How this physician handles burnout

“Put me out of my misery!” I’ve pleaded to anyone within earshot in the throes of a grueling day, a rant from one feeling burnt out. There are days I want to pull my hair out, even the ones that aren’t gray. One night I caught myself grunting, “I hate my life,” while heading out the door at 12 a.m., after an already exhausting day in the OR. No sane person should ever say that. But the world of medicine nowadays is far from sane. After returning home for two hours of sleep, I drag myself to the office with a full patient-load, which is not bad in itself if it weren’t for that unsettling, acronymic world of EHRs, MACRA, MIPS, CPOE, PQRS, etc. and those other unmerciful disturbances such as pre-authorizations, meaningful use, fraud and abuse, medical-legal this-and-that, insurance companies, policies and procedures, rules and regulations, anything to do with the government … and lawyers, all sucking the life-blood like a school of piranha. It’s enough to make my head spin — words an ENT doc loathes to hear. “Please, shoot me now!” I say to my loyal office staff. I’d even loan them one of my guns.

Don’t get me wrong; I’m not, nor ever have been, suicidal. But we know the doctor suicide rate is frightfully higher than the general population. When I chose medicine as a career, I understood it was a calling going far beyond a typical 9 to 5 job. I knew I’d experience glorious highs but terrifying, pee-in-the-pants lows. The long hours and rollercoaster life are the price to pay for an exciting, noble profession as a doctor. Yet, I was unprepared for how overwhelming the life of a doctor could be.

There are times I feel trapped, suffocating under a heavy cloud of doom and despair, a sense of utter hopelessness from which there’s no escape. I hadn’t anticipated nor wanted this. Far too often, I questioned my sanity for choosing this profession, only to realize that I have no other means to support my family; and doggonit — retirement is a long way out!

And sometimes I think bad thoughts: “I don’t care anymore” or “I hate my life.”

Though exhausted, my day oddly gets a little better. Many of my patients are nice and a few comment on my ragged appearance, some taking pity on me: “You look like crap. You need a beer,” or “Go home and get a hug from your kids, your wife or your dog.”

The day finally ends, I’m no longer on-call, and I decide to finish my electronic charting later that night at home. But before doing that, I need to go out for a run before the sun sets. I head out the door into my neighborhood and slowly begin to run, barefoot. Yes, I run barefoot, with absolutely nothing between feet and ground — no “barefoot shoes, no socks, nada, nothing. Running in bare feet grounds me, so to speak; it forces me to concentrate on carefully landing my feet, feeling the nuances of the ground and increasing awareness of my surroundings. I must be in-the-moment, mindful of the world around me. My heart rate reaches an elevated and steady state, pumping out all the impurities of mind, body, and spirit, emptying and cleansing my burnt-out head. I realize again that it’s not about me — I am a single yet vital cell within the entire organism of humanity. The universe is much bigger than me. I feel a wonderful sense of freedom by the time I’m done. In the past upon arriving home, my kids occasionally commented, “Uh, oh! Dad’s having a happy thought!” — as they’ve caught me smiling after a run.

How wonderfully strange a simple activity can be. Though my mind clears during a run, sometimes new ideas or solutions to problems suddenly pop in. In fact, the idea for this post came during a run.

Though my circumstances have not really changed, I return home with a sense of well-being, that everything is again right with the world.

Not too long ago, far from home, I was running barefoot on a paved trail along a beach in California. Coming from the opposite direction was a 70-ish looking man, bare-chested and rather fit physically, though appearing entirely unhappy. He screamed, “Get the f**k off the road!” to anyone in his way. Really?

An old adage came to mind, saying we need not be the product of our circumstances, that we are as happy as we make ourselves to be. If that guy could make himself unhappy on a beautiful, sunny Sunday morning along the beach, then perhaps I could make myself happy under any circumstance. It’s all in the attitude.

We all know exercise is good for us, a great concept but one difficult to apply. It requires motivation. But motivation typically comes only after we act, not before. My solution was to shake things up, to exercise unconventionally by running barefoot. It was a challenge, but like most things in life, improvements came incrementally each time I headed out the door. The novelty has not worn out — I’ve been doing this for the past seven years. People often comment as I run, usually friendly, and being different is a reward in itself. This works for me, but anything that gets your heart racing and forces you into the here-and-now is enormously therapeutic. Though I at times I lack the motivation to run, I remind myself that I always feel better afterwards. Always. That is, unless I injure myself doing something really stupid. But being stupid at times makes life interesting, and I eventually recover and get back to running.

We may feel hopeless within this reality. Yet we do have choices. Though we cannot change overnight our professional world or our circumstances, we do have the ability to change our attitude towards them. And this can make all the difference.

Randall S. Fong is an otolaryngologist.

Image credit: Shutterstock.com

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