COMPASSION IS WHAT SUSTAINS ME: CAROL COTTRILL

It seems so fitting that Carol Cottrill’s medical specialty is the hearts of children - both physical and emotional. Her career path began when her 4th child was born with congenital heart disease.  Growing up on a family farm, she learned to balance compassion and necessity, a skill she would use in caring for her daughter and later during 18 years as medical director of UK’s pediatric ICU. Her daughter’s illness introduced her to wonderfully compassionate doctors and nurses who….

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FRIEND TO THOSE WHO ARE AILING: DANESH MAZLOOMDOOST, MD

Danesh Mazloomdoost, MD has inherited a tradition reflected in his name itself. In his family’s native Iran, Mazloomdoost means “friend to those who are ailing.” His life in medicine seems almost preordained by his family history. His father (a U.S. trained anesthesiologist who specialized in pain management) and mother (who trained in anesthesiology in Iran and retrained in psychiatry in the U.S.) built their practice around a comprehensive mind-body approach to pain management, long before such….

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SUSTAINING AN ALTRUISTIC SPIRIT: TERRY BARRETT

Terry Barrett is Chief of the Gastroenterology Division of the Department of Medicine, University of Kentucky College of Medicine. He came to Lexington in 2013 from Northwestern University Medical School in Chicago.  Becoming a Doctor.   Although there were no doctors in his family, he always felt a parental expectation of excellence and high achievement. He had a poor impression of the competitive nature of pre-medical education he witnessed among his peers.

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several times a day to move, stand, breath and simply pay attention to the present moment.


He refers several patients a week for mindfulness training and says “I particularly find this approach useful for treating anxiety-related disorders, chronic pain, inflammatory bowel disease and irritable bowel syndrome.”


Keeping Compassion Alive

He is still motivated by the altruism of his college years. He feels an inner compulsion to serve. He focuses on the good he is doing at home and at work. He takes comfort knowing he is making a difference. The meaning of being a physician is constantly renewed by such activities as teaching 1st year medical students at the UK Student-Run Salvation Army Clinic. He also feels renewed by providing free care to the indigent men and women seen there- some of whom are desperate, addicted, homeless, mentally ill and at the end of their rope.


He says, “You must be compassionate to them all.” He may not receive thanks from some patients. He will never see most of them again. “But an inner purpose drives me to help them.”


The Next Generation

The conflicting demands and inefficiencies of hospital systems can negatively impact physician job satisfaction and lead to burnout from institutionalized external stressors. The training environment of fellows, residents and students can be affected- and despite the best intentions of caring professionals, patients can be harmed. Terry enjoys doing research enough to tolerate these drawbacks of medical academia. Many physicians choose to practice in the private community, usually without the triple academic demand of teaching, research and clinical care- not to mention the supervisory demands of being a division chief.


His evaluations of his faculty and fellows includes a realistic assessment of these environmental stressors they are exposed to. He sits down individually with his faculty at least twice a year for a focused review and guidance on each aspect of their career. He praises them and shows appreciation as much as possible, knowing such feedback can reduce the risk of burnout.


But he also knows that external rewards and praise are not enough. To be truly satisfied and effective, they must also be internally rewarded and driven. He asks them “Why are you here? What makes you excited? What brings you happiness?”


He thinks we need to arm students, residents, fellows and faculty with the life skills of self-care and resilience. Based on his own personal experience, he recommends mindfulness and its toolkit of mind-body skills as a preventive antidote to stress and burnout.


Societal, parental and financial pressures impact career choices between academia and community practice. Competition for grades and class rank add to the burden of isolation so common among medical trainees. He observed this dynamic first hand in his own daughter. Though she is now in her dream residency, there were times in medical school that she felt distraught over her academic performance, leading to self-defeating inner dialogue. He thinks we need to intentionally weave self-care throughout health professional training - in medical school, residency, fellowship and practice.


Terry Barrett is a physician who has found a way to sustain his lifelong altruistic spirit. In the process, he is helping medical students, residents, fellows and faculty sustain their own.

Terry Barrett is Chief of the Gastroenterology Division of the Department of Medicine, University of Kentucky College of Medicine. He came to Lexington in 2013 from Northwestern University Medical School in Chicago.


Becoming a Doctor

Although there were no doctors in his family, he always felt a parental expectation of excellence and high achievement. He had a poor impression of the competitive nature of pre-medical education he witnessed among his peers. Having a fondness for math and science in high school, he entered college thinking about becoming an engineer and perhaps a patent lawyer.


After growing up Catholic, going to mass every Sunday and attending a Catholic high school, he went through a deepening process of self-discovery in college as the Notre Dame faculty helped him and other students identify their unique personal strengths, gifts and skills. He recognized how much he was personally motivated by altruism, service and addressing world hunger. He became involved in the South Bend community, connecting college students to nursing home patients. He began making straight A’s in humanities courses. This combined interest in science and altruistic service led naturally to medicine as a career choice. He shifted to pre-professional studies and took theology courses. He was fascinated by the study of comparative religions and the common threads among spiritual traditions.

BY JOHN A. PATTERSON MD, MSPH, FAAFP

He brings this personal history to his mentoring of junior faculty and fellows. He knows they are also vulnerable to these self-defeating attitudes and their potentially destructive impact. He tries to help them avoid feeling despair as a new normal. He knows how easy it is for men and women who choose medicine for all the right reasons to burn out.   


Managing Stress

He has learned to recognize the signs of a stressful situation and which factors are external (over which he has limited control) and internal (over which he has much more control). The practice of mindfulness helps him distinguish between these external and internal stressors and manage them proactively. This allows him to take action to change the things he can rather than blame other people or external factors. He has taken to heart and regularly used the tools he learned in the Mindfulness-Based Stress Reduction (MBSR) course. Mindfulness has given him a non-pharmacological antidote to stress in the deceptively simple practice of being with all life experiences (physical, mental, emotional and relational) with equanimity, curiosity and openness. Mindfulness helps him to take action characterized by wise and skillful responses rather that unwise, unskillful and habitual reactivity. He also uses a mindfulness app on his phone that reminds him

JOHN A. PATTERSON MD, MSPH, FAAFP

Dr Patterson chairs the Lexington Medical

Senator Alvarado earned his bachelor's degree in biology from Loma Linda University (California) in 1990, and then went on to receive his Doctorate in Medicine in 1994. He completed his medical residency in Internal Medicine and Pediatrics at the University of Kentucky in 1998. Society's Physician Wellness Commission and is certified in Physician Coaching. He is on the family practice faculty UK College of Medicine and teaches nationally for Saybrook School of Integrative Medicine and Health Sciences (San Francisco) and the Center for Mind Body Medicine (Washington, DC). After 30 years in private family practice in Irvine KY, he now operates the Mind Body Studio in Lexington, where he offers integrative mind-body medicine consultations specializing in mindfulness-based approaches to stress-related chronic conditions and burnout prevention for helping professionals. He can be reached through his website at www.mindbodystudio.org

Knowing Burnout

Juggling his obligations to family and medicine has not been easy. During training, he and his wife had 5 children within a two-year span (aided by triplets). He is a researcher, clinician and educator. He has felt the impact of stress on his family life and his work productivity. He knows how it feels to begin to doubt oneself under the strain of so many competing demands. He has heard the inner voice of negativity that says “ You can’t do it” and “You aren’t that good.”