over worked, overwhelmed, and over it

Burn out is real, yall. I can honestly say I never felt burnt out or completely overwhelmed during college or medical school. Yes, there were days that I really, really didn’t want to study for twelve hours or moments that I hated holding the retractor during a six hour surgery. But overall, the time passed freely with enough breaks and “me time” to not be bogged down interminably.

Intern year is different. At the end of a twelve or thirteen hour shift, I am wiped out. And when the realization strikes that I must repeat that again the next day, and the next day, for six days a week all year long, depression immediately washes over me. One day off a week is barely enough time to recuperate my sleep debt, much less finish chores or enjoy the outdoors with Whitney. Although I love the intellectual challenge and lifelong learning involved in medicine, the quality of life is pretty shabby.

Resident salaries have remained stagnant since the 1970’s despite inflation, and school loans have skyrocketed with an average debt of $250,000 for medical school graduates. When divided by the number of hours per week that residents work, we make less than minimum wage. And all the while, interest accrues monthly on our ridiculous debt burden that we can’t even begin to make a dent in until we are attending physicians many years later.

The sleep deprivation, 24/7 intensity of patient care, and overall stress have tanked my energy levels and zapped my empathy. There are days that I feel absolutely zero connection with my patients, days where I find my mind elsewhere as I am doing chest compressions on basically a corpse. Then there are moments where the flood of emotions that have been dormant for weeks rush over me all at once, where I find myself rushing to the restroom to let the tears fall uninhibited and unwitnessed. Empathy falls by the wayside, as the onslaught of tasks, medical records, rapid turnover of patients, and complicated diagnoses predominate my everyday thoughts. Medicine shouldn’t be this way, shouldn’t take the healing out of patient care, leaving only bare bone facts and guidelines.

Physician satisfaction has declined over the decades, and it’s easy to see why. You put yourself through the endless stress of studying constantly to make perfect grades, stretch yourself thin with extracurricular activities, volunteering, and leadership activities, and publish research papers all to gain acceptance into medical school. And then you do it all over again to gain a residency position. When you think you have finally made it, finally become a “real doctor,” you realize the scut work and crazy work hours have only just begun as you are the absolute bottom of the totem pole as an intern. By the time residency is over and you can finally practice unsupervised as a physician, you realize that attending physician schedules still entail long hours with overnight call or working weekends and holidays. That to me does not represent a good quality of life. Something has got to give, and clearly the system isn’t going to be the one to compromise.

My only saving grace from burn out currently is this blog, this creative space that welcomes my rambling, reflection, and remembrance. Writing and quality time with Whitney keep me moving forward along this medicinal path, tenuously walking step by step along the tight rope between joy and struggle, satisfaction and desperation, and fulfillment and remiss.

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