The last year has been mentally, physically, and emotionally exhausting for health care professionals, particularly those individuals on the front lines of providing care to coronavirus 2019 (COVID-19) patients and those who have had to postpone operations for patients needing nonurgent care. Add to that situation constant threats of payment cuts, hospital and private practice closures, and the rapid movement toward telehealth, and it is unsurprising many surgeons and residents are finding themselves burned out and having a difficult time sustaining the passion they once felt for our profession.
The American College of Surgeons (ACS) offers many resources for surgeons seeking to improve their well-being. They are described in greater detail in the “Your ACS benefits” article on page 77 of this issue of the Bulletin. I have found another resource that might be useful to members of the ACS who are looking for guidance on how another physician overcame what seemed to be insurmountable obstacles to have a fulfilling family life and career in medicine.
In Gone: A Memoir of Love, Body, and Taking Back My Life,* Linda K. Olson, MD, FACR, diagnostic radiologist, professor of radiology, and director of the breast imaging center at the University of California San Diego (UCSD) for 30 years recounts how she and her husband Dave overcame a tragic event that left Dr. Olson severely disabled and were able to go on to enjoy the life they had dreamed of creating. Dave and I were interns together, and Linda and I worked together when I was a trauma surgeon at UCSD.
In 1979, Linda and Dave were recently married and visiting Dave’s family in Germany when a terrible accident occurred. The Volkswagen van in which they were traveling near the Germany-Austria border stopped partially on railway tracks, as a train was barreling around a nearby curve. Most of the passengers were able to escape the vehicle with minor cuts and abrasions; however, Linda, seated in the middle seat near a door that was jammed, was not optimally positioned to escape through the front door.
As she describes it, “In one earth-shaking, deafening instant, the locomotive smashed into the van, pushing me down onto my back across the track.”
As she describes it, “In one earth-shaking, deafening instant, the locomotive smashed into the van, pushing me down onto my back across the track.” Dave tried to pull her away, but it all happened too quickly. Ultimately, in a matter of seconds, Linda lost both her legs and her dominant arm.
She and Dave, who had broken his fibula trying to save Linda, were taken to the trauma hospital in Salzburg, Austria. The morning after surgery, Linda told Dave she would understand if he wanted to leave her because, at that point, she didn’t believe they would be able to have the family they both wanted and that he couldn’t possibly be attracted to her any longer.
She was wrong. She and Dave received excellent trauma and postoperative care in Salzburg, where they were able to share a room and plot out what life would look like after they returned to the U.S. Upon their return, Dr. Olson began her formal rehabilitation at the Naval Regional Medical Center San Diego, CA, where her husband was an active duty Navy Officer and third-year resident in radiation oncology.
When she first arrived at the naval hospital, she felt discouraged. “I’m nobody, a crip [sic], a patient who appears to have nothing ahead of her but life in a wheelchair,” she wrote. “They don’t know I’m one of them, that I’m in my third year of a diagnostic radiology residency in Los Angeles, that I passed part one of my radiology boards just before leaving for Germany.” She resolved to show the orthopaedic team and her fellow patients “that on the inside, I was still a normal person.”
She describes the phantom pain she would get in her legs and missing arm, as well as the struggle to become adept at putting on and using her prosthetic legs and to build up her core strength in order to do her “toy soldier walk” on prostheses with a quad cane. It took two months of hospitalization and physical therapy for Linda to reach a point where she started to accept her limitations and to begin feeling comfortable with her new legs, noting that only 20 percent of amputees with prosthetics master walking with the devices. And remember, this was the late 1970s, early 1980s, long before medical technology had advanced to develop more user-friendly prostheses and passage of the Americans with Disabilities Act—legislation that made shopping, chauffeuring children, and other acts we all take for granted a little easier. She and her husband faced these and other challenges to return to “normal” with grit, positivity, humor, and ingenuity.
Nine months after the incident, she had made enough progress to return to Germany and finish the vacation that had been cut short so abruptly. She went on to complete her residency at White Memorial Medical Center in Los Angeles, CA, living independently during the week as she worked, studied for boards, and, of greatest satisfaction to her and Dave, prepared for the birth of their first of two children.
Applying the lessons learned from this story
Linda’s and Dave’s story has much to teach all of us about handling crisis situations with resilience. Here are a few things I learned from reading this memoir:
- Stay positive. No matter how insurmountable or unresolvable a problem may seem, try to find the silver lining. Your mental state affects the other members of your team, your family, and friends. Staying positive will help you gain their support and enthusiasm to help you stay on track and heal.
- Exercise. To help relieve the stress of being Linda’s primary caregiver, Dave would go for early-morning runs, which were mentally cathartic and ensured he had the physical strength and agility he needed to lift her and even carry her on his back on hiking excursions.
- Set goals and be prepared to adjust them. At first, Linda’s main goal was to be able to go to the bathroom without assistance. Once that goal was achieved, she wanted to try living alone during the week while she finished her training and studied for her oral board examination. She learned to place an intravenous line and to read computed tomography scans and went on to become an award-winning radiologist and academic physician at UCSD. When the children came, she learned to feed them, change their diapers, and hold them with her one good arm. She also learned to drive, cook, and perform other household tasks with little or no help.
- Find solace in nature. Many people, including Linda and Dave, find hiking, canoeing, and camping provide a peaceful respite from the hassles of modern life. They shared their love of national parks, the beach, mountains, and lakes with their children—taking them on trips to these refuges. Their children, now adults whose stories bookend the memoir, both state that they had a wonderful upbringing.
Don’t be afraid to lean on others. Physicians by nature value their autonomy, but sometimes we all need a little help.
- Don’t be afraid to lean on others. Physicians, by nature, value their autonomy, but sometimes we all need a little help. Linda and Dave are blessed with loving, funny friends and family who have helped guide them throughout their journey.
- Maintain a sense of humor. Linda loves to gently poke fun at herself and her disability, and that is a buoy that has sustained her through triple amputations, childbirth and child-rearing, a broken hip, and, most recently, Parkinson’s disease.
- Accept the reality that the new normal will not look like the old version. This, above all, is an important lesson for everyone these days. Odds are that when cities, businesses, and so on reopen after the pandemic is under control, we will continue to work, play, and live differently than in the past. That doesn’t mean giving up on what always brought us joy. It just means we have to engage differently and adjust our expectations.
I would encourage anyone who is feeling challenged or burned out to read this memoir, both to put their own problems into perspective and to learn the true meaning of resilience in these trying times. I also would encourage anyone who is feeling particularly depressed, despondent, or dismayed to take advantage of the well-being resources the College offers and to get the help you need. Like Linda and Dave, we can get through anything, together.
*Olson LK. Gone: A Memoir of Love, Body, and Taking My Life Back. Berkeley, CA: She Writes Press; 2020.