Three years ago, I almost quit medicine. I left a clinical job that I loved to be closer to family. New job had me working eighty to one hundred hour weeks (more than residency). The environment was toxic and nepotism was rampant. Administration constantly reminded us how lucky we were to be working there. They also admonished us that more work was needed to ensure our promotions.
I sustained this abuse for three years. Looking back now, the subtle changes in myself were so obvious. Despite eating clean and exercising several times per week, I felt exhausted all the time. Eight hours of sleep never relieved my fatigue. I was less interested in doing things I normally enjoyed. My normally extroverted self started turning inward. I no longer felt rejuvenated after being around people. I felt unsupported, alone and completely stuck. I didn’t feel worthless or suicidal, but I felt a deep sense of unfulfillment. My family told me they no longer recognized the person I had become.
Step 1: Recognition
I was at a crossroads. I could remain an indentured servant at a thankless job that didn’t value my humanity. Or I could take back my power and voice and assume my own well-being.
Much as the victim of domestic violence is terrified to leave their spouse, I was afraid to leave my job. I knew I had to leave for the sake of my own sanity and health. With nothing new lined up, I mustered up the courage to meet with my division director and give him my notice of resignation.
Step 2: Introspection
I contemplated leaving medicine altogether. I am the daughter of a small-town surgeon who was on-call 24/7 for the better part of sixteen years before a second surgeon came to town. Year after year, my father’s office was filled with holiday cards and gift baskets. Anywhere I went in town, I was met with stories of how my father saved someone’s life. I clearly understood the impact one person had on a community. I had been groomed for this career from a very early age.
It’s not easy to walk away from time spent learning a trade. Four years of medical school and four years of residency in the prime of my life totaled more than 10,000 clinical hours. 10,000 precious hours earned me the privilege to take care of patients independently. First, do no harm. Would abdication of my title cause harm to patients? Medicine certainly is not a career for the light-hearted. Most people who choose this arduous field do so because they feel compelled to make a difference in the world. It’s a calling. Was this even what I wanted anymore? Did I still yearn for the pleasure of helping people?
I took six months off for self-care. I realized that my moments of fulfillment in Medicine were in times I was able to help a patient and family. This could be making a diagnosis, creating a treatment plan or helping a patient and family come to terms with a bad diagnosis. I knew my purpose truly was to help people. I needed a single-blind study of my life. Ultimately, I was compelled to perform the same job in a different work environment. Interestingly, once my blinders had been removed, all sorts of possibilities came my way.
Step 3: Cautious Optimism
With trepidation, I sought and found new employment at a place reputed to be “physician-friendly.” I accepted my new position with the vow to myself that I would not stay to be abused. Even though my job provided health insurance, I took out a second policy in case I would leave. I needed to know nothing would hold me back if misery found me again.
Step 4: Learning to Trust Again
My new work environment was a big change. During orientation sessions when physician wellness and work-life balance were brought up, PTSD from my prior job whispered to me that it was all lip service. Every time administration wanted to meet to see how I was adjusting, I came prepared to fight. Even the sound of the pager elicited a reaction from within.
Then I started noticing a consistent pattern. I had most of my nights and weekends free. The Physician Wellness Committee coordinated social events for the physicians. Every single schedule change or vacation I requested was granted. I was allowed time to recuperate after work. Slowly I started to feel human again. It felt like my personal well-being mattered. In that, my identity changed to human and healer.
Step 5: Validation
Two years after being at my new job, someone from the old job contacted me. She was part of a “burnout committee.” This group was created not by administration but by “a group of physicians tired of seeing all their friends leave.” After some discussion, it seemed like little had changed at the last job. I knew I had made the right decision. No more “what ifs” to ponder anymore.
At the new job, our female medical director knows every single physician by name. With her blessing, our medical center recently launched an annual “Women in Medicine” conference. She is engaging women to get mentored and pay it forward. It’s no secret that women in medicine are taught to emulate men. But what if women can emulate women? I believe they can blossom! I’m incredibly thankful to be in an environment that’s caring and collegial.
As physicians, we are taught to treat our patients as humans. But physicians are humans too. Per airline safety instructions, when the oxygen mask falls, place your own mask on first before assisting others. In today’s era of heavy bureaucracy in medicine with increasing demands, it is of utmost importance to take time to honor and heal yourself. For me, that meant having the strength and courage to seek professional change which would allow me to be true to my authentic self. Was it easy? No. Was it worth it? Absolutely!
