Reigniting your passion for dermatology through Tao Te Ching

Clay J. Cockerell M.D.Former American Academy of Dermatology (AAD) President Clay J. Cockerell, M.D., was so concerned about the rising burnout rate in dermatology that he decided to try and do something to help. Dr. Cockerell teamed up with retired dermatologist and professional speaker Steven Shama, M.D., M.P.H., to present “Lessons for Dermatology from the Tao Te Ching,” at the AAD’s Scientific Sessions in July.      

Tao Te Ching (pronounced dou de jing) is 81 verses and the fundamental text for Taoism, written around 6th century BC by Lao Tzu. The passages are simple truths, still relevant today, and provide readers with a spiritual way of looking at the world and at life. The Tao is basically the way of life.

“The rate of rise of dermatology burnout is the highest of all the medical specialties. That’s surprising and almost shocking. It’s a wakeup call. Dermatology was always thought of as a fairly stress-free specialty,” says Dr. Cockerell, clinical professor of dermatology and pathology and director emeritus of the division of dermatopathology at UT Southwestern Medical Center. “I’m certainly no guru or spiritual master or anything like that. But I’ve found this to be a very grounding resource for me.”

Next: Beneficial verses

One of the verses that resonates with Dr. Cockerell has to do with being of service.

It goes like this: “Man at his best, like water, Serves as he goes along: Like water he seeks his own level, The common level of life, Loves living close to the earth, Living clear down in his heart, Loves kinship with his neighbors, The pick of words that tell the truth, The even tenor of a well-run state, The fair profit of able dealing, The right timing of useful deeds, And for blocking no one's way No one blames him.” 

Dermatologists and others in the medical profession are all about serving people. It’s when they turn away from that aim and toward money-making or power that they lose direction and purpose, Dr. Cockerell says.

Dr. Shama likens this and the other 80 verses to poems.

“They don’t necessarily rhyme, but they’re brilliant, condensed thoughts of many different ways. … the Tao is the way or the natural order of life and the universe-the way it’s supposed to be,” Dr. Shama says. “As you read the verses you come closer to understanding the Tao, which is basically how to harmonize life. You can’t change the way it is, and you have to understand how you fit into it.”

Among many other things, reading the passages can help put into perspective the stresses of dermatology.

“Burnout is the time in one’s life when that person starts to lose enthusiasm, value and passion for anything. There are many physicians in their 40s who are just beginning their careers who would love to quit,” Dr. Shama says.

Like meditation, yoga and other forms of introspection and relaxation, studying or reading the 81 verses offers solutions and opens the thought process to possibilities that don’t occur to people trying to control life.

For example, this verse on leadership, might help a practicing dermatologist to find purpose and direction:

“A leader is best When people barely know that he exists, Not so good when people obey and acclaim him, Worst when they despise him. “Fail to honor people, They fail to honor you; ”But of a good leader, who talks little, When his work is done, his aim fulfilled, They will all say, “We did this ourselves.”

Next: How to apply to dermatology

“There’s a great deal of introspection, which I believe the Tao causes you to do,” Dr. Shama says. 

It’s the opposite of trying to control life and force an outcome, he says. Trying to control your destiny and fighting what’s happening in healthcare, despite the way things are, is fueling burnout.

“If a hospital is trying to take over your practice, play with the concept. Do I have to be a private practitioner? We have to be able to bend without giving up who we are,” Dr. Shama says.

It’s the simplicity of the Tao that makes it ever-lasting and beautiful, Dr. Shama says.

“You have to yield to the Tao, which means it just is. It allows you to be genuine and, when you’re genuine, all things fall into place,” he says. “The Tao does not judge. The Tao is.”

Tao Te Ching is not a magic bullet, Dr. Cockerell says, but it is a lifeline that helps reframe situations in life that lead to stress, at a time of great distress in dermatology and other medical specialties.

Dr. Shama says dermatologists should consider reading the verses, talking about what they mean with colleagues and referring to them when they’re stressed or face decisions. There’s no need to struggle to interpret every line. Rather, dermatologists might find meaning in a sentence or two that helps them to think more clearly.

“If you’re having a problem at the practice or at the hospital, you read a verse and it can solve your problem and give you a way,” Dr. Shama says. “There are no rights and wrongs in how you interpret the verses.”

According to the Tao:

“The greatest perfection seems imperfect,

yet its use is inexhaustible.

True straightness seems crooked.

True eloquence seems awkward.

True wisdom seems foolish.

True art seems artless.

The Master allows things to happen.

He shapes events as they come. He steps out of the way

and allows the Tao to speak for itself.”

For those interested in the interpretation of the book from which passages are cited in this article, please look for “The Way of Life, According to Laotzu” Translated by Witter Bynner.