They clock out and the last room comes with them.
An hour on letting a small piece of that finish before the drive home.
Who it is for
A department chief, a training officer, or a conference chair can put this hour in a room. The person on the night shift will feel whether it is real.
The bay
The bay doesn't stay empty. A tone pulls someone up from a chair that is still warm. At the bedside a shove starts, or a cry, and the work in front of them means it cannot finish. The patient is gone and the note is filed. The shoulders have not come down.
The rig
That tone cuts a sentence in half. The shove has started before the wheels stop. Then the person is needed for the patient in front of them, and the shove does not get an ending. On the drive back the hands stay tight on the wheel.
The watch
In a military unit, training makes the protection fast, and a watch can order it to stop. Afterward the room is quiet. The body stays ready anyway.
What stays
The body starts a protection it does not get to finish. A flinch, a run, a shove, a cry, a collapse. The tone has already put the person in the bay, or sent them out to the rig, and the shift goes on to the next task. On the drive home the body will not power down. It is still in the last room.
From the inside, that leftover sequence is burnout, numbness, rage, and the startle that shows up at 3 a.m.
The return
Feet on the floor, and the back given to the chair. If the room has a window, it can go unsearched. The breath is allowed to leave, all the way out, including the pause at the end of it.
A person comes back to this after a small piece of the action finishes.
The mechanism
Completion is a small piece of the ending the shift blocked, done on purpose. The person picks a size they can stand, lets that piece happen, and stops. Attention comes back to a steady contact. The dose stays small enough that they can still feel the chair. If they can no longer feel the chair, the piece was too big.
A medic hears the tone, and the right foot loads to push the door of the rig. On scene the work is hands and kneeling, so the push never comes. Later, in a chair, that foot is still loaded. They let it press into the floor, only the beginning of the push, and stop while the seat is still easy to feel. The chair takes the weight. The breath leaves. If the tone sounds, they go.
The sequence is already in the body. Between calls, people practice the size and the return. They are still on the job when they stand up.
A person can pass it on in a few words. A protection got started. Let a small piece of the ending happen. Come back to the chair.
What the hour gives the room
They leave able to do one thing tonight.
In a chair, they find the place still running the last call: a foot, or a jaw. They let a small piece of its motion finish, and they stop while the chair is clearly under them.
They do it once, seated, before anyone leaves. They can use that same dose between calls tonight, or before sleep.
Matt Chellew, MD
A physician in emergency medicine, more than twenty years in high-acuity departments, urban and rural, in Canada and the United States. He went through severe burnout and found this work through his own body. He learned it because he needed it. He speaks for an hour on the mechanism, to people who go back on shift.
Already measured
In emergency medicine, disaster response, and combat-related PTSD, the symptom is already in heart rate, in hyperarousal between sessions, and in courses measured over years. Feeling an emotion recruits somatosensory and interoceptive cortex, and a body-attending strategy uses a different neural route from reappraisal. Slow breathing and trained self-regulation move that physiology. Healthcare workers, asked directly, ask for an embodied practice rather than another app.
- 01Frontline physicians, PCL-5, 1,017 complete responses
- 02World Trade Center responders, symptoms followed for up to 7 years
- 03Firefighter trainees, stress separated in heart-rate variability
- 0499 veterans, hyperarousal detected from a watch
- 05Body-sensation maps and somatosensory, motor, and insular cortex
- 06Acceptance and reappraisal, a different neural route
- 07Equal inhale and exhale, stress EEG down in one session
- 08Combat PTSD, amygdala training, 20 versus 11, CAPS fell
- 0926 healthcare professionals asked for embodied, collective practice
Book the hour
Ask for a talk for a department, or a conference session. The email can say:
We would like to book Matt Chellew, MD, for a one-hour talk for our department on how to let a small unfinished protective action finish between calls.
Or write to matt@thrivingbeyondburnout.com in your own words. The hour is a talk. Attendance confers no certificate. Official somatic experiencing training is a separate program.