I’ve been ready for it to be Friday since Monday afternoon. It’s been a trying week, and as I came into the office this morning, I was readying myself to make it til 5 o’clock through sheer willpower. I charged up my computer and opened the electronic medical record. Welcoming me were 10 online messages from patients sitting in my inbox from overnight, some of them sent at 2 in the morning.
I sighed, knowing my 2 cups of coffee I chugged this morning was not even going to be close enough.
Message #1:
- I’m sick and tired of gaining weight. The insulin for my diabetes that you put me on is making me fat. What should we do about this?
Message #2:
- I just read the side effect profile of the cream you prescribed, and cancer is listed as one of the side effects. What else can I take?
Message #3:
- Just looked at my labs and I see my CO2 is high. What is that, and why is it high? And why did you write in the notes that it was “normal”, because it wasn’t.
Message #4:
- The new pain med you put me on isn’t working. I need my norco. Please call me back as soon as you get this message.
I got up from my desk and walked away, the remaining 6 messages left unopened. My day hadn’t even started yet.
My kindness and empathy well has run dry. What I’m left with are snarky responses that won’t do anyone any good.
Answer #1:
- Wrong. What you are putting in your mouth is making you fat – remember that conversation where you were eating 4,000 calories a day? The insulin I gave you is saving your life. Why did I even spend 30 minutes trying to convince you to work on diet and exercise, making me late for the rest of the day? Because of you, I didn’t leave work until 6 pm, and you forced 5 other people to spend 20 minutes of their lives in an exam room waiting for me to finishing wasting my breath on you.
Answer #2:
- I’m sorry.. I forgot you were a patient I didn’t want to give cancer to. My bad. Here, put this high potency steroid cream on your face so you can get stretch marks instead.
Answer #3:
- Please ask Dr. Google your questions. Be sure to ask Dr. Google if he/she can condense 8 years of medical training into a 2 sentence answer for you. Also, if this is what you’re doing at 2 am in the morning, please consider melatonin.
Answer #4:
- Nope. Just nope.
I thought I had a handle on my burnout by cutting back. But, I’m coming to realize it’s not the sheer hours that I’m working, or even the volume of patients that I’m seeing. It’s that every day I am accosted by phone and online messages that siphon off my empathy and compassion before my day even starts.
This is what’s draining me every day. This is what’s making me not care anymore. This is what’s making me fantasize about quitting medicine once I pay off my student loans in 2 years.
But, then I remember the good I can do. I remember the trust and faith that people put in me to take care of their families. I remember people who thank me for taking the time to listen, including the woman I just diagnosed with breast cancer this week.
So, I guess I’ll just push through with sheer willpower.
Fake it til you make, right guys?
It’s good to read about life from the other side of the desk.. Thanks for your amazing authenticity. What a privilege to meet you.
Thanks for the comment Geoff! To be honest, I wasn’t sure if I should publish that rant because it’s not something people would want to know their doctors think. But, at the same time I’ve been reading more and more about physician burnout and suicide, and I think hiding frustrations away is perhaps not in my best interest. Maybe it’s time to pull the curtain back. Again, thank you!
Your authenticity is what makes your writing so powerful. Thanks for sharing. An attending once told me that we have to treat our career as a marathon instead of a sprint if we are going to have any chance of getting through it. My two cents regarding burn out are a) try to do international mission trips as often as possible b) since so much of one’s day is devoted to the care of others, make sure you carve out time every day for things you like to do (for me it’s working out) and c) let go of the things you can’t control, e.g. long patient wait times due to the documentation requirements of US medicine, which is compounded by the use of EMRs. Along these lines, are you mandated to answer patient emails?
Thank you for reading and for your comments! I have toyed with the idea of doing an international mission trip, but even volunteering at our local free clinic leaves me even more drained – typically it’s a 7 to 9 pm shift, so I go straight there from work, go back home to sleep, then head back to my regular clinic hours the next day. It’s not ideal.
As for carving out some me time, I will admit – last week was not my best in terms of self care. I typically work out 4 days a week, but came down with a cold last week and didn’t exercise, which definitely contributed to my spiral downward. I need to get back on the bandwagon for sure!
Finally, I am required to answer patient emails and probably spend a good 45 minutes of my day going back and forth with them. It’s infuriating since that eats up my personal time because I’m seeing patients during the work day. Letting go of the things outside my control is something that has always been a work in progress for me… it’s just this was not the type of medicine I thought I’d be practicing when I started this journey all those years ago.