When we navigate the tumultuous waters of a demanding career and personal life, how do we keep from sinking? Listen as Dr. Mary Rensel, a neuroimmunologist from the heart of Cleveland, joins us to unravel the complex tapestry of psychoneuroimmunology. She illuminates the mysterious ways our emotional states can command our immune system, offering a beacon of holistic wisdom for those battling neuroimmunologic disorders like multiple sclerosis. Dr. Rensel also shares the intimate details of her own voyage, balancing the storms of passion and fatigue in medicine whilst anchoring herself in family life. Her candid conversation steers us toward understanding the significance of boundaries and priorities in preventing the erosion of our well-being amidst life's relentless waves.
Though I am a physician, this is not medical advice. This is only a tool that physicians can use to get ideas on how to deal with burnout and/or know they are not alone. If you are in need of medical assistance talk to your physician.
Learn more about female physicians' journey through burnout to thriving!
https://www.theworthyphysician.com/books
Let's connect for speaking opportunities!
https://www.theworthyphysician.com/dr-shahhaque-md-as-a-speaker
Check out the free resources from The Worthy Physician:
https://www.theworthyphysician.com/freebie-downloads
Battle of the Boxes
21 Day Self Focus Journal
When we navigate the tumultuous waters of a demanding career and personal life, how do we keep from sinking? Listen as Dr. Mary Rensel, a neuroimmunologist from the heart of Cleveland, joins us to unravel the complex tapestry of psychoneuroimmunology. She illuminates the mysterious ways our emotional states can command our immune system, offering a beacon of holistic wisdom for those battling neuroimmunologic disorders like multiple sclerosis. Dr. Rensel also shares the intimate details of her own voyage, balancing the storms of passion and fatigue in medicine whilst anchoring herself in family life. Her candid conversation steers us toward understanding the significance of boundaries and priorities in preventing the erosion of our well-being amidst life's relentless waves.
Though I am a physician, this is not medical advice. This is only a tool that physicians can use to get ideas on how to deal with burnout and/or know they are not alone. If you are in need of medical assistance talk to your physician.
Learn more about female physicians' journey through burnout to thriving!
https://www.theworthyphysician.com/books
Let's connect for speaking opportunities!
https://www.theworthyphysician.com/dr-shahhaque-md-as-a-speaker
Check out the free resources from The Worthy Physician:
https://www.theworthyphysician.com/freebie-downloads
Battle of the Boxes
21 Day Self Focus Journal
Welcome to another episode of the Worthy Physician podcast for physicians by a physician, combating physician burnout through awareness to reignite passion for medicine. In addition to hearing great pearls, tips or tricks that you can utilize, you can now also earn CME by reflecting on what you learned from this podcast episode. The link is in the show notes. Well, good morning. Today I have Dr Renzel on the Worthy Physician podcast and I'm really thrilled.
Speaker 2:So I'm honored. Yeah, thanks for having me. Thank you, I know.
Speaker 1:Thank you for taking your time. And for the listeners, could you please?
Speaker 2:introduce yourself. Yes, so I'm Dr Mary Renssel. I practice in Cleveland Ohio. I'm a neuro immunologist. I'm also the founder of a company called Brain Fresh, where I support professionals with neuroscience tools. And yeah, I just. I've been in practice for 30 years.
Speaker 1:I have four kids and a cute dog and a hobby, and and so you work with neuroimmunology, mm-hmm, can you tell us a little bit about that Sure?
Speaker 2:Yeah, I remember the day in med school when I read this word psychoneuroimmunology, and I was just like, how do those three, how is that one word, those three systems? You know, I just like how I was so flabbergasted, you know. So, you know, and since I've come to learn and read, you know some studies that confirm this is, you know, it's very amazing, but our, you know, our immune system is influenced by our psyche, so our emotional state as well as our nervous system state, so so that's, you know, it's good and bad news, right? So that means, you know, maybe we can modify that with some actions and that is powerful. You know, our psychological state and our emotional state and our neurologic state, you know, definitely influences our immune system and of course we're all one system, so we like to kind of learn about ourselves in parts, but we're all one connected system.
Speaker 2:So I mostly see adults, I see some teens with neuroimmunologic disorders. The most common one that people know would be multiple sclerosis, and then there's some other related diseases and my goal, as we were just talking about earlier, is to make it boring for them so that it's not a big part of their life, just to hopefully make them neurologically, to help them manage their disease state and make it hopefully not eventful, so that they can just fill their lives with what they want rather than their disease. But we support people along the whole lifespan. That's one of the many benefits of treating people with neuroimmunologic diseases. For me personally, is I get to know them for a lot of years and decades and sometimes know, you know multiple generations of family members, so it's been really an honor for me Sounds like you get to really develop that personal relationship with the patient.
Speaker 1:That's what medicine's about, or what it should be about. Um, but one thing that you told that you said was psyche, the neurological system, and the immunological, the immune system. So they are interconnected, that we try to treat them as separate, separate systems.
Speaker 2:Well, we do that with all our parts, right. We try to separate them off. It turns out they're all connected, right, so we try to do. You know, just look at one system, but they all influence the other systems.
Speaker 1:Yeah, that is because I don't think that we give the mind and emotions and stress enough credit for manifestations in life and the body. And I mean you've, you've studied it, so you're, you're the expert, that's that. That's a great segue to to burn out, because we know, we know that that can manifest in several different ways, even though there's a criteria. What was your journey through burnout or what has been your experience with burnout?
Speaker 2:Yeah, so I've been a doc for 30 years and, you know, raised four kids during that and so I never used a term burnout, like you know, stamped myself like I am burned out, you know. But I definitely have had, I feel like, peaks and valleys of the level of enthusiasm, you know, or level of energy toward a project. Or, you know, at certain time in medicine and I found for me what would lift me from the valleys. Number one, just to kind of double check, I was, you know, caring for myself and my family and just kind of realign, maybe, my priorities. So my youngest is 18, our youngest 18.
Speaker 2:I know like when we're fighting about something our liberals say disagreeing, you know, I physically feel differently, Like I carry that with me, like the stresses of whatever challenge is going on with the kids. I feel it in me, you know. So I like it's part of me. It's like you know what's going on at home. I bring to work, you know what's going on at work. I bring to home and I try, you know you try to set boundaries.
Speaker 2:But I know if there's something challenging going on with one of the kids, I feel it it's harder to kind of jump into work and feel energy toward it. You know. So I I always tried to know my priorities in both areas work and home and and feed those first and then, if there's anything extra, I would do it. But I also I know like when my kids were very young I had to say no to a lot of things because I wanted to be there for for events and things after work, or, you know, mornings before work were busy, weekends are busy, so I said no to a lot of things and I honestly I didn't write a lot of manuscripts then.
Speaker 2:I just, you know, kind of focused on the family when I could and that's that was my decision. I don't regret it honestly. You know, I and I always worked part time, so that really helped me. So I would, a lot of times I would either have a day off in the workday so I could get them all to the doctors, you know, get them to the dentist and all those kinds of things, or do something with the school so I could see them in the school settings. Or or I would like, you know, have shorter days throughout the week so I could get home a little earlier. Depending on their age, different things worked at different times.
Speaker 2:I remember one time I learned that the pharmaceutical companies had something they called school bus hours. So they had they. They, you know, some of the workers work the nine to three hours so they could get their kids on the bus and get them off the bus and I thought, oh, that's pretty neat. So for a few years I I scheduled my time, you know, my part-time, on more days but shorter days, so I could sometimes be there when they get off the bus or get them on the bus. So yeah, and the other thing I think that helped when I felt like I was in a low point or low energy point at work was to find a project or to meet some new people or build a new skill. You know, I didn't always recognize it but sometimes I felt like, ok, there's nothing new.
Speaker 2:I'm really I love new learning, new ideas. When I've learned kind of my Clifton strengths and things. I like ideas, I like innovation, so that really kind of brightens me up to look at something from a new way. So if I start a new clinical program or I started something at home or something new and then I met new people, then I'm in my happy place, I'm building. I realize I like to design programs and watch something grow and watch how other people did it maybe, and bring it to our clinic or so those. So I would notice, you know, if things were low or boring, quote, unquote or, you know, or stale, you know, then I would look for something to give it some excitement for me to use my strengths. So that's, I guess I didn't realize, as I was doing it for some years, but then now I realize that's what I like. I like to build and develop and design things.
Speaker 1:And how long did it take you to really pinpoint what you enjoy and how to pull your strengths together? Because I think that that's kind of something that physicians, we're always. The way that we're trained is that you go see the patient and we're just part of this system and we're pretty structured to stay in that box.
Speaker 2:Right, right, I guess you know I kept waiting to see somebody who had all my interests, you know, and I would want to model them, or I would see someone I really admired and I would want to model the way they did it.
Speaker 2:And it took me a long time to figure out there's not the one person I can model, for exactly what means something to me, what I'm good at, you know what, what interests me, and so, honestly, it took me a long time so, but I do remember.
Speaker 2:It struck me when I was in the leadership development course at the Cleveland Clinic and one of our speakers got up and she said you know, sometimes you're in a high point of your your. You know, sometimes you're in a high point of your professional development, sometimes you're in a lower point and you don't. If you're in a low point, don't hang out with people who are in the high points. You know, maybe you don't, just because then you just compare, you know. So I don't know about that, but it just, I guess, helped me to acknowledge like we're not all in a growth zone every second. You know, like sometimes we're more in a recharge zone in our professional development. Sometimes we're in a growth zone. Sometimes there's so much going on at home I didn't have any time to say yes to growth opportunities.
Speaker 2:So, yeah, I don't know. I mean, if I had the luxury of now having 30 years looking back at it so I could see patterns, but when I was in the middle of it I didn't always have the insight. Sometimes, when things felt stale, I wasn't sure what to do, and I would talk to others and I couldn't always find the answer, because I was looking for my answer. You know something that worked for me.
Speaker 1:And how did you prioritize everything going on? Because we know that burnout happens and when it more so than men, just because of kind of the double role, some of it's placed on us by society and I think some of us also place it on ourselves but balancing the doctor and being a physician and developing all these programs like what you've discussed, and the family, even though you've worked part time, how did you make those priorities? I mean, how did, how did you go through that? What was the process that you used?
Speaker 2:Yeah, I mean I think there were some non-negotiables for me. I'm I know personally like my nutrition has to be healthy or I I'm tired. You know I'm tired if I eat junk. I'm tired if I eat. If I don't eat, you know so I. And emotionally I'm tired, you know I'm tired if I eat junk. I'm tired if I eat. If I don't eat, you know so I. And emotionally I'm different if I eat junk food and things, and so I I make it a priority, so that I had to have like a plan on the weekend to know what we're eating throughout the week.
Speaker 2:I didn't leave it to chance, like what dinner may look like. So I would always like meal plan and pack a lunch. I never left it to chant that part of it because that was something I could control is, you know, to have healthy nutrition for myself so I could get through the days. That was a number one, for sure, you know. As far as spiritual support and family support, those also are non-negotiable. So if I do have free time I go there and that kind of feeds me personally and kind of rebalances me after busy weeks. So there was just some things that absolutely were my party. So if I, if somebody would ask me to do something else, if I didn't have time for those things, I'd have to say no. So that was a must.
Speaker 2:And then at work yeah, I mean I, we have, you know, very high level. I personally, and of course, where I work, I have high level demands of patient care and quality and that's really important to us. That's why I'm there and I would never want to put myself in a position if I physically didn't come in. You know, like I said, nourished, rested, et cetera, to give my best to my patients. I never wanted to be in that situation because you know I'm just honored by that. Like we talked about the patient physician relationship, but I want to do everything I could personally to present my best self for my patient and their families. So yeah, I think that, like for sure, that was always non-negotiable, for sure, nutrition was kind of foundational family foundational, spiritual, religious for me Foundational there's no, those have to be in place. And then I would add extra things.
Speaker 2:I mean there's a lot of years where maybe my husband and I didn't go out to dinner with all their friends as much because we were always doing family stuff, you know.
Speaker 2:So now we have time though, because the kids are older, so now we can do our own thing and set our own schedules.
Speaker 2:But there are some years, you know, we just focused on the kids and their needs and their parties and their events, and but as long as those foundational things were there for me, then things went well. And when, if I slipped or I didn't put the time toward those things or put the foundational, you know, like meal planning for me or something I didn't like with four kids to just have to stop somewhere and grab dinner, I didn't like with four kids to just have to stop somewhere and grab dinner. I didn't like that plan because usually I was tired, they're hungry, like I didn't really want to add that to the end of my day. So generally we would have something going for dinner in our house in some way, so that we didn't have to waste time on running and getting something. So yeah, I think I don't know, I just would change over the years as the kids were different ages on what we could do and how we prioritized it.
Speaker 2:My husband's job was more unpredictable. Mine was outpatient mainly, so mine was more. My hours were more predictable. That was helpful for our family planning and you know planning meals and events and who's doing what and who's driving where I can relate to that.
Speaker 1:So can you tell us about BrainFresh? I'm very intrigued by this.
Speaker 2:Yeah, that's the other. You know the part of me that's like the builder, designer, innovator, new idea person. I was again looking. So you know, if you've been in your career for so long, again, there's moments that sometimes feel stale or, I don't know, not exciting. So I mean, look around, is it me, is it them? Is it you know the structure? Is it medicine? Is it what is it? You know, and where do I have control to change it? And I, you know, I started a group.
Speaker 2:Well, first I gave, I guess I gave my first talk to a group of professional women for long-term brain health and professionally thrive. And so, you know, we talked a little bit about that and I thought, you know, I need to kind of break that down for them. I was surprised the room was like busting open the seams. There was like no seats left in the room because I wasn't sure if they'd want to come to a medical conference, at a, you know, a business leadership conference. And so I saw, you know, people are really interested, they're trying, they want to know how to do it and I just couldn't find a good resource for folks like you know, step by step, how to, you know, support people and especially women in their busy lives, and the burnout, it just wasn't okay with me. I mean, as I looked at the literature I saw, you know, burnout's been reported since the 1970s. The numbers are going up and up. And now I, you know, I keep meeting.
Speaker 2:I'm at the age where a lot of my kids' friends are going, trying to get into med school and I, you know, look at their parents in the eyes and I think, geez, I want to say that their kids are going to be okay, they're, they're working so hard, they're hanging everything on getting into med school. And and then I hear these. You know, I can, I see the data, burnout, and you know the suicide risk and depression risk and anxiety risk of working in this profession, and I just think that there's some opportunities Again if we put some foundational tools in place. So I just built it, I just built BrainFresh and I thought I'm going to try, I'm going to and it'll help me personally, because I've been learning about business as I build it. I got some business coaches and I kind of hang out with people that are building businesses and so it's been fun for me again, as I'm certainly not finding that I'm stale at this point I'm learning, I'm building, I'm trying to just support people who are, you know, their goal is to be their best selves and help their communities.
Speaker 2:So I think you know, if we nourish the mind, we really nourish the world. And I don't know that we ever go to brain school to kind of figure out how to do it. And emotions, like we started this, conversations matter. Emotions matter for our community. You know our perceptions, our workability, our quality at work. I don't know that I ever saw a place that really explained that well. So I'm just trying to make it really understandable and give people foundational tools.
Speaker 2:So I did partner with a life coach and we made a program for residents. So that's been really just an honor for me to support residents because they're working really hard. So we have it in some institutions, an app-based program so that they can just use it on the fly If they have five or 10 minutes, jump into one of like the little video lessons and make it real and make it foundational for them. You know, because we've seen it, our programs one of the residency programs did an IRB project with our app-based digital course and they saw really, you know, neat outcomes in resiliency and self-efficacy. So I'm grateful to be, you know, just trying to support, and you know, these amazing young docs that are trying to do wonderful things and professionals. In other areas I've worked with some businesses and things to support their teams. So, yeah, I'm just trying to make the brain kind of understandable and help people. Just simple tools but that are really powerful.
Speaker 1:No, thank you for that. I mean, we do know that. We know what the burnout is. What is it? 63% post-pandemic and almost across specialties that's probably even underreported almost across specialties, that's probably even underreported. And so to really impact the young minds, the young physicians that will be treating us when we're older, that's a big thing to get them those tools that they need at the beginning. So it becomes part of it, becomes part of it and self-care and knowing your needs, absolutely.
Speaker 2:Like I saw one program because I've been just kind of diving into literature trying to find anything that has worked. You know I'm giving a grand rounds on it in a few weeks at another institution and just looking at the fresh new data and there's these, you know, national calls to do something for health care workers by the National Academy of Medicine, the Surgeon General. There's national, you know huge nonprofits, you know government agencies, et cetera, like we need to do something. So I keep looking like who's doing something interesting. You know, I mean one program I thought was, you know, did something smart where they just as the default setting was that all the residents started just seeing a therapist, like they just booked them and they had to actually cancel it, you know, to not go, so they had to take some energy to not go and they just normalized it so that all the residents met with a therapist and then learned the tools and you know again, some foundational tools. So I know there's, you know, a lot of institutions out there trying so many things to support their residents, because you know it's really scary out there, those numbers, like you said, the data is really concerning and I think we need to get ahead of it. You know there's some books that are called like Upstream, like you see, a problem like how do you go ahead of it so that you don't get to that problem? You know we do that medicine right.
Speaker 2:We try to be preventative, but you know, I think we need both now. I think we need preventative and restorative for burnout. I think it's huge, it's a huge shift in culture to normalize the use of. You know, a group of folks that are working with you know our government trying to is really neat, you know to put some again, some foundational tools, whether they be preventative or restorative for burnout, today, right now, you know, and look at changing laws across the board so that people don't have to if they're not impaired in any way, they don't have to report if they've seen a therapist. So that's yeah. I'm glad there's many people looking at this issue. I mean, of course we don't want anyone impaired but we want, you know, people to be able to care for themselves and do something preventative or restorative to get them back you know, 100% or not get there, not get burnout right, and this is I like, efficiency, and I think it's way.
Speaker 2:Of course, we know that through all kind of medical studies as well, it's way cheaper, easier to prevent something rather than treat something. So I know a lot of people are interested in this topic and the time is now. We can't wait any longer. The numbers are very concerning.
Speaker 1:I mean that's just burnout. That's not including what the AMA showed back in January, that 25% of those that are currently within medicine physicians will they be retiring and leaving or cutting back and that's just going to increase the shortage. And physicians can I mean with our training, we cannot be replaced by mid-levels, even though the uh c-suite thinks that we can. You know, there's just, there's just no comparing the uh training right, right takes a long time.
Speaker 2:You can't just suddenly birth a physician. You know it takes us many years to, yeah, to train, You're right, so many years, yeah. So I know you know nationally and you know regionally, locally, a lot of folks are looking at these issues and you know I stay active with the advocacy committee, with American Academy of Neurology as well, and they're looking, you know, to bring in more international grads, make it easier for international grads to stay. I mean, so many people are trying to figure out how to support the healthcare system.
Speaker 1:But, yeah, I think prevention is really the key, of course, we know that in medicine. And so, for the listeners, what is one last pearl of advice that you would have for them?
Speaker 2:Well, I think we just need to not have magical thinking about our neurobiology and just know that we have to honor our neurobiologic needs, that we need to be well hydrated, we need to have the time to eat. You know, when you work in health care, you need to have the time to rest adequately. We should not have these super long shifts. You know people need to rest adequately and people need to connect with other humans and they need to have time to move, they need to have time to exercise. So I think you know this.
Speaker 2:You know these really super long shifts, even for nurses, any healthcare worker that works you know the 12, 18s, you know 24s. Healthcare worker that works you know the 12, 18s, you know 24s it's not neurobiologically okay. We know that that's not okay. We know we're not at optimal performance. So I think if in the very least, just think about nourishing your mind and your body first, and then we will be able to change the world and make things better for others. But we can't forget that we can't have magical thinking about our needs, our physiologic needs.
Speaker 1:Well, thank you so much for your time. As always, it's a pleasure talking to you.
Speaker 2:Oh, my honor. Yeah, thanks for all you do.
Speaker 1:Thanks for joining us. If you have enjoyed this episode, click subscribe. Share it with a friend, because we could all use a little bit of normalizing the topic of burnout for joining us. If you have enjoyed this episode, click subscribe. Share it with a friend, because we could all use a little bit of normalizing the topic of burnout, knowing that we're not alone.