When Dr. Susan Biali recognized that the emergency room wasn’t her calling, she cleaned up the stress in her life. Now she’s helping others do the same. Author, Wellness Expert and M.D. Biali talks to Kim Parlee about her tips to de-stress.
Print Transcript
So I'd like to start off with your story, because it's a fairly interesting story. You started off as an emergency room doctor. And then something happened.
Yes. Something very bad, which turned out to be very good, thankfully. Yes, I was an emergency medicine resident for just a couple of years. It was actually a five-year program. But a couple of years in, just because of the stress, the sleep deprivation, and actually how totally unsuited the profession was to my personality, I just spiraled downwards and suffered from severe depression and burnout, and was forced to take a stress leave.
I heard you once describing this, saying that you saw the sight of blood. And you fainted.
Yes. I didn't actually pass out. Thankfully, there was a chair nearby, which was meant for family members to sit in.
Yeah. I joke about it. It's not quite a joke. But I say that the two primary issues with my being an emergency physician were that number one, I panic under pressure. And number two, I can't stand the sight of large amounts of blood. Not good qualities in an emergency physician.
And those I say jokingly. There was a lot more to it. But really they illustrate just how out of touch I was with myself and my strengths and my weaknesses, and had just followed this path where I had let others really dictate where they thought I should take my life and my career. And it ended up quite disastrously.
So what happened? I mean, obviously that happened. And you then, of course, leave.
And I think I read the story. You sit down. You're in an apartment by yourself of which you're never in, because you were so busy, you couldn't be there. But what did you do to move forward? I mean, that's as you mentioned, pretty catastrophic.
It was. And no one would ever wish depression or suicidal depression, which actually I reached on a terrible night where I was actually contemplating taking my life. But thankfully, I survived that. I got a phone call while I was in the dark in my apartment that night. And it was one of the chief residents who was actually calling me. And she had noticed that I just wasn't myself.
And they had actually had a resident take their life a couple of years prior. And so she staged an intervention and told me to take stress leave. And during that leave, she told me to really reflect on who I truly was, what my real gifts and talents were, and how I might actually like to live my life, which was something that I didn't even know was an option. I was just so focused on success and achievement at all costs.
Just I'm sort of digesting what you just said. There's a lot there. So you have that episode. And thankfully, someone calls you.
But then how do you evaluate? How did you start that process saying, here's what I like. Here's what I think I'm good at. What did you do?
Yeah. It's very difficult. And at that time, there weren't coaches around or people like that to help. I was on antidepressant medication, which was very helpful, obviously, at the time.
But originally I didn't really know the answer to that. And getting more sleep and getting some rest and just having a break was very helpful. But all I had to go on initially was that I had this urge to go to Cuba.
And so I just took a little trip by myself during that break. And I saw the Cubans dancing. And I remembered that as a little girl, I had dreamed of becoming a dancer-- a "Solid Gold" dancer, actually. That's a little embarrassing!
And it was something when I saw those dancers, I realized that my life had become so uni-dimensional. It was so focused just on work, I completely lost myself. And anyone is going to get depressed and burned out in those circumstances.
So the first clue I had was to pick up dancing again literally to save my life, like it did. There's much more to it. But it was the dancing and the joy and just finding that part of myself again that was so healing.
You're a flamenco dancer.
I am. Yeah!
You perform.
Yeah. Yeah, I do.
Wow. As I mentioned, you write. And you've written-- you're a prolific writer. And you've done a lot of work on all sorts of journals and in magazines.
You've recently come out though with an e-book. And I love it, because it talks about the essential ways that people can kind of avoid stress and have a great lifestyle and those types of things. And you've got 10 chapters with little actions behind each chapter, I think, which is really great.
We don't have time to go through all 10. But I want to highlight a few, because I thought there were some really interesting. The second one I think you have here is an opportunity to stop and breathe. What do you mean by that?
Yeah. We don't as we rush through our lives. And it's such a great way physiologically to stop the stress response. Most of us pretty much all through the day, if we're racing from one thing to another and have the constant to-do list going, our stress response is on high. We're pumping out cortisol and adrenaline, which raises blood pressure, also is related to depression, causes all kinds of problems.
And we can actually literally instantly stop or decrease that by inducing the relaxation response. And you can do this just by breathing.
It's funny, because when I read through this, I've started doing it since I've read it. And I read this probably about a month ago. And it really does make a difference. I think sometimes if you read it, but just do it. Everyone just try it once. And then, you know you said it makes a difference.
My other favorite you have her in your list of 10 is say no to something. I love this, because people think no is such a negative. You think you have to say yes.
But I guess saying yes is what got you into-- you think about the beginning of your journey. That's where things happened.
Yeah. A key risk factor for burnout, actually, is being what they call a yes man or a yes woman. If you're that kind of person who everyone can count on you to say yes, and that feels really great on some levels, but it's extremely depleting. And one of the best things you can do is make a stop doing list where you decide what you're going to start saying no to, and then say it.
How do you say it though so that people don't think you're negative?
Well, one of the ways that you can actually avoid saying no to people's faces is saying, I'll get back to you on that.
How about I've got time for two more here. Get moving. You say it's really important.
Oh, it's so important. You probably heard about the sitting disease, how we're all sitting way too long at our desks, that it impedes blood flow to the brain, affects our mood, and blood sugar, everything. So if you can get moving in just the smallest way during your break, you'll get up once an hour or so at the workplace, walk around, get out your lunch hour, go for a walk.
Just those little types of movement will get your circulation going and also get your body relaxing. And it makes a big difference.
It's funny, because I think people would think that doesn't make-- you know what I mean? Cause it's like, really? Me getting up and going for two minutes in my office? Really? That makes a difference?
Yeah. The blood's not flowing through your brain, because it's pooling in your legs. So if you get up and you walk around, those calves start pumping it around. And you get your brain perfusion, blood flowing to your brain. And you can think more clearly. You have a less sense of stress. And actually, your body even produces better insulin functions so your blood sugar is better, cardiovascular function. It's really remarkable.
Thanks so much for coming in.
Yes. Something very bad, which turned out to be very good, thankfully. Yes, I was an emergency medicine resident for just a couple of years. It was actually a five-year program. But a couple of years in, just because of the stress, the sleep deprivation, and actually how totally unsuited the profession was to my personality, I just spiraled downwards and suffered from severe depression and burnout, and was forced to take a stress leave.
I heard you once describing this, saying that you saw the sight of blood. And you fainted.
Yes. I didn't actually pass out. Thankfully, there was a chair nearby, which was meant for family members to sit in.
Yeah. I joke about it. It's not quite a joke. But I say that the two primary issues with my being an emergency physician were that number one, I panic under pressure. And number two, I can't stand the sight of large amounts of blood. Not good qualities in an emergency physician.
And those I say jokingly. There was a lot more to it. But really they illustrate just how out of touch I was with myself and my strengths and my weaknesses, and had just followed this path where I had let others really dictate where they thought I should take my life and my career. And it ended up quite disastrously.
So what happened? I mean, obviously that happened. And you then, of course, leave.
And I think I read the story. You sit down. You're in an apartment by yourself of which you're never in, because you were so busy, you couldn't be there. But what did you do to move forward? I mean, that's as you mentioned, pretty catastrophic.
It was. And no one would ever wish depression or suicidal depression, which actually I reached on a terrible night where I was actually contemplating taking my life. But thankfully, I survived that. I got a phone call while I was in the dark in my apartment that night. And it was one of the chief residents who was actually calling me. And she had noticed that I just wasn't myself.
And they had actually had a resident take their life a couple of years prior. And so she staged an intervention and told me to take stress leave. And during that leave, she told me to really reflect on who I truly was, what my real gifts and talents were, and how I might actually like to live my life, which was something that I didn't even know was an option. I was just so focused on success and achievement at all costs.
Just I'm sort of digesting what you just said. There's a lot there. So you have that episode. And thankfully, someone calls you.
But then how do you evaluate? How did you start that process saying, here's what I like. Here's what I think I'm good at. What did you do?
Yeah. It's very difficult. And at that time, there weren't coaches around or people like that to help. I was on antidepressant medication, which was very helpful, obviously, at the time.
But originally I didn't really know the answer to that. And getting more sleep and getting some rest and just having a break was very helpful. But all I had to go on initially was that I had this urge to go to Cuba.
And so I just took a little trip by myself during that break. And I saw the Cubans dancing. And I remembered that as a little girl, I had dreamed of becoming a dancer-- a "Solid Gold" dancer, actually. That's a little embarrassing!
And it was something when I saw those dancers, I realized that my life had become so uni-dimensional. It was so focused just on work, I completely lost myself. And anyone is going to get depressed and burned out in those circumstances.
So the first clue I had was to pick up dancing again literally to save my life, like it did. There's much more to it. But it was the dancing and the joy and just finding that part of myself again that was so healing.
You're a flamenco dancer.
I am. Yeah!
You perform.
Yeah. Yeah, I do.
Wow. As I mentioned, you write. And you've written-- you're a prolific writer. And you've done a lot of work on all sorts of journals and in magazines.
You've recently come out though with an e-book. And I love it, because it talks about the essential ways that people can kind of avoid stress and have a great lifestyle and those types of things. And you've got 10 chapters with little actions behind each chapter, I think, which is really great.
We don't have time to go through all 10. But I want to highlight a few, because I thought there were some really interesting. The second one I think you have here is an opportunity to stop and breathe. What do you mean by that?
Yeah. We don't as we rush through our lives. And it's such a great way physiologically to stop the stress response. Most of us pretty much all through the day, if we're racing from one thing to another and have the constant to-do list going, our stress response is on high. We're pumping out cortisol and adrenaline, which raises blood pressure, also is related to depression, causes all kinds of problems.
And we can actually literally instantly stop or decrease that by inducing the relaxation response. And you can do this just by breathing.
It's funny, because when I read through this, I've started doing it since I've read it. And I read this probably about a month ago. And it really does make a difference. I think sometimes if you read it, but just do it. Everyone just try it once. And then, you know you said it makes a difference.
My other favorite you have her in your list of 10 is say no to something. I love this, because people think no is such a negative. You think you have to say yes.
But I guess saying yes is what got you into-- you think about the beginning of your journey. That's where things happened.
Yeah. A key risk factor for burnout, actually, is being what they call a yes man or a yes woman. If you're that kind of person who everyone can count on you to say yes, and that feels really great on some levels, but it's extremely depleting. And one of the best things you can do is make a stop doing list where you decide what you're going to start saying no to, and then say it.
How do you say it though so that people don't think you're negative?
Well, one of the ways that you can actually avoid saying no to people's faces is saying, I'll get back to you on that.
How about I've got time for two more here. Get moving. You say it's really important.
Oh, it's so important. You probably heard about the sitting disease, how we're all sitting way too long at our desks, that it impedes blood flow to the brain, affects our mood, and blood sugar, everything. So if you can get moving in just the smallest way during your break, you'll get up once an hour or so at the workplace, walk around, get out your lunch hour, go for a walk.
Just those little types of movement will get your circulation going and also get your body relaxing. And it makes a big difference.
It's funny, because I think people would think that doesn't make-- you know what I mean? Cause it's like, really? Me getting up and going for two minutes in my office? Really? That makes a difference?
Yeah. The blood's not flowing through your brain, because it's pooling in your legs. So if you get up and you walk around, those calves start pumping it around. And you get your brain perfusion, blood flowing to your brain. And you can think more clearly. You have a less sense of stress. And actually, your body even produces better insulin functions so your blood sugar is better, cardiovascular function. It's really remarkable.
Thanks so much for coming in.
