Healthcare Professional Burnout and Resilience

How I Choose to Repair the World

I’m often asked why I do what I do.

Actually, it’s rare that someone questions my decision to look after sick people as a physician. People also rarely wonder why I chose to get married or to have children. On the other hand, my academic interests – the focus of my research and educational work – seem to confuse a lot of people, albeit for a range of different reasons.

Perhaps because I spend a lot of my time with researchers, I hear their concerns the loudest. Why, some of them wonder, do I feel the need to be such an activist? Why am I constantly trying to change things, to question decisions that have already been made, to challenge the established order? Why can’t I just focus on my research – on understanding phenomena or discovering facts – and leave the system be?

My clinical colleagues, on the other hand, don’t question the need for change. Some are trying to change the system, whereas others are just trying to get by in the system we have or have given up out of exhaustion. What some of them question, however, is the kind of change for which I’m advocating: health care that’s at least as focused on compassion, equity, and the needs of each individual patient as it is on efficiency and cost containment.

And then there are my activist friends, colleagues, and students. Why, they demand to know, am I collaborating with the powers-that-be? Why am I not constantly pushing for immediate, radical change? Why do I attend meetings instead of protests, why do I wear suits, why do I waste time writing reports and publishing papers? Have I, they ask, been co-opted by “the man”? Is all my talk of equity and compassion really just talk?

In my mind, the answers to all of these questions can be summed up in one simple concept from my own culture, that of “Tikkun Olam” (often translated into English as “repairing the world”). From my cultural perspective, it is my duty to use my particular skills, privileges, and connections as best I can to make the world a better place. For me right now, sometimes the most effective way to do that is to write a paper, sometimes it’s to disrupt complacency at a committee meeting, and sometimes it’s to focus on the needs of the individual patient in front of me. At other times it has been to carry a protest sign, to shingle a roof, or to ask a question.

We all bring our values into the work we do. I value equity and compassion, engaging ideas and well-thought-out ideals, hard work and personal well-being. I will always be the child brought up by Holocaust-survivor refugees and the parent who cared for critically-ill children. I will also always be the over-educated professor with a doctorate from Oxford and a physician husband. Each of those components of my identity gives me different skills, knowledges, and connections. My job – just like yours – is to use all of them as best as I can to repair the world.

About the author

Ayelet Kuper

Dr. Kuper is a Scientist and Associate Director of the Wilson Centre, University of Toronto and a Staff Physician at Sunnybrook Hospital. She is also an Associate Professor in the Department of Medicine at University of Toronto.

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