and not only emotional pain, but physical, mental, and spiritual pain from burnout. It’s that secret ingredient, the secret sauce.

Kevin Pho: So let’s talk about the KevinMD article that you wrote, and it’s titled “The unspoken pandemic in frontline health care workers.” Now, for those who didn’t get a chance to read that article, can you just walk my audience through it and share the story of why you decided to write it?

Olivia Ong: Yeah, I decided to write that article because of a personal story that I had. My brother Andrew is a doctor in Singapore, and unfortunately, in the second wave of the pandemic, like many other doctors around the world, they were deployed on the front line, and so was Andrew. And being his sister, of course I was concerned that he might get COVID. He’s a father of two young kids, and he was isolated from his family for months.

And when we had a conversation on the phone, I could feel his emotional pain. It was very palpable. And he was telling me that he had gotten his affairs in order, and he was telling me that with the steps to wearing PPE, protective personal equipment, they had to be very vigilant, because one wrong step and they can get COVID. And he was living on edge every day. He was very anxious. He didn’t sleep very well. I mean, he was already burnt out before COVID, and this, being deployed on the front line and being socially isolated from his family, just made his burnout a lot worse, and he was having insomnia, and I was quite concerned.

Then I began to reflect that if my brother Andrew was feeling this way, I’m sure many other doctors and nurses around the world who are, you know, fighting on the front line in the pandemic were feeling the same. And I guess, as a pain physician, I’m quite a highly intuitive person, so I can feel someone’s pain, and not physical as in, like, not just physical pain, but their emotional pain as well, spiritual and mental pain.

And I was starting to reflect: I think this is what the frontline health care workers had to go through, similar to Andrew’s experience, the social isolation from their family and friends and their community in general, and the fact that some of them, especially where you guys are in the U.S., you had to treat your colleagues, and sometimes your family members come in for COVID and they die in front of you, and having to look after patients who couldn’t even say goodbye to their loved ones, and they passed away.

And I was just reflecting on vicarious trauma and compassion fatigue. Vicarious trauma is a term that I’m very familiar with as a pain physician, because as pain physicians we see a lot of patients with chronic pain and complex trauma, but inevitably we also tend to kind of absorb the trauma experience in our body as well, and then mentally it starts to affect us, and then we burn out. There’s a very high burnout rate in pain physicians. And I was just thinking, I was just translating my experience as a pain physician in terms of the pain from burnout that these frontline health care workers had to go through, and that’s how the whole idea behind the article started.

And that’s why I wrote in the article about the fact that these frontline health care workers had to, I guess, endure vicarious trauma, having to witness friends and colleagues die in front of them, literally, and them being socially isolated with no support. And I don’t think the hospitals were able to support them, because they were probably under the pump as well, right, to deal with the COVID patients. And certainly burnout was a big issue way before the pandemic, and then the pandemic just really added the extra mental load and emotional and physical and spiritual burnout load on these frontline health care workers.

And I wrote the article to give them a voice. I felt that they were, I wrote it down as the unspoken pandemic because the politicians, they talk about revitalization of the economy, opening the doors, and all these things, but the frontline health care workers were forgotten. And it’s the same here in Australia. Our politicians were exactly the same: revitalization of the economy, opening up, well, most borders, but the frontline health care workers are forgotten. And certainly in Sydney, where they’re locked down at the moment, where there’s been a spread of the Delta variant of the virus, the doctors are certainly feeling it, and there are a lot of patients in the ICU, and their hospital system is taking the brunt from, you know, the patients coming in.

And probably the premise behind the whole reason why I wrote the article is to give these health care workers a voice, and for, I guess, not us, like the politicians, to acknowledge that this is the unspoken pandemic and something needs to be done. And that’s why I wrote the article.

Kevin Pho: Now tell me, what kind of advice did you give your brother, and to the other frontline clinicians who may be having similar feelings to him?

Olivia Ong: What I told my brother Andrew was what I told myself years ago, when I was learning to walk again, and my journey with self-compassion. So I told Andrew the exact same thing. It was a new concept for him. He thought it was fluffy, and he thought it was really, he’s like, “What happened to your sister?”

I explained to him the three pillars, and I told him, first of all, you know, the first pillar is mindful awareness. I told Andrew that you have to acknowledge the fact that you’re suffering from burnout, and this whole experience you’re going through, being isolated from your family, having to deal with, you know, the patients on the front line, looking after them. You just have to not acknowledge you are suffering, and it’s OK to acknowledge that you’re suffering.

You don’t have to be the lone ranger anymore, not, you know, being afraid to ask for help, because, you know, I guess for us doctors, if we ask for help, that means that we’re weak or we’re incompetent. But that’s not the fact. It’s just, you know, lone ranger programming is something that we’ve had since we were med students. And I told Andrew, “Look, you just have to let go of your old programming that, you know, if you don’t ask for help, you are not capable. You have to ask for help. You have to ask me for help. I’m your sister.” And similarly, I guess, health care workers who are afraid to ask for help and are being lone rangers can ask their family and friends for help, and it’s OK to ask them. You know, if you can’t see them face-to-face, virtually, by telephone, stay connected with them by, you know, social media or WhatsApp or anything.

And then lastly, self-acceptance would be what I told Andrew: Like, you have to accept that you are suffering, and then allow and forgive yourself. You can’t, you know, you let that patient die in front of you. It’s not your fault. Telling them to be, you know, that’s why I told Andrew to be kind to himself and just move forward and heal. And essentially, self-compassion allows you to do all that.

And that’s my encouragement to health care workers out there who are still battling on the front line of the pandemic: to practice self-compassion during these unprecedented times. Self-compassion practice doesn’t take very long. It only takes 10 seconds. Put your hand on your heart like this and take three deep breaths. It’s 10 seconds, but it could save your marriage, your relationships, your life, and your mental health. And I feel that the sooner the world learns about, you know, self-compassion and discovering this technique, the sooner, you know, the world can heal itself.

Kevin Pho: And how’s your brother doing now?

Olivia Ong: I’m pleased to say that he’s doing really well now. He’s actually been in the media a lot. He’s a gastroenterologist with a very strong interest in irritable bowel syndrome, and he’s really enjoying his life teaching medical students. That’s his other work: It’s medical education. So he’s really back. He’s back into it. He’s enjoying it, even though they’re doing it virtually, and he’s back in his job as a gastroenterologist. It’s pretty much normal in Singapore now, given that everyone’s been vaccinated and they’ve opened up their borders internationally as well. So Andrew feels that his life is back to normal.

Kevin Pho: We’re talking to Olivia Ong. She is a pain and rehabilitation medicine physician in Australia. She wrote the KevinMD article “The unspoken pandemic in frontline health care workers.” Olivia, what’s your take-home message that you want to leave with the KevinMD audience?

Olivia Ong: We already own self-compassion. As you know, as a result of burnout, and now we’re talking about post-COVID stress syndrome, a lot of health care workers right now are probably coming to grips a bit with what’s happening right at this moment and what they went through last year with the pandemic. Some of them, unfortunately, are self-medicating with alcohol and drugs, relationships are impaired, marriages are breaking down, and in worse cases, suicides arise. But as I said, there’s a cure, and they already own it: It’s this practice of self-compassion. If they’re willing to let go of their lone ranger programming, they can learn to love and forgive themselves.

And certainly I talk a lot about this in my book that I’ve written, called The Heart Centeredness of Medicine. It’ll be launched on the 9th of September this year, which coincides with R U OK? Day in Australia, which is essentially a practice where you ask your colleagues and your friends and your family, “Are you OK?” So it’s a practice, I guess, a way to check in with one another, whether they are feeling OK. And this is certainly something we can practice in our hospitals with our colleagues, or even with our family and friends: “Are you OK?”

Kevin Pho: And how can people reach you?

Olivia Ong: So people can reach me on my website, at www.drolivialiong.com. I have some free resources about burnout, and if you need more support, there is a way you can reach me through an inquiry form. And another way you can reach me is through ordering my book and having a read, and hopefully learning some heart-based tools can help you recover from burnout.

Kevin Pho: Thank you, Olivia. Thank you so much for sharing your time and insight, and thanks again for being on the show.

Olivia Ong: No problem. Thank you so much.

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