How doctors disconnect — and why it’s critical to their health during the coronavirus

Dr. Robert Udelsman, chief of endocrine surgery at Miami Cancer Institute at Baptist Health South Florida, spends every day of the week working with his hands, but only five of those days are in surgery.

The other two days — Saturday and Sunday — he spends, on average, 20 hours in his open-air garage in Coral Gables chiseling away at scraps of gumbo limbo wood and turning them into sculptures, most of them whimsical, imaginary animals. Many have wings.

“I have patients’ lives in my hands every day, so it’s nice to do something that’s not stressful,” said Udelsman, 64. “My wife got me a subscription to Audible, and I have noise-canceling headphones, so I just spend all day out here and listen to the most amazing novels while I work on my art,” he said.

“It sends me to a completely different world and I disconnect from everything else.”

Disconnecting for doctors is critical to staying healthy and avoiding burnout. Physician burnout has surpassed 40 percent over the years, and physician suicide is more than double that of the general population, even higher than in the military, according to a Medscape article published in response to the 2018 meeting of the American Psychiatry Association.

And when physicians’ mental health is suffering, they make more medical errors, studies show. Finding joy outside of work can be a lifesaver for both doctors and patients alike.

“You know, before moving down here in 2017, I was chair of surgery at Yale where I oversaw 110 surgeons. I had to have very difficult conversations with some of them who were older than me and planning on retiring. I’d ask them what they were going to do now, and some would say, ‘All I know how to do is surgery,’ and it was very sad. They had no family, no hobbies and now they were all alone. They had dedicated their entire life to medicine and now they had nothing.

“To be a surgeon you need your eyes, your hands and your brain. If one of those goes, you’re done,” said Udelsman, who took a summer arts program at Cornell University.

Teaching doctors to pursue a hobby

Dr. Heidi Allespach is a University of Miami Health System psychologist who works on physician wellness — mainly focused on interns and residents.

She said that when she first meets with a new patient, she asks them, “What brings you joy outside of work?”

When they respond, she follows up with, “And when was the last time you did that?”

Usually, the answer is, “A couple of months ago,” she said.

She sends them home with an assignment to practice their passion for at least 15 minutes a day.

“When they come back to see me, if they haven’t done that joyful thing each day, I tell them, ‘If I told you to do something for your child every day that took 15 minutes and it would improve their health, wouldn’t you do it?’ ” she said.

She gets a unanimous yes, which usually helps get the trainees back on track.

“Physicians are really good at delaying gratification because their whole life has been, ‘After college I’ll go to medical school, after medical school, I’ll do residency,’ and so on,” she said. “If you don’t put yourself first, your patients are going to suffer. I tell them this is critical, it’s not just about joy.”

Allespach noted that finding coping strategies alone isn’t enough; they need to be healthy coping strategies. So becoming a wine aficionado wouldn’t be on her list of hobbies to take up.

Allespach practices what she preaches. On weekdays, she plays with her dogs and on weekends she’s either spending time with her grandchild or horseback riding, she said. She’s not saying to cut Netflix out of your life completely — even she enjoys it — but make sure it’s not the only other thing you do, she said.

Baking as meditation

For Dr. Josefina C. Farrá, 37, an endocrine surgeon at the University of Miami Health System, her outlet is baking.

A Miami native, she returned to Miami to enroll in medical school at the University of Miami after completing her undergraduate work at Duke University.

“I used to come home late during residency, but it would be someone’s birthday the following day, so I would start baking. My dad would say, ‘What are you doing?’ but baking didn’t make me tired, it gave me energy,“ she said. “It’s almost like a mini-meditation.”

In many ways, having a hobby that requires intense focus is similar to practicing mindfulness meditation, which teaches people to be present and not think of other things that are going on in their lives.

At her Coral Gables home on a recent Sunday, Farrá perfectly laid out chocolate chip cookie dough on a cookie sheet, using an ice-cream scooper so each cookie would be the exact same size.

“I can be a little OCD,” she joked.

One of the things that Farrá particularly likes about baking — and surgery — is that everything has to be organized and there are steps that you need to follow.

“I love the process of baking. It’s very soothing,” she said. She particularly likes decorating, “because it’s very detail-oriented.” She compares it to the focus and delicacy required when closing up a wound and making sure it leaves a “pretty” scar, she said. “Surgery is not only a science, but it’s also an art.

“Assuming no one’s on a major diet, I bake every weekend,” she said.

Indeed, the previous Sunday, she and her 2 1/2-year-old daughter baked three different goodies.

Baking as a hobby came early for Farrá, who started baking in middle school. Some doctors, however, discover their passions later in life.

The allure of ice dancing

“I’ve done aerobics, jogging, biking, gone to the gym and even auto racing,” said Dr. Ana Duarte, a pediatric dermatologist and medical director of the Children’s Skin Center at Nicklaus Children’s Hospital. She is also director of the dermatology division at Nicklaus.

It wasn’t until 2011, when Duarte was 49, that she discovered her passion for ice dancing, which is similar to figure skating, but without the jumps. She now competes nationally and at the World Championships in Europe every year. She and her dance partner have won gold together.

“It uses a completely different part of my brain than my day-to-day work,” she said. “A part of my brain that needed some dusting off,” she laughed.

As a native Venezuelan who grew up in Miami, she had only skated a few times during her childhood, on field trips and at birthday parties. But of her experience later in life, she said, “I just stepped on the ice and felt like I was transported through a different portal. I love the glide, speed and power.”

While she has found her work rewarding, she said she was always looking for something else to distract her from work.

“Skating really turned into my second passion. My work in medicine with sick kids can be very stressful,” she said.

When she’s training for a competition, she trains five days a week and on the weekends, always with a coach.

“When you train by yourself you think you’re good, but when the coach arrives it’s usually a different story,” she joked.

Like most people, some days it can be hard to drag herself ice skating after a long day of work. “You just have to say, ‘No!’ I’m going to skate and then when I’m done I have even more energy,” she said.

“There are days when I really do take a lot with me on the ice, and as I warm up and start skating, it all melts away. I really do believe that finding something you love gives your career longevity,” she said.

Duarte, 58, is a grandmother and says she’s much more energized than many of the younger people on her medical team. “Sometimes I walk into work and see my staff [looking tired], and I’m like ‘Come on guys, you’re younger than me!’ ”

Udelsman, the Baptist surgeon-sculptor, credits his hobby with part of his success as a surgeon. He was first in the United States to perform thyroid and parathyroidectomies via the mouth, avoiding visible scarring on the neck,

On a Saturday morning at his home, he’s dressed in a khaki fisherman’s short-sleeved shirt, tucked into army green fishing shorts, and some black Nike slides. His right pointer finger has a purple nail that resulted from a wood carving accident. “As a surgeon, I have to be careful not to saw off a finger,” he said.

He has woven his art skills into his medical practice. After each surgery, he sits in the OR while the patient is waking up from anesthesia, and sketches an anatomically correct diagram that shows what he did in the surgery.

“I give a copy to the patient and keep the original, which then becomes part of the patient’s official records,” he said.

“I like to be creative both in my artwork and in my surgeries. I’m constantly pushing the envelope.”

Udelsman scours the streets of Miami scavenging for scrap wood. “I have two secret places that I like to go to,” he said mysteriously.

“Freud had a saying,” he said, “Love and work ... work and love, that’s all there is.”

This story was originally published April 3, 2020 at 6:46 PM.