Let’s talk about Burn-out.

According to the WHO, Burn-out is: “A syndrome conceptualized as resulting from chronic workplace stress that has not been successfully managed. It is characterized by three dimensions: feelings of energy depletion or exhaustion; increased mental distance from one’s job, or feelings of negativism or cynicism related to one’s job, and reduced professional efficacy.”

Basically, the movie Office Space (can you believe it’s over 20 years old?).

In Medicine, in particular, there are often times when there seems to be more frustrating days than happy or rejuvenating ones. Life or death situations sometimes cause a little bit of stress, amongst long work hours and fewer days off than some professions, and the ever increasing pressure from hospital administrators to churn out an unreasonably escalating level of productivity. It can be difficult when there is no pop-off valve for all of the pressure, and the circuit gets overloaded. Like anything, eventually too much tension, can lead to complete breakdowns and becomes a cyclical pattern.

Talked about in the media, social and old-school, written in articles all over the interwebs, and a growing focus among medical education as well as larger corporations, finding ways to focus on “wellness” becomes ever important. Just because we signed up for a stressful field and life, which was clearly our own masochistic mistake, doesn’t mean we should allow ourselves to be buried in the rubble of the machine.

There are lots of articles and discussions on wellness and burnout advocating for things like exercise, taking time for ourselves, meditation, etc… But for myself, I have a particular driving motivation that from time to time helps me to maintain some semblance of self: I focus on daily instances of re-motivation, patient encounters that rejuvenate me and if I can, I try to spend more time with patients. Lucky for me, that’s often just holding little bebes 😬 – a luxury those working with adults probably don’t have; although, I guess when you become old enough you revert to being a bebe again anyways.

A Snapshot of my Life: Examples of Re-Inspiration in 1 week

• I followed a baby in clinic for 4 months alternating with my 2 colleagues. Mom was young, naive and only spoke Arabic. Every visit was filled with frustration, misunderstandings and feelings of futility on both our end and the mom’s. She would ask for medications which we could provide none and we would all groan in preparation for what we knew would be a difficult visit – we’re human after all. At 6 months of age, I had a visit with her. I acknowledged her questions on why the baby cried and why it didn’t sleep – I told her it was developmental, he was growing, forging his own personality. I emphasized something I had never tried: This is just what babies do. She paused. For the first time in 6 months she looked at me and said, “Oh. Ok. Well, I just… This is my first child, you know? I’m worried.” I reflected on 4 months of frustrations and long drawn out visits, I had a breakthrough, finally.
• A 4 month old had been born premature at another hospital, mom would show up to visits on the DOT. She would provide exact numbers of feedings, diapers, everything. She remembered all of the history and the events and was sad when I told her I was leaving the clinic. I made an impact, when I hardly thought I did, she already had everything under control.
• A new baby showed up to my clinic. On her hospital discharge paperwork, from a different hospital, she had written MY name down as her Pediatrician… But, I had never seen any other kids in the family before. I asked where she had heard my name. She responded her cousin and a friend. The friend had recommended me by name and said I was the best… A few months prior I had listened to the friend’s concerns, made the correct gut call to send her and her baby 1.5 hours away to an emergency room due to my concern for a bad neurologic disease called Infantile Spasms – My heart broke for this one.
• The sweetest but incredibly obese 9 year old. She always came in with her ‘stunna shade’ crazy glasses. I worked so hard with grandma to help her lose weight, but we just weren’t progressing in a few visits. Yet, she always told her grandma about how she wanted to see me because, “He’s so nice!” I’m not, but it made me think about being nicer.
• The babies that were born en route to see me from across the border in Mexico. In the ambulance, at the border itself, into my hands at the hospital… And how so many of them came back for “2-month old Tuesday” when by chance 6 of our 10 visits were my little 2 month olds, all wiggling and growing perfectly.
• The parent that listened to my long talk on Bronchiolitis, why It didn’t deserve breathing treatments and why their child was breathing the way they were… And the moment they said, “Oh. Thank you for explaining everything so well. No one else has ever taken the time to do that…”

Ultimately, like anyone else, I’m only human. Currently I take around 4-5 days off total a month. It’s intentional and I have particularly aggressive career goals that drive me to do so. But I definitely get physically and emotionally exhausted. Sometimes I get burnt out just like the rest of us. Focusing on my time with patients and these little victories makes it much more bearable and helps me from falling into a deep rut; but it requires active constant intro/retrospection.