In medicine, we’ve long relied on the oxygen mask analogy to justify self-care: “Put your own mask on first before assisting others.” It’s a powerful image—but it’s not enough.

Oxygen masks drop in emergencies. Putting them on is a reactive action. They keep us alive—but they don’t help us thrive.

For many physicians, the oxygen mask has become the gold standard of wellness. In a culture that rewards self-sacrifice and martyrdom, “putting on your oxygen mask first” was the first metaphor to grant us permission to take a breath.

When I began leading physician wellness work nearly two decades ago, this metaphor was transformational. It opened the door to what had long been taboo: caring for ourselves. While putting on your oxygen mask is necessary, it is not enough.

Oxygen masks are for crises. Wellness is for life.

In a depressurized airplane cabin, an oxygen mask keeps you alive. Walking around with it strapped on long-term is not sustainable.

If your only strategy for self-care is waiting until you crash—until you’re burned out, exhausted, or in tears—you’re missing the fullness of what’s possible. And medicine, as a profession, is missing the point.

The culture of crisis in medicine

The culture of medicine rewards depletion. We can’t rest until we’ve earned it. We don’t ask for help until we’re desperate. We don’t pause until we break. This isn’t resilience. This is survival mode.

Somewhere along the way, the oxygen mask became a symbol not of early care—but of emergency-only care. In many medical environments, it’s still only acceptable to take care of yourself if you’re in crisis.

No wonder more than 60 percent of physicians report symptoms of burnout. No wonder so many are leaving the profession—or quietly wondering if they should. We’ve set the bar for wellness at not collapsing. We can and must do better.

What sustainability really means

In medicine, we don’t talk enough about energy—how we manage it, how we lose it, and what restores it. We should. Because sustainability in medicine isn’t about resilience, grit, or pushing through. It’s about renewable energy—and that requires consistent nourishment, not oxygen masks.

Nourishment and energy stores are about so much more than food.

• Sleep
• Fresh air
• Stretching and movement
• Stillness and solitude
• Connection and community
• Purpose and meaning
• Laughter. Love. Beauty. Breath.

For medicine to be sustainable, we must replenish our bodies, minds, spirits, and soul—not just survive with a mask strapped to your face.

If wellness is defined only as reaching for oxygen when you’re crashing, we’ve confused emergency response with longevity—and coping with actually living.

From crisis mode to full-spectrum living

My podcast co-host on the Healing Medicine podcast is a pulmonologist. She reminded me that even oxygen masks come in different flows and fits. Having a mask that fits well matters.

The same is true for wellness. Wellness must be personal, flexible, and deeply human. It needs to be more than reactive.

For some physicians, that means yoga that restores energy rather than depletes it. For others, it’s coaching to patch chronic energy leaks. For many, it means nature, quiet mornings, shared meals, naps without guilt, or a moment to simply breathe.

These aren’t luxuries. They are essentials for a sustainable life in medicine.

We need a new metaphor.

Physician wellness can’t be limited to crisis response.

What if the goal wasn’t just to keep going—but to live well while caring for others? What if the goal wasn’t just to breathe—but to breathe deeply, joyfully, in a life that fits?

We are trained to help others breathe. Perhaps it’s time we learn to do the same for ourselves. Not just with a mask. But with our full presence. With our full being.

Let’s raise the bar.

Let’s stop measuring wellness by how long we can hold out before needing help. Let’s move from survival mode to sustainable impact.

Survival mode got us here. Sustainability is what will carry us forward—peacefully, purposefully, and powerfully.

It’s time to change the conversation from: “How do we keep going?” to “How do we live well—while helping others do the same?”

Physicians deserve more than an oxygen mask. We deserve to breathe fully. To live fully. And to be well—and to stay well. Because when physicians are well, everyone we care for benefits as well.

Jessie Mahoney is a board-certified pediatrician, certified coach, mindfulness and yoga teacher, and the founder of Pause & Presence Coaching & Retreats. After nearly two decades as a physician leader at the Permanente Medical Group/Kaiser, she stepped outside the traditional medical model to reimagine what sustainable well-being in health care could look like. She can also be reached on Facebook and Instagram.

Dr. Mahoney’s work challenges the culture of overwork and self-sacrifice in medicine. She helps physicians and leaders cultivate clarity, intention, and balance—leveraging mindfulness, coaching, yoga, and lifestyle medicine to create deep and lasting change. Her CME retreats offer a transformative space for healing, self-discovery, and renewal.

As co-host of the podcast, Healing Medicine, she brings self-compassion and presence into the conversation around modern medical practice. A sought-after speaker and consultant, she partners with organizations to build more human-centered, sustainable, and inspired medical cultures.

Dr. Mahoney is a graduate of Dartmouth College and the University of California, San Francisco, School of Medicine.