Four years ago, my burnout at work had reached the point of crisis. I knew what it was like to be enthusiastic and warm and positive, but I found it impossible to summon up those feelings that had come so easily in the past. The nurses and other doctors noticed that I was no longer the same Dr. Shelton they thought they knew.

One morning, the psychologist in charge of our mental health branch called me up and asked if I would be willing to visit Doby, the traditional healer. I reluctantly agreed, because I knew the psychologist cared about me.

I felt awkward, though, and I didn't really expect the healer to be able to help me. How would he understand when I couldn't even explain what was going on with me? My hesitancy was complicated by the fact that I was the medical director at a clinical center created for the purpose of helping and treating the Native People. I wasn't supposed to become one of their patients!

At the mental health building I was greeted by Doby, a short, thick, elderly native man with a white crew cut, dressed in a Pendleton vest and blue jeans. In the corner sat a middle-aged man with a drum who, I learned later, was the his son.

We sat down at a small table in the center of the room.

"So, what's going on?" he said. I started with, "Well, it's getting harder and harder for me to come to work." He put up his hand abruptly, signaling for me to stop. He told me a story about the time of his father's death. The healer didn't want or need to hear any more about my problem. I was a little troubled by this. I didn't see how this rambling story about his father was going to help.

Finally the healer completed his story and said, "Okay, I'll see what I can do." He came over to me. Placing his hands over my head, he began to sing a native song. I felt respectful, present, and open, but to be honest, I didn't expect anything beneficial to come of this. Doby sang for another five minutes or so, and then he was done.

He announced, "Your spirit had left you, and I put it back." I was astounded. What sort of thing was that to say? I felt no different. I almost laughed, but I didn't want to offend this kind man. After all, he was only trying to help me.

I thanked him and left. What an interesting experience, I thought. As I began seeing patients, my skepticism and amusement quickly turned to marvel. I was back! I was able to address each patient and problem with the natural sense of compassion and creativity I had known before. At the end of the day, I was still energized. I felt wonderful!

Unfortunately, over the next few weeks I began to feel less energetic and increasingly irritable. I knew I couldn't keep seeing the traditional healer over and over. I needed to find some way to nourish and develop my spirituality. After much pondering, I became convinced that if I could discover how to stay spiritually connected and in balance with the whole of life my burnout would dissolve.

The Native American concept of wellness led me to a solution to my struggle with burnout. In the Native American understanding, you are well when all aspects of your life are in balance and in harmony. There is a sense of inner peace and wholeness. It is more than the absence of disease, or enjoying good health. You thus might be well while living with a chronic illness. This kind of wellness is reflected in behaviors and attitudes; how you respond to situations, problems, or people. Wellness means having a sense of poise and serenity that allows you to respond creatively and responsibly in a crisis.

How do we improve on our state of wellness? In the Native community where I work every day, I hear constant references to "the wellness circle." The circle is an important sacred symbol for Native Americans. It represents the cycles of life, the four seasons, the four directions, the heavens, Mother Earth, and the universe. It represents a holistic symbol of physical, mental, emotional, and spiritual health in its broadest sense, revealing the parts of human nature that must be nourished to bring a person to wholeness.

The Native American wellness circle describes four aspects or dimensions of life: physical (what one does), mental (what one thinks), emotional (what one feels), and spiritual (what one believes). When all four dimensions of life are in balance and functioning at an optimum level, a person is considered to be physically fit, mentally stimulated, emotionally adjusted, and spiritually connected. To be well, then, means to have vitality in each part of life, and to have all of these parts in relative balance.