Doctors: First, do no harm to yourself

There’s this prevailing theme in modern medicine that I don’t understand. It’s called: “Do no harm to others, but neglect yourself.”

It’s perpetuated by ridiculous working hours, emotional, psychological and sometimes physical stress, minimal vacation and maximum pressure to always do a little more. Did you overwork yourself as an undergrad, watch your hair fall out during MCAT studying, then give up family and friends for a fire hydrant of information to the mouth in med school, while simultaneously volunteering, doing research and maybe even juggling a couple kids or a second degree, just to watch yourself burn out in residency? Well, then you should definitely do a fellowship. After residency, did you add another three years of interest on a vomit-inducing sum of loans for a $10-an-hour fellowship that makes you only-just-competitive-enough for your dream job? Well, then you should consider churning out a few extra publications to beef up that CV! Now that you are finally a working physician and have found an hour to spare every month to catch a fleeting glimpse of one of your children’s band performances, you should definitely consider being on the board of something. Don’t worry, you will be compensated! Not handsomely, but just enough for you to choose evening meetings over quality time with your spouse and kids.

Let me divulge a major trade secret. It. Never. Ends.

As a physician, you can never quite meet the expectations of each new level you reach, because as soon as you think you’re good enough, something else comes along. It’s like being in a never-ending game of Tetris —complete with flashy blocks of résumé builders that keep falling from the sky faster and faster until you suffocate trying to fit them into your life.

For some, the pressure and the expectations are indeed too great. We’re seeing more physician suicides than ever before — 28-40 per 100,000, which equals about one dead doctor a day. That’s more than double the suicide rate of the general population and the highest suicide rate of any profession. The worst part is: even as we spiral into the lowest of our lows, there is minimal support for us as we constantly support others. Who takes care of doctors? An unsettling irony.

Which reminds me of the overhead speaker on a plane. While I’m zoning out thinking, please let me nap, the flight attendant barks, “In the event that the plane loses cabin pressure while at altitude, oxygen masks will appear overhead. Please place the mask over your own mouth and nose before assisting others.” This selfish admonition telling you to sniff some oxygen before helping your kids actually has a purpose: the only way you can be of service to others is if you help yourself first.

Today we see doctors losing consciousness everywhere as they put oxygen masks on just about everyone but themselves. Neglecting their own health and families to become bitter, overdrawn, jaded versions of their previous selves, increasingly unable to help their patients effectively as they continue to battle their own looming problems. When was the last time you saw a doctor take time off to go see their doctor? Ask your doctor about the last time they got their teeth cleaned or when they last exercised. Ask them about the last time they got Christmas off or went to bed without working on patient notes. Ask them about the last time they got reimbursed for doing their job without fighting tooth-and-nail with an insurance company. Don’t even bother asking them the last time they got a good night’s sleep. And we wonder why, despite their flashy Audis, so many physicians tell others not to become physicians.

They do manage, though. Honestly, doctors are super-people. Somehow they show up, give their all to their patients, raise families, take calls all night, teach classes at universities, do groundbreaking research, battle insurance companies, tread through $600,000 in loan repayments, and live up to endless “quality” standards. But, during all of that, we lose so many to the chaos, to depression, anxiety, and alcohol. We lose them to a bitterness that uproots the hopeful, compassionate medical students they all began as.

Medicine’s motto used to be, “First, do no harm.” I think today it should be, “First, do no harm to yourself.” Put your damn mask on. As a physician, it is so important to find balance and moderation in your work. It’s easy to get caught up in more projects, directorships, manuscripts and board positions. It’s so enticing with the idea of more money, more prestige, and more power. But sometimes it is an excess of those very things that takes away from what allows us to flourish — our families, our communities, our hobbies and all the little things that, alongside our career, give us true satisfaction and inner peace.

So I say, as a physician, indulge in yourself. Love yourself. Treat yo’ self. Take the time to travel, to read, to cook, to sleep. Go tailgate with your friends, spend time with your mom, or talk to someone about your own issues for a change. Take care of your own body — exercise and eat well.

Cut back on the alcohol. Skip the meetings for an extra ten grand a year and take time to go to baseball practice/ballet recitals/camping/the movies with your kids. Remember that you are more than a physician, and nurture the other “you’s” — the mothers and fathers, husbands and wives, the sons and daughters part of you; the athletes and artists, the readers and writers, the musicians and dancers, the hikers, gamers, builders, and explorers part of you. The best way to love medicine for a lifetime is to invest in all the other facets of you that keep you happy and keep you whole.

So here’s to a new medical motto: Take care of yourself first, so that you will always enjoy taking care of others.

Mariam A. Molani is a pathology resident.

Image credit:

View 3 Comments >

Most Popular

✓ Join 150,000+ subscribers
✓ Get KevinMD's most popular stories