Permission to Pause

by Dr. Trisha Lal

Like many general surgery residents, I’ve opted to pursue two years of academic development during my training. After two clinical years, I recently completed my first research year. It was a year of growth and learning – learning how to do research, and also, unexpectedly, learning how to rest.

When I transitioned into research last July, I was genuinely elated at the idea of a slower pace. I pictured sunlit mornings with coffee and breakfast, focused work sessions, and midday walks. I told myself I would paint again. But instead, my days looked eerily familiar: I woke up early, jumped straight into work, ate lunch at my desk, and felt restless if I shut my laptop at 6 p.m. I realized, quickly and uncomfortably, that I didn’t know how to not be busy.

After two years on the clinical grind, during which I spent 12-14 hours at the hospital followed by ABSITE prep or case reviews at home, I had developed a near-constant need to be productive. Stillness felt wrong. In that realization, I came face-to-face with the toxic effects of productivity.

Since then, I’ve gone through what has felt like the five stages of grief. Denial was short-lived. Anger and depression showed up together: Why didn’t I enjoy spending time with myself? Bargaining looked like reopening my laptop after dinner just to feel like I had “done enough.” Finally, I arrived at acceptance. Without the constant demands of clinical life, I had to confront a silence I hadn’t felt in years. I had internalized the idea that my value came from my output – notes written, tasks completed, cases logged. In the absence of those metrics, I started to question if I was doing enough. It turns out that stillness is deeply uncomfortable when your sense of worth has been tethered to productivity.

Learning how to slow down has been its own form of hard work. It’s taken deep reflection and small, intentional shifts. As a lifelong checklist devotee, I started adding “fun” tasks to my to-do list: cooking a new recipe, going to pilates, calling a friend, or finally taking that midday walk. I’m motivated by goals, so I signed up for a 10-mile race and discovered a newfound joy in running. I still struggle with rest, but I’m proud of the progress I’ve made. While it feels like a radical act in a culture that glorifies overwork, making room for restoration is not indulgent. I firmly believe that stepping away from the productivity trap has helped me exceed my academic goals this year.

If any of this feels familiar, I want you to know that you are not alone. Many of us, especially women in surgery, have been conditioned to prove our worth through tireless effort, to equate busyness with value. I hope we can start talking more openly about the guilt, the pressure, the quiet fear of slowing down – and that we can give ourselves, and each other, permission to pause. 

Trisha Lal, MD is a general surgery resident at University Hospitals in Cleveland, Ohio who aspires to be a surgical oncologist one day. She is a first-generation immigrant and passionate about health equity. In her free time, Trisha likes to cook, do arts and crafts, binge reality TV, practice yoga, and watch basketball (go Celtics).