Summary

Amy introduces Dr. Adam Rosen, an orthopedic surgeon and author of "OR Confidential: Confessions of a Gen X Surgeon," highlighting the book's exploration of the challenges and mental health struggles faced by physicians, especially during the COVID-19 pandemic. She emphasizes the book's relevance to both medical professionals and patients seeking to understand the physician's journey, its consequences, and recovery . 00:00:02

Dr. Rosen shares his lifelong aspiration to become an orthopedic surgeon, detailing his training and career until his mental health crisis in 2023, which led to a year-long absence from work. He reflects on the initial desire to help people that drives many into medicine, contrasting it with the systemic pressures that erode empathy and compassion over time . 00:01:38

The discussion shifts to the impact of COVID-19 on surgical teams and patient care. Dr. Rosen describes the efficiency and synergy of his pre-COVID team, where experienced members anticipated his needs, leading to streamlined procedures. He contrasts this with the challenges of working with traveling staff during the pandemic, who, despite being highly paid, lacked familiarity with the hospital's systems and procedures, causing frustration among permanent staff . 00:04:47

Dr. Rosen elaborates on the emotional toll of striving for perfection in an environment of constant staffing and supply chain issues. He recounts his hypervigilant state, driven by the need to ensure optimal patient care amidst systemic challenges, which ultimately led to his mental health breakdown. He also mentions a quote in his book from the Hip and Knee Society about the high percentage of doctors still facing supply chain and staffing issues years after COVID . 00:08:57

Dr. Rosen describes the red flags he missed leading up to his breakdown, including chronic sleep deprivation, increased alcohol consumption, cessation of exercise and meditation, and social withdrawal. He acknowledges the feeling of being trapped by financial obligations and professional responsibilities, which prevented him from addressing his deteriorating mental health . 00:11:17

Dr. Rosen recounts the events leading to his breakdown, triggered by a combination of hospital issues, electronic medical record stress, insurance demands, a patient complication, and a lawsuit. He describes waking up one Friday unable to get out of bed, experiencing a sense of detachment at work, and ultimately being unable to move, leading to a three-week period of isolation . 00:14:34

Dr. Rosen reflects on a prior panic attack, which he initially dismissed, and contrasts it with the overwhelming fear and inability to function that characterized his breakdown. He credits his wife and therapist for intervening and initiating his treatment, highlighting the importance of support systems and access to mental healthcare . 00:18:43

Dr. Rosen discusses his experience with psychiatric treatment, including medication and an intensive outpatient program involving cognitive behavioral therapy (CBT) and group therapy. He describes the challenges of accepting the healthcare system's limitations while striving for optimal patient care, and the difficulty of admitting the need for help due to stigma . 00:26:26

Dr. Rosen emphasizes the importance of continuous self-assessment and seeking help, recounting how sharing his experiences has become easier over time. He notes the surprising number of older colleagues who have privately struggled with similar issues, underscoring the prevalence of mental health challenges in the medical profession . 00:35:06

Dr. Rosen details the tools and strategies he has adopted to manage his mental health, including mindfulness meditation, regular exercise, nutritious eating, social interaction, and creative outlets like writing and YouTube. He shares a personal anecdote about reframing frustrating situations by rewarding himself with a treat, illustrating his approach to managing stress . 00:36:50

Dr. Rosen discusses the principles of cognitive behavioral therapy (CBT), including identifying and challenging negative core beliefs and cognitive distortions. He recounts his experience in group therapy, where he had to confront his belief that he was a failure and reframe his narrative . 00:41:16

Dr. Rosen describes his current activities, including his YouTube channel, which provides information and support to patients undergoing knee replacement surgery. He also mentions his plans to resume work on a fictional medical crime thriller . 00:50:24

Amy commends Dr. Rosen for his openness and advocacy, highlighting the value of his resources for patients and healthcare professionals. She also acknowledges the unique challenges faced by female surgeons and expresses appreciation for initiatives supporting them . 00:54:51

Chapter

Introduction to Dr. Adam Rosen and His Book 00:00:02

Amy introduces Dr. Adam Rosen, highlighting his book "OR Confidential: Confessions of a Gen X Surgeon," which explores the mental health challenges faced by physicians, especially during the COVID-19 pandemic. She emphasizes the book's relevance to both medical professionals and patients seeking to understand the physician's journey, its consequences, and recovery.

Dr. Rosen's Journey to Becoming a Surgeon 00:01:38

Dr. Rosen shares his lifelong aspiration to become an orthopedic surgeon, detailing his training and career until his mental health crisis in 2023, which led to a year-long absence from work. He reflects on the initial desire to help people that drives many into medicine, contrasting it with the systemic pressures that erode empathy and compassion over time.

The Impact of COVID-19 on Surgical Teams 00:04:47

The discussion shifts to the impact of COVID-19 on surgical teams and patient care. Dr. Rosen describes the efficiency and synergy of his pre-COVID team, where experienced members anticipated his needs, leading to streamlined procedures. He contrasts this with the challenges of working with traveling staff during the pandemic, who, despite being highly paid, lacked familiarity with the hospital's systems and procedures, causing frustration among permanent staff. He notes that travelers were often paid two to three times what the home market paid.

The Emotional Toll of Striving for Perfection 00:08:57

Dr. Rosen elaborates on the emotional toll of striving for perfection in an environment of constant staffing and supply chain issues. He recounts his hypervigilant state, driven by the need to ensure optimal patient care amidst systemic challenges, which ultimately led to his mental health breakdown. He also mentions a quote in his book from the Hip and Knee Society about the high percentage of doctors still facing supply chain and staffing issues years after COVID.

Red Flags and the Feeling of Being Trapped 00:11:17

Dr. Rosen describes the red flags he missed leading up to his breakdown, including chronic sleep deprivation, increased alcohol consumption, cessation of exercise and meditation, and social withdrawal. He acknowledges the feeling of being trapped by financial obligations and professional responsibilities, which prevented him from addressing his deteriorating mental health.

The Breaking Point 00:14:34

Dr. Rosen recounts the events leading to his breakdown, triggered by a combination of hospital issues, electronic medical record stress, insurance demands, a patient complication, and a lawsuit. He describes waking up one Friday unable to get out of bed, experiencing a sense of detachment at work, and ultimately being unable to move, leading to a three-week period of isolation.

Panic Attack and the Importance of Support Systems 00:18:43

Dr. Rosen reflects on a prior panic attack, which he initially dismissed, and contrasts it with the overwhelming fear and inability to function that characterized his breakdown. He credits his wife and therapist for intervening and initiating his treatment, highlighting the importance of support systems and access to mental healthcare.

Psychiatric Treatment and the Stigma of Mental Health 00:26:26

Dr. Rosen discusses his experience with psychiatric treatment, including medication and an intensive outpatient program involving cognitive behavioral therapy (CBT) and group therapy. He describes the challenges of accepting the healthcare system's limitations while striving for optimal patient care, and the difficulty of admitting the need for help due to stigma.

The Importance of Continuous Self-Assessment 00:35:06

Dr. Rosen emphasizes the importance of continuous self-assessment and seeking help, recounting how sharing his experiences has become easier over time. He notes the surprising number of older colleagues who have privately struggled with similar issues, underscoring the prevalence of mental health challenges in the medical profession.

Tools and Strategies for Managing Mental Health 00:36:50

Dr. Rosen details the tools and strategies he has adopted to manage his mental health, including mindfulness meditation, regular exercise, nutritious eating, social interaction, and creative outlets like writing and YouTube. He shares a personal anecdote about reframing frustrating situations by rewarding himself with a treat, illustrating his approach to managing stress.

Cognitive Behavioral Therapy (CBT) and Challenging Negative Beliefs 00:41:16

Dr. Rosen discusses the principles of cognitive behavioral therapy (CBT), including identifying and challenging negative core beliefs and cognitive distortions. He recounts his experience in group therapy, where he had to confront his belief that he was a failure and reframe his narrative.

Current Activities and Future Plans 00:50:24

Dr. Rosen describes his current activities, including his YouTube channel, which provides information and support to patients undergoing knee replacement surgery. He also mentions his plans to resume work on a fictional medical crime thriller.

Commendations and Acknowledgements 00:54:51

Amy commends Dr. Rosen for his openness and advocacy, highlighting the value of his resources for patients and healthcare professionals. She also acknowledges the unique challenges faced by female surgeons and expresses appreciation for initiatives supporting them.

Find Dr. Rosen at:
His Youtube channel here
His podcast here
His book here