Physician burnout, depression, and suicide are tearing at the fabric of our health care system, which Dr. Mukta Panda
has witnessed firsthand, written about, and sought to address for years. Mukta Panda, MD, MACP, FRCP-London, is a physician, speaker, and facilitator whose work seeks to transform the heart of patient care and medical education.
Dr. Panda has lived and practiced medicine in places as varied as India, London, Saudi Arabia, and now East Tennessee, where she serves as the Assistant Dean for Well-Being and Medical Student Education and a Professor of Medicine at the University of Tennessee College of Medicine at Chattanooga. She is also former chair of the Department of Internal Medicine. Her multicultural background strongly informs her work in health care as a clinician and educator where she strives to bridge the gap between evidence-based and empathy-based medicine. "I've learned the importance of embracing my own Indian culture, the faith I carry, and my spiritual roots, which are so embedded in who I am," she says. "My ability to live in the world, accepting differences, has been influenced by being in other cultures."
Author of over 60 publications, Dr. Panda focuses on spirituality in medicine, addressing fatigue and stress, educational and curricular development, and promoting the well-being of health care professionals.
"Burnout affects not only physicians but all stakeholders, from the janitorial staff and the cafeteria workers to the nurses and students, as well as the families of those who work in health care," she has observed. In a culture that privileges evidence over empathy, technology over touch, and what's measurable over what's meaningful, many of us – no matter our profession – feel more fragmented and isolated than ever.
"Evidence has its maximum impact when applied in the context of these other E's that make up the whole of empathy-based medicine: emotions, expectations, ethics, engagement, empowerment, effort, education, experience, error, environment, and equity," she argues
. "Sometimes sufficient evidence isn't available, but these other E's provide a viable way forward. You may not always know what to do to cure the patient, but your heartfelt care will go a very long way."
In her latest book, Resilient Threads: Weaving Joy and Meaning into Well-Being
(Creative Courage Press, 2020), Dr. Panda gives voice to the exhaustion and offers courage for another way. As a physician and medical educator, she has fought to return human touch to healthcare. As a mother, she has committed – and sometimes failed – to balance the personal with the professional. And as an immigrant, she has clung to the wisdom of her family and faith in the face of discrimination and fear.
By weaving stories of connecting to her patients, students, and colleagues with her own stories of belonging, she models how we can each thrive by creating community and self-awareness. "Ritual, relationships, and reflection are key threads in how I learned to thrive," Dr. Panda writes in the introduction of her book
. So, too, are they key for the thriving of our world. Our well-being depends on integrating these threads into a new social fabric, one that honors the whole of who we are with what we do.
The issue of physician burnout is a personal one for Dr. Panda, and she says that in order to find a way forward, we must first accept that there is no magic answer. "It is a convoluted issue. It's like peeling an onion. You will take steps forward and backward, and that is okay. But it starts with the self." The second step involves building community. "Being in community requires courage and the ability to communicate and care deeply about the shared covenant. The word covenant feels sacred, as if there's ownership. I prefer that over mission or goal. It addresses the loneliness, but if we are working together on the same thing, there is unity that builds community."
"As we are so aware in the face of COVID-19, physicians who are relatively well (and relatively 'protected') are better able to serve their patients, students, colleagues, profession, and society," Dr. Panda says. "Partnership is needed now more than ever to mitigate and plan and advocate for self-care during this pandemic – and the post-traumatic stress to follow – not only for healthcare professionals but for our entire community at all levels: nurses, nursing assistants, physician assistants, physical therapists, mental health providers, custodians and cafeteria workers, receptionists, administrators, executive team, our families and the community at large."
Dr. Panda developed a new Oath to Self-Care and Well-Being
that she co-authored with Margaret C. Lo, MD and Kevin E. O'Brien, MD on behalf of the Collaborative for Healing and Renewal in Medicine
(CHARM). "In framing this oath to supplement our Hippocratic Oath, we see wellness as a shared responsibility between the individual provider and the system, with the major responsibility lying with the system itself," she explains.
Self-care and well-being of health care professionals is particularly relevant during this time as we witness the bravery of those serving on the front lines and the unwavering support of the communities rallying behind them. "In this COVID era, nurses are the ones who have given of themselves selflessly and with a smile," Dr. Panda reflects. "They not only care for the patients and their loved ones, they care for us physicians too. Many many times I have been offered a cup of freshly made coffee, a snack or food."
As we lean into the mysteries of this uncertain time, a line from Dr. Panda's new book offers comfort: "It's important to surrender and say to yourself, 'I don't need to have all the answers as long as I can live into the questions and hold the tension for what it is, to be comfortable with not knowing.' For me, there is so much peace in that."
Join us in conversation with this gifted and compassionate physician!
Five Questions with Mukta Panda
What Makes You Come Alive?
For me, coming alive is a feeling of such joy or deep sadness that my eyes spontaneously tear up. It can be the pure connection with another person, nature, music, a picture, or anything that touches me in the extreme of emotion. At work, it's when my eyes lock with the eyes of my patient, or their family members in a moment of real joy, or even in the moment of giving really bad news, our hands lock together in a tight squeeze, and there are just tears in the eyes. I'm alive because I am connected to the person in their humanness. Or when I see my students or my children achieve something they had been striving for, I feel tears swell up in my eyes. When I see another human being really going out of their way and being kind to another, even if it is in a movie, I feel the connection. Any time I feel that deep connection with another, I feel I'm alive.
Pivotal turning point in your life?
The pivotal event that made me intentionally think about and name that deep connection came from understanding what it means to listen to your own inner voice. That happened at a Circle of Trust retreat I attended in 2008. It was an important and pivotal moment of transition for me, both as a human being and as a human wearing multiple hats based on my various roles both personally and professionally. It gave me an introductory view of the "what-if" questions for my life and left me hungry for wanting to understand more. I realized then that there was something I needed to explore for myself to fulfill my purpose.
An Act of Kindness You'll Never Forget?
There are so many, I wish I could name them all. However the prime act of kindness is the mercy of the Supreme Power to give me these acts of kindness throughout the life. I have been bestowed by kindness from every direction. I don't think I could repay all the kindness I have been shown in this life. I will definitely be intentional about paying them forward.
One Thing On Your Bucket List?
I want to go to the Dharamshala. I do want to travel. There is so much of God's beauty that I want to see around the world and meet people.
One-line Message for the World?
Be kind to yourself and others, trust and surrender unconditionally.Happy Thoughts