What a dragonfly teaches physicians about burnout and self-compassion [PODCAST]

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After 20 years as a pediatrician, she stopped believing burnout meant she couldn’t hack it. The problem was never her. In this episode, pediatrician and physician career development coach Gita Balakumar reframes burnout as a systemic burden wrongly blamed on the individual, and offers a different way to think about it. This episode is based on her article “What physicians and dragonflies share in resilience and agility,” published on KevinMD. Drawing on the dragonfly, an insect revered across cultures for transformation and resilience, she explains why the demands of medicine ask physicians to keep evolving. You will hear why self-compassion is a foundation and not a luxury, how career coaching helps physicians name what they actually value, and why the idea that doctors just aren’t resilient enough is a fallacy. Hear why she says the most resilient people in medicine still deserve compassion, and that seeking support is a strength, not a failure.

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Transcript

Kevin Pho: Hi, and welcome to the show. Subscribe at KevinMD.com/podcast. Today, we welcome Gita Balakumar. She’s a pediatrician, and today’s KevinMD article is “What physicians and dragonflies share in resilience and agility.” Gita, welcome to the show.

Gita Balakumar: Thank you. Thank you for having me.

Kevin Pho: All right. Let’s start by briefly sharing your story, and talk about why you decided to write this article on KevinMD.

Gita Balakumar: So I’m a board-certified pediatrician of 20 years, and I’ve worked in a variety of communities and medical settings, including outpatient care, a military base, and pediatric urgent care. I even participated in the California Medical Corps. I still currently work in direct patient care as a locums, and now I’m involved in physician career development coaching.

And I wanted to write an article to share my journey through my certification as a career development coach.

Kevin Pho: How did you decide to make that transition from pediatrics to a development coach?

Gita Balakumar: Yeah. I ended up having what I’ll call a sabbatical in my career. So I knew that there was a program to get certified to help coach physicians, but I didn’t quite understand what it was.

So after I went through the program, I wanted to find a metaphor in nature that connected and resonated with my personal journey, and this led to dragonflies. I like dragonflies. I had just admired them from afar. So I found this profound link between these unique creatures and the medical profession, which ultimately gave me the foundation of my coaching practice.

And what I found was this shared bond of longevity and cultural reverence and historical significance, and this was also found in many cultures, such as the Navajo, the Chinese, and the Japanese samurai. For centuries, these cultures have honored the dragonfly as a symbol of transformation and resilience, and I think that really speaks to our profession.

I’ll give you an example. The Navajo consider dragonflies sacred symbols of life. They actually feel that dragonflies are a conduit between the living world and the spirit world, and there’s a bit of a folklore story of the dragon being tricked into a dragonfly, and once tricked, that new dragonfly was OK to adapt and accept.

In Chinese culture, it’s a symbol of renewal and harmony and flexibility, and this is the heart of medicine. And my favorite was the Japanese samurai. I don’t know if you’ve ever seen samurai armor, but they use the image of a dragonfly on it, and they revere it to the point that they call it a victorious insect, because they’re relentless and they’re forward flying.

So these are attributes that I think people in health care and physicians have. They’re very much having to adapt and accept, and there are also hopeful things like renewal and harmony. And what I found with all of these cultures that resonated was the same truth, the symbol of transformation.

Kevin Pho: So let’s talk more about that metaphor. In your article, you talk about the dragonfly’s metamorphosis from nymph to flyer, and you compare that to medical training. So tell us about how those two compare.

Gita Balakumar: Yeah. So the dragonfly has an unusual life cycle. It starts as an aquatic nymph in the water, and it’s deep in the water before it becomes this beautiful creature of air. And I feel that that’s just not a transition. That’s a transformation.

So when you decide to become a physician, or whatever avenue you take, whether you decide in high school or once you get to college, you have to adapt and change into a medical student, and then you have to continue through residency. And then however your career pans out, I think it shows how flexible and adaptable we have to be to move forward, and there are all these transformative stages, just like the dragonfly has had, going from a water life, coming from the depths of that, to being a flying insect.

So without getting into all the little nuts and bolts of the life cycle of a dragonfly, this was very inspiring, because this transformation is going on in all of us. And for me, that was my personal journey.

I think many of us didn’t think that we were going to have side gigs or lateral moves, or leave medicine so early, earlier than we thought we would. But in truth, for all that medicine requires us to be, many are maybe going through another transformation. I want to stay away from the word transition, because I think transformation has a little more depth to it. And as humans, we all evolve.

And I know the word burnout is out there. And when health care professionals use the word burnout, I think it’s to the truest definition, but when it’s used within the health care organizations and within the system, there seems to carry a negative implication that the doctor couldn’t hack it. The business of medicine has co-opted the word to place the blame a little bit on the individual.

And the issue is not a personal failure of resistance, but rather this immense burden and systemic impact that has been placed upon physicians by the health care system.

And how it connects back to that dragonfly is that we have been flying forward and relentless, and the dragonfly has predated dinosaurs. So when you’re 20 years into your career, you kind of feel like, “I’ve been at this for a minute.” And I’m trying to adapt and renew and transform, but we’re also humans who evolve, and it can take a toll.

So that’s how I wanted to bring my coaching platform and the education of coaching to health care professionals and clinicians, because maybe they’re not aware of it, or they’re not fully understanding what it provides. So I wanted to connect them back to something that I found personal and relevant.

Kevin Pho: Yeah. That framing that physicians aren’t resilient enough is such a fallacy, because as we both know, just to make it through medical school, internship, residency, and then in some cases practicing for decades, it takes the most resilient people to go through that journey. So I love the reframing that you’re bringing with this metaphor.

In the beginning of your piece, you open with an image of a helicopter hovering with a missing blade. What was the feeling you were trying to capture with that image to introduce your piece?

Gita Balakumar: I think when we come into medicine and we finish residency, we feel like we have the skills and the capability, but we just need a little bit more practice, hence the practice of medicine. But after your career has gone on for so long, and there are so many ups and downs in the system, we are hovering, and we’re always moving from one thing to another.

And a dragonfly has four independent wings to fly. One can break off, and it could keep still flying. So I feel like we have come to that point with physicians where we keep going, we keep going. Do we have to lose all four blades before we say enough is enough?

So I really wanted to use that metaphor to say that this can’t keep going on. We can still function independently, but I don’t think it’s healthy.

Kevin Pho: So we’ve talked about this metaphor, and I love this connection. This is actually the first time I’ve heard so much about dragonflies and the history of dragonflies, and you equating this to what physicians are going through. Tell us how you incorporate this imagery, these metaphors, as part of your coaching business whenever you talk to clinicians.

Gita Balakumar: Yeah. So we have a right brain and a left brain, and some people connect with an image or a metaphor. Some people are more logical. So it just depends on the individual as far as, if there’s an interest in coaching, how they may feel that they’re this resilient person.

But if I set it up in a dragonfly metaphor, they can see that connection, and they can see that this little insect has continued to exist for eons. And if they connect to it, great, but I can also do the logical part, too, where it’s like, “Hey, this is coaching. This is how we’re just going to unlock what’s inside, what’s your skill level, your mastery, to address and strategize for any career challenges that you have.”

Kevin Pho: In your article, you talk about self-compassion and how that is a foundation and not a luxury. Do you find that some of the clinicians that you talk to find self-compassion and that concept difficult to accept?

Gita Balakumar: Yeah. I think there are a couple of things going on. I think we feel that we have to put our patients first. But we have to be healthy as well to take care of others.

And if they’re lacking some self-compassion, yeah, that’s one of the things I want them to get back to, because if we don’t give it to ourselves, then who will? The system is hard on us, but it’s also unfair.

And so if we’re not giving it to ourselves and to our fellow colleagues, that grace and that compassion, we have to at least congregate among ourselves to provide that foundation.

Kevin Pho: So tell us a success story. As you said earlier, there are a lot of physicians who are burned out, and of course, I talk about that a lot on this podcast and on my site. Give us an example where maybe you made a little bit of that transformation in that physician, and what that looked like.

Gita Balakumar: So there was a client who was a physician, and they were recently understaffed, and they were putting the non-physician, non-doctoring work on her until they filled the void. But it wasn’t her responsibility, and she felt responsible to do it because she needs the office to be open and to do all these other logistical things. But it’s not what she’s hired to do. It’s not that she’s incapable of doing it, or that it’s beneath her.

So as we were going through the session, because of the type of coaching model that I learned, you’re trying to bring forth what their values are. And toward the end, we had this breakthrough where she realized, “This takes away time from my family. This takes away time from the things I need to do in my life,” to get up an hour earlier and do the things that aren’t required of her skill set.

So she did have this breakthrough and got visibly sad, because she’s trying to manage two great responsibilities, which is this work she does as a physician and then her family. And I think she got to a point where she realized, “I need to speak up and say something.”

Kevin Pho: Now, the next time a weary clinician sees a dragonfly hovering nearby, what would you like them to think about it as they see that dragonfly?

Gita Balakumar: When we see dragonflies in nature, they seem to be solo, and with all the connection that we have with dragonflies and the beautiful and historical presence they have in the environment and in nature, whatever our role in health care is, we are not a silo. We are not alone.

And there is this model in coaching for physicians and health care professionals that can assist and take that edge off, and we don’t have to feel shame or failure, because we are ordinary humans doing an extraordinary thing, just as a dragonfly is so extraordinary in nature.

And so we are allowed to seek out ways to feel empowered, supported, transformed. And I really want them to know that they’re not alone.

Kevin Pho: We’re talking to Gita Balakumar. She’s a pediatrician and physician development coach. Today’s KevinMD article is “What physicians and dragonflies share in resilience and agility.” Gita, let’s end with your take-home messages that you want to leave with the KevinMD audience.

Gita Balakumar: I think by giving ourselves permission to be who we truly are, we have our own boundaries, emotions, and needs. We don’t diminish our professionalism. We strengthen it, and we have to accept how other people function. And this professionalism, this new way, can spill over into the culture that we want to be in and where we can lead.

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

Gita Balakumar: Thank you so much.

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