A Journey From Burnout to Balance

I wanted to share a sincere thank you to Elizabeth Metraux at Primary Care Progress, for the opportunity to be interviewed on her Podcast, Relational Rounds. Becky and I were able to share our story from medical school and residency training to fellowship and private practice, navigating challenges along the way.  Elizabeth has a strong interest on the topic of physician burnout and has written about it at STAT:  I experienced trauma working in Iraq. I see it now among America’s doctors

After reading my post on How Do You Know When Someone Is Broken?  Elizabeth reached out to talk. She then asked to interview both Becky and I for what turned out to be a pretty interesting experience.  Attached below is a player linked to the podcast for those interested in hearing a little of what has gone into almost twenty five years of medical training and practice while trying to balance the needs of work, family and myself.

 

Taking a Step Back to Move Forward

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This was first written and posted on Doximity’s Op-(M)ed and can be seen by clicking here... I will be writing monthly for them and hope to have a year-long discussion about the trials and travails of being part-time. Whether its enjoying more time with the kids, suffering through a bad Locums placement or learning to be a student all over again, I plan to share it all with all of you. For those that have been keeping up with a lot of my writing, a lot will be familiar. But I hope you enjoy the slightly different perspective.

Taking a Step Back to Move Forward…

“The simplest questions are the most profound.
Where were you born? Where is your home? Where are you going? What are you doing?
Think about these once in a while, and watch your answers change.”
— Richard Bach, Illusions

To an outsider, a hospital often feels like a chaotic place. Varied people flutter in and out of rooms, the color of their scrubs identifying nurse vs. patient care tech vs therapist. Bulky portable X-ray machines compete for hallway space against more streamlined transport carts, shuttling patients to procedures and tests and back again. All this against a soundtrack of monitor alarms in-between intermittent overhead announcements.

For those who work inside the hospital walls, there is a structure and pattern beneath this apparently random Brownian motion. Environmental services with their Zamboni-like machines clean the floors at 4 AM. Phlebotomist follow soon after to draw 5 AM labs. Portable X-rays make their way into the rooms about 5:30 AM. Resident handoffs start at six before the nurses have their shift change at seven. Multidisciplinary rounds tentatively start at eight. Notes finished by twelve so I can get to my first office patient by one in the afternoon.

Patients add improvisation, going off-script to inject their own episodes of distress, instability and crisis. But every day, in each hospital, there is a unique structure and rhythm to the day to anchor and build off of, to manage and cope with the unpredictable nature of the ICU. Almost every day for the last twenty years, I have relied on and used these routines and patterns to navigate and manage my day.

A year ago, everything changed.

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How Do You Know When Someone Is Broken?

How do you know when someone is broken? When their spirit is fractured? When their sense of self no longer aligns with what once was. When you feel as if you have woken up in a foreign land, but that sense of displacement is coming from you, not your surroundings.

In television shows and movies, that moment for a doctor is obvious. The scene in which a physician cries in the stairwell, knees bent, head hanging dejectedly. A downward spiral into drugs and alcohol that leads to a near-miss in surgery. Or a final, explosive ranting monologue, that alienates the doctor in front of patients and peers. They have snapped. They have broken. At least until the next scene or episode.

Real life rarely follows a Hollywood script.

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Snow Day

I woke up to a blanket of white covering the ground. Unlike in childhood, this was not met with excited anticipation. Forced to skip my morning coffee, I layered up in my thermal gear and put on my boots, the blister on my heel reminding me to buy a pair that fits properly. I struggled to find gloves and settled on a mismatched pair as I braced for battle with the cold. I tried not to tweak my back while repeatedly yanking the starter cord on our stubborn snow blower. As I began to clear the thick snow off the driveway, the layer of ice hidden below was a reminder that I was not quick enough to clear the driveway last time. Obstacles and challenges now loomed ahead as I anticipate colder temperatures, icy windshields, hazardous driving, and ill-fitting boots and blisters.

When did snow become the enemy? When did it become a chore? When did it become something that added to the weight of my day?

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