Untangling Your Line
September 2015
"I'm as mad as hell, and I'm not going to take this anymore!" Howard Beale, Network (1976)
“People here are funny. They work so hard at living they forget how to live” Mr. Deeds Goes to Town
“It ain’t the way I wanted it! I can handle things! I’m smart! Not like everybody says...like dumb...I’m smart and I want respect!” Fredo Corleone, The Godfather II (1974)
“If you hold anything back, I’ll kill ya’. If you bend the truth or I think you’re bending the truth, I’ll kill ya’. If you forget anything, I’ll kill ya’.In fact, you’re going to have to work very hard to stay alive, Nick. Now, do you understand everything I’ve said? Because if you don’t, I’ll kill ya’. Rory Beaker, Lock, Stock, and Two Barrels (1999)
Let me start by telling you a story:
On January 28th, 1986, I was sitting in my car in a parking lot getting ready to make a sales call. The shuttle Challenger was getting ready to launch, and it was big news because of a school teacher – the first teacher to fly in space, Sharon Crista McAuliffe. She was selected from among more than 11,000 applicants. She had been selected because NASA’s intent was to find a gifted teacher that could communicate to students from space. (NASA, 2004)
As they finished the countdown and the shuttle lifted-off, the thought came into my mind, “The shuttle is going to blow-up.” I’ve never forgotten that day because of that experience. It’s one of three events that I can remember where I was and what I was doing when I heard about it: JFK’s assassination, the Challenger disaster, and 9/11.
Do you know what the major cause(s) of the Challenger disaster were? The answer: fatigue and stress. Now, you may be saying to yourself, “Sure, I know that. I remember that the cold weather that day caused the silicone seals to shrink, causing heated gasses to escape and burn through the fuel tank.”
Nope! President Reagan appointed a commission – the Rogers Commission – to find out the causes. The commission determined that cultural and mechanical processes that contributed to the failure. (Lineberry, 2009)
The Human Factors Subcommittee attributed the error to “the severe sleep deprivation of the NASA managers.” (Lineberry, 2009)
A major cause was the pressure on the launch crews to make the launch happen on time. The Commission report says, “While shiftwork is commonplace in many industrial settings, few can equal a Shuttle launch's potential for inducing pressure to work beyond reasonable overtime limits. Such workload pressure increases when launch rates are accelerated or when unanticipated delays are encountered in the launch schedule, especially within the last few days before liftoff. Research has shown that when overtime becomes excessive, worker efficiency decreases becomes and the potential for human error rises.” (Accident, 1986)
In fewer words: “The report cites operator fatigue as one of the major factors contributing to this incident. The operators had been on duty at the console for eleven hours during the third day of working 12-hour night (8:00 p.m. to 8:00 a.m.) shifts.” (Accident, 1986)
Stress and fatigue are inseparably connected and cyclical. Stress contributes to fatigue which causes more stress, etc. etc. Both stress and fatigue effect performance. The more stressed and fatigued we are, the more difficult it is to be effective in the tasks we need to accomplish just to get through the day.
Have you heard of Purpose, or Intention Tremor? I’ll bet you’ve experienced it. There is no physiological cause for these tremors. Here’s an example: you’re trying to thread a needle and the harder you try, the more tense you become and, the more tense you become, the more difficult the task becomes. These tremors not only affect voluntary motion of the arms and fingers, but may also affect the voice and other parts of the body. (Intention Tremor) Ever had your success level start crash diving because you make a mistake, then you tried harder, then harder, then...?
Stress is a self-defeating state that we can, if we know how, overcome. We can break the cycle of Stress – Fatigue – Stress – Fatigue.
Dentistry is one of the most stressful vocations there is and has one of the highest burn-out rates of any profession. Here are some statistics from an article by Dr. Randy Land that were published in Oral Health Group. (Lang, 2007)
* The suicide rate of dentists is more than twice the rate of the general population and almost three times higher than that of other white collar workers.
* Emotional illness ranks third in order of frequency of health problems amongst dentists, while in the general population it ranks tenth.
* Coronary disease and high blood pressure are over 25% more prevalent among dentists than in the general population.
* Dentists suffer psycho-neurotic disorders at a rate of 2 1/2 times greater than physicians.
* The #1 killer of dentists is stress-related cardiovascular disease.
* The dental profession in North America loses the numerical equivalent of one large dental school class each year.
These are some pretty sobering statistics. I’m pretty sure that, at one time or another, we’ve felt all the emotions expressed in the “movie” quotes at the beginning of the article.
So, now what do we do? How do we overcome this very real, very serious problem?
Here are a few ideas for you:
1 – If you are stressed and tired, you are in good company. Don’t be afraid to recognize your stress and fatigue. You are not crazy. You are not weak. You work in a high-pressure profession. We can be our own worst critics. Take it easy on yourself.
2 – Don’t allow yourself to get caught in a stress cycle. Stress can lead to more stress. Our thoughts can run away with us. The “what ifs” and “I’m doomed” ideas can become a maelstrom that will suck you right down to despair. When this starts happening, stop (!) and take a breath. Take a short walk. Change the scenery. Go into your office and “chill-out” for a couple of minutes. You are not doing you or your patient any favors by sticking with it until you blow. In my almost 40 years as a dental industry professional, I’ve see more explosions and tantrums than you can imagine. Do you remember the good old days of removing a toffelmire from an amalgam filling and have the margin fall apart? And, again. And, again. And... Boy, oh boy – those were always good for causing profanity and flying bracket trays. Stop. Take a breath. Leave the scene. Go get a cold drink. Hide in your office for a few minutes.
3 – Separate yourself from toxic people. These can be chronic complainers. Family members and others that get their jollies by making a fool out of you. People who put you down. Doomsayers. Don’t let these people rent space in your head!
4 – Plan. As you plan, make some room in there for you.
5 – Ask yourself, “What’s the worst that can happen?” As we fall into the maelstrom of worry, we tend to lose perspective.
6 – Find a trusted friend that you can use as a sounding board. Find someone that can help you get a “reality check”.
7 – Breathe!
8 – Keep yourself healthy.
9 – Find an activity or hobby that you like to do and do it. Remember big-bad Rosey Grier. He was one of the “Fearsome Foursome” of the LA Rams; and he did needlepoint. You could take up needlepoint, or writing. Rosey also wrote “Needlepoint for Men” (1973).
10 – Get the sleep you need. If you can’t sleep, then relax at least.
11 – Prayer and/or meditation. Take some quiet time at the same time every day to center your thoughts on what’s important and how well you are doing. There is an excellent book on meditation that has helped me a lot. It’s about somebody like you and me that occasionally, or more or less permanently goes off the rails: 10% Happier by Dan Harris. The subtitle is, “How I tamed the voice in my head, reduced stress without losing my edge, and found self-help that actually works – a true story.”
11 – And, if you can’t pull yourself out of the spiral, get some professional help. This ain’t the mid-20th century. Getting professional help doesn’t mean you’re crazy; it means you have good sense. If you were having heart problems would you hesitate to see a cardiologist? You may have a condition that a professional can treat – just like heart disease.
In summary, if you’re stressed and fatigued, don’t add to the problem by “stressing” over it. It’s OK. It’s fixable. Work on your perspective. Be good to yourself. Breathe! You have my permission to ask for help.
Works Cited
Accident, P. C. (1986, June 6). Volume 2: Appendix G - HUman Factor Analysis. Retrieved September 14, 2015, from NASA History: http://history.nasa.gov/rogersrep/v2appg.htm
Intention Tremor. (n.d.). Retrieved September 14, 2015, from The Free Dictionary: Medical Dictionary: http://medical-dictionary.thefreedictionary.com/Purpose+tremor
Lang, R. (2007, September 1). Stress in Dentistry -- It Could Kill You! Retrieved September 14, 2015, from oralhealthgroup: http://www.oralhealthgroup.com/news/stress-in-dentistry--it-could-kill-you/1000214585/?&er=NA
Lineberry, D. (2009, April 4). Langley Research Center. Retrieved September 14, 2015, from Nasa: http://www.nasa.gov/centers/langley/news/researchernews/rn_sleep.html
NASA. (2004, October 22). THe Crew of the Challenger Shuttle Mission in 1986. Retrieved September 14, 2015, from NASA History: http://history.nasa.gov/Biographies/challenger.html