The Power of a Pen: Story and Reflection

Sometimes autonomy doesn’t start with a policy change or a big career decision. Sometimes it starts with… a pen.

Last week, I listened to Dr. Jeff Haney, Vice Dean for Clinical Affairs at WSU Elson S. Floyd COM, share a story during a session on emotional intelligence. He described a night on call as a resident, writing notes in the middle of the night with a cheap Bic capless pen, and deciding the next day to replace it with one he actually liked.

It wasn’t about the pen. It was about choice. It was about agency. Every time he used that pen, it was a reminder: I chose this. I want to be here. I’m building who I want to become.

A few days later, I met with this year’s Resident Well-being Advisory Board, a space I created so residents from various programs can name the evolving challenges of their day-to-day, while I share evidence-based well-being strategies at both the systems and individual levels. Along the way, those conversations have also sparked unexpected connections across programs, and that shared “oh, it’s not just my program” moment can be powerful in itself.

This time, our conversation landed on Tait Shanafelt’s eight drivers of burnout and engagement graphic. We explored what was going well (breaking it into areas made those successes more recognizable), and what the biggest pain point was for themselves and their colleagues. One word emerged from every program: autonomy.

That reminded me of Dr. Haney’s pen (and the pens I included in their welcome gifts weeks ago. How cool is that?!). That led to a fun conversation about the best pen for keeping track of things as in-patient senior (fine-tipped and multicolored, by the way). They also identified areas where they could reclaim a little agency in small ways to support their own well-being.

It’s easy to think autonomy is only found in big system changes. But small, intentional choices matter too.

Sometimes the first step in reclaiming agency is simply noticing where you already have it — and then using it.

Reflections: Where do you have more agency than you give yourself credit for? What’s one small choice you could make this week to support your well-being? Why do you choose to be where you are and do what you’re doing?