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Pearls:

  • Three themes emerge from Lawrence’s work as the former CFO of Pixar and his current work with the Juniper Foundation that he applies to the current state of physician burnout today:

    • 1. We can change the narrative of medicine from one that values perfectionism to one that values balance.

    • 2. We need to carve out time for self-care.

    • 3. The system is a problem; however, we can continue to work on ourselves even before the system completely changes.

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  • Lawrence is a lawyer by training who worked as CFO of Pixar with Steve Jobs, before eventually getting into meditation by founding the Juniper Foundation. He and Todd, an internist and medical educator, connected around the issue of physician burnout.

  • Three major themes around medical culture and the work of clinicians:

    • 1. The narrative of medicine is out of sync with the realities of medicine

      • Until we change the narrative of physicians as infallible, we cannot change the reality of constant pressure and fear of being wrong

      • Overemphasis on IQ over EQ when humans are emotional beings first

    • 2. Physicians spend far too little time on self-care and self-nurturing

      • Self-care must be a continuous habit of self-nurturing and mutual support just like food or exercise

      • Check-box yoga or meditation is not the answer → building time into the day and committing to self-care is how such practices can be sustainable

    • 3. While we need to change the system to address burnout, we can’t wait to also change ourselves

  • Things Lawrence learned from journey to Pixar and then to Juniper:

    • Pixar’s narrative needed to change from one of a graphic technology company to an entertainment company

    • Companies like Pixar create amazing things through the tensions between people (ie: technology people and creative people) and a culture of collaboration enables this tension to create amazing things

    • There were costs to high-performance culture: high levels of stress/anxiety, living life as a race and low levels of meaning/self-worth/joy/fun. These costs led Lawrence to explore anecdotes to them in Eastern philosophy and meditation. He found the key is figuring out how to master the outer world and inner self.

  • The Middle Way:

    • 2500 year old philosophy of harmony that states humans do better when in harmony with the inner and outer worlds. Suffering comes from one extreme or another (ie: too much of the bureaucrat or too much of the artist in all of us)

    • From an organizational perspective it means putting some structure in place to keep the momentum going without stifling the artist spirit too much

Reference:

Burns D. Feeling Good: The New Mood Therapy. William Morrow and Company; 1980.

Elton C. Also Human: The Inner Lives of Doctors. New York, NY: Basic Books; 2018.

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Gazoni FM, Durieux ME, Wells L. Life after death: the aftermath of perioperative catastrophes. Anesth Analg 2008;107(2):591-600.

Goyal M, Singh S, Sibinga EMS, et al. Meditation programs for psychological stress and well-being: a systematic review and meta-analysis. JAMA Intern Med 2014;174(3):357-368.

Hari J. Lost Connections, Uncovering the Real Causes of Depression, and the Unexpected Solutions. New York, NY: Bloomsbury; 2018.

Hill AB. Breaking the stigma: a physician’s perspective on self-care and recovery. N Engl J Med 2017;376:1103-1105

Schwenk T. Resident depression: the tip of a graduate medical education iceberg. JAMA 2015;314(22):2357–2358.

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Shanafelt TD, Dyrbye LN, West CP. Addressing physician burnout: the way forward. JAMA 2017;317(9):901–902.

And

Simpkin AL, Khan A, West DC, et al. Stress from uncertainty and resilience among depressed and burned out residents: a cross-sectional study. Acad Pediatr 2018; pii: S1876-2859(18)30122-0. doi: 10.1016/j.acap.2018.03.002. [Epub ahead of print]

Simpkin AL, Schwartzstein RM. Tolerating uncertainty -- the next medical revolution? N Engl J Med 2016;375:1713-1715.

“Lovely and surprising . . . This delightful book is about finance, creative genius, workplace harmony, and luck.”—Fortune

”Enchanting,”—New York Times

“I love this book! I think it is brilliant.”—Ed Catmull, cofounder and president of Pixar Animation, president of Disney Animation, and coauthor of the bestseller Creativity Inc.

The revelatory saga of Pixar’s rocky start and improbable success

After Steve Jobs was dismissed from Apple in the early 1990s, he turned his attention to a little-known graphics company he owned called Pixar. One day, out of the blue, Jobs called Lawrence Levy, a Harvard-trained lawyer and executive to whom he had never spoken before. He hoped to persuade Levy to help him pull Pixar back from the brink of failure.

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This is the extraordinary story of what happened next: how Jobs and Levy concocted and pulled off a highly improbable plan that transformed Pixar into one of Hollywood’s greatest success stories. Levy offers a masterful, firsthand account of how Pixar rose from humble beginnings, what it was like to work so closely with Jobs, and how Pixar’s story offers profound lessons that can apply to many aspects of our lives.

“Part business book and part thriller—a tale that’s every bit as compelling as the ones Pixar tells in its blockbuster movies. It’s also incredibly inspirational, a story about a team that took big risks and reaped the rewards . . . I loved this book and could not put it down.”—Dan Lyons, best-selling author of Disrupted

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“A natural storyteller, Levy offers an inside look at the business and a fresh, sympathetic view of Jobs.”—Success Magazine

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An Amazon Best Book of 2016 in Business & Leadership • A top pick on Fortune’s Favorite Booksof 2016 • A 2017 Axiom Business Book Award winner in Memoir/Biography