[00:00:00] Hi everyone, my name's Dex Randall, and this is the Burnout to Leadership podcast, where I teach professional men to recover from burnout and get back to passion and reward at work.

[00:00:22] Hello friends, this is Dex, and today I am really delighted to welcome our special guest, Dr. Jonathan Fisher, who is a cardiologist from Charlotte, who's written a pretty spanking good book that we'll talk about in a minute. And Jonathan focuses on healing the heart in the broader sense, encompassing both the physical and emotional aspect

[00:00:43] of cardiac care. Harvard educated, he's a mindfulness meditation teacher and organizational wellbeing leader, who, as he says, took care of 20, 000 other hearts before taking care of his own. And Dr. Fisher delivers programs and keynotes globally on stress and wellbeing. And he's co hosted The Ending Clinician Burnout Global Summit.

[00:01:11] Mad cheering over here for that. And his mission, he says, is to help others train the mind and heal the heart. And wow, I so much love all of that. We share a mission then, I think. So welcome to the podcast Jonathan. 

[00:01:26] Thank you so much, Dex. It's a real pleasure to be here, and we definitely share a mission, and we're stronger together.

[00:01:33] I think so, too. The more the merrier. But my first question to you, okay, here it is. How are you? How is your heart today? 

[00:01:42] Thank you for that question. What a great question, and if we could ask that every time we met someone, what a world it would be, and if we listened for the answer. My heart is quite full today.

[00:01:53] I am meeting new people today which is something I really enjoy and I've had a chance to have lunch with someone I've known for a while but never met and we really had a wonderful conversation. I got to see my family today. And I took care of myself today as well which is something I didn't always do.

[00:02:14] Yeah, terrific. It's a revolution starting to do that I think. All by itself. Just looking after yourself. 

[00:02:20] Yes. 

[00:02:22] So I've just been reading your new book, Just One Heart. Very highly recommended, listeners. I've just read it twice actually and I do think it's a pretty bold and radical departure from the prescribed expectations normally placed on cardiologists.

[00:02:38] This one, to my intense glee, it's different. 

[00:02:41] So how did you get brave enough to write it? 

[00:02:44] Thank you for asking it that way. It did take courage. I would say that I looked to my mother because she was a very brave woman and she was never afraid to speak the truth, even if it rubbed some people the wrong way.

[00:03:00] And I didn't know it at the time. I feel like I was maybe embarrassed about how she spoke her mind rather than went along with the prevailing wisdom, but as I'm getting older and hopefully a little wiser, I realize that it requires courage to speak to things that are deeply important.

[00:03:19] In healthcare, we have a very well established, well entrenched culture in the modern industrial complex of medicine, which goes back over a hundred years, and it really values the status quo, and change happens slowly, and we also for many reasons have developed a very reactive approach to health and care in the world, I would say.

[00:03:44] Western medicine has diverged far from what healing used to be, and I felt that first hand myself as I was a wounded healer walking around trying to take care of really 3000 patients every single year while my own heart was breaking, not only metaphorically, but also I was experiencing pains in my chest and palpitations and I had no way of making sense of all of this, so I had to explore the connection

[00:04:13] between our state of mind, our state of emotions, our thoughts, and our beliefs, and our physical heart health, and finding the answers to that helped me take care of myself and come back to a place of health, but more importantly, helped me help my patients, and now by extension, colleagues around the world.

[00:04:32] It's a beautiful thing. I work with a lot of physicians myself who are in burnout and I'm not going to mention any names but one of my cardiologist clients endured a five year performance plan for documentation lateness and was losing his mind about that and another one lost their job and I think there's a lot of fragility.

[00:04:53] Most of the physicians I work with are pretty scared of the system, which seems to be a tad unforgiving. What do you think about that part? 

[00:05:02] It breaks my heart to hear colleagues who are suffering. And it also strikes me that we're really only addressing the surface of the problem when we have superficial remedies.

[00:05:14] If we see problems with documentation, it usually reflects issues that run much deeper than that. In the individual doctor or nurse or executive, the performance is just the tip of the iceberg. Essentially, it's the exposed wound and I think this is not something that physicians willingly do. And what I mean by that is the most resilient, hardest working, most committed people that I've ever met are people who want to serve on the front lines of life and death. Who want to sacrifice nights and weekends often and their own family's well being in order to help others. And now we have this population where 50 percent of these physicians, are experiencing burnout.

[00:05:57] And the manifestations you mentioned a couple of them, performance issues, but there are manifestations that happen on the home front that are even more devastating around addiction, marital distress, neglecting to pay attention to our children and our loved ones. And I think we need to take a fresh look

[00:06:17] at the practice, the way we practice, not only medicine, but how we practice business in general. It's time to update the traditional capitalist model to move something that's much more about consciousness, awareness, and compassion. 

[00:06:33] Yeah. And you don't mention suicide, but it's such a big issue for physicians and anybody in the medical industry.

[00:06:40] It's 

[00:06:40] devastating. Since you mentioned that we do have such a high rate, higher than other industries. 400 physicians will take their own lives this year in the United States alone. And the shame is that a lot of that would be preventable. We have such a stigma against even coming forward and acknowledging the pain that precedes suicide.

[00:07:04] People don't wake up one day and say, I want to end my life. Often, it is after years of feeling like no one cares. Working in a system that almost seems designed to strip away our humanity and our sense of purpose and meaning. Combining that with exhaustion day to day, and a lack of power to have any flexibility over schedules.

[00:07:24] So, the good news about this Dex is that we've had now 30 years of burnout research. We don't need more research. We know what drives it. We know what causes it. It's time for action. We're past the stage of awareness. We need to make changes now and I see that happening. 

[00:07:40] Yeah. I follow quite a lot of people in the medical revolution space, people like Casey Means, Aseem Malhotra, you probably know in

[00:07:49] the UK and a lot of others who are flying the flag and somehow the tide seems to be on the point of inflection. It's gaining so much media attention now that we're, I think there's an awful lot of us out here praying for change. 

[00:08:08] We're all patients. We're all patients at some point in our lives. We can avoid the system.

[00:08:13] We can deny the medical afflictions that we have, and some of us do because it's even more painful experiencing health care, unfortunately, in some systems. I have a colleague in England who, she has to wait months in order to get a potentially, life extending procedure. And then in America, the average office people want to avoid it like the plague because the Dr

[00:08:37] may look into your eyes for a minute or two if that, and we are so distracted by these computer screens that are in the office and we're so focused on billing and clerical activities that we really, it doesn't often feel, and in rare exceptions, it doesn't feel like a place of healing or a place of health.

[00:08:57] Agreed, wholeheartedly. Have you seen, you read this book? 

[00:09:01] Yes, it's on my shelf and I had a chance to interview Dr. Steven Ciziak who is a co author. 

[00:09:08] Yeah. 

[00:09:08] Yeah. What I remember about that is he gave the example where he saw things were broken in his own healthcare system in Cooper University in New Jersey.

[00:09:18] And he is an intensive care doctor and suggested to the CEO, maybe we should look at our values. It was interesting. He went back to values and he said, we've got this plaque on the wall that says that we stand for so many wonderful things, but that's not what our nurses and doctors are experiencing.

[00:09:35] So he took everyone on a retreat and he said, let's decide amongst ourselves, what are our top values as an organization? At the very top, blindly, everyone agreed that it would be compassion. And once they started to ask what does that look like? How do compassionate people speak? How do they behave?

[00:09:54] What is the experience of a patient in a compassionate, loving environment? All of their numbers improved. Their safety, their quality metrics, their outcomes, and the experience of the patients and the experience of the providers all improved just by focusing more on compassion. 

[00:10:10] Yeah, so the book I referenced was Compassionomics, and really, if only the industry leaders understood that compassion boosts profitability and effectiveness both at the same time, if only they knew that.

[00:10:24] But isn't it a shame, Dex, that we have to make a financial case? to be compassionate humans? 

[00:10:30] Absolutely. But given that's the state of play, you'd think that it would be attractive to them to promote compassion. 

[00:10:36] Yes. Yes. Absolutely. That's why I dedicated chapter 13, the final chapter in the book to leading with heart, which for me reflects a combination of empathy, compassion, and love among other things.

[00:10:50] And listeners, for those of you who've never heard of Dr. Fisher or haven't read his book yet, but I know you will soon. He's really talking in the book quite a lot about the physical, emotional, social, and spiritual energies of the heart, which is revolutionary for a cardiologist, I'm sad to say, but really when you, when I read it, it's hard to believe that no one thought of it before.

[00:11:14] And I 

[00:11:14] wonder, if this is the path that life has taken you on, when you look back on your own burnout and your own difficulty. How do you feel about that now, about those experiences? 

[00:11:26] I can draw a direct line, which explains why I went from a very naive, very open, sensitive, empathic medical student to a jaded, exhausted, burnt out and depressed physician for many years.

[00:11:44] I can draw a straight line and along that line has to do with the modern model, the modern approach to, on the one hand, delivering health, which we discussed a little bit, and on the other hand, the way we treat our employees in most organizations and physicians are employees like any other in the modern version of health care.

[00:12:05] And it's, as I understand it, it relates to a disintegration of the natural harmony that we're all born with, which is an alignment of our mind, our body, our spirit, all of these social dimensions, and that's slowly chipped away. We're told in medical school, for example, we follow the senior doctors around and do surgeries, and it may go on for five or six hours, and there's no discussion of do you need to take a break for the bathroom?

[00:12:34] And there, between the surgeries, there's no conversation about, do you want to talk to your family member or take five minutes of rest? The physical heart is ignored. And then the emotional heart, that's obvious. Our society in the West believes that emotions should be avoided, should not be trusted.

[00:12:49] Particularly among men, emotions should be stuffed down, and we all have unhealed traumas and wounds of one kind or another. I won't say all of us, but most of the people that I know and that I've had a chance to work with have some type of emotional wounding that they never fully healed, and I see them replaying that again and again in their lives.

[00:13:11] And then we have the social dimension with the epidemic of loneliness. That's the disintegration of our society. Just look at American politics right now. Neighbors can't talk to neighbors. Even worse, people are shouting at each other. We don't have close friends that we can rely on and be our authentic selves.

[00:13:27] And then, beneath it all, it's this spiritual dimension, which I don't mean religious, and I'm not talking about any dogma or particular text. By spiritual, this essence of being human this element that transcends the physical body. It's, it has much more to do with what is our meaning in life.

[00:13:45] What purpose are we serving? And I think we're suffering a crisis of purpose right now which is what really is the core driver of burnout. 

[00:13:55] Yeah a crisis of purpose and connection I would say. 

[00:13:58] Yeah. 

[00:13:59] Yeah. So really when you come at your book you talk about these kinds of things quite a lot and this is the exact work I do with my guys in burnout as well.

[00:14:07] I bring them back in touch with the whole self instead of them being these compartmentalized humans, where a lot of the compartments have been shut down completely by force, by the role of people in society, you must shut down these parts of you, but coming back to the book. The first part of your book is very facty, it's full of research and history and context, the unfolding of your own understanding in various dimensions.

[00:14:33] And I found that enormously helpful. But I really like the off piste explorations that followed a little bit more. Some of the things that you've already mentioned, things like suicide and addiction being a disease of disconnection, and would you say that burnout also is? 

[00:14:50] Yeah, I would. There have been a couple of books and I'm sure you've read them about, how the root cause of the rise in addiction, it's more of a disconnection issue.

[00:14:59] And it's, we know that it's often fulfilling a need other than the physical need. It's a deeper need than that. But in terms of burnout, there are three dimensions of burnout traditionally described, and they each involve some form of disconnection. So the first is a disconnection from our, needs as a human body.

[00:15:20] We have been turned into mechanical workers, cogs in a machine with very little respect for normal circadian rhythms, or rhythms of the body. So this leads to physical exhaustion. There also is this disconnection from our full humanity. We're told that when we come to work, we should leave our emotions at home.

[00:15:39] And so this leads to a disconnection there. And we become, in a sense, so exhausted from putting on a false exterior. Many of us, all day long. That is what's called emotional labor that people don't acknowledge. Women tend to do it more than men for a variety of reasons.

[00:15:57] And so that's the first element of burnout is the exhaustion. The second element is this lack of a sense of competence or mastery. So essentially, we're disconnected from our own genius, from our own skill that we've spent decades developing. And then we get into a workplace and maybe it's a workflow issue or a staffing issue or a manager issue, but we've got suddenly these hurdles that are placed in front of us.

[00:16:22] It's very frustrating, leads to resentment. And then the worst disconnection that leads to burnout is the disconnection from the humanity of the people that we serve. We're so busy seeing so many patients every day that we stop seeing them as individual humans and start seeing them as just another number.

[00:16:41] And I felt this myself. I'm ashamed to say, Dex. There was a time when someone would come to see me and lay out all of their personal, physical issues before me. And yes, I would be helpful, but in the back of my mind, I was thinking, how can I just move on to the next person? I'm so exhausted, I don't have energy for this anymore.

[00:17:01] And so people stopped being people in my eyes, and I'm not proud of that. And that is what caused me to burn out because I went into this profession in order to connect with other people and here I was doing exactly the opposite. And this is, I think, the most significant driver right now, this disconnection of our humanity.

[00:17:21] And disconnection with ourself as part of that, I 

[00:17:24] think. 

[00:17:25] Yeah, absolutely. Absolutely. I would say connection is my favorite word. 

[00:17:31] Me too. I think a burnout really is a repair of the connective tissue, between us and inside us. 

[00:17:38] Yes. Yeah. And then the other piece about burnout, as you say it, it doesn't happen to people who are not motivated.

[00:17:47] It doesn't happen to people who like to sit on the couch all day. It tends to happen to people who burn brightly, who have such a passion for what they do that they almost don't know how to say no, and some of us feel bad saying no, and some of us are raised to please other people. We see that external praise is the source of our inner worth, and this leads us to not take the breaks that we are desperately needing.

[00:18:15] Really it's the Type A personality or Type A characteristics and traits that play out in burnout, but those people are always unbelievably wonderful humans, very talented, very potent, very skillful, very dedicated. Just a heartbreaker really. 

[00:18:33] I think that's what's heartbreaking about it, is that you have people who do have a sense of purpose and a mission and have talent and are committed to the hard work and grit that it takes.

[00:18:43] And at the same time, these are the people that are disengaging from their work, are trying to get home early. One out of five physicians, the latest surveys show, are looking to leave their career within the next two years. The majority of doctors won't recommend to their children to become physicians.

[00:19:02] This is very different than when my father was the town doctor 50 years ago, when all seven of us followed quickly in his footsteps because it was a mark of pride. Now it's almost it's a badge of shame to some degree, but I really want to change that because it's such a wonderful profession. It's life giving.

[00:19:21] It has so much potential. I think it's just the systems aspect that we've somehow gone astray. 

[00:19:28] Yeah. Having the large proportion of the medical industry being in burnout , is equivalent to me of having the whole farming population of small farmers in burnout. They're the people who are feeding us.

[00:19:39] They're the people who are healing us. Why aren't we looking after them? 

[00:19:42] Yeah exactly. And I think this comes back, and I'm interested what your thoughts are. Some of this is the capitalist western approach to doing business. Which goes back to the 1970s and 1980s the rise of Wall Street, Milton Friedman, who said that our ultimate responsibility is to the shareholder.

[00:20:01] Yes, we need to have profits in order to have successful companies and to be competitive. If profits are the ultimate goal, then we cannot sustain a workforce that is ready to give of their hearts , and especially those working in professions involving emotional labor. There's a difference. If somebody is crunching numbers in a cubicle by themself, it's not the same emotional work as somebody who is face to face with another person who is on the brink of death, whose family is looking at you to save a life and is putting the trust in you and also having to navigate the complexity of a cancer diagnosis or a heart disease diagnosis.

[00:20:45] It's an added layer in what I'll call the caring professions. 

[00:20:49] Yes, I think that's right. And I think all of us, as you pointed out earlier, I've had an experience as a patient of such people who are in such chronic distress themselves they can barely see out. They can barely function. They don't know how to handle you.

[00:21:05] I've been fairly shocked fairly frequently about the state of the doctors I've been consulting with, as a patient. It's been hair raising. How they force themselves into this super analytical money making machine state to the exclusion of all else which goes against every fiber of their being and that conflict on top of the workload and all the other difficulties that conflict alone,

[00:21:34] it's going to wipe them out. 

[00:21:37] Yeah it, the trend, the statistics say that you're right, that by the year 2030, at least in the U. S., we're expecting a shortage of 80, 000 to 100, 000 physicians. And so there is the alternative solutions right now, which on the one hand, people suggest, elevating the role of what's called a mid level provider assistants, and these kinds of things.

[00:21:58] I see burnout in these populations just as well. And on the flip side, there's suggestion that artificial intelligence, which is a wonderful technology and will definitely help with burnout, is going to take the place of physicians. In some situations yes. In others especially around delivering empathic care, heart to heart connection AI has a long way to go.

[00:22:21] I actually worked on a medical diagnostic AI system back in, I think it was 1988, 89. It wasn't called AI back then, but it was the same thing. And I was thinking, oh, it'll never take off. Unless what it does is buy physicians back more face to face time with their patients, in which case,

[00:22:37] go for it. 

[00:22:39] It it does. Right now the number one product and there are dozens of these on offer right now is what's called ambient AI, which is where the device sits in the room between the doctor and the patient and listens. So the doctor no longer has to be the cleric, which has become our role, and taking notes.

[00:22:55] The AI essentially serves as a smart scribe. and creates a document and can even help with the billing. So when we offload these clerical and administrative tasks, the physician can then return to what they are essentially feel like they're called to do, and their fire starts to burn a little more brightly.

[00:23:13] Yeah, and that's what I help physicians do, buy back a little bit more time with their patients in the way that they feel will serve them and their patients better. Let's come back to the book for a second. So you make a lot of really great points about emotional exhaustion the autonomic nervous system, stress effects, and all of that in the book.

[00:23:32] How do you see those ideas in relation to the global inflammatory disease explosion that is, across the board. 

[00:23:42] Yeah. So the World Health Organization has reported that about 80 percent of the world's diseases are non communicable. In other words, they're chronic diseases, they're diseases of modernity.

[00:23:55] And they often involve simple behaviors, like eating a diet that's rich in unhealthy foods, let's say, and people are sedentary. One third of people around the world don't get the recommended amount of exercise. Obesity is on the rise, particularly what's previously called morbid obesity or massive obesity.

[00:24:15] And these conditions I believe, underneath them all, are driven by stress of some sort of or another. Stress it's emotional. People are don't have the skills to regulate their emotional life, and they're facing external world, which is becoming more complicated and moving more rapidly, more and more decisions, and we end up seeing those stresses taken out in what's called maladaptive behaviors.

[00:24:41] And then that leads to stress within the body, inflammation in the body, constriction of the blood vessels, which raise the blood pressure, increase in the heart rate, respiratory rate, and stress has direct effects on the mind itself. So it narrows our attention focus, or it reduces our ability to make wise decisions and consider the future.

[00:25:00] So we end up, if we're not aware of the stress cycle, we end up on a downward spiral. Which brings both our mind, our body, and our spirit downward, and it gets harder and harder to escape from that cycle of stress, which seems to be everywhere. Which is why I wanted to give people a very simple explanation of how does stress affect us?

[00:25:22] What is stress? And is stress all bad? Stress is not all bad. There is good stress in the world. And reframing , even our view as a society, I think we've gone too far towards this belief that stress is an evil thing. And stress can be wonderful. And when we take the view that certain forms of stress really will help us grow, and help us learn and advance we start to welcome it and become What Nassim Taleb writes in his books, Antifragile.

[00:25:51] So not only are we not trying to avoid stress, in a sense we welcome stress and we embrace it as a way to make us stronger. 

[00:25:59] Possibly we'd have to come out of overwhelm first. Get some energy. 

[00:26:03] Absolutely. 

[00:26:04] There's some restorative process that needs to happen for us to have stress resilience. 

[00:26:09] Yes. Yeah. Yeah. When we're in a full shutdown and I, this is where the vagus nerve comes into play. There's a spectrum of activation. We can become activated with stress. We've seen everyone have road rage, that's a result of, but then like you pointed out, shutdown, There's fight or flight and then there's also flee and then there's finally there's freeze or fawn which is part of the stress response that doesn't get enough attention and I'm glad you pointed that out.

[00:26:36] And just to point out to listeners there are quite a lot of sections in the book that deal with things like stress, anxiety, depression, burnout, loneliness and how they affect the heart in detail. I thought it was a beautifully written book I'd have to say the way it unfolds. 

[00:26:50] Thank you. Thank you. I made up a couple of simple ways for people to remember those.

[00:26:54] You just had a litany of emotions there. And those are very specific. I didn't just select the most challenging emotions. I did a review of the science, the modern science that connects certain emotional states with the health of the body. And I want people to know, particularly executives and leaders and people who are not taking breaks, and are not taking care of their emotional health and who are carrying around anger and resentment.

[00:27:19] I need them to know that is having a direct impact on their physical health and it's going to bring them to the doctor whether they know it or not, sooner or later. And I found that there were a collection of nine emotions. that have the strongest scientific link with disease of the heart and stroke.

[00:27:38] And there are also fortunately, and I call those the heart breakers because they can break your heart. And then on the flip side, there are nine emotions and there are only nine that I found that can do the opposite that have a almost an antidote effect, which can lower blood pressure and increase longevity.

[00:27:58] Yeah. And we're going to come to that in a second, but I've got one observation about that, because I had a heart attack in 2017, immediately after my burnout crash. A couple of weeks later, heart attack, running on the beach. And I went to the hospital, and I'm slim, fit, I eat well, my diet's beautiful, I don't drink, and all that stuff.

[00:28:19] And I went there and all the cardiologists were looking at me going, What the heck are you doing here? And one cardiologist after another is we don't know what to do with you, why are you here? And I think that's interesting training for a cardiologist, because I can tell you why I'm here.

[00:28:34] And I would tell them about the genesis and they would just dismiss it out of hand and go back to, no we don't know why you're here. And I think it's important for people in burnout as you say to really understand the stress the emotions they're having are placing on their body and The magic thing that they can manage their emotions so they can develop a much more positive, healing, emotional state.

[00:28:58] Yeah. 

[00:28:58] Energetically, that has a profound effect in the moment and on long term health. I agree with you completely on that. So this I think brings us into your seven traits that you've discovered. Yeah. Are 

[00:29:11] good 

[00:29:12] to work on with people. Tell us a little bit about that. 

[00:29:16] Dex, I'm sorry you had that experience in 2017 particularly the feeling of not being seen or understood by the professionals who are supposed to be experts in that area.

[00:29:27] I can't imagine what that would be like.

[00:29:29] This is why I wrote the book.

[00:29:31] The first sentence of the book is for your doctor. And it said, I have something to prove. It's the first sentence. And people have asked me, why do I, in the back of the book, have 320 scientific citations? I could have just written a self help book with no references. And I did that so that anyone can pick it up, but in particular, if people want to give it to their doctor, or if a doctor wants to learn about the modern science, it's there.

[00:29:55] It's, this is all from reputable journals, just so people know. In terms of the seven traits, I'm often asked can I give three hacks or tips or quick tricks to improve someone's heart? 

[00:30:08] And I typically reject the question. I think it does a disservice to answer because it perpetuates that idea that we can take a lifetime of habits and certain behaviors and undo them with a quick fix.

[00:30:22] And for me, studying philosophy in college and growing up in a household that loved and honored wisdom my mother in particular would read the ancients, I had a sense that the answer was somewhere deeper. How do we restore the disconnection? It comes back to living according to certain virtues, according to certain human characteristics that either we've lost or they're underdeveloped.

[00:30:47] And in researching the book, the first six months, I interviewed 55 people. experts in science and medicine mind body connection. And I asked them a very simple question. I said for you, what does it mean when we say someone lives from their heart? Someone leads with their heart. We've heard the metaphor.

[00:31:07] What does it mean? And I got dozens of answers and I tallied them all down. And I found that there were seven that aligned with the science of positive psychology, which is the science of how do we live well, and how do we find joy in our lives. And these are arranged in a very specific stepwise fashion.

[00:31:27] From the very first quality of the heart, which is steadiness, we need to steady the heart. Like you were saying before, if somebody's in full shutdown, we have to honor that. We can't go straight into an exercise program.

[00:31:40] Yeah, that's not it. We have to meet people where they are. And so the seven traits range from steadiness, which is the first step, to the ultimate, which is warmth. The ultimate healthy state of the heart is a warm hearted state, which means we are able to deploy empathy for ourselves, compassion for ourselves and our own needs, and to love ourselves, and by extension, we can deploy those, we can demonstrate those freely with those around us those that we serve, empathy, compassion, and love.

[00:32:11] But it's so short sighted to advise people to just be kind. And the book that you showed, Compassionomics. It's a wonderful book, but I've met too many people and I was in my own state of shutdown where that book wouldn't have made any sense to me because I was, as you say, I was unable to see past myself.

[00:32:30] I was stuck inside. And so the seven traits are number one, steadiness. Number two is wisdom. Three is openness of the heart. Four is wholeness of the heart. Reintegrating parts of ourself, being fully present. The next is a courage. From the word cor in Latin, which literally means heart. And number six is lightness of heart.

[00:32:53] Life can't be only serious. We have to know when we can laugh at the absurdities of life and laugh with others and amplify joy. And then the last is warmth. So these seven traits, each one is a different chapter. And I go through the science of social psychology and also medicine to show the connection between these traits and physical health.

[00:33:13] Yeah. And it's beautifully done. And this is partly why I would recommend the book to anybody, any human who's got a heart should read the book. 

[00:33:23] Thank you Dex. 

[00:33:24] But I think some of these, yeah, some of the traits you mentioned are just underdeveloped and a lot of people we've been almost forced to shut that side of ourselves down.

[00:33:35] But I think the warmth of the human heart is always present. My personal belief is everybody's heart is good enough already. They're just not very connected with how it works. They just need to express it a little bit more and so all the things that you teach in the seven traits are the same things that I try to hook people up with.

[00:33:53] It's their own innate goodness, warmth, connection, passion, love, all of that stuff. 

[00:34:02] I think it's beautiful. 

[00:34:03] If we all develop that out, we would live in a completely different world. 

[00:34:07] Yeah. Yeah. Someone asked me, why did you write this book? Why do you do the work you do? And I'm really, working to get more and more clear on why I do that.

[00:34:17] And the simplest version, and I described this in the last chapter is that, as a kid, I was bullied. I was picked on. I was physically attacked emotionally. And, I felt very weak. I felt very alone. I felt ashamed of my own state. And the reason I do the work that I do is so that we live in a kinder world.

[00:34:41] My dogs agree. My dog says that he wants to have a kinder world. Yeah, but this is the mission. This is the real, yes, I want people to have healthier hearts. Yes, I want to prevent reversible heart disease and preventable heart disease. 80 percent of heart attacks could be prevented.

[00:34:56] Much of that relates to learning how to manage stress and to manage our emotions and develop healthy relationships. All of this, but at the core, I really want to leave a kinder world for my children. 

[00:35:08] Yes, 

[00:35:10] absolutely. I think it's a difficult thing to come at, but really pretty much all of the clients who come to me in burnout are in burnout because they've had some sort of traumatic upbringing that has shut down their heart in a way that's too painful for them to bear and they've felt unsafe in the world and they've been unable to express themselves and connect.

[00:35:30] And that's the reparation I think needs to happen. 

[00:35:34] Yeah I imagine it as walls that we put up around our heart consciously or subconsciously in order to protect the most vulnerable part of ourselves so that we don't experience repeated injury until we either find an environment, usually or a person or people,

[00:35:50] who can provide a loving, healing space, while we can then reparent ourselves or, rediscover those missing parts of ourselves to find our own worth rather than listen to these messages that we play over and over that we're, we have to prove our worth to others, because that's what we were taught as children, sometimes to survive.

[00:36:10] Yeah, to survive. Absolutely. But it turns out as an adult, that's a pretty shitty way to live with your heart shut down. It's not fun. 

[00:36:17] Yeah, 

[00:36:17] for sure. 

[00:36:18] I really want to ask you, we're running out of time, but I'm keen to hear what your prognosis is for the future of burnout in medicine. 

[00:36:26] I love the question. . My prognosis for the future of burnout is, I would say, positive. And it relates to my core belief that humans have immense potential for goodness. For kindness and for correction, and I, if I didn't have that core belief in the goodness of people, I would say that we're going to continue doing business as usual to continue to destroy our greatest resource, which are the people that do the work, and those in the caring professions, those who are giving the care.

[00:37:00] My prognosis is positive partly because of one of the roles that I fill is as an executive working on for the well being of doctors and nurses in a large healthcare system. This is an official role that's becoming more and more common, at least in the West. And we are having conferences and working on best practices and we're getting into the nitty gritty of operational reform.

[00:37:23] Wonderful. I'm so pleased to hear that's what you're doing. So we're out of time. Any last words? Anything you wish I'd asked you or tell us about your book? 

[00:37:32] Oh, goodness. It's, you've been so gracious in your words about the book.

[00:37:37] I appreciate that. The first sentence of the book is, I have something to prove, and this is my task, which is to lay out the case in very clear terms, to speak essentially two different languages. In the book, I speak the language of science, for those who are more logical and left brained, and I also speak the language of the spirit and emotions.

[00:37:57] And I leaned heavily on experts in psychology and psychiatry and neuroscience to help me with those messages because I really I want us to start thinking about the heart in a new way, and that is in a much broader way, and to stop treating it only as a physical organ. And by extension, it's not really about the heart, it's about this thing that we call human life.

[00:38:22] We're so compartmentalized that if you have a physical problem, the physical doctor will look at the physical aspects of that problem, and often, as you described, give very little honor and acknowledgement that there are emotional, social, and spiritual dimensions that are part of this living a healthy life.

[00:38:39] And if we don't know what health is we can't heal. And I also firmly believe we can't be truly happy, sustainably happy, unless we understand what health is. And health doesn't mean the absence of disease. I can be physically ill and still be happy. In fact, I can still feel whole and healthy in a way, even if part of me isn't working properly.

[00:38:59] But we have this now prevailing mentality that if there's something wrong with you, then you're broken. And so my takeaway message is that wherever someone is in their journey, however they are feeling broken or were made to feel that there's something not quite right about them, I want them to know that's not true.

[00:39:16] That's BS. And that we are already whole. We already have the resources we need. And these are just some of the things that are happening either within us or with people around us who care about us that we may or may not even have met yet. But we all have the resources and often it's up to us to simply say, I need help, for those at that end of the spectrum.

[00:39:37] And for those that are in this end of the spectrum who are so balanced and succeeding and looking to go from good to great. Maybe they can lean in more to the aspect of giving, altruism, generosity, volunteerism, and service which is really the ultimate mark of a full human life is serving others.

[00:39:57] This is an invitation for wherever people are to ask what would it mean to live with more heart?

[00:40:03] Yes, and now I hope they are all listening. But I would say as well that a lot of people do reach out for help. I myself have reached out for help many times and had my experience medicalized and then been treated with blame and shame or dismissal. And I think that's a very common predicament.

[00:40:22] Part of my mission is to be the available antidote to that. Because I believe in people so strongly 

[00:40:28] Mmm 

[00:40:29] I believe in people's healing so strongly 

[00:40:31] so I'll ask you, how can we scale that?

[00:40:35] How can we bring this approach that you would like to see to more people? What can we in healthcare do? Both mental health and physical health care do, so that no one has to feel the way that you've felt. 

[00:40:48] Medical training needs to change. 

[00:40:51] Yeah, the traditional medical training, though, does not address the concerns that you have.

[00:40:56] Only the most modern progressive medical training incorporates this holistic view of health. And so you're saying that it has to change. 

[00:41:04] You're the proponent of exactly how to spread this message because you're doing it already in several of your roles.

[00:41:11] And I think this is so wonderful. You've got much more gigantic reach than I have. 

[00:41:15] Yeah, I'm with you. I'll follow your advice. I'm giving a lot of talks and programs for medical students, medical residents, people in the community, giving care in the community, just to try to spread this word that we have to think more holistically about health, or we're going to keep going in the wrong direction.

[00:41:34] Yes, because that's their original intention of coming into medicine, right? Yeah. Nursing or whatever it is. 

[00:41:40] Yeah. Yeah. But it's not profitable. 

[00:41:43] But it's not the practitioners that are having the wrong intention. It's the system that's closing down that intention.

[00:41:51] I'm still gonna give my positive prognosis. Things are turning in the right direction. This conversation you and I are having I'm only able to have it because of many people who've come before me and you, who are helping nudge the conversation in this direction. 

[00:42:05] Yes, I'm seeing an increasing groundswell of very senior people who are out there making big noise about it and including mental health, which I think psychiatry is in a little bit of a dilemma as well.

[00:42:17] So , I think it's going in the right direction. 

[00:42:19] We're really right out of time so I must let you go, but thank you so much for being here Jonathan. It really has been a joy to speak with you and bravo on the book. 

[00:42:30] Thank you Dex and thank you for all you do.

[00:42:33] I mean your heart is in the right place and you're speaking to a wonderful community and keep it up. Keep it up. We need every single person to be looking at how we can bring more kindness to ourselves and more compassion to others. 

[00:42:47] All right. So listeners, please look for Jonathan's links in the show notes and go read his book.

[00:42:54] And if you've enjoyed today's show, I would love you to share it with your mates, especially those who are in distress. This is how we can reach out and help more people who suffer in burnout. And if you yourself are in burnout, you must come and talk to me about whatever's pissing you off at work, and then we can make a plan for you to get back to your best performance, leadership, and most of all enjoyment inside work

[00:43:17] and out. You can book a time to talk to me at DexRandall. com.