When my wife and I learned that our children’s school intended to cut recess and lengthen classes to help improve test scores, we responded with the power of science. I had just finished reading the book “When: The Scientific Secrets of Perfect,” by Daniel H. Pink, wherein Pink presents the data from the Danish school system correlating a student’s performance with recess. The science was unequivocal: The more breaks, the better the test scores. The absence of breaks, i.e. recess, resulted in worse scores. If our school wanted test scores to go up, they needed to do the opposite. The science for improved academic performance supported increasing the amount of recess, not cutting it.
After our small victory in preserving recess (which made me immensely popular with my children), my wife turned to me and said, “if all the science on restorative breaks is true, why don’t you take a break of your own?” My wife was referring to my days in clinic. Over the years, she has heard me recount a day in the life of a neurosurgery clinic. For the most part, after making rounds on my patients in the hospital, I stand in the dictation room clicking the 37 boxes that allows me to get through a patient’s EMR. Throughout the day, I walk the 10-15 feet needed to get me from the dictation room to the examination room, meet with the patient, examine the patient, review imaging and then walk the 10-15 feet back to the dictation room for the 37 clicks of the EMR. Back and forth, I repeat the process until I get through all the patients on the schedule. My “lunch hour” provides me about 30 minutes to catch up on partially completed notes and await the dreaded peer to peer phone calls to secure the prior authorization for surgery. After my last patient in the afternoon, the Zoom meetings begin. By the time I return home, I would have spent the entirety of my 11-12 hour day in a 20-25 foot radius. There are no windows.
But now, my wife disarmed me with my own data. The science on restorative breaks is in fact unequivocal, and I did not have a leg to stand on. The science is so granular that researchers have demonstrated not only the value of breaks, but the value of breaks outside in nature. A 2016 study published in the Journal of Conscious Cognition clearly showed that rest improved performance, and if that rest was outside in nature, the pause was of even greater value. Facts are stubborn things, and I could no longer ignore them. Faced with the unequivocal data that saved my children’s recess, I had to introduce a recess of my own. As clinicians, we use the peer reviewed scientific literature to guide the management of our patients. Should we not use the same peer reviewed scientific literature to guide wellness for ourselves? And thus began the Neurosurgery Wellness Walk.
Now on clinic days, regardless of the circumstance, after I see my last patient for the morning, I don’t walk back to the dictation room. Instead, I make a bee line for the exit and begin my wellness walk. The results of a simple one mile walk in Old Town Scottsdale are difficult to describe. he impact that those 16 minutes have on my ability to reengage back into clinic would be difficult to articulate. But the science is real. I am outside in nature, walking through a historic city district. I see people on vacation, people taking walks of their own, small business owners in front of their shops. My pattern has become so predictable that people now expect to see me on my loop around 12:15 and wave to me. If I am running a little behind, there is one store owner in particular that will point to his watch and shrug his shoulders as if to say, “you’re late!”. Sometimes it is sunny, sometimes it is rainy, but regardless of the weather, the walk is always restorative. Along the way, I have run into monuments that have been hiding in plain sight all the years I have been in practice (Figure 1). My Wellness Walk has now become an inextricable part of my routine, so much so that my staff will usher me out the door because they want the afternoon clinic to start on time.
Initially, I found it hard to admit, but neurosurgeons need recess too. In attempting to salvage recess at my children’s school, I discovered the value of a recess of my own. My restorative pause in the middle of a busy clinic has become as transformative as suggested by the science. As we all look for sustainable patterns that we can embrace throughout our careers that will promote wellness, I invite all of you reading this article to consider a restorative pause of your own if you haven’t already. You might be surprised by what you find during a walk in your immediate vicinity. I certainly did.
