RENEW NEWS ARCHIVES:
RENEW– Refreshing and Reviving Personal and Professional Lives
By Edare Carroll, Managing Editor, San Francisco Medicine , May 2002
(journal of the San Francisco Medical Society)
When Dr. Linda Hawes Clever saw exhausted, disheartened doctors and nurses around her, she felt compelled to do something about it. She realized that she, like her colleagues, was trained to hide it or deny this type of pain and worried about the impact on patients and physicians and their families.
Inspired by the work of statesman author John W. Gardner and with a home base at the Institute for Health and Healing at California Pacific Medical Center, plus seed funding from the Eva Benson Buck Trust of San Francisco, Dr. Clever began to study and understand the deep-seated personal and institutional challenges confronting health professionals.
So in 1999, with the help of friends and colleagues, she founded an organization named RENEW. Its aim is to help doctors, nurses and other professionals resolve the conflicts and competing demands that are an inevitable part of their complicated, time-constrained lives. In addition, the organization develops practical ways to intervene and to help health professionals (and those in other walks of life) renew. The ultimate purpose is to renew institutions and society as a whole.
RENEW involves refreshing values, goals, motivation and energy. Its approaches include: presentations, conferences and workshops, Conversations Groups, audio-teleconferences, a renewal resource library, programs cosponsored with hospital departments, faculty development seminars, house staff education, and networking.
SFM Managing Editor Edare Carroll talked with Dr. Clever in April 2002 about the origin of this organization and how it was born from Dr. Clever’s personal experience.
Tell me more about the origin of RENEW and how you personally felt moved to establish this organization?
Dr. Clever: The idea for RENEW came from many sources. It seemed as if a whole lot of people I knew were having a hard time, caught in the treacherous intersection between their careers and their personal lives. In my own life, my mother died, our house was burglarized and some of my mother’s things were stolen and scattered around, two positions that I had evaporated (editor of theWestern Journal of Medicine and department chair at CPMC), my father died and my husband, Jamie, was diagnosed with carcinoma of the prostate. All of this happened within 18 months. I was compelled to try to make a difference in my own life and that of others.
I realized that no one pays attention to doctors’ lives and whether or not they are fulfilled and that we desperately needed some attention and help. Once I began working with physicians, I noticed that nurses felt the same way as doctors-exhausted, degraded, undervalued-and then we looked out into the community we saw the same painful phenomena happening among others: teachers, clergy, attorneys.
So with the wonderful support from CPMC’s Institute for Health and Healing, we began to put on some conferences. Kaiser Permanente in the East Bay asked me to convene some “Conversations Groups” for physicians just as we had at CPMC. These were groups of docs talking and listening to each other. We discussed things such as “what is success?,” “how to get through a tough day,” “how to deal with abuse of power,” “how to go for tenure while raising a toddler” and “how to have a whole life, not just balancing.” It turns out that it helps to converse and share. It is a relief not to feel so alone.
I’m not saying these groups solve everything. It’s not easy. A psychiatrist in Vancouver named Michael Meyers whose entire practice is filled with medical students and physicians says that managing a personal and professional life is a life-long struggle. It’s not about time management, it’s about defining the source of meaning in one’s life, recovering our values. Once you recall them, you can accomplish the things you want to do and you’ll make better decisions about how you spend your time. I’m not talking about a Palm Pilot or organizing your life. I’m talking about a person’s soul or spirit, what it takes to be a wonderful healer, a wonderful teacher, a wonderful parent and friend–that’s what RENEW is about.
Aren’t we just talking about dealing with physician burnout?
Dr. Clever: No. Burnout is way too late; I don’t use the term. I’m talking about long before that ever happens because burnout is indicative of such despair that often there seems no room for turnaround. The people who are being attracted to RENEW’s programs are people who see the writing on the wall, so to speak. They see others around them reach a low point and don’t want to repeat the pattern. They make a decision to change things before they hit rock bottom.
We want to get the message out that it is possible to resolve competing demands, to figure out the priorities of your life by re-connecting with your values and making decisions. It’s not about snatching time away from your work to watch your child play soccer. It’s about making choices about fulfilling practice and personal responsibilities based on your values.
The process is not exactly linear. Life is not linear. It’s an adventure. Looked at in this way, when the inevitable difficult, random events occur, we are much more able to deal with them without crashing. I’m the kind of person who prefers to control things, but life, especially recently, showed me that I cannot. So I gave up on control. I settle for “influence” on a good day.
But aren’t the Conversations Groups really kind of a group therapy session?
Dr. Clever: No. Our purpose is to renew and refresh individuals so that they can function effectively and joyfully in their personal, professional and civic lives. It’s not group therapy. I’m an internist and an occupational medicine person. . .people involved in RENEW’s Conversations Groups are ordinary doctors. It’s about the power of conversation. No doctor is going to be interested in going to a support group-we’re trained not to! As physicians we are supposed to be independent and self-sufficient. RENEW established Conversations Groups because the word conversation means “to turn with.” The idea is that something is going to change, either you get a new perspective or new idea simply from listening and conversing with colleagues. Only these conversations are about our lives. One doctor might be inspired by another’s way of handling his or her life. It’s that simple and that revolutionary.
I was in Delaware giving a talk at an American College of Physicians meeting. I told attendees-and it was standing room only-about the importance of renewing and that it was impossible to be a good doctor if you are not in great shape. We simply cannot take care of patients with excellence if we feel haunted by our own personal lives or are going nuts with hassles. People at the meeting began to share stories. One physician said he had started to coach softball. He said he had to give up some income but that he and his family decided that having less money was worth his having more time with his children. Another doctor shared a similar experience about coaching baseball, but said he tried to make up the time by working nights and weekends and that that was a big mistake. At another meeting, one woman said she was married to a physician and that she was a “single mom.” Another said that her husband had had no real influence on their children. When I reported that woman’s story at a later scientific session, one physician said that the woman’s husband did have an influence, but it was through his absence.
Who will you accept into your programs? What about physicians who lose their licenses or are suspended? What about doctors dealing with drug or alcohol problems?
Dr. Clever: There is no screening process. . .it’s whoever shows up. But I want to make it clear that RENEW is not a counseling process. If people need legal advice or drug abuse counseling, we refer them to other resources. RENEW is not a psychological or psychiatric service. It’s a group of people having a conversation about what is important to everyone in the group. This is not to say that sometimes someone is going through a personal crisis. On any given week, we might decide to abandon our agenda for that evening and listen to and work on a particular challenge. The people who come to these groups don’t come because they’re in crisis, however; they come because they do not want to be in a crisis. They have inklings: their partner just quit; they’re feeling overwhelmed with work and home life; they want to participate in life, not just hunker down or get swept away. They realize that we can help each other just as we consult with each other about our patients.
Let’s talk about the future of RENEW. . .where do you see this going?
Dr. Clever: We are on a roll! We are presently seeking (and welcoming) funding. We are building a community of professionals who want excellence in their lives. We have big goals and dreams and we need partners and professionals to help us as participants and faculty. Our next steps are to have more people convening Conversations Groups, to get our Web site up to speed and expand our staff to handle the increasing demand for RENEW services. We need both physician staff and professionals from other fields, such as teachers, attorneys and clergy. At this point we’re operating on fees, gifts from individuals and grants from the Eva Benson Buck Trust of San Francisco, the McGovern and Irvine Foundations and the Walter and Elise Haas Fund. The Haas gift was to start working with teachers in the San Francisco school district and we are excited about that!
These days I’m devoting almost all my time to RENEW but I still do some occupational health consulting. But my “cause” is our profession and the rest of our world. RENEW is for physicians, nurses, teachers, attorneys. . . it’s about creating a more capable, creative and optimistic world. It’s not nirvana, it’s hard work, but I love it and it makes me smile. It’s exhilarating and fun to see the changes people make, to witness the resilience in our colleagues.