You spend your nights trying to keep patients alive while you imagine ways to die by suicide.
This was #2 on a list of "reasons to quit your job" due to burnout. Terrifyingly poignant. Thankfully, there has been an increased awareness of depression, anxiety, and other mental health aspects in health care in the last few years, but there is still a lot to do.
I'm passionate about this area of medicine not only because I've struggled from time to time, but I have also seen the effects on great people whom I know and love. Part of it is the culture of medicine -- the other part is awareness, education, and action. Maybe it's not just about the art of practicing medicine, but also the art of self-care so that you can care for others.
The stethoscope is a way physicians do this with patients by listening to the heart's rate and rhythm, lung sounds, bowel sounds, and sometimes to subtlely assess abdominal pain. As people in health care, we often cater to people all day long as we see patients, their families, co workers, bosses or anyone above us, and every single person in between. At one point, having a server at a restaurant cater to me was the most self care I had in a week. If a stranger is the only person ministering care to you, there's some work to do. So we have to be diligent in checking in to measure our stress levels, taking a mental temperature, and listening. Allowing (and forcing, at times) to sit silently and listen. Some things I am learning about and how to do:
- Understand your triggers
-Things like not making sleep or "me" time a priority, not exercising, feeling unloved or unappreciated, doing busy work/meaningless work for an extended period of time
- Learn your personal early signs of burnout or depression
-Increased anxiety / planning (yes, burnout can look hyper-productive at first), shortened temper, poor sleep habits, decreased desire to maintain (cleaning/cooking/caring for yourself)
- Routine, routine, routine
-Having certain things you do every day - no matter how small - and planning your day the night before, can help tremendously
I was recently reading an article regarding the infantilization of medical students that was on point. I think this breeds burn out because no trust is given (sometimes not even a healthy amount), and then medical students are tasked with mundane secretarial tasks that do not contribute to learning. On the other side, medical schools are putting the pressure on about professionalism (understandable) and the amount of power/responsibility we have. It's like the father telling his son that while he's gone at work, the little boy is the man of the house - but Mom is still cutting the corners off of your sandwich and it doesn't feel all that way.
So we "have to pay our dues" and be the "lowest on the totem pole," and it is true that you learn something new from every situation - but the education of future physicians should mean more than that. The person who could potentially be caring for your mother, father, or child? You'd want more for them as well. I think this may build up to breed a yearning for more, to finally practice what they've chosen, and earn respect in that field, only to sometimes lose identity and self worth within the grueling process. Finding balance is a moving target, but self awareness and self care are the first steps to getting there.