After focusing solely on my medical career for so long, I have forgotten that I am more than just a doctor. My time for hobbies, family and friends had been stripped from me for so long I started to only identify myself by one thing: Doctor. If I stop doctoring, then what good am I?
"You're all F****** idiots!!! I'm going to report Dr. M to the state board and get her medical license revoked! You're just after our money, trying to make us come back to get re-examined again! You've just lost four patients, you F****** M************!!! ... To repeat this message, press 7." I sighed, handing the phone back to my medical assistant. "Well... I guess just try to document that in a phone encounter and censor it a bit. We still need it for the patient's chart. Also, don't delete the message." It's time to face the music. This is my new normal.
For the last week and a half, I've been lost. After experiencing compassion fatigue and realizing I wasn't even close to pulling myself out of burnout, I've been racking my brain trying to rethink my situation yet again.
When I went into primary care, I had dreams of being able to prevent disease. I had dreams of doing my part to help this broken, expensive healthcare system - chronic diseases directly attributable to obesity make up 80% of healthcare spending in the US. If I could just catch deadly habits before they caused harm and set people on a better course, I could do so much good, I told myself. What I didn't take into account was for this to work, the people I took care of would need to also buy into this dream.
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.
Today, you came to me with a chief complaint: right breast lump. You told me there were no overlying skin changes or strange nipple discharge. What you didn't relay was the countless hours you've spent researching on WebMD, where all roads lead to cancer. Cancer.
When I first started working in my primary care clinic after residency, I was adamant I was NOT going to prescribe long term narcotics. Unless you've been living under a rock, I think most people are aware of the opioid crisis that is storming across America. I'm talking about Oxycontin, Morphine, Norco, Vicodin, Percocet, etc. During training, I already had my fill of drug-seeking patients in my residency clinic, ER and the hospital - there was no way I wanted to continue that trend in my new big girl job. If anyone wants to talk about things that immediately suck the empathy right out of young doctors, I've got two words for you: Opioid abuse.
Recently, a friend of mine approached me and asked if I would help her with her MCAT studying. She would be a non-traditional med school applicant after taking a few years post pre-med to do great and wonderful things, including organizing cancer research at a local academic centre. Because of a few gap years, she felt the need to ACE this standardized test to prove she still has the academic chops to both herself and prospective medical schools. Immediately, I froze. Seeing that I've just been pulling myself out of burnout and in the process have heard from so many of my colleagues sharing their own burnout stories with me, I looked at her and thought: Do I have a moral and ethical responsibility to protect you from yourself and your idealism?
This horrendous cold and flu season has been an exercise in running on auto-pilot. Running from room to room every 10-15 minutes has been a blur of declaring, "Virus - no antibiotics needed. Virus - no antibiotics needed. Ear infection - here's your amoxicillin. Flu - Tamiflu sucks and you're going to feel like dying for the next 7 days, sorry. Maybe take me up on the flu shot next year." This was my life for two weeks after making the mistake of not taking any time off Christmas/New Year's at the end of 2017. (Note to self: Worst . Idea . Ever. Take a vacation already!!!) Just as I was ready to go insane from the monotony, the palest toddler with the most crystal blue eyes brought everything to a screeching halt.
A recent comment on one of my posts stopped me in my tracks - "Thank you for your positive reflections." Whoa. I don't think I've ever been told I'm a positive person. Like EVER. But, looking back at my recent posts it's true - I have been on a positivity kick for the last 2 months. I could see where people would mistakenly think I'm very zen. Saccharine even. In reality, I actually would avoid that person like the plague if I saw her coming. The overabundance of happiness would be grate on every last nerve. Too much inner peace is just not natural. Who is this person I've become??