Editor's Page: We've been thinking| Volume 27, ISSUE 11, P1163-1164, November 2021

Following Our Hearts: Prioritizing Self-care and Wellness

      At the journal, we (Anu and Rob) meet virtually with the HFSA Director of Publishing, Meredith Hurt, every Friday at noon. After spending some time talking through logistics (“Are any papers held up in review? Did we receive that invited editorial?”), most of our time is spent brainstorming on our JCF strategy: ‘what's our next innovation to improve the journal?’ and ‘how can we think differently about academic publishing more broadly?’. The three of us find these meetings to be some of the most invigorating and refreshing of the week—and it's not just because they conclude right at happy hour for Meredith who lives in Germany!
      In one of our recent meetings our list of “to-dos” seemed overwhelming and we found ourselves sighing in need of respite. It was then that Meredith reminded us of the need to be prepared for natural lulls in enthusiasm as we approach the 1-year timepoint at the helm of the Journal. It has been exciting to see the number of high-quality manuscript submissions increase, review times decrease substantially and to be part of the broader JCF movement. Yet we have been reminded of the fact that this is a marathon, not a sprint. We need to make sure our approaches are sustainable and that we, our editorial team, and broader JCF family is supported and engaged.
      As such, at JCF we have strived to create an environment where we can pass the baton to another member of the team (as needed) when our load is too high. While we derive much satisfaction from professional activity (journal engagement, clinical medicine, research efforts) we recognize they can be taxing if we don't stop to replenish our stores and “fill our buckets” as some of us quote to our children. Sometimes, such a restoration simply requires taking time off and knowing that advocating for a break is not being difficult or needy, but rather - necessary for self-preservation.
      It occurred to us then, that this is not unlike how the heart is designed to function! As one of the most central organs, the heart is responsible for pumping nutrient rich blood to the rest of the body. Yet it requires its own supply and source of energy and for that, it is equipped with vessels reserved for itself, so that it can continue providing for the rest of the body. What is a heart attack? Simply put, it is when one of those arteries is blocked, obstructing self-blood supply, resulting in muscle death and dysfunction. As clinicians we are no different! We need to take care of ourselves to take care of others and this means prioritizing and integrating self-care and wellness in our day-to-day lives (Figure 1).
      So, We've been thinking…how do we nurture and support self-care and wellness in the HF community and specifically in academic publishing?
      The central importance of self-preservation and wellness amongst clinicians seems obvious - without which burnout and depression may result. Yet despite efforts to prioritize their importance by the ACGME and other institutions, the pursuit of self-care and personal wellness in medicine is often trivialized as peripheral.
      According to Myers et al

      Myers J, Sweeney T, Witmer J. The Wheel of Wellness Counseling for Wellness: A Holistic Model for Treatment Planning. Journal of Counseling and Development. DOI:10.1002/J.1556-6676.2000.TB01906.X

      , wellness implies a “way of life oriented toward optimal health and well-being in which body, mind and spirit are integrated by the individual to live more fully within the human and community.” The Wellness Wheel depicts 8 different domains of health that contribute to one's overall sense of wellness including emotional, spiritual, intellectual, physical, environmental, financial, occupational and social (Figure 2). Attention devoted to each permits the highest level of functioning and prevention of illness in its various forms. Though not routinely assessed, increased clinician wellness could translate to better patient care. Further, assessments of patient and family wellness could be better incorporated in routine heart function visits potentially leading to better outcomes.
      At JCF, we have accordingly been working hard to improve and enhance the experience for all stakeholders – reviewers, editors, authors, and readers alike. We have launched and worked to sustain streamlined author pathways, developed reviewer recognition programs, and improved article presentations/dissemination. We have also focused key efforts on DEI and belonging, enhanced global appeal, trainee mentorship, the “language matters” movement and redoubled efforts to keep patients at the center. We now wish to share our focus on self-care and wellness with the broader #FunctionNotFailure community, by encouraging self-reflection and pause from the everyday treadmills of our professional lives.
      Along these lines, we are thrilled to announce our newest team member, Kristin Flanary – who has already taught us so much about what it means to serve in the role of the “caregiver” and how a better term to reflect this complex experience is “Co-Patient”. In this issue, she shares her experience as the spouse of a physician who experienced sudden cardiac death. She pens the personal and impactful narrative of her experience and her journey in and out of the “Quiet Place”.
      We all process our stress, fatigue and grief in different ways. We aim to shine a light on these experiences and to personalize the human story that is behind the journal – for the community of editors, authors/reviewers and readers. How we come out of our own “Quiet Place” and help others in their journey is what strengthens us all.
      This Thanksgiving, let us contemplate on how we can fully embrace the significance of finding sources of joy and energy that permit wellness in our everyday lives. Though attempts to shift culture may seem idealistic and sometimes even unachievable, change begins with small steps. We should all encourage one another to take the time to reflect on what activities are nurturing and restorative, and then outline strategies whereby they can become better integrated in our daily routines. In so doing, much like our hearts, let us remember to improve our own self-care and preservation so we may best serve ourselves, our patients, and communities living with heart failure.


      1. Myers J, Sweeney T, Witmer J. The Wheel of Wellness Counseling for Wellness: A Holistic Model for Treatment Planning. Journal of Counseling and Development. DOI:10.1002/J.1556-6676.2000.TB01906.X