Burn Out

There's some irony in this piece. This is the third time I've tried to write it - the first, I wrote a long stream of consciousness on all the reasons I felt burnt out and didn't feel it would be worthwhile to anyone. The second, a measured, well-rounded but short piece tumbled out of my fingers at 0330 waiting for a flight at Newark. And this is the third, after twelve hours at work (a "short" day) and training and dinner. By this point, I'm a little exhausted of writing even this piece.

The first time I wrote this, I was burnt out. Seriously burnt out. In no way had life prepared me for the ups and downs of my full-time work life. Or the fact that once it starts to feel down, it feels like it's mostly down with no ups. I thought I was a pretty strong, resilient person. But...there were so many buts. Nothing had prepared me for sixty- to eighty-hour work weeks. Nothing prepared me for sleepless nights dreaming of all the bad things that could happen to my patients when I wasn't around to keep an eye on them. Of waking up in the middle of the night wondering if I'd ordered this blood test or that CT scan. And knowing that some mornings the patients I'd thought were the most stable would be the ones to crumble on me overnight. Nothing prepared me for the overwhelming guilt of my sick patients getting sicker. Or the sadness that comes with those patients I'd gotten to know dying, even though I knew it was a long time coming and something even they had wanted to come faster. There's also nothing that makes calling a family member at three o'clock in the morning to tell them that their loved just died easier.

There was a time where I felt like I'd done everything wrong. Where, the buzz of my pager made me worry that I'd forgotten to do something rather than think another person was trying to work with me on optimal patient care. No matter how much I got done, there was always more to do. Instead of seeing all the good work, I just felt like I'd let everyone down. Let the patients down for not helping them sooner, let the nurses for making them wait. And I forgot that I was just one person against a gargantuan list of tasks, not all of which were urgent, important, or life-altering for my patients.

And when work life feels like that, so does everything else. I apologised profusely for not being able to catch up with friends, or do the dishes, or whatever else should be done, could be done, would be done.

When you're burnt out, you have blinkers on to the world. I thought to myself, I'm not normally this stressed about little things. I'm not normally upset by these tiny details. And I normally laugh more. So when my annual leave was coming up, I decided to reset.

For weeks, all I did was play with my cousins, go on ridiculously long walks and take part in deep, meaningful discussions about politics and the world. For a little while, I explore all of the outside-of-work things that make me happy.  On my flight away to my holiday, I watched sad movies and remarked quietly to myself that they didn't make me feel anything. And that anything that sounded vaguely medical made that little emotional switch turn right off. And on the way back, different sad movies moved me to quiet tears in my compact seat, surrounded by so many others drifting quietly off to sleep.

I thought, sitting there, tears streaming down my face as characters I'd come to care about in the film passed away, that I was back. The Brooke that feels and loves and embraces life was re-commissioned. And when I turned up to work on Monday, I was excited to see so many familiar faces. Happy to answer my pages. Enthusiastic about helping out. And I felt sure, for the first time in a long time, that my happiness cup was full to over-flowing.

I recognise that this is just a nice little story about me. So what messages do I want to get across? First, I think it's important to recognise when you're not coping. Earlier is obviously better than later, but recognition is key. And then do something about it. Take a day out. Go somewhere. Do something you ordinarily enjoy. And it doesn't have to be expensive or far away or impressive. It just has to be for you. Have a go-to list of things you know you enjoy and when you're feeling flat, go back to it. Try those things. Even if you're tired. Sometimes it's better to be sleep-deprived doing what you love than slightly-less-sleep-deprived and not doing things you enjoy.

Communicate. I love talking to people - long, deep, one-on-one conversations about life or politics or history. I forget, often, that people want to talk about the weather or lunch, and tend to launch into a long-winded analysis of systems processes. It doesn't work for everyone, which is why you need to find what's right for you.

And, importantly, if there's something that's toxic in your life, take steps to remove it. You can't escape every stressful, difficult situation but you can turn them on their heads. Or, if you need to, get out. For a little while, for a long while...whatever you need.

Finally, if you're burnt out, you don't have to do it alone. There are lots of people around who want to lift you up. Find them. Trust them. Turn a fire that destroys you into one that keeps you warm.

Resources:
http://www.ama-assn.org/ama/ama-wire/post/ways-residents-found-conquer-burnout
http://theconversation.com/the-epidemic-of-burnout-depression-and-suicide-in-medicine-one-doctors-story-41800
https://web2.bma.org.uk/drs4drsburn.nsf/quest?OpenForm

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