1. “The chief task in life is simply this: to identify and separate matters so that I can say clearly to myself which are externals not under my control, and which have to do with the choices I actually control.” - Epictetus, Discourses
Epictetus, a Greek philosopher and former slave, provides us with this quote about the importance of focusing on what is within our control and letting go of what is not. This is one of the fundamental practices of a Stoic lifestyle. In residency, many things are out of our control, such as patient outcomes, unexpected complications, and the actions of our colleagues. By recognizing and accepting these external factors as what they are, external, we can focus on what we can control - our actions and decisions. Focusing on what you can control, including your mindset, your preparation, your actions, and your resiliency, will assist you in only applying effort to the aspects of your life that are changeable and (most importantly) avoiding wasting energy on things that are not.
2. “You have power over your mind – not outside events. Realize this, and you will find strength.” - Marcus Aurelius, Meditations
Marcus Aurelius, a Roman emperor and Stoic philosopher, recognized the importance of mental discipline and the power of cultivating a positive mindset in difficult situations. It can be easy to fall into a negative spiral of self-doubt and criticism during a time of stress or adversity. However, by reframing negative situations as opportunities for growth, we can improve our response to a bad outcome, a missed opportunity, or an embarrassing moment. These events are only negative if the resulting action and perception are limited by a destructive emotion. It is important to understand that your viewpoint on an obstacle is just as important as the obstacle itself. By shifting your frame of reference, you can be better prepared to face these hardships and improve your chances of taking something valuable from the experience, no matter the outcome. I most effectively tackled feelings of inadequacy and perceived failures by reducing negative self-talk and reframing undesirable situations as important lessons to grow and learn from.
3. "It is not that we have a short time to live, but that we waste a lot of it." - Seneca, On the Shortness of Life
Seneca, a Roman philosopher and statesman, reminds us that time is our most valuable resource, and that we should use it wisely. Additionally, as an orthopaedic surgery resident often your schedule is dictated by outside influences. It can be all too easy to get caught up in the demands of the job - neglecting your health, relationships, and personal goals while losing sight of the bigger picture. By prioritizing even the small amount of time you are allotted and setting clear boundaries when possible, you can ensure that you are using your time in a way that aligns with your most important priorities and supports your long-term success and happiness. Personally, for example, I established more rigorous and effective sleep patterns that enabled me to use the early morning hours for self-care and preparation for the day ahead. This was in addition to fully planning and optimizing my day to allow for more focused tasks while decreasing the amount of ambiguity in my schedule.
4. "We suffer more often in imagination than in reality." - Seneca, Moral Letters to Lucilius
As residents, fellows, and faculty, we are no strangers to stress and anxiety. However, this quote reminds us that much of our suffering is often self-inflicted. Frequently, we create worst-case scenarios in our minds that never come to pass, causing unnecessary stress and anxiety. In addition, the toll that worrying plays on the mind is often exaggerated and ultimately wasteful when the very thing you are worrying about never occurs or is far less than feared. By practicing mindfulness and staying present in the moment, we can learn to recognize and let go of these unhelpful thought patterns, reducing our overall stress, and improving our mental health. When I was able to quell negative thought patterns and reflect on my worrying as a harmful emotion, it prevented me from perseverating on things that ultimately do not matter and things that never come to be.
5. “It is quite impossible to unite happiness with a yearning for what we don’t have. Happiness has all that it wants, and resembling the well-fed, there shouldn’t be hunger of thirst.” - Epictetus, Discourses
This passage exemplifies the Memento Mori concept which is a recurrent theme in Stoicism, reminding us that we are mortal and our time on this earth is limited. Epictetus is explaining here that we cannot wait for happiness after we graduate, after we land the perfect job, or after we retire. It is something that comes from gratitude in the present moment, appreciating the opportunities you have been given, and cherishing the things in your life that are truly important and bring you joy. By not focusing on the next step and actively seeking the positive in my present environment, it helped me maintain an upbeat attitude on even the most difficult days.
By cultivating a disciplined mind, prioritizing our time, avoiding the trap of unfruitful worrying, focusing on what we can control, finding happiness in the present, and consistently reflecting on our progress, we can stay motivated, resilient, and purposeful in our pursuit of excellence in all facets of our careers. These quotes purposefully have overarching themes which reiterate the important aspects of a Stoic life and have reverberated through time to the present day. I would recommend the several authors listed below as further resources to dive further into this mindset, as often newer non-fiction books on the topics of wellness, discipline, and happiness draw inspiration from the Stoic philosophies.
- Meditations of Marcus Aurelius - Marcus Aurelius
- The Obstacle is the Way & The Daily Stoic - Ryan Holiday, with further information at his website https://dailystoic.com
- The Practicing Stoic: A Philosophical User’s Manual - Ward Farnsworth
- How to Think Like a Roman Emperor: The Stoic Philosophy of Marcus Aurelius - Donald Robertson
- Tao of Seneca - available in PDF for free at https://tim.blog/2017/07/06/tao-of-seneca/
- Aequanimitas - Dr. William Osler