About 2-3 years ago, I begrudgingly saw that I was not doing well mentally. In retrospect, I was feeling the tell-tale signs of burnout. I saw my day as adversity, full of roadblocks and things keeping me from a sense of happiness, peace and wellness. I of course, refused to see this until it had gradually set in and became my new normal. I took a burnout quiz on AAFP, the Maslach Burnout Inventory (MBI) and scored quite high. This, in retrospect, was not a good sign. I was only about 2-3 years into my attending career path at that point. The long stressful hours were taking their toll. And I predicted another 30+ year career – seeing myself in this role for that long was difficult, and I could see this was not going to be sustainable.
Physician burnout is well summarized and described on various sites on the Internet. I like the AAFP article linked here that summarizes physician burnout well. Physician burnout can be likened to a battery running out of juice. I definitely can relate to this analogy. About 2-3 years ago, I wasn’t quite a dead battery, but I was pretty close. I was run down, a battery at maybe 10-20%, fizzling out. I felt exhausted in every aspect – mentally, emotionally, and physically. This was a slow process over several years, so my recognition of the problem was poor. It took me time to admit to myself there was something wrong. My natural inclination was to get more rest. But in spite of getting more hours of sleep, I felt a constant tiredness. And I could feel a subtle, diminished quality in my ability to care and feel, both in my job and with my family. I also went for medical care, and was diagnosed with hyperthyroidism. I did fortunately get this treated and managed, and felt great improvements, but I still felt twinges of something abnormal in my life. I often found myself feeling wiped out, way out of proportion to my exertion level or work load.
I began to analyze other things I could change. I began exercising regularly. I resumed running. I tried to rest more. I resumed hobbies I previously enjoyed (reading, writing). I analyzed my life, and my life priorities, and shifted things around so they brought me better peace. I made a scary leap into a new job. And I am very glad I took all of these steps. I quit treading along in a pathway that was not good for me. I currently feel valued, balanced, and in better alignment with my personal ideals.
I still struggle with tendencies toward burnout. I think this stems from a drive to do more each day than I probably should. My tendency is to be a workaholic and perfectionist and superwoman. I have a driving need to prove to myself I can do more. But, as I grow older, I am learning to recognize and admit I am human. I have a set “tank” of energy – my battery life is sadly not infinite. I need to rest, digest, and recharge. I cannot always go, go, go. It is not laziness or weakness or wrong to rest. It is a necessary and natural part of life to rest. Looking at the human body, there are processes for high octane stressful situations in life (i.e. the sympathetic nervous system, or the “fight or flight” system), and also natural, needed ways to recuperate and simply be still/less active (i.e. the parasympathetic nervous system, or the “rest and digest” system). Life should be no different – there needs to be balance in life.
When I do too much now, I am getting better at recognizing the tell tale signs of overwork and pending burnout – a nag of irritation at myself or others, a feeling of mental exhaustion out of proportion to my work load, physical feelings of tension in my back, shoulders, and neck. I force myself now to take a step back. More breaks. More recreation. Focus on my hobbies and things outside of medicine. More time with family and nurturing relationships. Looking at the big picture. Practicing gratitude. With all of these tools, I am slowly learning how to reignite my fire for medicine and my passion to care for my patients, and I hope to prevent fizzling out again any time soon.