John D. Kelly IV, MD, is a professor of orthopedic surgery at the University of Pennsylvania. He focuses his blog on helping surgeons reduce stress while achieving balance in their practices and families.

Listen to the path to wellness

Your body holds great wisdom. It can teach you a lot about yourself. Most importantly, your body sends distress signals that you are a least temporarily off track if you seek a long and healthy life.

Physical pain is a great teacher. It indicates that the body has lost homeostasis or balance. I have a mildly arthritic hip and when my left groin aches, I know I have exceeded my “envelope of function.” In other words, the squats I did at the gym last Sunday were more than my hip can handle. I guess it is back to the elliptical machine. My left thumb metacarpophalangeal joint, another victim of arthritis, acts up when I tend to hold surgical instruments too tightly. It is my cue that I could be gentler in the way I handle the knife or the arthroscope.

Fatigue and blepharospasm

When I find myself falling asleep during office hours, I know I need to get more rest. Despite our best efforts, we cannot retrain our bodies to need less sleep. The effects of sleep deprivation are far reaching and include increasing ones risk of diabetes, weight gain and even Alzheimer’s disease. If I get less than 7 hours nightly, I dramatically lose effectiveness at work and at home. In my efforts to get more done, I am losing effectiveness and putting my health at risk.

When one or both of my eyelids starts twitching, that is my body’s way of saying that I am overloaded. Blepharospasm for me is due to stress and it indicates that:

A)    I need a vacation ASAP.

B)    I am overcommitted.

C)    I am not seeing the world correctly.

Item C means that I am taking myself too seriously and I have drifted away from my mindfulness practice. I am no longer living in the moment and the anxiety of future events has taken hold. Blepharospasm is simply my cue to be more loving, grateful and present.


This is a hallmark of burnout and essentially means we go about our lives like a robot with little feeling or passion. We are merely “getting by.” When I experience depersonalization, it is truly time to jettison certain obligations. I am way overloaded and my compulsive “yes” to opportunities that I should do has overtaken my inspired “yes” to things I want to or feel called to do. Like my eye twitching, depersonalization indicates I need a break.

Fear, anxiety and sleep

Fear and anxiety indicate that my “pain body” or ego has taken over. These thoughts are not derived from my source and will lead always to negative consequences. The more I practice self-awareness and label these thoughts as coming from my wounded past the more I can return to the present and extend love and gratitude.

Sleep deprivation also tends to make me more anxious. Lack of rest merely makes the well dry. It saps our inner strength.

The key to any signal your body is sending you – whether physical or emotional – is to acknowledge and label it and then own it. Carl Jung once stated “what we resist, persists.” Again, the task is to develop awareness of negative feedback and use it to grow. For instance, if I am feeling particularly irritable, I accept these feelings, become aware or observe them, and use them as a cue to be more mindful and extend love.

A recent series of particularly sleepy days prompted me to exercise more (so I could sleep more soundly) and to go to bed earlier.


Our most beloved vocation is a marathon – not a sprint. To navigate the long journey successfully, we must reap the wisdom that our body holds. Listen to the signals your body is sending and respond. You will be your best self and your best surgeon.