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Developmental behavioral pediatrician Roxanne Almas discusses her article “The making of a rested healer.” Roxanne shares her deeply personal journey through the “quiet unraveling” of burnout and the profound grief of losing both parents. She describes how she moved away from the cold efficiency of modern medicine to rediscover her “right brain” through creativity and intuition. The conversation explores the practice of Yoga Nidra as a portal to healing, challenging the “grind culture” of health care by framing rest not as a reward, but as a radical right. Roxanne draws powerful comparisons to aviation and athletics, arguing that just as pilots require rest for safety, physicians need a “Rest Ethic” to preserve their humanity and competence. Discover how slowing down to witness, rather than just fix, can transform the way we care for patients and ourselves.

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Transcript

Kevin Pho: Hi, and welcome to the show. Subscribe at KevinMD.com/podcast. Today we welcome Roxanne Almas. She is a developmental-behavioral pediatrician. Today’s KevinMD article is “The making of a rested healer.” So let’s start by briefly sharing your story and then talking about why you decided to write this article on KevinMD.

Roxanne Almas: This is really my rest story. Essentially, I am a developmental-behavioral pediatrician, as you shared. I am a mother of two boys. I am the daughter of immigrants from Pakistan and France, where two completely different worlds came together. That is where I grew up in a multicultural and multilingual family. Within that family, I was also coming across the challenges of immigrant parents trying to navigate pediatric care for one of their kids, my sibling with developmental disabilities and mental health challenges. Seeing that was kind of eye-opening. It allowed me to become someone extremely perceptive to my environment and sensitive to my environment.

I was the eldest daughter. I know you have had Dr. Jessie Mahoney on talking about the eldest daughter. All of that kind of came together where I was really in tune with the waters I was often swimming in and the air I was breathing. It really encouraged me to often see how I could make a difference in the spaces I was in. So medicine became important for me. I saw it as kind of a calling, wanting to support other families navigating through similar things as my parents did.

I also experienced the weight through that role as a developmental-behavioral pediatrician. Carrying the families and all of their difficulties navigating the compassion fatigue came with that. I was also experiencing my own personal grief. About five or six years ago when the pandemic happened, C wasn’t COVID for me. C was cancer. My mom got diagnosed with an aggressive form of cancer and was otherwise completely healthy. I thought I had 20 extra years with her, but we lost her within a year and a half of her diagnosis. That just completely broke me open.

So I was carrying personal grief and trying to navigate that. She was the caregiver of my father who had advanced Parkinson’s. All of these are personal experiences that we as physicians go through while also trying to support our families going through similar things. That load, along with the collective grief around us and the experiences that families were having just by living in this country and what was happening and what is currently happening, really kind of opened my eyes to a new vision for medicine, for grief, and creativity. That is where I got excited to talk about the rested healer.

Kevin Pho: All right. Now for those who didn’t get a chance to read your article, tell us more about the rested healer and talk to us about your journey. You mentioned the quiet unraveling before you realized that you were suffering from burnout. So tell us all about that.

Roxanne Almas: Noticing in medicine, carrying all of this like so many of us do, it was feeling extremely transactional. Like I shared before, what I wanted most in medicine was to be in this frequency of compassion, and I was finding myself in this vibration of urgency. I had this sense of I can no longer connect with my patients. I think many of us felt that.

I actually looked back and found a journal because I did a lot of journaling and writing even as a child. Before medical school, I wrote to myself and said: “Do not lose your soul in this field.” So I am coming back to that. I recently found that journal and I am wanting to inject and infuse humanity into the spaces that I am in. I do this through the realization that I had to turn inward to find out what my values are. That came through a deep rest practice. For me, it came through Yoga Nidra, which I became a facilitator in. I also became a facilitator in narrative medicine. So these are kind of fields and spaces where I can be in that connection with others. That frequency I was talking about where oxytocin is being emitted when I connect with others. Hearing about the grief that others are experiencing allows the humanities to kind of support us in our interactions with patients.

So finding a deep rest practice has been a mindset shift for me. What I am realizing is we are exhausted. As physicians, we don’t even realize how exhausted we are. One of the things I want to contribute, I guess you can say, to medicine and in this mindset shift is allowing physicians to recognize what their narrative is around rest. From what I have heard, and because I have spoken about this at large meetings like the American Academy of Pediatrics, for example, is that if they feel like they stop, they will no longer be able to continue. It is like climbing a mountain, and this is actually what one physician said: “If she stops, she will fall.” So what I am encouraging others to recognize is what are those obstacles to rest and why is it so uncomfortable for us to rest. In those obstacles, we can find the antidote because I see rest not as a reward to the hard work and not as optional, but I truly see rest as the growth. It comes first and it is part of the work.

I am going to give you an example of an August Lily. It is a flowering plant. They are native to California in the Bay Area. We have some in our garden. My kids think it is funny because they are also called naked ladies. They also laugh at the naked mole animal idea. But the reason for that is they have a stalk with no leaves and then they flower. We became intrigued by this with my kids and we discovered this because they are learning about photosynthesis. In the spring, right now in February, there is so much foliage and the leaves are just so full right now. They get all of their energy through that photosynthesis, and then the leaves die off. All that energy is stored deep into the bulb in the root of that plant. That essentially is holding onto the energy and resting for months until the growth actually happens. That is when the expression of that plant happens, which is the stalk, and then this beautiful pink flower.

I see that as rest is the preparation for becoming. I like to draw from nature and different analogies. I think in medicine we have a lot to learn from the fields of athleticism where rest is mandatory for peak performance. We can learn from the fields of aviation where it is very carefully calculated when pilots rest.

So why are we uncomfortable? What are the contracts that we are holding onto potentially? These are like ancestral contracts for many people where resting could have been jeopardizing to people if they rested. But I really want us to think about how we can break those cycles. Instead, ask who modeled rest for you because I feel like a lot of people didn’t have those models of rest. For me, it was my dad. He would come home from work after a long day and have his unwinding time, which was sacred. It was 15 minutes of him in his room with his shoes off, just releasing from the day before he would be present with us, where he could be fully present with us.

I see that as a model for how we can be with our families and our patients and the best version of ourselves. I like to use this idea that is often used in meditative circles and through my work with Yoga Nidra, which is yogic sleep, that when we close our eyes, we begin to see. We become more clear about what our values are. When we become more clear about our values, it is much easier to be present with others. It is much easier to interact with the forces and the leaders within our organizations when they ask us to do things. We have a much better sense of when we put our boundaries and when we say no, and when we say yes. For me, the clarity that comes with deep rest and being able to prioritize that is a preparation for our future creativity. Medicine needs a lot of creativity right now.

Kevin Pho: I hear this a lot that one of the reasons why it is so difficult for physicians to rest is that they are almost hardwired not to, ever since pre-medical, medical school, and residency. Those who rest often get left behind, and that is kind of hardwired as they continue through their professional lives. You gave that analogy of that physician who felt that if she rested, she would fall off the mountain. Now, tell me from your perspective, and I know you have done a lot of research and talks on this, what are some of the biggest reasons that prevent physicians from properly resting?

Roxanne Almas: The culture of medicine, just like you shared. I like to use the root word “action.” Medicine is a transactional experience. There is distraction and extraction. Those aren’t the words I love because “action” and “rest” are interesting words that I don’t think are opposing words. I think you can reach action with better rest.

But I recognize that medicine requires us to push through everything. It requires us to push through our maternity leaves. It requires us to push through parenting and to push through perimenopause and menopause. It requires us to push through grief when we have lost someone so important in our lives. We are supposed to return back, and there is very little processing that goes with that. So the culture of medicine is one that requires us to constantly push through. There aren’t moments of pause.

I want to give an example that is a little off-topic but Bad Bunny comes to mind. I don’t know if anyone watched the Grammys. I think the music industry is also one that pushes through, and you can even argue society is a grind culture that pushes through. But there was a moment there. I don’t know if you saw this, Kevin, where Bad Bunny sat right before he was called up on stage because he won the award. With that vibration of urgency where everyone just immediately goes up, he sat in that moment. He took it in. He honored where he came from and all that hard work it took for him to go there.

I bring that up only to recognize once we taste the experience of deep rest, whether it is journaling or meditation or micro moments within the day where we just become more expansive, we become more able to respond versus react. I feel that medicine really attracts people who are very much Type A and love the use of their left brain. But when we can shift a little bit and recognize we have this whole other part of our brain, which is the right brain, which wants to enjoy and play and find joy in the moment, in connection, and be expansive, we actually are better physicians for our patients and for ourselves. But that does require us to take a look inward and to ask ourselves what it is we want out of this field, rather than to just go with the motions.

Kevin Pho: So what are some of the first steps for a lot of these physicians? Like you said, Type A has a lot of programming against rest. How can we start to value rest for these physicians? What are some first steps that they can do?

Roxanne Almas: It is the first step before you can walk a thousand miles. I offered in my article kind of a tier-based approach where I start with a personal one. You have to find a rest practice or an opportunity to rest that works for you. I can’t determine what that is. There are passive kind of more deeper rest practices. Then there are active forms of rest, which could be going on a walk, doing artwork, or gathering with friends, things that allow you to pause and reflect.

I am a very deep person. I love having the opportunity to rest. I am realizing the more I do it, the more I need it, and the more sensitive I become to other people’s frequency and how unrested they are, which is interesting. So feeling it in your bones is really important.

Doing it in a community is kind of the second approach. So finding others who value rest is key. If you are interested in this space, connect with me. There are many organizations and many people thinking about rest and then writing. That is the birthplace, that is kind of the bedrock. Then creativity can emerge. It is a portal to creativity. More and more physicians are talking about building that right side of the brain and how we can use that creativity even in our fields because the creatives are the ones we need right now in this world we are living in.

Then the third approach is thinking about how to shift medicine so that the leaders are hearing this message. That is what I was able to do at the American Academy of Pediatrics. It was a room that also had chairs and chiefs where we were talking about this and they were becoming very vulnerable about their narratives and thinking about publishing on this or speaking on this. I am going to be invited to a medical school on the East Coast in Connecticut to talk about this because there are people talking about it. There are few, but the message is really resonating.

Kevin Pho: We are talking to Roxanne Almas, developmental-behavioral pediatrician. The KevinMD article is “The making of a rested healer.” Roxanne, let’s end with some take-home messages that you want to leave with the KevinMD audience.

Roxanne Almas: I truly feel that rest is where growth happens. I feel that rest is the ingredient for becoming a healer. I truly feel that when we rest, we are empowered, and we are better versions of ourselves because we are more aligned with our values. Rest is a radical act, but it is one that medicine needs. This is how I think we are going to not only support and heal ourselves, but heal medicine as a field.

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