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Your 4 AM Buddy

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By Steven Reames, Ada County Medical Society (Boise)
It’s 4 AM and you are in over your head. You just lost a patient. Or you just lost it with a co-worker. Again. You’re exhausted and you’re ready to throw in the towel. But, you’ve got six more days to muddle through before you’re going to get a real break. How are you going to bounce back?

I firmly believe that everybody needs a 4 AM friend – this is a confidant that you can reach out to any time of the day by phone or text AND they’re going to get back to 
you, sit with you in your ashes, maybe even pray with you if you have a common faith. What they’re not going to do is judge you for being “weak” or “human” because they know that they are too.

This kind of relationship takes effort. It requires a willingness to reach out, test the waters of friendship, in order to have a mutual commitment to being vulnerable in your weakest moments and expecting confidential treatment. It requires maintenance and a deepening of trust when there is no emergency so that when actually there is, you feel free to reach out. In return, of course, it means you being available to return the same favor and consideration.

When you need that person – and for doctors, it is probably going to be multiple times in your career – they are going to be your life preserver.

Now, does this have to be a physician? I suppose not, although they may be more uniquely qualified to understand your stress points than others. I’m hoping if you are married that your spouse is one of your 4 AM friends. But frankly, on some things, I really need somebody other than my wife to talk with and gain perspective and encouragement from.

There is a scientifically based reason for all of this by the way: did you know that friendship – the tending to and befriending of others – actually releases oxytocin into your body?* That’s far healthier for the long term than any other chemical that does the same. And it’s natural too!

So can I encourage you: take a moment to think of somebody you trust that might be your 4 AM Friend. Don’t dive into the deep end of the pool in the relationship, but rather wade in gradually, opening up areas of your heart and mind to see if they reciprocate. Pro-actively, keep an eye out for your buddy and they’ll keep their eye out for you – and when you’re in a pinch, you’ll be within arm’s reach.

*. Carter, C.S., Lederhendler, I.I., & Kirkpatrick, B., eds. (1999). The integrative neurobiology of affiliation. Cambridge, Mass.: MIT Press
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Public Support and Commitment to the Principles of the Charter for Physician Well Being 

Rachel Oliver, MD | OGA Idaho | Greg Trapp, MD | Michael Kaylor, Kaylor Family Medicine | Julie Lyons, MD | Deb Roman, DO Finding Health | Susan Martin, PhD Full Circle Health | Amy Baruch, MD | Dawn Dewitt, WSU College of Medicine | Mark McConnell, MD | Abhilash Desai, MD
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Original Content Copyright 2015-2022* Ada County Medical Society
PhysicianVitality.org and the Capital Coalition for Physician Well-Being is sponsored by Ada County Medical Society, Boise Idaho.

The National Charter on Physician Well-Being was developed by the Collaborative for Healing And Renewal in Medicine, under a grant from the Arnold P. Gold Foundation.

Local services offered here, specifically the Physician Vitality Program (counseling services) are directed at ACMS Members only. All other information is published in the hopes it will be useful to other physicians and clinicians seeking help and inspiration.

If you have research, examples, or ideas that illustrate approaches to implementing the Charter on Physician Well-Being, you may submit or recommend content to: director@adamedicalsociety.org. However, this webpage is focused on non-commercial solutions and does not list commercial products or recovery, diagnosis, or treatment services unless are narrowly focused on physician well-being and locally based in Idaho.  
  • HOME
  • GET HELP
    • National Support Resources
    • ACMS Physician Vitality Program
    • Find a Boise Area Counselor
    • Peer to Peer
    • Get Connected
    • ACMS Member Resource Physicians
    • Physicians Recovery Network
    • Suicide Prevention
    • Other Links
  • Guiding Principles
    • Supportive Culture
    • Policy Advocacy
    • Supportive Systems
    • Engaged Leadership
    • Interprofessional Teams
    • Anticipate Emotional Challenges
    • Mental Health Care
    • Promote Self Care
  • BUILD STRENGTH
    • Personal Resilience
    • Practice Differently
    • Adverse Events
  • CHANGE SYSTEMS
    • Counting the Cost
    • Cultures of Wellness
    • Technology
    • Advocacy