Medicine and Self-Discovery: Part II of a Q&A With Dr. Victoria Sweet

Taking care of ourselves, both physically and mentally, is extremely important if we are to function at an optimal level. The effects of over-working, extreme exhaustion, and sleep deprivation can be irritating at best, and devastating at worst. Arianna Huffington addresses our need-for-speed culture and counters with the importance of self-care in her new book, Thrive. She spoke with Sheryl Sandberg at the Commonwealth Club about her work.

Dr. Victoria Sweet, who served as a physician for 20 years at San Francisco's Laguna Honda hospital, also found that "slow medicine" allowed her to do her job best. For Dr. Sweet, "Medicine works best -- that is, arrives at the right diagnosis and the right treatment for the least amount of money -- when it is personal and face-to-face; when the doctor has enough time to do a good job, and pays attention not only to the patient but to what's around the patient." Dr. Sweet spent time with complicated patients at Laguna Honda while getting her Ph.D. in history. The focus of her study was a 12th Century mystic and medical practitioner, Hildegard of Bingen, whose approach Sweet incorporated into her practice.

Dr. Sweet wrote about her work at Laguna Honda, her study of Hildegard's medicine, as well as her pilgrimage to Santiago de Compostela in her book, God's Hotel: A Doctor, a Hospital, and a Pilgrimage to the Heart of Medicine, which won the gold medal for nonfiction at the California Book Awards from the Commonwealth Club last year. I chatted with Dr. Sweet about her work, her take on the Affordable Care Act, and her advice to those who seek self-discovery. We shared her thoughts on the Affordable Care Act last week. This time, we explore thoughts from her about navigating the health-care system, being a woman in the workplace, and self-discovery.

MB: Considering the complications that our health-care system presents, how can patients or family members of patients navigate the system and be assertive about their health-care needs?

VS: Let me tell you what I do. First of all, it depends on whether you're sick or well. I try to use as few medicines as possible if somebody is not sick. I think in general I would really look at what you're taking and what you're asked to do. Do you really need that test? Do you really need that medicine?

If you're sick, I divide sick into being acutely ill or chronically ill. I think on the whole, we do a very good job with the acutely ill -- an amazingly good job. And I just sit back, relax, and enjoy the flight. Stepping in and trying to do Internet searches and probing the neurosurgeon, I don't think it's useful and I think it distracts people. If you're really sick, just let docs and nurses do their job.

Now, after you've been acutely sick, it's after that, in the rehabilitation and chronic stage, that I think we can do the most for ourselves and people we love. Because that tends to be where we haven't paid very much attention and we've lost that whole Nightingale approach. [Dr. Sweet wrote a piece on Florence Nightingale in The New York Times.] So what often happens is your loved person gets thrown out of the hospital really fast, [with] a whole bunch of pills, and that's the point where I think it becomes really tricky, because there's a pace of getting better that's slow. You end up with a lot of medicines [and] you need them at first, but as time goes on, you don't need them. I think if you're a person who's not sick but you're giving support, go to the doc with your person. That's when they really need you. Take all the medicines they're taking, all the treatments, bring them to the doc, and start tightening things up.

MB: Shifting gears a bit, can you tell me about what it's been like to be a woman in the workplace? In your book, you describe an incident with Dr. Dan, where he presented your patients at a meeting even though you were in the hospital. Do you think he would've done that had you not been a woman?

VS: When I was getting my interview to go to medical school, the interview guy actually said, "What are you going to do when you get married?" He actually said to me, "Look, we invest as a society a whole lot of money into docs, you know? And you're just going to get married and have kids and you're just going to drop out." He said this at my interview! I mean the difference between now and then is just mindboggling. Do I think it had something to do with him in particular that I was a woman? Yes. Absolutely. If I'd been a man, he would not have done that. But I don't think it's reflective of much [these days]. I just haven't felt it anymore, especially about the last five years. It's really been amazing.

MB: What was your approach when you encountered sexism?

VS: I was really lucky because I grew up in a family where, when I was five years old, [my dad] was teaching me mathematics. I think a lot of times, I just didn't see sexism, it just didn't occur to me. When it doesn't occur to you, it doesn't happen in quite the same way. However, when it did happen, I pushed back. I seriously pushed back.

In medical school, there were 400 medical students and 12 women. There were two women professors out of 126 professors. So we actually formed a committee on the status of women. The dean was fantastic, and we were allowed to write up professors if they were egregious. I remember walking into a room, and a patient looked at me and said, "You're the doctor?" Because not only am I a woman but I'm not very tall, and I said, "Yeah, fortunately all they cared about for me to get into medical school was my grades, not my gender or my height," and he looked at me, and that was the end of that.

So I found [helpful] the combination of not having too much internal sexism myself and then really being able to push back on a personal level, and then on an institutional level having a group behind you so you didn't feel crazy and didn't introvert all of it.

MB: Much of what you write about in God's Hotel is about discovery: discovering your role within medicine and personally with your pilgrimage to Santiago de Compostela. What advice would you give to others who want to undertake this type of discovery?

VS: I get asked this by a lot of people in their 20s who've read the book and resonate with what I say in part because, when you've got a lot of strengths and interests, you just don't slot into a slot. You feel like you should be able to tie those things together in some unusual way and then you look around and there are like four things you can do, from a practical sense.

I will say for me, being a physician turned out to be an excellent thing to do, because it gave me credibility, it gave me security, [and] it gave me education. I think having a degree that teaches you how to do something is actually really useful. Having a profession, something you profess, was worth it, even though it was so laborious and it was pretty brutal. But I don't regret that.

I'd say having adventures, doing different things, trying different things -- not huge, big things but on a daily basis, trying different foods, talking to different people, reading books you don't think you're going to be interested in, taking a different walk home, I think that's really good for our brains.

Then I think I would say, as a philosophy, that we need space in our lives. It's having some time everyday when you literally do nothing. You just sit and stare into space. The last thing I would say, I think a lot of the image of Santiago, the Camino, also called The Way: when you're on your pilgrimage, you don't even need to know where you're going. You just have to know when you're off your path. So staying attentive to your inner sense of, 'This just doesn't feel right.' Having a certain kind of integrity and a certain respect for your internal way. And it's OK to do things that you look back and say, 'Gee, I wish I didn't do them.' I mean, who wants to live a life with no regrets?

You can find the finalists for the 2014 California Book Awards here. The winners will be announced May 5th and an awards ceremony open to the public will be held on June 9, 2014. Dr. Sweet also spoke at the Commonwealth Club about her book. Listen to her speech here. You can also watch Arianna Huffington and Sheryl Sandberg talking about Huffington's book, Thrive, here.