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Total Well-Being in Anesthesiology: Looking Beyond COVID-19

Published:February 02, 2022DOI:https://doi.org/10.1016/j.anclin.2022.01.015
      It is admittedly impossible to predict where we will be in the COVID-19 pandemic by the time our readers receive this issue—hopefully, somewhere better, and not at the height of yet another surge or amid preparations for one. Indeed, it seems uncertainty has endured as the only reliable theme throughout these unsettling times. Likewise, physician well-being has emerged as a pandemic in its own right, as the ways in which we care for one another and ourselves—as individuals, medical professionals, and a society—have been upended. One thing has become abundantly clear: the adage of putting on your own oxygen mask before caring for others resonates now, perhaps more than ever.
      Caring for the critically ill during a global pandemic, particularly when basic safety needs of frontline clinicians are compromised and science is met with skepticism, has wrought extraordinary personal and professional moral fatigue and injury. The suicide of emergency medicine physician Lorna Breen, MD, tragically epitomized the untold suffering and grief experienced by so many in health care. The long-term sequela in anesthesiology remains to be seen, and we have reason to worry—in a specialty already vulnerable to loneliness, feelings of despair, burnout, and isolation now exacerbated by the pandemic are pressing considerations for trainees, faculty, health care systems, and professional organizations alike. It is prescient to look beyond the pandemic and ask ourselves as a collective: what do anesthesiologists need to be well and stay well?
      We are at a critical juncture in anesthesiology, one that has illuminated the interconnectedness of physician burnout, organizational accountability, institutional culture, systemic inequity, structural racism, gender bias, underrepresentation, social justice, psychological and physical workplace safety, peer support, patient safety, compassion fatigue, domestic caregiving responsibilities, and job security, among others. In urgently recognizing—and embracing—physician well-being as durational, we have the opportunity to disrupt, remodel, and invest in sustained wellness efforts while engendering compassion for ourselves and one another. We must intentionally and diligently assess the ongoing toll of the pandemic on anesthesiologists’ well-being and continue to do so. We must all be stewards of wellness in anesthesiology by upholding a culture of care and making space for the conversations foregrounded in this issue and within our workplaces.
      This inaugural well-being issue of Anesthesiology Clinics is an intentional effort to collate different institutions and organizations’ wellness experiences, authored by peers and trainees both within our field and beyond. We hope this diverse compilation of perspectives yields insights to broaden our understanding of how to operationalize well-being in relevant clinical and educational contexts. From systems-based and individual interventions to “bottom-up” initiatives and curricula, the articles presented here thoughtfully advocate that timely action is essential if we want to attract and retain diverse, bright individuals within our field and to continue doing the work of caring for others.
      We wish to thank Dr. Lee Fleisher for entrusting us with this timely and incredibly urgent issue. To Joanna Collett and Arlene Campos, we could not have done this without your patience and guidance. To our many authors, we are beyond grateful for your generosity of spirit, professionalism, and collegiality. We recognize that we approached you at a challenging moment and greatly appreciate your shared wisdom and lived experiences. We see this issue as a joint effort and collective embodiment of the ethos we hope will permeate and impact wellness and well-being efforts in anesthesiology across programs and institutions.