Surgeon’s book explores high-stress jobs and mental health

What do surgeons and skydivers have in common? If you ask Dr. Alexandra Kharazi, the common thread is high stress and high risk.

In her new book, “The Heart of Fear: A Surgeon's Collection of Stories on Adversity, Passion and Perseverance,” Dr. Kharazi interviews her medical peers and professionals in other high-risk careers. She explores how they have learned to navigate the waves of negative emotions and thoughts that arise from being in extremely stressful occupations. And she offers guidance on how to overcome life’s challenges by reenvisioning them as opportunities to grow character and achieve goals.

Dr. Kharazi herself is in what many would consider to be a highly stressful job. As a cardiothoracic surgeon affiliated with Sharp Grossmont Hospital’s Burr Heart & Vascular Center and Sharp Chula Vista Medical Center, she devotes her time to operating on and treating patients with life-threatening conditions.

“I like to think that I am a doctor first and a surgeon next,” says Dr. Kharazi. “In my line of work, there is a lot involved when doing both preoperative planning and postoperative care for each patient.”

She feels mounting pressures on health care professionals across the nation are complex and come from various sources, including heavy patient loads, hostile work environments and medical malpractice — particularly in the post-pandemic era. In fact, according to the American Medical Association, nearly 63% of doctors reported symptoms of burnout at the end of 2021, up from 38% in 2020.

“’The Heart of Fear’ was created as a resource to help sort through emotions, reframe negative events, and harness the power of pivoting from the original plan to live your best life,” Dr. Kharazi says.

Finding clues in your surroundings

One of the strategies Dr. Kharazi introduces is recognizing “mindset coordinates.” This refers to looking around yourself for a specific set of clues in the surroundings.

“Look to the left, look to the right,” Dr. Kharazi says. “This gives you a specific location of where your mind is in the present moment, mostly by becoming aware of your thoughts. Once you know your mindset ‘location,’ you can work to change it. You can work to improve it.”

From there, Dr. Kharazi says that we can focus on “deployment.”

“I define this as the first step necessary to achieve your goals,” she says. “This is much like sending out a pilot chute during a skydive, which opens your main container and deploys the main parachute.”

The sky’s not the limit

Writing “The Heart of Fear” was a passion project for Dr. Kharazi. She strived to share stories that would move people to turn adversities they might experience in their own career — as well as in life in general — into positive outcomes.

“I have a strong interest in exploring the mindset, which can certainly have a large impact on mental health,” says Dr. Kharazi. “This is what led to the concept behind the book. It’s actually more than a book. It’s about creating community by learning from each other and inspiring each other. From this, we can create a positive collective mindset shift.”

“The Heart of Fear” features stories from doctors in high-risk specialties as well as professionals in “distinctly different, yet surprisingly comparable fields,” such as stunt drivers and skydivers. “Through my interviews, I wanted to shed light on why traditionally high-risk occupations can be used to build a positive relationship with fear,” Dr. Kharazi says.

She notes that many people may be afraid to skydive because there is a misconception that it’s exceptionally risky and often results in injury or death. However, according to the United States Parachute Association (USPA), in 2021, there were 0.28 fatalities per 100,000 jumps, or about 1 in 400,000, which is lower than the likelihood of being killed in a car crash in any given year.

Through the stories in her book, Dr. Kharazi uncovers the techniques used to ease the risks and remain safe even under high-pressure situations. These techniques include focusing on training during times of heightened awareness; practicing positive visualization; and strengthening the confidence needed to persevere after a setback.

One interview features an emergency medicine doctor from Northern California who is also an avid BASE jumper. “He tells me about his scariest BASE jump, which ultimately resulted in some broken ribs and a trip to the hospital,” Dr. Kharazi says.

Dr. Kharazi asked him how he felt during that situation, what went through his mind and how he reacted.

“’I just got up,’ he said,” Dr. Kharazi recalls. “I thought that was powerful.”

A deeper dive into mindset and motivation

One of the techniques derived from the BASE jumper’s story is identifying the “sequence of events,” which Dr. Kharazi defines as the specific steps in a chronological order needed to achieve a desired outcome. It applies not only in high-risk situations, such as the one shared by the BASE jumper, but it can also be applied to career goals and navigating difficult work situations.

For Dr. Kharazi, it is her personal experiences in medicine that have propelled her to become a storyteller focused on encouraging others to not let negativity dampen their ability to become better versions of themselves.

"Helping people through some of the toughest times in their lives — when they are very sick — is an incredible privilege,” Dr. Kharazi says. “But we all have our good days and bad days in medicine or in any career. This is the reason why I wanted to dive deeper into learning more about mindset and motivation. By sharing the stories of the incredible people interviewed in the book, my hope is that it can inspire at least one person to rise above any adversity in their lives.”

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