Wear Red Day: What Our Systems Ask the Heart to Carry
February is American Heart Month.
On Friday, many of us will wear red- an outward signal meant to spark awareness.
In medicine, we’re very good at awareness.
We’re less practiced at reckoning.
When we talk about the heart in training, we usually mean endurance: long hours, emotional stamina, the ability to keep going.
But the heart is also affected by something we talk about far less: systems.
Not just schedule or workload, but the constant, low-grade stress of navigating fragmented processes, unclear expectations, and environments where asking for help feels risky.
This is the part of training that doesn’t show up on a duty hour report.
It shows up in:
the resident who hesitates before speaking p,
the fellow who absorbs friction so the team can keep moving,
the quiet normalization of stress that’s “just part of it.”
We often frame wellness as an individual responsibility.
Eat better. Sleep more. Be resilient.
But hearts don’t experience systems as abstract concepts.
They experience them as lived reality- day after day.
A confusing onboarding process.
A feedback loop that never closes.
A safety concern that gets documented but not addressed.
A culture that praises toughness while overlooking strain.
None of these alone cause burnout.
Together, they create a steady pressure that wears people down.
Wear Red Day doesn’t require us to fix everything.
But it does invite us to pause and ask better questions:
What parts of our systems quietly increase stress?
Where does unnecessary friction exist simply because “that’s how we always done it”?
What would it look like to design processes that support the people moving through them, not just the institution running them?
Protecting the heart of medicine isn’t only about preventing disease.
It’s about recognizing how the environments we create shape the people who train within them.
Sometimes the most meaningful act of care isn’t adding another wellness initiative.
It’s removing what never needed to be there in the first place.