B&Bs are perhaps the only place where I feel predictably comfortable talking socially with strangers. My wife, Suzanne, introduced me to them about 20 years ago, and we’ve stayed at many since. The owners have a lot to do with the sense of openness and accessibility to others that leads to rejuvenating conversation. It begins with the first phone contact and peaks the morning we awaken and join everyone for an over-the-top breakfast. What’s different from a hotel or lodge is that the owner lives there too. You are in their home. An often quoted number — and B&B owners all know it — is that that on average they burn out after 5 years. That’s why I was struck recently when Suzanne, Karen (our daughter) and I stayed at the home of Mary and Red on the coast of Oregon and learned that they have been in business for 20 years. On top of that it became clear they have no intention of stopping any time soon. What keeps them going? And are there lessons here for those of us in professions that bring us into frequent, close intimate conversation with strangers?

It seems that the best B&B owners and care providers — the ones who comfort always — fully engage with those they serve.  Mary and Red are probably in their 70’s and seem comfortable with where they are in life. During our visit Red did something unusual, in my experience, for B&B owners: he sat with us during the meal. Mary hovered nearby at the stove, part of the conversation. Because they had learned my wife is a rabbi, they asked her if she would say a blessing. That is not something Suzanne does over breakfast, but was happy to oblige. Over hot muffins, French toast and strawberry smoothies, we learned about their kids and grandkids, and Mary showed us photos. They learned about us, often asking direct open ended questions, including this one to Karen who is a teenager: What do you like to do? When we left, just 18 hours after meeting them, Mary hugged Suzanne goodbye.

One might argue that shared intimacy with countless people who come and go, most of whom you won’t see again, is a folly – a recipe for burnout. That’s often said about medical practice, and is given as a rationale for why physicians maintain emotional distance. I asked Mary and Red why they’ve lasted so much longer than expected in their business, and Mary replied “I think it’s because a lot of B&B owners want to travel and we are perfectly happy being here.” I think she was saying something deeper than the literal meaning of not needing to travel.

Mary and Red’s way of being present with their guests and their lack of restlessness suggests they are happy “here” because here is where they are. We only live, literally, in the present place and moment. To self-consciously attempt to manage interpersonal interactions, holding others at arm’s length instead of just engaging with them is a strain. An engine burns out when it is working against too much resistance. When we are detached there is a psychic strain, because we are not unselfconsciously in the present.

Another rationale for a self-conscious task based approach to professional interactions is the presumption that if we are not “paying attention” to what we say, we’ll say the wrong thing. I’ve observed, however, that when one person gives another their full attention, they are unlikely to say the wrong thing. When they do say the wrong thing, it’s usually because they didn’t hear what the other person said, as it was drowned out by distracting thoughts or distorted by preconceptions in their own head.

Physicians who are fully present during patient encounters are not necessarily having a terrific time all the time. For instance, the same damn problems with the computer freezing up or radiology not answering the phone when you need them arise. Those are unfortunate realities of the present that one has to deal with. However, not having to simultaneously “manage” the patient frees up psychic energy for coping with real albeit mundane issues. Instead, the person in the room who has come for our help is a partner for the moment in the journey we call life. The tables could as easily be turned under other circumstances. That is what is meant by shared humanity. And it is the antidote to burnout, not the cause.