Doctors are too hard on other doctors: Dr. Jillian Horton

In the second part of a Q&A interview, Dr. Jillian Horton emphasizes the importance of storytelling to foster vulnerability, self-compassion and resilience, helping doctors confront unacknowledged grief and redefine their narratives. Indeed, her podcast, Conversations with Jillian aims to shift medical culture by sharing authentic stories of physicians, focusing on their personal challenges and diverse experiences. Dr. Horton, author of the 2021 memoir We are all perfectly fine. A memoir of love, medicine and healing, also encourages physicians to write by embracing imperfection, clarifying motivations and trusting in the creative process, which has led to her memoir being optioned for a television series.The first part of her interview focused on why burnout hits doctors particularly hard, what to do about it, the core structural problems and more. Here she goes into how hard doctors are on themselves—and each other—when sick as well as the power of narrative.Q: How has the journey been with this new podcast, Conversations with Jillian?“The Conversations project at the Royal College has been just a joy project for me. That's how I often describe it to the staff,” Dr. Horton said. Around four years ago, the initiative began with a connection facilitated by Dr. Susan Moffatt-bruce, the CEO of the Royal College, who recognized the importance of sharing well-told stories about physicians—stories that reflect the diverse, sometimes difficult realities of practicing medicine today, she said. “I wouldn’t call them silver lining or happy ending stories. I would just call them reality-based stories about challenges that our colleagues face. And of course, as you know, our culture has often discouraged us from talking about personal stories: health challenges, life challenges.” Dr. Horton argues that medical culture has historically conveyed that singular devotion to the profession is necessary. Physicians are often implicitly taught that any other passion, including family, should come second. By sharing stories of courage, uncertainty, and overcoming adversity, she believes this project helps reframe what it means to be a physician and validates the richness of diverse life experiences within the profession.She said her own background in personal narrative work has shaped her belief that storytelling is a powerful strategy for cultural change. Through the podcast, she said she continues to learn key lessons about vulnerability, resilience, and the collective challenges faced by physiciansRead: Doctors: how to get a literary agentQ: When you’re preparing for an interview for the podcast, how are you deciding what aspect of narrative to focus on?Dr. Horton said her approach is to begin by seeking out people who have a clear sense of why they want to share their story. She often advises physicians interested in storytelling to understand their motivations. In some cases, a person may still be too vulnerable or uncertain to share deeply personal experiences. However, she believes there is a moment when people become ready to share—when they have done the necessary emotional work and are strong enough to face any discomfort or uncertainty.She also finds that many guests are motivated by a desire to make the path easier for others. Dr. Horton herself has often felt that while medicine is intrinsically difficult, the profession has made certain things harder than they need to be. By sharing stories, physicians can soften some of these hardships and lessen the psychological, physical and emotional toll that comes with the profession.Q: Physician-to-physician storytelling is especially valuable. Why do you think these stories resonate so deeply?Dr. Horton recounted an interview with two Toronto-based colleagues: Dr. Rob Stewart, a urologist and kidney transplant surgeon, and Dr. Marie Faughnan, a respirologist. “You might have seen this story somewhere else,” she said. “But Rob experienced liver failure, and Marie, who was a colleague who knew his wife but didn’t really know him, gave him a piece of her liver. She was a living donor for him!” She added that she was struck by what Dr. Stewart said. “One of the things Rob talked about in that interview is a how hard we are on ourselves as physicians, if we have any kind of physical illness,” she said. “I thought this was so striking just how angry he was at himself for getting sick—and his whole saga started with a snakebite. So this wasn’t like he’d stabbed himself in the liver with a corkscrew when he wasn’t being careful. This was a fluke accident.”This story underscores a broader phenomenon Dr. Horton has observed: physicians often lack compassion for themselves and for their colleagues. She theorized that when doctors see their peers struggling with illness or personal challenges, they project their own suppressed self-criticism onto others. Medicine conditions practitioners to be ruthlessly self-critical, often neglecting the benefits of self-compassion, even though research shows that self-compassion leads to better performance and well-being.Q: What other barriers do physicians face when confronting personal challenges or vulnerability?She said there can be grief and unmet emotional needs that accumulate over years of practicing medicine. Many physicians sacrifice significant life events for the sake of their careers, often without ever processing the emotional cost, she said. They can think: “Did it have to be this way? Did I really have to give up? Miss my grandfather’s funeral, so I could round on the ward that day because my attending made me feel that I’d be a failure if I (didn’t). I’m just using that as an example. But those are the kinds of things that happen to all of us all the time. And so there’s a lot of unmetabolized grief in our profession. It’s hard to face that, you know.”This kind of grief, Dr. Horton said, can remain unacknowledged and unresolved.Part of the work she and her colleagues undertake involves helping physicians confront and rewrite the narratives they tell themselves. Many doctors justify hardships by framing them as character-building experiences, but Dr. Horton challenges this perspective. She believes that reframing these experiences can be uncomfortable but ultimately liberating.Q: What advice do you typically doctors who want to write?She regularly encounters physicians who express a desire to write but are unsure where to begin. She emphasizes that writing is not a purely contemplative act—it requires getting words onto the page, even if the first draft is imperfect. “And because physicians are so type A, such perfectionists, what’s our role model? What’s our vision of what we have to do? Write a bestselling book, write the definitive commentary, reference, resource, etc. Well, if that’s your goal, that’s like saying, ‘OK, I want to be in the Olympics.’ Well, you’ve got to break that down into some bite-sized chunks before you can even see if if that’s a realistic goal for you.”Q: To write, you have to be able to get out a ‘shitty first draft.’“(Right.) If you are this type A plus plus plus person with (it is hard to show) vulnerability. You don’t want to show someone a first draft. So the first thing is: figure out what you really want, and figure out the why,” she said. Dr. Horton encourages prospective physician writers to focus on finding their authentic voice rather than aiming for instant perfection.She also advises aspiring writers to clarify their motivations. Writing a book solely to achieve fame or external recognition is unlikely to sustain someone through the arduous creative process. Instead, she encourages writers to connect with deeper, internal goals, such as wanting to make others feel less alone or to inspire readers. Dr. Horton credits her early work writing unpaid columns for CMAJ Blogs as a crucial period when she found her voice.Q: How did you navigate the process of finding an agent and publishing your book?She said that finding a literary agent requires serious preparation. Agents work on commission, so they need to see a high level of commitment and professionalism from prospective authors. Dr. Horton emphasized the importance of crafting a strong query letter and understanding the publishing process. She advises writers to thoroughly research agents who have represented similar works and to be strategic in their approach.In Dr. Horton’s case, after years of failed attempts and learning experiences with an earlier, unpublished fiction manuscript, she found an agent who resonated deeply with her memoir in a matter of days—because the learning from the early failures had made her into a deeply polished writer. Q: Your book has been optioned for a television series! How has that experience been?“(Yes!) I am working as a consulting producer on that. We’re in the process and it’s moving very quickly with an absolutely amazing creative team. It has officially gone into development with a major network, and I will be able to say more about that soon. And again, I’ve just been reminded: many physicians, we if we work in high functioning teams, we actually have those skills to already be really collaborative,” she said. She said her role involves contributing to the development of the show’s narrative while also trusting the expertise of the producers and showrunner.Interestingly, Dr. Horton noted that her previous work in mindfulness has equipped her to handle the uncertainty inherent in creative projects. In medicine, uncertainty is often something to be controlled or eliminated. However, in creative work, embracing uncertainty becomes essential. Dr. Horton has learned to view uncertainty not as a source of anxiety but as a necessary part of the creative process. She credits her friend and mentor Dr. Ron Epstein for helping her to see that relationship as a positive.She said she believes that sharing authentic stories about physicians helps dismantle the myth of medical exceptionalism. These stories foster greater empathy and understanding between the public and healthcare professionals. She sees this work as a form of knowledge translation, helping to illuminate the interconnectedness of physician well-being and patient care.

Doctors are too hard on other doctors: Dr. Jillian Horton

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