As physicians, most of us do not need another Zoom webinar on burnout; we need open space.

Even at the earliest stages of training, we are made to feel that we cannot take a break. In a med school course I teach, I assigned a renewal activity with a short reflection. Some protested, but most expressed gratitude for an assigned pause.

Many admitted how afraid they felt to step away, to take a weekend vacation, to go on a hike, to spend time with their spouse, for fear that looking away for even a moment or lightening their grip on the steering wheel of study would be disastrous. Yet, just about universally, they reported that when they took time to pause, they returned with added clarity, energy, and freshness and their studies became much more productive.

One student remarked that she had lost touch with the seasons and had not even realized it was fall until she set everything aside to take a walk in the autumn leaves. Another said he had postponed a visit home, but with the permission granted by the assignment had chosen to go home for the weekend and say goodbye to his dying grandfather. Another said that for months she had not taken time to feel or process anything, so when she paused to pray and meditate she cried and cried and felt a huge weight was lifted.

The fear of stepping away

Though sometimes not addressed in academic research, burnout is not just a work thing. It is a state of overload when all aspects of life combine and feel like too much. And sometimes it IS too much, so we must step back and assess: What is needful? What is unnecessary? What are my non-negotiables?

Medical training and practice can be relentless. There is always more to learn, more to do. But without pausing, burnout is inevitable. This is not an acknowledgment of weakness, but a call for wisdom. Too many physicians have felt trapped and without choices, without room to breathe.

This is a call, an invitation, for open space.

Every spring I host a physician retreat in the red rock and sunshine of southern Utah. It is a chance to pause and just “be,” surrounded only by wide open space and compassionate colleagues. This year, I offered scholarships so physicians could come at cost. Still, few raised their hands and made it happen. Why is this?

Yes, logistical barriers are real: not being able to get the time off, difficulty in arranging childcare, or not having the bandwidth required to even investigate the possibilities. But what other barriers exist? Perhaps, like the medical students, we are afraid. Afraid that if we stop running, we will never get back up again. We are in a trance of servitude.

The treadmill of servitude

Recently my son traveled to Guam. While visiting, he participated in a workout that involved running along the bottom of a 13-foot deep, enclosed ocean pool with a kettlebell. At each end, the runners dart upward from the depths, gasp for air, and dive back down. Perhaps we are trapped in a similar exercise. We are conditioning ourselves, but to what end? To be even better at being buried, carrying weight, and floundering for air?

Yes, the system must change, but we have conditioned ourselves to exist within it. To accept it, at least for now.

What is the alternative?

To step away, even for a weekend. To return with new ideas, new energy, and freshness.

Recently, I went on a hike with a friend to an overlook. I saw the layout of my southern Utah town and realized the actual lay of the land. I saw how certain common destinations connected with each other in ways I had not realized. Sometimes we need the vantage point gained from stepping away to see everything more accurately.

The physiological benefits of silence

What could “open space” do for you, or for us collectively? Studies show that silence invites neurogenesis and lowers cortisol. Perhaps in a “wise mind” state with new innovative brain pathways, we could come up with better individual and systemic solutions.

But the greatest gift of all? Becoming reacquainted with ourselves and liking what we see.

Mary Wilde is an integrative pediatrician and founder of Imagine Pediatrics Behavioral Health and Wellness in St. George, Utah. She takes a strength-based, whole-child approach to supporting children and teens with emotional and behavioral challenges. Dr. Wilde has developed several online programs, including Resilience School for youth with anxiety and Compassion Parenting, a membership community for parents.

She serves as an assistant professor of medical humanities at Rocky Vista University College of Osteopathic Medicine and is affiliated with St. George Regional Medical Center. A Harvard Macy Scholar, her scholarly work focuses on resilience, empathy, and humanistic medical education. Dr. Wilde is also an author, podcaster, TEDx speaker, and frequent online contributor.

She hosts the annual REVITALIZE Physician Retreat in Southern Utah, integrating nature, mindfulness, and creative arts into physician well-being. More information about her work and the retreat is available at REVITALIZE Physician Retreat.