Thinking Presponsibly
“I am not a product of my circumstances. I am a product of my decisions.” – Stephen R. Covey, from the book, The Seven Habits of Highly Effective People
It’s easy to feel like life in medicine (or even life in general) is something that happens to us. With shifting policies, unpredictable patients, relentless demands, and daily “surprises”, many days can feel like a firestorm we’re just trying to survive. But what if the most powerful choice we can make each day is to decide that we do have a choice? That’s the heart of Covey’s first “habit”—Be Proactive. It’s about reclaiming our agency, even when the world feels out of our control.
I remember a particularly grueling stretch early in my residency. It was the trauma surgery service, a month with every-other night call, a tough chief resident, and what felt like an unrelenting stream of emotionally draining cases. Very quickly I became exhausted and resentful, often blaming the system, the leadership, even the patients for my condition. Then, during a desperate moment of “commiseration” with the other intern on the team, we had an unexpected breakthrough. “What if we looked at this time as being an adventure – like Outward Bound, but we get paid!?” And so we did.
Covey defines proactivity as taking ownership for our responses (“response-ability”). It’s not about controlling everything—far from it—but about consciously choosing our response to whatever life throws our way. Research backs this up. A recent systematic review of healthcare workers found that proactive behaviors— actions among workers that are self-starting, change oriented, and future focused, are associated with lower burnout and higher job satisfaction. Being proactive moves us from feeling powerless to purposeful. I have come to call this mindset shift as being “presponsive.”
Looking back on that month, our change-of-mind didn’t alter our circumstances, but it did change how we engaged them. I started small—setting one intention before each shift as we handed off “the list,” holding my words when tempted to complain, choosing one thing I could improve in my work environment rather than lamenting what I couldn’t. And much to our amazement, things did get better. The chief resident didn’t get nicer and the workload didn’t lessen, but we felt more grounded and in control, and in our own strange way, greatly enjoyed the month. It became a challenge we overcame – together.
Ultimately, being proactive is about embracing the space between stimulus and response—and realizing it is in that space is where our power lives. It’s where resilience is born, where purpose takes root, and where change begins. And like my “Outward Bound” rotation, it’s easier to do if you have someone who is journeying with you. So this week, why not take some intentional time early each day to ask and answer, “Who do I want to be and how do I want to show up today?” and then notice what happens. Share your experience with your PeerRx partner. You may find, as I did, that being proactive isn’t a burden—it’s a gift. And it just might be the first step toward becoming not just a more effective professional, but a more fulfilled person. So remember, please “think presponsibly.”