Emotional freedom and resilience: a family physician’s inspiring journey [PODCAST]

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Join Dhruva Gulur, a family physician, to explore his journey from burnout, addiction, and self-hatred to emotional freedom and personal growth. Discover the unique concept of “Empower ACES” and “Disregard FACES” that helped him turn his life around and how daily mind hygiene through writing became a transformative practice.

Dhruva Gulur is a family physician.

He discusses the KevinMD article, “Unlocking emotional freedom and empathic communication.”

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Transcript

Kevin Pho: Hi, and welcome to the show. Subscribe at KevinMD.com/podcast and get CME for this episode by clicking on the CME link in the show notes. Today we welcome Dhruva Gulur. He’s a family physician. Today’s KevinMD article is titled “Unlocking emotional freedom and empathic communication.” Dhruva, welcome to the show.

Dhruva Gulur: Thanks for having me, Kevin.

Kevin Pho: So we’ll talk about your article in a little bit, but first off, just briefly share your story and journey.

Dhruva Gulur: Well, my story with being a patient experience and burnout speaker starts from my personal experiences with being burnt out. About six years ago, I’m walking into the urgent care area from the primary care area, and today the lights are a little bit more fuzzy, a little bit more bright, and the sounds are a little bit distant. As I’m walking in, I sit across from my medical director, and he asks me, “Are you OK?” And then I started crying. I’m like, “No, I’m not.” He was like, “Well, we’re all worried about you. Why don’t you take 10 days off, come back, gather yourself,” and then I’ll resume seeing patients, and then everything will be fine and dandy.

But what happens is that I go to rehab for three months. At this time, I’m fully burnt out. I’m in a full-blown mental health episode. I’m drinking a lot of alcohol, I’m doing cocaine, I’m smoking a lot of weed. So I was just completely done. I was in gambling debt, and I was just in a deep state of self-hatred. So what happens is that I was trying to fix my emotions, trying to overcome my thoughts, and trying to deal with things and find coping strategies, and when I couldn’t, I resented myself, and that’s when I put my hands on things I didn’t want to.

Well, over those years, I’ve been sober for five and a half years. I lost 60 pounds, and first time, great. I mean, my credit score is great now. With that said, I put a lot of tools in place during that time, with mindfulness-based cognitive therapy, dialectical behavioral therapy, and eye movement desensitization and reprocessing therapy, where I’ve gone back generations and I’ve forgiven myself and others, which has allowed me to be in the state of emotional freedom where I don’t have silly things renting space in my head. My patient experiences are great. I’m not burnt out anymore. I live with a higher purpose today.

Kevin Pho: As you were telling that story, as you were spiraling into the depths of burnout, what exactly were the causes and triggers that were leading to that burnout? You’re a family physician. What specifically about the profession led you to that state?

Dhruva Gulur: It had to do with me growing up, Kevin. My parents lived the American dream for me. I was born in Juneau, and my family moved from South India in the early ’70s, and I was born in ’79. And what happens is that growing up, I had an intimate relationship with the domestic violence shelter, Adult Protective Services, and the Juneau police. And then what happens is I became a bully, and I moved to Seattle when I was seven. My parents divorced. My mom would go on to live with schizophrenia. She would be institutionalized for 16 years lockdown, nine years step-down. My brother would go on to be found, dead for 17 days, and my dad would go on to die with narcissistic personality disorder.

Well, a lot of these emotions I tried to fix even when I was a teenager, and I got into a lot of trouble, and I went to jail three times. Luckily, it wasn’t anything violent. It was a short stint, but nevertheless, I was going to die or end up in jail for the rest of my life. And then I went to India. To be cool in India, you studied. To be cool in Seattle, I had to wear blue. I was a Crip half of the year, and I was a Blood half of the year. And in India, to be cool, you had to study. So I wound up getting seven scholarships in medical school.

Interestingly, that’s when the burnout began, because my low self-esteem and self-hatred were buried, because I’m a doctor now: “Oh, man, I’m a good guy.” And then med school, I tell you what, was like one big drug, OK? I’m, like, high the whole time, because you’re always studying, you’re always up to something. So after that, residency, you’re always up to something. And then that’s when it all came crashing down, and I’m like, “Oh my God, I’ve got all these emotions that are just not accepted.” And so it was my childhood, and me resenting and judging the memories, which led me to judge patients and led me to judge myself, and I had bad patient experiences, and I got burnt out because I didn’t accept who I was.

Kevin Pho: Now, was there anything specifically about the job that kind of exacerbated some of these predispositions to burnout?

Dhruva Gulur: Interesting that you asked me that. Kind of, sort of, but not really. When you think about somebody like me, Mom, Dad, the way I grew up, I could have been dead or in jail. What I started doing is I started speaking at the juvenile detention that I was at, so that allowed me to live that higher purpose. I worked as a doctor at a prison for six months. So I was a prison doctor for six months, so some of these things alleviated it. That higher purpose was always there, but the burnout really occurred because of me not wanting to live a higher purpose, me making everything about myself: “Let me make sure that I have my reservations for Friday on Monday, and let me make sure that my vacation time is taken care of.” So that’s why I got burnt out.

But to be honest with you, coming from the background that I did, I was radically accepting everything in medicine, because I’m like, “Dude, look at me. Where am I at? Can you believe it?” I would wake up in the morning and do, like, believe meditations: “I can’t believe that I’m here.” So I never really hated charting or management or admin. I never really cared about any of those things, because look where I came from. So, yeah, that was never it. It was more my emotions.

Kevin Pho: All right, so let’s talk about your KevinMD article, where you share a little bit more about your story, titled “Unlocking emotional freedom and empathic communication.” Now, tell us, how did your article come together?

Dhruva Gulur: It actually started before, Kevin, even before I was burnt out. I rap, and throughout the times that you rap, it’s like a recurring diary, especially when the songs turn out to be good. When you listen to Eminem, he’s like, man, you know when it’s not good. So there are a lot of songs that are like that, and you’re trying to make it good, and I’m rapping about things like, “Low self-esteem and no confidence was my genetic makeup. I had to accept it in order for me to wake up. Let me take a moment and show you what it took to self-love.” So I’m like, “Dude, why is this kid saying all these things?”

So first of all, I’m trying to make sure that fits into the song, that the bars are correct, that the syllable counts are right. But then one day, when I start listening to it, I’m like, “Oh, so this is what’s happening. Oh, I’m drinking too much. Oh, I’m hanging out with the wrong people.” So then it began, and then I started writing more and more, and as I started going to therapy, even before I got sober, I was hiding it, though. I had all these code words in my songs where nobody would know what I’m talking about.

And then as I’m going to therapy, I’m writing more raps, I’m writing more and more. I’m writing on boards. And then when I started showing myself self-sympathy, self-empathy, self-love, self-forgiveness, then I’m like, “OK, so this is what emotional freedom is.” And if I can lose 60 pounds, if I can become sober, maybe I can train my mind to do something that I feel is healing. And emotional freedom is a state where I don’t have anything renting space in my head. I accept things for what they are. I’m reliant on myself. I’m able to empower others and communicate empathically to have high-level patient experiences and avoid burnout.

So it kind of started from the rap, because rap, I tell you, it’s not like you’re looking for melodies. So then I’m just writing and writing. That’s where it really began.

Kevin Pho: So for all those other physicians who are burned out, and as you know, this is a worsening phenomenon, with like 60 percent of physicians, according to some studies, saying that they are burned out, and I go to all these Facebook physician groups and they’re saying how terrible the practice of medicine is, share some lessons that you could share with them. How can they be emotionally free? What are some tips that you could share with them?

Dhruva Gulur: Yeah, so this is a good step. I was just writing this, and this has to do with sugar right now. I’m really trying to cut sugar out. And when it comes to, let’s say, burnout, or let’s say I have a bad interaction or I’m trying to please somebody at work, a lot of the time before, I would say, “OK, fine, I’ll just go smoke a cigarette,” or “I’ll drink.” Now I’m like, “Dude, I’m going to eat some sugar.” Then what happens is that that burnout is taking place perpetually.

So what I do is I’ve come up with this concept called mind hygiene. Interestingly, I was writing this, where I enhance my mind with empathy, and I’ll write something like this for 30 seconds, where I just create awareness, I show myself compassion, and I empathize with myself. What this allows me to do is write down exactly what I’m thinking and feeling. What am I going to do with this information? I don’t know right now. All I want to do is create the awareness. And then what I’ll do is I’ll keep on writing, and you can see here how I’m writing for 30 seconds, where I have this ACES, not FACES, with mind hygiene, where I accept, I communicate with compassion, I embrace with empathy, instead of trying to fix my emotions, overcome my thoughts, and deal with them. And the more you do this, the more you’ll get used to it.

And you always have to have a mission, vision, purpose. If your mission is to go to work and get paid and complain, well, that’s what’s going to happen. But if your mission is to go and to serve and to get high-level experiences and do something that’s greater than yourself, because I’m like, “Dude, who gets to be a doctor?” Nobody gets to be a doctor. All of this red tape, all of this stuff that people complain about, don’t make it about yourself. That’s the biggest thing: You can’t make it about yourself.

If there’s that one patient who’s coming in, I remember I got an Uber for a patient. This is, like, the first time I’ve even told anybody. The thing about empathy is that I can sit down with them: I was there, my car got repossessed. So that’s 20 seconds, 20 seconds of empathy, where I’m present, where I understand where they’re coming from. I’m like, “I cannot make this about me anymore.” I feel guilty now because I’m serving a higher purpose. I think that’s where the big challenge is.

And the other challenge, Kevin, is that people don’t want to be in the present. That’s another thing. I’ll share a quick story with you. I was in New Zealand about six weeks ago, and it’s picturesque. I snowboarded, I bungee jumped, I did all kinds of wild stuff, climbed all of these mountains. But the day that I remember is when I’m overlooking this big, I don’t know, this canyon-type thing. You can see all these broccoli trees and these New Zealand palm trees in the distance. And as I’m looking, I look in front of me, and there are these rocks, and they’re kind of spread out, and there’s some grass that’s coming up from that viewpoint, and I started crying a little bit, and I’m like, “I cannot believe I missed this while looking for that.” So I call that the present, present meditation.

So you have one tab open. You’re meta-aware that you have coffee, and that you do these as a separate event. It’s impossible to get overwhelmed if you’re doing just one thing at a time. So all of this stuff sounds great, and whatever I’m saying may not work for other people, but it’s really about empathizing with yourself and understanding what you’ve been through and what you’ve been blessed with.

Kevin Pho: In your article, you talked about this, and you mentioned this a few times: Empower ACES, disregard FACES. Tell us a little bit about that technique.

Dhruva Gulur: Yes. So when it comes to mind hygiene, really quickly, I’ll share this with you again. That’s me, and that’s Crumbl Cookies, that’s Crumbl Cookies, and that’s Lowrider Cookie Company in Seattle, which makes fresh cookies. So now I’m just creating the awareness. And with that awareness, I want to ACE it and not FACE it, meaning I want to accept that I’m doing this. Let me communicate with compassion, because I’m trying. Let me embrace myself with empathy, because maybe nobody really taught me. And let me soften the process: “Oh, it’s really hard to quit sugar.” No, somebody else did it; I can too. I just don’t have the right resources right now.

This is the most important thing: I don’t want to fix. I don’t want to FACE my thoughts. Fix, anger, when you don’t, overcome, coping, controlling thoughts, dealing with things, those are all resentments. “Let me be strong,” that’s a resentment. So you just want to accept the situation for what it is, and then I would train my mind. So this is ACES, not FACES, and I haven’t done that. And so this is mind hygiene, mind conditioning, and mind training. I just want to train my mind to not eat sugar in the next 30 minutes. That’s it.

So it’s just very simple things. And as you keep on going, it has to do with the fact that I’ve been sober for five and a half years, so some of those tools I’ve also put in place.

Kevin Pho: So now, I know that you’re a physician burnout speaker. Tell us a success story. Has anyone come up to you and said, “Your coaching or speaking really inspired me and helped me through burnout”? Tell us a success story where someone used some of these techniques to kind of move the needle in their own life.

Dhruva Gulur: Yeah. For yourself, as a speaker yourself, and with other people that speak, there are challenges that come along with it. As I’m writing these, I have multiple speaking coaches. I have about 12 speaking coaches, and I communicate with them regularly still, well, if I need to, I can. And I’ve had multiple other coaches in my life, and what I realized from all of that is the theme is: Don’t make it about yourself. So that’s the biggest thing.

But one day when I’m writing, I’m like, “When that day comes that this person cries, or somebody in the audience cries, and I cry, that’s when I know I’ve made it.” So I’m speaking at an international engagement, and at this time, I was speaking on patient experiences, and it was the power of self-belief, that you can have a great experience. And as I’m talking about this, we’re talking about judging emotions. I’m like, “When you judge emotions, you get burnt out, you have bad patient experiences, you make it about yourself, you get depressed, and then people commit suicide.” I would have died. So it’s my time to tell the story.

And then somebody came up to me at that event, and the camera guys that I was with were recording them, and they were like, “I felt like this too. I felt like I was burnt out. I felt like my self-esteem was low. I hated myself.” And then she started crying, and then I started crying. I was like, “This is it. This is it. So this is what I need to do.” And you just have to honor the fear that comes along with it. You have to embrace the fear instead of trying to overcome it. I think that’s really, really helped me.

And when you serve and you don’t make it about yourself, like a speaking coach told me one time, he was like, “They don’t care about you.” And that’s the best thing I’ve ever heard from a coach, almost, because you need to serve them. So that’s when it becomes more special. And you can see there, people who are like, because I rap in Seattle, “You’re rapping about dialectical therapy.” My wife is in there, and then they start crying, like, “I can’t believe that you’re a doctor and you’re doing dialectical behavioral therapy.” Well, I’m rapping about that too. Some of these things really help you, because being a speaker is a lonely game.

Kevin Pho: Now, you meet physicians and clinicians across the country. Of course, you talk about burnout. What’s it like out there for them? What are you hearing from these physicians today, just to give my audience and the people watching you today a sense of what physicians are going through?

Dhruva Gulur: I mean, it’s very legitimate: overwork, seeing patients every 10 minutes, having to document more and more. Of course, you hear a lot of these things, but a lot of the time, what I hear is complaining too. And when they’re complaining about patients, or they’re complaining about, I mean, imagine you complaining to me, or somebody complaining to me, I don’t want to say you, somebody’s complaining to me, and then I chime in on that, and then I join them, and then we create this cohesive complaint together. Well, you’re just furthering yourself from being the best version. So that’s kind of what I see a lot. I see a lot of complaining.

The cool thing about speakers is that we’re always looking for solutions. So when I talk to them, I’m like, “Maybe it won’t be with me, but maybe you don’t want to complain, and find a mini solution at least, so you don’t have things renting space in your head all day long.” Because our interaction could be 30 seconds to five minutes, and that interaction is full of complaints. So I see that a lot.

And then I do see a lot of people who get burnt out in that way, because it keeps on stacking up. Alcohol, drugs, it’s prevalent in the medical community here. Oh, yeah, because I was a part of AA groups with doctors and physicians. So I see a lot of that too. So it’s mainly just not accepting things. I see a lot of that.

Kevin Pho: We’re talking to Dhruva Gulur. He’s a family physician. Today’s KevinMD article is titled “Unlocking emotional freedom and empathic communication.” Dhruva, tell us some of your take-home messages that you want to leave with the KevinMD audience.

Dhruva Gulur: One thing I would like to say is in this practice of mind hygiene, it’s simple: You accept, you communicate with compassion, and you embrace with empathy, and please soften the process. That means it’s not hard. That’s rational emotive behavioral therapy, where it’s not hard. And whatever I do may not work, but the most important thing is writing down your thoughts incessantly.

There’s a lot to be said about dictating your thoughts and listening to it. There’s a lot to be said about writing your thoughts, X-ing out the ends, and rhyming it. There are so many different ways that you can write, and the more that you write, the more you’ll understand yourself. When you talk to people and when you go to therapy, I think that’s well and good, but you’re not going to know who you are until you write.

Writing for 10 seconds a day, writing for one second a day, it can pile up. It’s just like losing weight, so it just keeps on going up and up. Whatever I’m doing may not work, but writing down what you’re feeling and trying to do something about that on a very low scale, right, for one second. Try to implement a strategy for one second, and then it’ll keep on going.

Kevin Pho: Dhruva, thank you so much for sharing your story, time, and insight. Thanks again for coming on the show.

Dhruva Gulur: Thank you.

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