ESSAY ON BEING A DOCTOR
Eve Cohen. Avoiding Burnout. Methodist DeBakey Cardiovascular Journal: April 2013, Vol. 9, No. 2, pp. 117.
I find driving intolerable. Traffic lights, aggressive drivers, detours, missed exits, potholes, more traffic lights, rush-hour congestion, invisible road signs. Did I mention traffic lights? I accepted this as the unavoidable reality of urban living until I heard a colleague speak about his own struggles with the red light on the way to work. You know the one—the one that turns red just as you get to it, the one you would have made if the drivers ahead of you had been just a little more vigilant, the one that makes you late. My colleague spoke about the rage he felt behind the wheel each morning, as if that light were a divine personal insult, and how he would panic behind the wheel, tapping the horn, inching his way into the crosswalk in an attempt to trigger the light-sensor, fumbling with the radio. He used to drive himself crazy every morning at that light and show up to work harried, frazzled, defeated.
I can’t explain what ray of light shone out from the clouds, but one day he decided to relax. Winding himself up into a tight knot behind the wheel was not going to get him to work any faster. The light was red. He was going to show up late. But he had a choice about whether or not he let that ruin his day
Instead of spending those 5 minutes at the light berating himself for hitting the snooze button once more or for not packing his lunch the night before, what if he sipped his coffee, sang along to the radio, or mentally thanked his coworkers in advance for laughing off his impeccable tardiness? What if he chose to appreciate the extra moment to himself? As a talented physician and a classic type-A “gunner,” his greatest challenge was allowing changes in his carefully laid-out plans. What if the red light was his opportunity to practice tolerating delays and allowing himself to be less than perfect. Better yet, what if it were an opportunity to practice humility and recognize that regardless of how well he planned, there were always going to be situations he could not have foreseen. What if he chose to be grateful for the team at work that was going to fill in seamlessly for him while he was held up, as he had done many times for them? Most days, he said, he failed; he took a deep breath, tried to relax, tried to enjoy this unanticipated quiet moment in his morning commute, and then became impatient. But that was exactly the point. It was an opportunity for improvement because it was challenging, because he could rarely succeed, and because each time he had another chance to try.
Don’t misunderstand me. My dear co-residents, my advice for avoiding burnout does not entail showing up late for work. My daily challenge, which I extend to you, is to find opportunities to practice tolerating setbacks and embracing situations that try your patience. When you catch yourself feeling overwhelmed or overworked, try to reframe the situation and ask yourself if there is an opportunity to reach beyond your tested abilities. If you fail, if you become frustrated, upset, or defeated, then forgive yourself and look forward to your next chance to practice.
I know it sounds like a Hallmark card to white-wash the world with such forced optimism, but hear me out: you are incredible people. You are brilliant, kind, competent, honest, enthusiastic, creative, resilient, helpful, modest, skilled, fun, considerate, and humane. I’ve seen you handle knee-buckling stress with quiet grace, exhaustion with defiant joy, and sorrow with peaceful resignation. Give yourselves a break. When your pager goes off and you’re a little less than patient with the nurse who has called, just recognize it, thank him or her for taking it in stride the next time you see them, and recommit yourself to not letting your on-call stress become the caller’s problem. When you get held up by a patient’s family in the morning and have to rush through the last few progress notes before rounds, recognize that taking the time to answer that family’s questions was important. The setbacks, frustrations, and complications are inevitable, but the way you respond to them is a choice. You do an amazing job every single day. Give yourself credit for what you accomplish, take responsibility for the things you do have control over, and let go of the rest.
I don’t drive anymore. I ride my bike everywhere, and sometimes, when no one is looking, I run the red lights. I haven’t made my peace with traffic. I also don’t hold myself as a model for maintaining balance in residency. What I can tell you, though, is that each time I fall short of being the resident I pictured myself becoming, I try to renew my commitment to that goal and appreciate the challenge. I’m much happier for it, and that’s all I would want for you.