Rethinking Mental Toughness

For a long time, personal and career development for physicians seemed to center on self-discipline—becoming the CEO of your own life, thinking like a boss, being mentally tough. Mental toughness is a well-trodden term in business, leadership, and athletic circles; a phrase used to describe inner fortitude, mental toughness is a kind of will-power and strength that allows people to keep going and succeed in the face of obstacles and fatigue.

Vince Lombardi said, “Mental toughness is spartanism with qualities of sacrifice, self-denial, dedication.” Embedded in the idea is that you can complete the task at hand if you are just committed enough. If you just keep going, you can win.

But the idea that we must always be strong is incredibly damaging to physicians. Most physicians have internalized the idea that we ought to be superhuman, working exhausting hours with no breaks for food, or even to use the bathroom. We should be teaching physicians that it’s okay to be weak. It’s okay to take a break. We all have moments in which to keep going at top speed is too much. To pretend that we don’t is to deny our humanity.

The number of physicians whose lives are lost to suicide every year lets us know that there is something wrong with the practice of medicine in America. Right now, I’m not interested in how mentally tough you are. I want to know if you’re embracing your humanity and that of your colleagues.

Instead of teaching physicians how to build a mental strength that will allow them to endure anything, perhaps we need to focus more energy on building a system that respects their humanness. Maybe we can spend more time teaching them how to recognize when they need a break, or if it’s time to ask for help. There’s strength in that, too.