Pain and Suffering builds RESILIENCE among Healthcare Professionals

In our hospital, there is a problem of the decreasing number of applicants for residency training, particularly in pediatrics.  I've heard it said before that the new generation of doctors (those who were trained virtually during the COVID-19 pandemic) lack grit and resilience.  They stay away from discomfort and inconvenience and from traumas and rigors of residency training. So they are looking for alternative careers that are available to them.

This is why I would like to talk about RESILIENCE and how we develop resilience among the younger generation.

T1.  How do healthcare workers exhibit resilience?

What is resilience?

The US Department of State defines RESILIENCE as the ability to successfully adapt to stressors, maintaining psychological well-being in the face of adversity.  It's the ability to "bounce back" from difficult experiences.  

Ian Robertson questions whether in today's culture we are reinforcing a "mental illness" mindset rather than fostering resilience and building "mental wellness".  Pain is your friend, so embrace pain for resilience.  "Resistance + pain = degree of human suffering" is the pain paradox.  Resisting or avoiding pain leads to more suffering.

To develop resilience, we must learn to lean into pain rather than avoid it. Embrace pain as if it were a trusted companion. By fostering a new relationship with pain, it begins to shift and become more manageable. 

This chat topic was inspired by a reel I came across on facebook of the NVIDIA CEO saying "I wish upon you ample doses of pain and suffering..."

https://x.com/joshuapliu/status/1769439388155482606

I understood then that the lack of resilience among the younger generation of healthcare professionals is because our parents shielded us from trauma, pain and suffering.  However, overcoming pain and suffering is how we develop resilience, and resilience is critical to success!  Therefore, in order to develop resilience, we need to overcome pain and suffering.  

The thought struck me again when I heard my mother listening to promotions about oud oil production from agarwood.

The speaker was saying that agarwood is a simple tree, and hardly valuable.  It is when agarwood is injured and inoculated with a fungal pathogen that it creates a resinous wood chips where oud oil comes from, which is valuable for fragrance, more expensive than gold.  It is the pain and suffering of the agarwood that makes one more valuable.

It makes sense because an oyster needs the irritation of a stone to produce a pearl.  Carbon undergoes intense pressure in order to become a diamond.

Residency training is tough because one day the discipline that we learn from training will spell the difference between the life and death of our patient.

T2. How do we develop resilience among our healthcare professionals?

Natalie Franke shares five simple steps to build resilience:

1. Nurture a positive view of yourself
2. Move toward your goals
3. Take decisive actions
4. Accept that change is a part of living and be willing to innovate
5. Make connections

The challenge stil boils down to BALANCE - with all the talk and importance of work-life balance and being mindful of mental health, how do we make sure we are providing amples doses of pain and suffering for our healthcare worker trainees to develop not only resilience but also GRIT?

T3. How do we balance developing resilience through pain and suffering while uplifting mental wellness?

References:

1. US Department of State Diplomacy in Action at https://2009-2017.state.gov/m/med/dsmp/c44950.htm#:~:text=Resilience%20refers%20to%20the%20ability,have%20or%20don%27t%20have

2.  Ian Robertson, October 24, 2025.  The Benefits of Pain and Suffering: The Key to Developing Resilience at https://ianrobertsontherapycounselling.com/our-blog/benefits-of-pain-and-suffering-developing-resilience/

3.  Natalie Franke, November 11, 2019.  Five simple steps to build resilience at https://nataliefranke.com/2019/11/5-simple-steps-to-build-resilience/

Sleep Hygiene

I have difficulty sleeping.

I've always been a night owl most of my professional life.  I am most productive from 6pm to 10pm.  Somehow, when menopause hit, I had difficulty sleeping before 12 midnight.  Some nights I watch the clock chime 5am to meet the sunrise.

I looked up Sleep Hygiene for tips on how to get better sleep.  One tip stuck to me, is the last line that you don't use your bed for anything but sleep and sex.

Body Odor Stinks

It feels depressing when your own team talks about you behind your back, when they only see your bad side and feel that you are just there to make work and life complicated for them.  It becomes difficult when your team is not rowing in the same direction.  Worse is when this is all an open secret, and everybody knows all this except you.

It's like body odor.

Everybody can smell it and they just laugh at you without you getting in on the joke.  People make all sorts of memes and jokes and have fun at your expense, because nobody cared enough to take you aside and tell you what the problem was.  Other people don't know how to tell you so you wouldn't get offended.  Other people don't know how to tell you so you don't get hurt.  

The truth hurts.  You're not perfect.  When you have a blank white page, the one that draws your attention is that tiny black dot - the imperfection.

All my life I had difficulty fitting in because I always felt like an ugly duckling.  In high school I had to endure bullying and rumors about me because I was  different and I came from another school.  I know how it feels to be vulnerable, knowing that others had the power to hurt you.  I know how it feels to be rejected, when you're always the last to be picked when joining teams. 

The coping mechanism is to develop a hard shell to protect you from ever being hurt again.  Or you can continue to risk yourself to vulnerability in the hopes of opening up to being accepted for your own true weird self.

Career Choices: what influenced you?

I would like to share some of my thoughts with regards to the questions for tonight's #HealthXPH tweetchat on career choices:

T1. What specialty/field are you in, and what is the most interesting thing about this field for you?

Doctor for all seasons.  I am an obstetrician-gynecologist.  We take care of women.  This is like taking care of the whole family since the woman is the pillar and the light of the home.  

Mobilizer.  The training in OBGYN requires you to coordinate and work in multi-disciplinary teams because we need to make sure our patient gets what she needs:

During childbirth, we need the nurse or midwife and the pediatrician.

In gynecologic surgery, we need the anesthesiologist, the surgeon, the internists, the OR nurses and even the orderlies.

In women protection, we need to coordinate with social workers, police and community advocates.

Clinician.  OBGYNs hold clinics for women from womb to tomb, providing outpatient care and performing office procedures.  The OBGYN is involved with diagnosis and management of reproductive health diseases. 

Surgeon.  An OBGYN is a surgeon with surgical procedures involving the female reproductive tract, with cesarean section as the most common major surgical procedure.  As the saying goes, a good surgeon should have an eagle's eye, a lady's hands and a lion's heart.

Public Health Advocate.  As empowered women empowering women, OBGYNs promote health and wellness, screening and early diagnosis for early prevention.  Maternal health is always a priority in healthcare because of its impact in public health.

Researcher.  As women's health is considered a public health issue, maternal health and reproductive health is always included in research priorities.  Being an OBGYN allows me to participate in research activities.

T2. What inspired you to go into this field? What fueled your enthusiasm?

Aura.  I was rotating in Fabella hospital as a clerk when I first assisted a normal vaginal delivery.  The parturient was having twins.  Despite not really knowing what to do, I was calm and patient, which the patient appreciated amidst the pains of labor.  The assisting midwife told me that I had the "aura" of an OBGYN...  At that time, I had my eyes on a surgical residency, but the observation stayed with me until the day I had to finally decide on my residency application.

Flexibility.  Ultimately, I envisioned that I would like to have my own clinic, make an impact on community health and be able to perform surgery.  I realized that obstetrics and gynecology ticked off all the items on my checklist, and comparing how prim and proper "amazon" OBGYNs presented themselves during conferences compared to the rugged surgeons, I chose to pursue my residency in obstetrics and gynecology, and later on a fellowship in infectious diseases (but that's another story altogether).

Empowerment.  Today, I am fortunate to be able to do what I love to do.  When I finished fellowship training and transferred to Cebu, my grandmother ordered me to rest and not work for a few months.  Then I got bored.  I asked permission from Dr Helen Amorin to volunteer to go on duty at the labor room doing labor watch.  It was something that felt natural to me, to simply be present and lend support to women amidst the pain of labor, coaching them that difficult roads lead to beautiful destinations.  There is light at the end of the tunnel and that after experiencing horrific pain is the joy of holding one's baby.  We are blessed to participate in the miracle of birth, taking care of women from womb to tomb.

Stigma Reduction.  Imagine delivering also women living with HIV.  In addition to the challenges of pregnancy itself, they need to deal with stigma and discrimination.  As empowered women, we empower these women to claim their own rights and to ensure that they get the treatment, care, and support they need for themselves and for their children.

Administration.  Amidst the hustle and bustle of the COVID19 pandemic, I was somehow dragged into hospital administration unintentionally.  The skills of coordination and facilitation and organization that we need in obstetrics and gynecology is also useful in managing institutions and health facilities in general.  Although this was unplanned and God seemingly led me into this, I am glad that I am able to make a contribution towards strengthening health systems.

T3. What advice can you give to someone who is still starting a career in your field?

Know your WHYs and choose something that you love doing so that there will be joy in your work.  If not, then find out what is NEEDED in your area so that you can strategically contribute to nation building and improving healthcare service delivery, because the country needs quality healthcare.  The Filipinos deserve quality healthcare service delivery.

In the end, we should remember that being a doctor is more than a job, it is a vocation.  Medicine is more than a career, it is a love for humanity.  The relationship with patients is based on trust.  We studied as best we could in med school because we knew that one day what we learned could spell the difference between life and death, and that the patient's life would be in our hands.  Choose your career based on what you do best, based on what is needed the most and based on what your heart desires.

Employee Empowerment

 

Employee empowerment is getting employees to do what needs to be done rather than just waiting and doing what they are told.  Empowerment is an act of building, developing and increasing other people's power through cooperation, sharing and working together to develop their COMPETENCY (knowledge, skills and attitudes).

It takes a level 5 leader to authentically empower their team to surpass you to reach their full potential.  It takes self-awareness, self-effacing and humility to genuinely empower one's employees.

Zig Ziglar Theory identified a list of seven steps associated with goal setting, identification, benefits, obstacles, skills, people, plan and timelines.

A stretch assignment is a project or task that challenges an employee to go beyond their current skills set and experience fostering growth and development by pushing them outside their comfort zone.

Situational Leadership

Situational Leadership is an approach where the leader matches and adapts behavior with the needs, commitment, capability and maturity level of his individual employee or team.

Leadership POWER

I was tasked to attend the Civil Service Commission Supervisory Development Course Track 2 and I share the nuggets of wisdom and learnings.

POWER is the prime mover of people and events, the ability to make things happen the way you want to.  The essence of power is influence over the behavior of others.

POWER is the ability to lead and inspire based on TRUST, respect and wholehearted commitment freely given and earned.