When we need help, we count on doctors to put us back together. But what happens when doctors fall apart? Funny, fresh, and deeply affecting, We Are All Perfectly Fine is the story of a married mother of three on the brink of personal and professional collapse who attends rehab with a a meditation retreat for burned-out doctors. Jillian Horton, a general internist, has no idea what to expect during her five-day retreat at Chapin Mill, a Zen centre in upstate New York. She just knows she desperately needs a break. At first she is deeply uncomfortable with the spartan accommodations, silent meals and scheduled bonding sessions. But as the group struggles through awkward first encounters and guided meditations, something remarkable world-class surgeons, psychiatrists, pediatricians and general practitioners open up and share stories about their secret guilt and grief, as well as their deep-seated fear of falling short of the expectations that define them. Jillian realizes that her struggle with burnout is not so much personal as it is the result of a larger system failure, and that compartmentalizing your most difficult emotions—a coping strategy that is drilled into doctors—is not useful unless you face these emotions too. Jillian Horton throws open a window onto the flawed system that shapes medical professionals, revealing the rarely acknowledged stresses that lead doctors to depression and suicide, and emphasizing the crucial role of compassion not only in treating others, but also in taking care of ourselves.
Jillian Horton's memoir about her five-day Buddhist mindfulness retreat reminded me a great deal of psychologist Caroline Elton's book from a few years back--Also Human: The Inner Lives of Doctors--which concerns doctors' personal struggles and mental anguish as they practise and sometimes decide to leave medicine. Initially strangers to each other, the participants who attended the retreat in Chapin Mill, New York along with Dr. Horton were similar to Elton's clients: doctors on the edge, all of whom were experiencing some degree of personal and professional "failure to cope."
Many physicians, Horton included, enter medicine for unconscious reasons, to right wrongs or address unacknowledged suffering in their own early lives. Horton's elder sister, Wendy, was diagnosed with a life-wrecking brain tumour in childhood. After surgery to remove the mass, Wendy developed meningitis, which further added to her brain damage. She was profoundly mentally and physically disabled, and the lives of all members of the Horton family essentially revolved around her care. Horton's other siblings also experienced great hardship. Her brother, Christopher, descended into psychosis in his teens. He spent the next twenty years--right up to the end of his life in 2020--in a psychiatric institution. Jillian's other sister, Heather, also had trouble making her way in life. She inherited the Lynch-Syndrome genetic mutation and developed cancer. Jillian was supposedly the "lucky" one. But was she? In a way, she was scripted to save them all. A gifted and musically talented student, she didn't inherit the faulty gene, and would likely have succeeded in any number of careers. After gaining undergraduate and master's degrees in English literature, she won a full scholarship to pursue a PhD at Oxford, but she opted to attend medical school instead. Her memoir opens many years into her successful practice when she is experiencing debilitating burnout.
Horton tells many compelling stories about her training and her patients. She acknowledges that some of the reasons for her reaching a point of despair are personal ones, but that flawed, dehumanizing, competitive medical education also played a significant role. The idealistic, perfectionistic, and driven young people who train to become physicians are conditioned to become increasingly divorced from their own emotions. Working punishingly long hours, they also learn to disconnect from or deny such basic needs as sleeping and eating. They compartmentalize, too, closing off many rooms in their own psyches--rooms that hold memories of failures, mistakes, and shame. Horton's book explores how the retreat helped her to open some of those doors in order to understand how she'd ended up in such a dark place.
This is a brave book that humanizes doctors. I can't imagine putting myself "out there" in the way that Dr. Horton has. Having said that, I do feel her memoir is too long and repetitive. Trimming it by a third would have made it a finer book. I'll admit, too, that I'm not fond of first-person, present-tense, play-by-play tellings. I don't care to hear about giggles, chuckles, and who raised her hand to "share" at the retreat, so a fair bit of the text just felt like filler to me. I grew impatient reading page after page about mindfulness exercises, sitting and walking meditation, the group sharing, and the hugs and tears at the retreat centre. While I understand why Horton set the book over a period of five transformative days, I personally would've preferred a more conventional chronological approach. Horton's frequent free associations, under-the-breath quips, and sardonic asides also became somewhat tiresome to me.
Thank you to Net Galley and the publisher for providing a free digital copy of the book for review purposes.
I want to be brave like Dr. Jillian Horton. Why do so many writers become doctors? I felt a connection with Dr. Jillian Horton from the beginning. She is a fellow Canadian, a lover of literature, who decided to study medicine at McMaster after turning down a PhD in english at Oxford. I have a soft spot for doctors who balance literature and medicine, because I feel they are two sides of the same coin: a study of the human condition. It takes courage to write this honestly, especially in a field that discourages discourse around mental health. This memoir doesn't offer answers so much as it offers insight. The notion that mindfulness will fix all doctors problems isn't the focal point for me, what shines through is the fact that doctors are left to grapple with a system that doesn't work, one that actually erodes the people who work within it, so much so that they end up at burnout retreats, in some cases only a couple years out of residency, if they make it out at all. COVID-19 put this struggle into perspective, and I hope the spark of a cultural shift that Dr.Horton hints at in this memoir grows stronger, because if we can't fix a system that's there to hold our hand on the worst days of our lives, what are we even doing?
Medical non-fic is the kind of book that I struggle to embark on because it feels like it's going to be too much of an emotional investment, but ultimately I end up liking pretty much all of the ones I eventually read. I knew enough about this book ahead of time to be interested in it but not enough to really know what was coming.
I was drawn in by how much vulnerability Dr. Horton showed throughout this book. From her initial inspiration to go into medicine, to the disenchantment with academic medicine, to her rather reluctant journey to the first retreat.
I liked how she was open with her initial doubts about mindfulness and sharing the internal monologue of negative self-talk. I expected there to be more talk on mental boundaries cutting between medicine and personal emotions but instead Dr. Horton talks openly about how she walks with her patients in the dark places. I've heard from so many physicians that you need to separate medicine and the rest of your life but I've never been able to do that completely. It's reassuring to hear someone else who is actually more emotionally regulated by sharing those difficult moments with patients rather than closing off from them.
Highly recommend to other physician colleagues who haven't had a chance to explore this yet. Moreso for physicians who might be experiencing burnout or disconnection from medicine.
Randomly coming across this book in the library, I have to admit that random doesn't always pay off. This book by Dr. Jillian Horton wasn't my favorite in terms of the story and the way it was written. I also didn't fully connect with the author, and the rest of the people she meets at Chapin Mill, especially at the beginning of the book. Not feeling a connection with the characters and the book overall, is often a sign to me that I'd rather finish it quick so that I can move on to another book. Yet, the way she reflects on her past wounds, her burnout as a doctor, and her way towards healing, was a touching part of this book and was written in an authentic, no bs kind of way. It presented some hard truths about the medical world and doctor life, that I think are important for people to talk about and for doctors to find a place to reflect upon. Luckily, a place such as Chapin Mill, a meditation retreat for burnout doctors, is there to offer a place just like that.
This is a beautifully vulnerable book that is worth reading by anyone, and especially people who work in medicine. I hope that it will be part of the slow culture shift that is happening within the field towards more compassion and life balance for the healers.
Ngl, as someone who is facing significant uncertainty in my professional future amongst increasingly significant confusion and uncertainty of what I even care for that future to look like, ESPECIALLY as someone interested in internal medicine (at U of T nonetheless) this sent me down a bit of a spiral.
This is a touching autobiography of one physician’s emotional awakening and how she overcame many of the institutional shortcomings of medicine for those who practice it. While it’s reflective of common experience, this story is highly personal, exploring Dr. Horton’s specific experiences, traumas, and suppression, which is valuable alone, however, it left me aching for solutions for the systemic failures that put her, and so many others, in that position. Despite her touching on the inadequacy of “resiliency” in these contexts, she only skims the surface of those systemic failures, offering only, in the end, personal changes.
I don’t expect Dr. Horton to propose a revolution in medical training and administration but the conclusion felt lacking, leaving me staring down the metaphorical barrel of a gun.
Friends in med, I’d honestly leave this until after CARMs.
The author undoubtedly deserves relief from the very real struggles she articulates in the book, but behind a very real and valid struggle, I feel like there is the undertone of the physician as this otherworldly warrior and martyr which really irks me. I think it is possible for society to recognize the importance and unique struggles of healthcare workers while simultaneously reckoning with the fact that a lot of them are fucking assholes with a huge superiority complex and need to be put in their place.
In other news, I listened to this via audiobook and have officially ended my era of disdain for them. Some of the anecdotes were much more poignant when being told to you as a story and I think it made me appreciate the little linguistic details I can speed over when reading more.
This book was so beautifully written. I think more than just doctors can take lessons from this book and am glad I read it. I actually see myself reading it again in the future.
This book is raw and honest. It exposes the real life and vulnerability that this author and her family have lived as well as the vicarious trauma and compassion fatigue of health professionals.
As I nurse and a mom, it is easy to relate. We all have our own issues to deal with which is something that I have learned as I have matured, learned and experienced life.
I will be pondering this memoir and thinking about the importance of mindfulness. Perhaps a retreat will be in my future!
A great read that accurately captures the struggles of life in medicine. As a student it's made me feel incredibly grateful for all the positive mentors I've had, and more empathetic towards the colleagues who haven't been as kind.
Strong 3.5 stars. Dr Horton writes beautifully and her stories are both heartbreaking and eerily familiar. I just wish she spent longer in her final few chapters reflecting on the steps she took towards healing, self-acceptance and mindfulness and how they are reflected in her current practice of medicine.
A beautiful book that captures some of the challenges of medical training that can leave lasting scars on us and ultimately effect how we approach patients and ourselves. I’d recommend it to any trainee or physician. ♥️
Though at times it felt a bit melodramatic, it made me feel lots of feels which grants it a bonus star. Also I listened to the audiobook which I thought was excellent and helped to bring power to the stories. 4.5
This book was presented to me at a time of life and in moments most needed. The words of a poem read near the end of the book helped the cracks in myself and in my heart today. With the mounting pressures of hospital work, of life, and after the unexpected and sudden death of not just a patient - a beloved person, the words are like a tender and healing balm applied where most needed.
“One winter’s day A crack appeared in all your lives We tried to stop it from spreading It was too late .... What I had to learn myself:
You could not save her And yet You did not fail.”
Thank you, Jillian! We did not fail...and although none of us are perfect and life in all its beauty and joy is filled with loss, grief, suffering, and many far from perfect moments.... We are all perfectly fine. My heart and soul are grateful for your reminder!
Horton’s memoir really affected me. I too have suffered burnout and immediately recognized a fellow traveller in Horton. She did a masterful job of recreating the experience of burnout which is defined as “erosion of the soul” or, in my vernacular, “the club of the living dead.” I appreciated that there were no miraculous moments of salvation; she makes it clear that the road to recovery is long and challenging. Still, the book isn’t unremittingly dark. It’s filled with humour, sometimes gallows humour, but humour nevertheless, and with stories that show doctors as fallible human beings and a system of medical education that so often brings even the best of them, as Horton clearly is, to their knees.
I was not expecting to be as moved while reading this book, I had thought it would be more clinical but this was a moving story of one doctor's journey of healing. Dr. Jillian Horton shares very personal stories with us as she works her way through the burnout she has been feeling. I loved the story of being "forced" to listen to her colleague at the Chaplin Hill retreat and then the two of them discovering how many life events they have in common; that story made me cry because you could feel their shared understanding and pain. I think after a book like this Dr. Jillian Horton no longer needs to call herself a failed writer, this story was beautiful, poignant, and eye-opening about what our health care professionals are dealing with daily.
Jillian Horton, a physician, attends a wellness retreat for doctors in an attempt to heal from physician burnout. While at the retreat, she encounters many others suffering similarly, thus noticing a need for changes to the system.
This book was a really interesting perspective on the professional and personal stressors that healthcare workers face, and how the systems designed to heal people can actually harm those working in healthcare.
I have a particular soft spot for anyone that has fought back from burnout and Jillian was witty and vulnerable.
I was really hesitant to read this book for fear of going back there. Residency is a big black box of emotions, many of which I have had to process through my own trauma work. This book was fantastic and made me feel not alone in what can be a dehumanizing, if not traumatizing, experience of becoming a doctor. We all hold on to threads. Reading Dr. Horton's experience was healing for me, just so relatable! It allowed me to tie up some loose ends and complete my own narrative to move forward.
What began as a reading assignment for my health class quickly developed into something much more. I found myself relating to her—whether it was my unequivocal love for literature or my desire to pursue medicine, I could see fragments of myself in her. The book touches on health disparities and inequalities, toxic pre-med and med culture, burnout, the inability to cope, and many more. ‘We are all perfectly fine’ is a completely gripping memoir that left me breathless yet breathing.
A lot of great life stuff courtesy of a local doctor and writer (and musician? Damn, save some talent for the rest of us Jillian). The line "anger is a response to helplessness" punched me in the face. It explains a lot about me to be honest!!