Methodist Journal

FEATURED GUEST EDITOR

ISSUE INTRO

The Burgeoning Field of Cardio-Oncology

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RECOGNITIONS

Barry H. Trachtenberg Leads Issue on Cardio-Oncology

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REVIEW ARTICLES See More

Heart Failure in Relation to Anthracyclines and Other Chemotherapies

Heart Failure in Relation to Tumor-Targeted Therapies and Immunotherapies

The Role of Cardiovascular Imaging and Serum Biomarkers in Identifying Cardiotoxicity Related to Cancer Therapeutics

Prevention and Treatment of Chemotherapy-Induced Cardiotoxicity

Cardiovascular Toxicities of Radiation Therapy

Electrophysiologic Complications in Cancer Patients

Vascular Toxicity in Patients with Cancer: Is There a Recipe to Clarify Treatment?

Future Directions in Cardio-Oncology

CASE REPORTS See More

A Rare Case of Pancreatitis-Induced Thrombosis of the Aorta and Superior Mesenteric Artery

Anomalous Origin of the Right Coronary Artery from the Left Main Coronary Artery in the Setting of Critical Bicuspid Aortic Valve Stenosis

Simultaneous Transfemoral Mitral and Tricuspid Valve in Ring Implantation: First Case Report with Edwards Sapien 3 Valve

Uneventful Follow-Up 2 Years after Endovascular Treatment of a High Flow Iatrogenic Aortocaval Fistula Causing Pulmonary Hypertension and Right Heart Failure

MUSEUM OF HMH MULTIMODALITY IMAGING CENTER See More

Do Not Pass Flow: Microvascular Obstruction on Cardiac Magnetic Resonance After Reinfarction Following Primary Percutaneous Coronary Intervention

CLINICAL PERSPECTIVES See More

EXCERPTA

Cardio-Oncology, Then and Now: An Interview with Barry Trachtenberg

POINTS TO REMEMBER

Onconephrology: An Evolving Field

POINTS TO REMEMBER

Herbal Nephropathy

EXCERPTA

Rolling the Dice on Red Yeast Rice

EDITORIALS

Letter to the Editor in Response to “Cardiac Autonomic Neuropathy in Diabetes Mellitus”

Vol 9, Issue 2 (2013)

Humanities Full Text

ESSAY ON BEING A DOCTOR

Avoiding Burnout

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Article Citation:

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.