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Textbook Ebook Powered by Me From Burned Out To Fully Charged at Work and in Life Neha Sangwan All Chapter PDF
Textbook Ebook Powered by Me From Burned Out To Fully Charged at Work and in Life Neha Sangwan All Chapter PDF
Neha not only knows the symptoms, she also has risen to the challenge of
dealing with one of burnout’s most intimate causes: the inability of so many
of us to recognize what is happening to us and to take charge of ourselves.
Step by step, she helps us to become aware of the hallmarks of burnout—
physical and emotional exhaustion, depression and anger, cynicism and
indifference—and she shows us how to regard these challenges as oppor-
tunities to recognize, embrace, and grow through and beyond.
—James S. Gordon, MD
founder and CEO of The Center for Mind-Body Medicine and
author of Transforming Trauma: The Path to Hope and Healing
Neha has written a beautiful guide to help us remove the internal road-
blocks keeping us from experiencing the true joy and beauty in life and
knowing that we matter. This book is essential reading for us all, especially
for those who accept the responsibility of leadership and want to bring their
full selves to be present to those within their span of care.
—Bob Chapman
CEO of Barry-Wehmiller and coauthor of Everybody Matters:
The Extraordinary Power of Caring for Your People Like Family
Neha combines a laser-like focus on hearing what you are saying with her
wide knowledge and deep experience to produce actionable insights and
results.
—Theresa Gattung
chair of Global Women and
former CEO of Telecom New Zealand
Neha Sangwan, MD
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To Raj Sisodia
Thank you for being a man as ambitious as you are generous and kind.
Your beautiful soul and unconditional love have restored my faith
in what is possible for the future of our world.
To Our Ancestors
You innately knew the wisdom of living in connection and
harmony with Mother Nature.
vii
Contents
ACKNOWLEDGMENTS 339
NOTES 347
INDEX 351
viii
FOREWORD
by Mark Hyman, MD
I
t is easy to lose ourselves in our overstuffed lives, which are fraught with
the endless pressures of work and family, with the relentless barrage of
tasks, to-dos, and requests, all while we are trying to manage our health,
sleep, and nutrition in a world under siege from existential threats—climate
change, never-ending gun violence, and the constant presence of war. It is
easy to get overwhelmed, exhausted, and anxious. Easy to neglect the sim-
ple practices of self-care that keep us grounded and resilient.
As a young physician with two children, a wife struggling with alcoholism
and mental illness, and a rural family practice in Idaho, who was putting in 80
hours a week, doing 24-hour shifts in the emergency room alone, working
all the next day, and delivering babies in the middle of the night, I hit a wall.
When I got home, I had to shop, cook, and take care of my young children.
I prided myself on my ability to push through the pain and exhaustion. I was
powered by caffeine and sugar. After four years of overdoing, overgiving, and
running myself into the ground, I had to stop. I had intended to take a little
break before my next job. We had bought a VW camper van and planned a
tour of the West, but as soon as I stopped working, I couldn’t move. I literally
couldn’t get out of bed or I spent most of my time on the floor, feeling com-
pletely drained, as if all the gas in my tank was gone. As a medical student,
I was told that “real doctors” don’t need sleep or lunch. I wanted to take my
family on a trip, but my body, my nervous system, and my brain all said no.
It took four months of doing nothing, being at home, walking, sleeping, and
renewing myself to finally feel a little better.
But I didn’t learn my lesson very well. After leaving Idaho, I worked in
Beijing, setting up medical clinics for expatriates, before I came back to the
United States and got a job in the emergency room—not just one but three
emergency rooms with different schedules. Sometimes I would do 24-hour
shifts, sometimes morning or afternoon shifts, sometimes overnight shifts.
ix
Foreword
—Mark Hyman, MD
senior advisor at Cleveland Clinic Center for Functional
Medicine and host of The Doctor’s Farmacy
A
t the beginning of this energizing, inspiring, happily practical book,
Neha Sangwan, MD, gives us a picture of herself 22 years ago, an
“overworked, undernourished, stressed-out internal medicine phy-
sician.” Every day, she tells us—in the clean, clear language that makes
Powered by Me so accessible—she “pushed harder and faster, running
headlong in the direction others wanted me to.” She came to realize she was
burned out.
The picture Neha paints is painfully familiar to physicians and other
healthcare professionals, especially since Covid-19’s tide of death and loss
overwhelmed just about everyone working in healthcare. However, so many
others easily recognize the phrase “pushing harder and running faster.” I hear
the refrain from people I work with everywhere: unhappy high school stu-
dents anxious about the future, frustrated police, fearful elected officials, rich
people who have what appears to be too much, as well as poor people strug-
gling to survive.
Neha not only knows the symptoms, she has also risen to the challenge
of dealing with one of burnout’s most intimate causes: the inability of so many
to recognize what is happening to us and to take charge of ourselves. Step by
step, she helps us become aware of the hallmarks of burnout—physical and
emotional exhaustion, depression and anger, cynicism and indifference—and
she shows us how to regard these challenges as opportunities to recognize,
embrace, and grow through and beyond.
Neha reminds us that all aspects of our lives—physical, mental, emo-
tional, social, and spiritual—are interconnected and that her program for
attending to and learning from each of these enhances our functioning and
satisfaction in all of them. She guides us in enhancing the self-awareness that
tells us which change is appropriate and sustainable. And she gives us tools
for dealing with the self-defeating beliefs and fruitless anger we may discover
xi
Foreword
—James S. Gordon, MD
founder and CEO of The Center for Mind-Body Medicine
and author of Transforming Trauma: The Path to Hope
and Healing
xii
HOW WE
GOT HERE
I
t was early 2001, when I officially became an overworked, undernourished,
stressed-out internal medicine physician caring for 18 hospitalized patients
a day. By definition, anyone admitted to the hospital was enough of an
emergency that they couldn’t be handled as an outpatient. I didn’t walk—I ran
from task to task, patient to patient, crisis to crisis. Pulled in multiple direc-
tions by my pager beeping, lab techs calling, and new medical complications
arising, I desperately tried setting priorities to guide my actions—only to have
them dismantled by the next emerging catastrophe.
My day started by getting sign-out from my coworkers on the night shift.
“Neha, same as usual—we were slammed last night and understaffed. I’ve
only done cursory workups and am still waiting for lab results and scans.
Sorry about that. And rumor has it that the ER and cardiac nurses are short-
staffed today and considering another union strike next week. Good luck.”
Message received: do more with less.
As I glanced at my new patient list, I saw two intensive care patients, a
liver transplant patient, three more waiting in the ER, and someone who had
been in the hospital for six months with multiple comorbidities. I felt drained,
and the day hadn’t even begun. Just before my colleague walked out, he
added, “Oh yeah, don’t forget there’s a mandatory department meeting at
noon today. I’ll be passed out in the call room. If you don’t see me at the
meeting, please wake me up—I’m beat.”
Our department chief began the meeting with, “So team, the theme for
this month is efficiency. Leadership has unanimously agreed that the best
1
POWERED BY ME
way to improve hospital flow is to prioritize all patients that are ready to leave
and discharge them before 11 a.m. This way, we’ll know exactly how many
beds are available for the day. The 11 a.m. discharges are effective immedi-
ately, so please get tomorrow morning’s discharges ready today. We’ll be
tracking your progress, and for those of you that lead the charge, you can
expect a bonus at the end of the year.”
Message received: faster is better.
After the meeting, I approached the department chief and expressed my
concern about repeated bullying behavior by a colleague on our team. He
looked at me emotionless and responded, “Tyler’s a physician partner and
one of the most efficient docs we’ve got. If you hope to become a partner
someday, you’ll need his vote—and mine. Just keep your head down and
focus on patient care, OK?” I nodded in disbelief.
Message received: success requires struggle.
Every day I pushed harder and faster, running headlong in the direction
others wanted me to go . . . until one day, I hit the brick wall of burnout and
was put on a three-month compulsory medical leave to recover.
After taking time to heal and reflect, I realized I had been listening to
and following everyone else’s guidance rather than my own. Burnout forced
me to look inward and figure out how I’d gotten so far off track that my body,
mind, and heart had shut down on me.
Faster is better.
These beliefs have been the engine driving how we think, behave, and live. In
fact, our collective brain power, time, and resources have been laser-focused
on accelerating our external world. Each year, we ask ourselves some ver-
sion of:
2
Another random document with
no related content on Scribd:
disposal of the dead by burning. “Henry Baldwin, my very dear
friend, my sole executor, ... is to burn my body, or at least bury it
without any direction,” he wrote; then he provided for the education
of his brother James, which was to be completed by his studying law.
In case the estate proved insufficient for the purpose, his brother
Frederick was to provide the deficiency. Any residue, he declared, “is
to go to my adored mother.”
The encounter took place the next day in a ravine in Oakland, in
what is at present the Fourth Ward of the city of Pittsburgh. The
ravine through which a rivulet coursed, called “Three-Mile Run,” long
since sewered over, opened on the Monongahela River, at a point
now occupied by the lower end of the Jones & Laughlin Steel
Company’s ore-yard, and by the office of the Eliza Furnace. To-day
there are laid out through the ravine several unpaved hillside streets
with narrow board sidewalks, one of which is the lower portion of
Halket Street. On the upper edge of the easterly border of the ravine
is Bates Street, named for Tarleton Bates. The duel was fought near
the Monongahela River; the distance was ten paces; the weapons
were pistols. Both principals displayed undaunted courage. Bates fell
241
at the second fire, shot in the breast, and expired in an hour. On
the day that Bates lay dead in the ravine which ever since has been
haunted with his memory, Pentland made another slanderous charge
in his newspaper: “I shall not engross the columns of this paper with
remarks on the private character of Mr. Bates, because that already
appears to the public in colors as dark as the skin of his
242
mistress.”
The community was shocked at the tragedy. Notwithstanding the
directions of Bates’s will in regard to the disposal of his body, he was
buried in Trinity Churchyard. A great concourse of people attended
the funeral, the chief mourner being Henry Baldwin; but the whole
town deplored his death. In its next issue, the Tree of Liberty added
to the general gloom, by appearing in mourning dress. Two weeks
later the post brought news of the dire calamity to the widowed
mother in her Virginia home, and to her children. Amid their tears
they rejoiced that the Virginia traditions of honor had not been
violated and that Tarleton Bates had accepted the challenge and
243
preferred “death to a life of infamy and disgrace.” The depth of
their attachment appeared in the fact that the family preserved his
letters as precious mementoes as long as they survived. For a time
the grave was a hallowed spot to be pointed out to visitors, but as
Bates’s old friends died, and a new generation came on, it was
neglected, and now the location is forgotten. Bates’s brothers
received their inspiration from him. He was the ablest member of the
family. Had it not been for his untimely death, the name of Tarleton
Bates might have become one of the great names in Pennsylvania
history, if not in that of the United States.
At the northwest corner of Market and Third streets, in the house
244
built by Major Ebenezer Denny, of brick taken from Fort Pitt, was
the store of Denny & Beelen. The firm was composed of Major
Denny and Anthony Beelen. They sold, “dry goods, hardware,
245
groceries, stationery, perfumery, china, glass, and queensware.”
Major Denny, the senior partner, was a slender, blue-eyed, and red-
haired man of thirty-nine. His was a most adventurous career. In the
Revolution he was ensign in the 1st Pennsylvania Regiment, and
lieutenant in the 3d and 4th Pennsylvania Regiments. He had served
as lieutenant under General George Rodgers Clark in Illinois, was
adjutant to General Josiah Harmar in the campaign against the
Indians in 1790, and aid-de-camp of General Arthur St. Clair in 1791.
He was the messenger who carried the news of the rout of St. Clair’s
army to President Washington at Philadelphia, then the seat of the
national government. On returning to private life he had gone into
business with Captain Joseph Ashton, a former Revolutionary officer
like himself, at the place later conducted by Denny & Beelen. This
partnership was dissolved in 1794 when Denny was again appointed
to a military command and placed in charge of an expedition sent to
Fort Le Boeuf. In Pittsburgh he took a conspicuous part in public
246
affairs. He was a candidate for representative to the Pennsylvania
House of Representatives against Lucus, but was defeated. Later he
was elected county commissioner. In 1803 he was treasurer of the
county, being the first man to hold that office, and was the first mayor
of Pittsburgh upon its becoming a city in 1816.
Anthony Beelen, Major Denny’s partner, was a native of the
Austrian Netherlands, now Belgium, and was the son of Francis,
Baron de Belen Bartholf, Minister of the King of Austria, Joseph II., to
the United States, who, upon the death of the King in 1790,
continued a resident of the United States. The Baron seems to have
soon discarded his title of nobility, as he was engaged in business in
Pittsburgh at an early date, going by the name of Francis Beelen,
being a partner in the firm of Amberson, Beelen, & Anshutz which
247
was dissolved in 1794. Anthony Beelen made the acquaintance
of Denny in Philadelphia, and became associated with him, and in
248
1794 settled the affairs of Ashton & Denny. In 1803 he was one of
249
the Pittsburgh assessors. In later years he conducted an air
furnace and other enterprises. Beelen afterward lost his property, but
the family fortunes rose again when Mrs. Mary Murphy died. In her
will she left all her valuable estate, the principal part of which
consisted of the block on Market Street in which “Clapboard Row”
was located, to Beelen in trust for his daughter and granddaughter.
On Third Street a short distance west of Market Street, Andrew
Willock, Jr., conducted a baking business, at the “Sign of the Sheaf
250
of Wheat.” He also kept a tavern, taverns and bakeries being
frequently carried on together. Alexander McLaughlin, an oldtime
merchant, was located at the southwesterly corner of Market and
Fourth streets in the same block with Denny & Beelen. He had
251
formerly been on Second Street. In 1800 he was a candidate for
252
county commissioner, but was defeated by Nathaniel Irish. James
Wills, who dealt in “boot and bootee legs,” adjoined McLaughlin on
253
the south. Next to Wills’s house was that occupied by John
Wrenshall. Wrenshall was a man of culture and, in addition to
keeping store and preaching the Gospel when the opportunity was
presented, was a writer of ability. His Farewell to Pittsburgh and the
Mountains, published in Philadelphia in 1818, was a poem of some
merit, and of considerable local interest. He was the grandfather of
Julia Dent, the wife of General U. S. Grant, eighteenth President of
the United States. Joseph Davis was located between Wrenshall and
254
Denny & Beelen. He was assessor in 1802.
John Irwin, one of William Christy’s old partners, had his store at
the northeast corner of Market and Fourth streets. He was a former
Revolutionary officer, having been captain in the 2nd Pennsylvania
Regiment. At the next corner, where Market Street intersected the
South Diamond, in the large three-story brick building were the
tavern and store of William Irwin, the other partner of Christy. This
building was another of the houses built of brick taken from Fort
255 256
Pitt. To this house William Irwin had removed in 1799 ; and
here he furnished public entertainment, and sold, in addition to
whisky, and other diverting drinks, “kettles, stoves, and dry
257
goods.” Dancing classes were also held in the building, those for
ladies at three o’clock in the afternoon, and the classes for
258
gentlemen at six o’clock in the evening. More serious business
was conducted there. In the large hall in the third story the courts
were held for more than a year after being removed from Andrew
259
Watson’s house. This was likewise the room in which Lodge No.
260
45 now held its sessions.
North of the South Diamond the buildings were farther apart. At
the southeast corner of the East Diamond and Diamond Alley was
261
the log store of William Woods & Company. On the opposite side
of Market Street from John Irwin and William Irwin’s stores, in the
middle of the block, was John Hamsher’s retail shop, where he sold
262
copper and tin-plate articles, and clover seed. Next door was the
263
store of James Dunlap & Company. In the Diamond, east of
Market Street, was the semicircular market house, which covered
most of this part of the Diamond. Its wide, projecting roof was
supported by a double row of brick pillars. In the interior of the
building were rows of stalls, with benches and blocks, for the
butchers. Encircling the structure was a brick pavement along the
264
curb of which the farmers and market gardeners were stationed.
265
In the Market House the borough elections were held.
Across Market Street from the Market House was the new court
house. It was the pride of the western country, and the only high
building in the town. It was a square, two-story brick structure with
one-story wings, for the county offices, and was surmounted by a tall
wooden spire. In 1800, the main building was barely completed,
some of the upper rooms being yet unplastered, although the county
266
offices had been removed to the wings two years before. The
belfry lacked the bell; and the space before the building was only
then being paved. The main entrance was on Market Street, and on
either side of the doorway were fluted wooden columns with
Corinthian capitals. The court room was on the first floor and was
paved with bricks which, like the brick used in the pavement outside,
were large and almost square. Supporting the ceiling were Doric
267
pillars resting upon square panelled pedestals. The judges’ bench
and the jury box were in the rear of the court room. They faced the
entrance, and the judges’ bench admitted seating the president
judge and the four lay associate judges, at one time. It was elevated
above the floor and was reached by stairs placed at the northerly
end. The jury box was southerly of the judges’ bench, with a narrow
passage between it and the judges’ bench. After the bell was placed
in the belfry in 1801, Joseph Harris became bell-ringer, and rang the
bell whenever court was about to convene.
Back of the court house, one hundred and forty feet west of the
West Diamond, and running parallel with it, was an alley, now called
Delray Street. On the westerly side of this alley, a short distance
south of Diamond Alley, was the new square two-story stone county
jail. It was erected on a lot purchased by Allegheny County in 1793,
and was completed at the same time as the court house. The
building was surrounded by a stone wall, the entire lot being
enclosed by a high board fence.
Immediately in the rear of the court house, at the southwest
corner of the West Diamond and Diamond Alley, was the tavern of
John Reed at the “Sign of the Waggon.” Here the Allegheny County
courts held a few sessions, during the interval between the time of
leaving William Irwin’s house, and the completion of the court
268
house. At the northeast corner of Market Street and the North
Diamond, was the tavern of Thomas Ferree at the “Sign of the Black
Bear.” Directly across Market Street in the new brick building, was
the boot and shoemaking establishment of John and Alexander
269
Wills. On the same side of the street, the second door south of
Fifth Street, was James Yeaman’s brick building, in which he
270
conducted his bakery and brewery.
REFERENCES
Chapter VII
233
Thomas Lloyd. The Trial of Alexander Addison, Esq.,
Lancaster, 1803, pp. 1–168.
234
William Hamilton. Report of the Trial and Acquittal of
Edward Shippen, Chief Justice, and Jasper Yeates and
Thomas Smith, Assistant Justices of the Supreme Court
of Pennsylvania, on an Impeachment before the Senate
of the Commonwealth, January, 1805, Lancaster, pp. 1–
587.
235
The Commonwealth, August 28, 1805.
236
The Commonwealth, December 25, 1805.
237
Onward Bates. Bates et al. of Virginia and Missouri,
Chicago, 1914, p. 45.
238
Onward Bates. Bates et al. of Virginia and Missouri,
Chicago, 1914, pp. 43–52.
239
The Commonwealth, January 8, 1806.
240
Collinson Read. Abridgement of the Laws of
Pennsylvania, Philadelphia, MDCCCI, p. 383.
241
The Commonwealth, January 15, 1806.
242
The Commonwealth, January 8, 1806.
243
Onward Bates. Bates et al. of Virginia and Missouri,
Chicago, 1914, p. 57.
244
William G. Johnston. Life and Reminiscences, Pittsburgh,
MCMI, p. 36.
245
Pittsburgh Gazette, December 22, 1798.
246
Major Ebenezer Denny. Military Journal, Philadelphia,
1859, pp. 21–30; ibid., pp. 29–30.
247
Pittsburgh Gazette, August 2, 1794.
248
Pittsburgh Gazette, June 14, 1794.
249
Pittsburgh Gazette, May 20, 1803.
250
Tree of Liberty, May 15, 1802.
251
Pittsburgh Gazette, September 6, 1794.
252
Pittsburgh Gazette, October 24, 1800; Tree of Liberty,
October 18, 1800.
253
Pittsburgh Gazette, March 30, 1799.
254
Pittsburgh Gazette, May 21, 1802.
255
Isaac Harris. General Business Directory of the Cities of
Pittsburgh and Allegheny, Pittsburgh, 1841, p. 6.
256
Pittsburgh Gazette, April 6, 1799.
257
Pittsburgh Gazette, July 1, 1799.
258
Pittsburgh Gazette, May 21, 1802.
259
H. M. Brackenridge. “Pittsburgh in the Olden Time,” The
Literary Examiner and Western Monthly Review,
Pittsburgh, Pa., 1839, pp. 27–29.
260
Centennial Volume of the First Presbyterian Church of
Pittsburgh, Pa., 1784–1884, Pittsburgh, 1884, p. 152.
261
Pittsburgh Gazette, October 10, 1800; ibid., December 16,
1802.
262
Pittsburgh Gazette, August 16, 1800.
263
Pittsburgh Gazette, October 17, 1800.
264
William G. Johnston. Life and Reminiscences, Pittsburgh,
MCMI, p. 68.
265
Pittsburgh Gazette, May 15, 1801.
266
Pittsburgh Gazette, October 13, 1798.
267
H. M. Brackenridge. “Pittsburgh in The Olden Time,” The
Literary Examiner and Western Monthly Review,
Pittsburgh, Pa., 1839, pp. 27–29; William G. Johnston.
Life and Reminiscences, Pittsburgh, MCMI, pp. 67–68.
268
Pittsburgh Gazette, February 1, 1800.
269
Pittsburgh Gazette, November 14, 1800; ibid., July 2, 1802.
270
Pittsburgh Gazette, August 28, 1801; ibid., August 5, 1803.
CHAPTER VIII
ZADOK CRAMER