It starts with a rumor, whispered in hushed tones among classmates and co-workers, as if some misfortune had befallen or as a cautionary tale. “Did you hear about so-and-so? He/ she was in the prime of her career when BAM!, up and quits his/ her practice, moved out of town. Couldn’t handle it. What a shame, what a waste.” And we all shake our heads, secretly wondering whether we might be next.
It happened to one of my best friends. She was a superb physician, giving 200% to her cancer patients. But the demands of family and career proved to be too much and she quit her practice and decided to stay home with her kids. She is happy, and her family is happy. But she has to continuously keep justifying her decision to friends, her parents, and colleagues. It was the right decision for her, because this is what she had to do for her own sanity. She would not have been of much use to her patients or her family if she persisted in a career that was making her miserable. I do not believe her training and education were wasted because she helped many many people while she was practicing and the experience made her a wiser, better person and parent. Furthermore, she had the courage, which most of us lack, to recognize and admit that she was miserable and to make a very painful change.
The medical culture does not encourage admitting to vulnerability or weakness, in fact in the lingo of residency training, trainees who do not perform up to standards are called “weak” and are stigmatized. We are taught to “soldier on”, similar to the reports about war veterans with Post-Traumatic Stress Syndrome who feel ashamed for admitting that they have a problem and need help.
In a study on medical career burn-out conducted by Vanderbilt University, it is characterized by “emotional exhaustion, depersonalization, and a decreased sense of personal accomplishment”.
The study goes on to conclude that:
“Preventing burnout-a responsibility of all physicians and of the healthcare organizations in which they work-entails the explicit promotion of physician well-being. Physicians must be guided from the earliest years of training to cultivate methods of personal renewal, emotional self-awareness, connection with social support systems, and a sense of mastery and meaning in their work. Maintaining these values is the work of a lifetime. It is not incidental to medicine, but is at the core of the deepest values of the profession: ‘First, do no harm.’
Harmlessness begins with oneself. If physicians hope to heal the distresses of the 21st century and lead their patients to enjoy healthy, sustainable lives, they must show that this is possible by their own lives of sustainable service that emanates from the depths of spirits that are continuously renewed.”(italics mine)
So, whether you’re in medical school, residency, or in practice for years, you have to take care of yourself before you can care for others. One thing we can change is to talk about it more openly without the stigmatization. As with all things, awareness and prevention are key.
So, here are some other useful links for dealing with/ preventing burn-out: