(This is the second of an ongoing series of reflections from Molly Taylor (’13) on life as a young doctor).
It had been a long day. It had actually been the 12th consecutive long day, but who’s counting? I was sitting alone in the resident workroom finishing up my progress notes, sipping on stale cafeteria coffee, when I heard the all-too familiar tune of my pager. My arm reflexively flew to my right hip before the first beep had even finished (intern year had made me Western-shootout quick, something I am secretly very proud of).
“Please change the diet order for Bed 682.” I read the page again, just to make sure I wasn’t hallucinating (which wouldn’t be out of the question, given the amount of sleep I had had lately). Nope, it was still there. This would make the fifth time today I had changed the diet order for Bed 682. I muttered bitter complaints aloud to the empty room and called the nurse back. Without thinking, in a tone that could not be interpreted as anything but passive aggressive, I said, “Have you checked your orders lately?” She hadn’t. After I hung up, the foreign-sounding curtness of my voice struck me.
I’m not sure if it was just one of those days, or if it was the cumulative effect of a string of “those days,” but I felt it: the pangs of burnout. The Maslach Burnout Inventory, which measures burnout, identifies three basic components: loss of personal efficacy, depersonalization, and emotional exhaustion. When I reflect on how I had spent some of my time in residency, it was actually not all that difficult to trace back why I might be feeling this way.
During particularly difficult months, it sometimes feels like you are running in a race with no perceptible finish line. Against the backdrop of being a novice doctor with significant limitations (both in experience and medical knowledge), it seems you are trying to juggle an infinite number of balls in the air. You are in constant pursuit of the balance between work and learning, between compassion and objectivity, between availability and self-preservation. You see firsthand some of the most heartbreaking tragedies humanly possible, and then must continue on with your work in the next moment as if nothing happened. We sometimes make mistakes, and people get hurt by those mistakes. Basic activities of human health and sustainability—sleeping, eating, exercising, socializing—ironically fall to the very bottom of the priority list of most young doctors.
Emotional exhaustion? Check. Depersonalization? Absolutely. Lack of personal efficacy? How could I not? I had completed a burnout hat trick.
On my way out to my car, I dropped my hospital cafeteria soup in the parking lot and cried. Actual tears were running down my face as I watched the most exciting part of my evening splatter all over the concrete. If this was an episode of Grey’s Anatomy, one of my impossibly good-looking co-residents would stumble upon me in distress, and we’d rush off to the local dive bar or start an impromptu dance party in the parking lot. But this is Chicago. And it’s –12 degrees outside. And there are no McDreamy’s coming to my rescue.
Almost unconsciously, I put my keys back in my pocket and found myself putting one foot in front of the other, heading back into the hospital. I went up to one of my teenage patient’s rooms. She had a very rare disease, and she and her parents had come a long way to see some of our specialists. She was surprised to see me so late, but promptly sat up in bed for me to listen to her heart and lungs as I had done every morning for the past three weeks.
But instead I pulled up a seat beside her bed and asked her about school, about her family, about who she was. We talked about cheerleading, boys, and how annoying little sisters can be. Everything except why she was in the hospital. Her parents asked about who I was outside of the hospital, and oddly enough, I told them. We were both from small farm towns, and we swapped stories of Friday night football games, tractor pulls, and southern cooking for well over an hour. I didn’t hide behind my white coat and medical jargon, maybe because I was just too tired. But I felt relieved to let the strict cloak of professionalism down for just a moment and have a conversation, person to person. I had examined nearly every part of this girl, seen all of her MRIs and lab tests, yet somehow this conversation felt like our most intimate interaction.
Getting back to the root of medicine—the people and the stories they carry with them—is the cure for burnout in medicine time and time again. No matter how tired or hungry or frustrated I am, it is always nourishing to connect with patients. It is therapeutic for both doctor and patient, and it is a gentle reminder of what a privilege it is to do this work. Becoming a physician is a long and difficult journey, and it is easy to get lost along the way. But whenever I feel that strain, I just put one foot in front of the other and find my way back.
Molly Taylor, MD, a 2013 graduate of the Dartmouth Geisel School of Medicine, is a first-year resident in Pediatrics at the University of Chicago Comer Children’s Hospital. Originally from Lockwood, Mo., she studied at the University of Arizona as an undergraduate before attending Geisel.