I have had the great privilege of working with some of the top psychologists in the resilience field including Drs. Karen Reivich and Andrew Shatte who authored the book the Resilience Factor. I had the unique opportunity to develop three online resilience programs with them that improved the lives of thousands of people across the United States and beyond. I learned from them that resilience is a complex web of seven factors that give us the ability to recover in the face of adversity and includes:
- Emotion Regulation: the ability to control one’s emotions in the face of adversity and to remain goal focused.
- Impulse Control: the ability to control one’s behavior in the face of adversity and remain goal focused.
- Causal Analysis: the ability to accurately and comprehensively identify the causes of one’s adversities and generate effective solutions.
- Self-Efficacy: one’s sense of mastery over adversity, challenges, and opportunities.
- Realistic Optimism: a reality-based belief that the future is positive.
- Empathy: the ability to read the verbal and non-verbal cues of others to estimate their mental state and emotion.
- Reaching Out: the ability to deepen relationships with others and to take on new challenges and opportunities.
For almost 15 years I have practiced the resilience skills they taught me and have boosted my ability to overcome minor day-to-day adversities, steer through life’s challenges, and even bounce back from major adversities. But recently in a four-day period, I learned more about resilience than I had in the previous 15 years. It was during my trip to Ethiopia where I learned the true meaning of resilience.
I had been invited to Ethiopia by the American College of Obstetricians and Gynecologists and the Ethiopian Ministry of Health to teach healthcare providers about curriculum development and e-learning. I was asked to conduct a 36-hour seminar over four days.
The first day of the course, one of the participants—an Ob/Gyn—arrived to the program an hour late and was very apologetic. I later found out that she had been dealing with a maternal and fetal mortality all night. A patient in the Ethiopian public health system had been laboring for several days at home but could not get to a hospital. She was finally taken to the hospital after she had a uterine rupture and her baby was expelled into the abdominal cavity. Both mother and baby died on the way to the hospital. I am also an Ob/Gyn but have never had a maternal mortality in my entire career. I would imagine if I had one, it would have a very traumatic effect on me that might require weeks or even months for me to process. But not this Ethiopian physician. She was a bit tired because she had been up all night, but she was poised and ready to learn. After all, she had seen her share of maternal mortalities since sub-Saharan African countries have the highest maternal mortality rates in the world. I began to realize how different her experiences and perspectives were from mine and that her resilience was far greater than mine.
After the first day of the seminar, the participants were truly engaged and excited to learn. The group started building this palpable sense of comradery and I began to experience their beautiful spirit and character first-hand. Through our conversations, I began to realize that they were beyond a doubt the most resilient people I had ever met. That realization would be confirmed just a few hours later.
Mid-afternoon on the second day of the course, we took a 15-minute break. We all congregated in a foyer in the conference hotel for coffee and tea and were having deep discussions about the educational needs for healthcare providers in Ethiopia. We were in one of the nicest hotels in Ethiopia and you could look up to the overcast sky through a glass roof over 20 stories above. Unbeknownst to us, there were some workers on the roof doing repairs that day.
We all heard it at the same time: what sounded like sonic boom coming from above. As we looked up toward the noise, we saw large chunks of concrete and glass shrapnel from the roof barreling down toward our group. Everyone scattered out of instinct to get out of the way. Some of the course participants were hit by pieces of glass and injured. We immediately went from student/teacher mode to healthcare provider mode. We triaged the injuries and sent three people to the local hospital.
We quickly found out that there was a worker accident on the roof that caused the collapse of a small section. When I surveyed the foyer area after the situation was under control, I realized that the table where I was drinking coffee and sharing insights during the break had been cut in half by a large chunk of concrete. I took a picture of the table that had been destroyed and thought to myself, “What if…”
We decided to take the rest of the day off from the conference, but we wanted to be together and process what we had just experienced. We moved to another area of the hotel and sat in a circle talking about the people who were injured and wondering how they were doing. We told stories of some of the worst things that have happened to us in our lives, and that seemed to be somewhat calming for the group. I quickly began to realize that this group is inundated day after day with some of the greatest poverty and harshest conditions on the planet, but somehow approach life with vigor, enthusiasm, and hope.
As we continued to share our stories, we began forming a bond closer than I could have imagined. We were from different cultures, different countries, almost different worlds. But in the end, we were all caring human beings who had gone through the same traumatic experience.
We were heartened to hear that the injured participants were released from the hospital. They came back to the course with bandages covering different parts of their bodies but participated fully as if nothing had ever happened. At the end of the course, we each expressed how grateful we were to have shared our time and experiences with one another.
A few months have now passed since my trip, but I reflect on it often. I truly believe I am a better person as a result of my experiences in Ethiopia. I am already looking forward to going back there again soon to see my new friends who have taught me the true meaning of resilience.
Please let me know if there is anything I can do to help you and your department build resilience. You can reach me at firstname.lastname@example.org. I look forward to interacting with you.
Jeffrey Levy, MD
Developer of CoreWellness Online for Residents
Author of CoreWellness: A Physician Wellness Program
CaseNetwork is a technology enhanced medical education company that delivers competency-focused, case-based education that enables learners to improve their knowledge and comprehension of critical patient situations and disease states. CaseNetwork’s simulated patient encounters integrate evidence-based clinical information with required proficiencies and skills. CaseNetwork’s proprietary platforms include interactive decision making and peer-to-peer problem solving that is conveniently delivered in a browser or on a mobile device for anytime, anywhere learning. The CaseNetwork solution helps healthcare professionals advance their skills and improve competency with the ultimate goal of enhancing patient outcomes. For more information, visit www.casenetwork.com.
CoreWellness Online is a breakthrough online program from CaseNetwork with 24 modules that provide your residents with the knowledge and practical skills to manage stress and adversities typical of post-graduate training. Residents will learn about burnout syndrome (BOS), improve resilience, and achieve self-awareness through proactive wellness and self-care measures. This comprehensive program is the first of its kind, designed to help residents cope with the unique demands of the healthcare profession and to better understand the impact stressors have on their cognitive, emotional, and physical well-being. This program provides information to help them not only survive training, but to actually thrive and flourish. For more information go to http://casenetwork.com/markets/corewellness/