While riding shotgun in the family minivan on the way home from a fall break water park trip, I received the following text message:

I thought of you today! One of the residents here had done a great job with a complex (and really sad) labor and delivery patient, and the nurse was telling me how awesome she was … so I thought to myself that I should do what you do and tell her that she did a great job and not just write it on an eval.

It was also one of those cases where I was so thankful that we had resident debriefings and we talked about dealing with hard things and what it means to be a doctor. I know that helped me teach her! So thanks for being a great example of a physician and teaching attending!

This was from a recent graduate of my pediatric residency program who was four months into her new life as an attending. Of course, it made me smile, and it reaffirmed what I had been thinking about while my kids were sleeping or iPad-ing in the back seat.

So I replied:

Thank you for sharing! Riding home from Kansas right now and thinking random thoughts, one of which is my belief that working with residents has protected me from burnout. So thank you, too, and I can’t even imagine how many people you will touch during your career!

I completed my first Maslach Burnout Inventory last summer as part of a professional development series. The questions were phrased in terms of “recipients” rather than patients.

When our results were passed out and discussed several months later, I was pleased (and a little surprised) that my numbers were so favorable. When I thought back to the day I filled it out, though, I realized that I had been mostly picturing my “recipients” as the residents and students that I teach and mentor. I think my results would have been different had I thought only in terms of patients-as-recipients.

I have had several occasions over the past year to reflect upon my work — do I like it? What do I like about it? What do I want to spend more time doing? And I keep circling back to my hospitalist partners (they really get me) and the residents (I really want to get them).

In some ways, they force us to be better. To use more evidence-based medicine, to role model more empathy, to find ways to keep ourselves from burning out because they are watching us and counting on us and hoping that they didn’t make a mistake with their lives and careers. And, for me at least, that has turned out to be a self-fulfilling prophecy.

What I didn’t necessarily suspect, though, is that the resident-student relationship could also be protective.

I received this reply from my former resident:

Yes! I felt really burned out between second and third year, but getting to teach medical students in the NICU and PICU made everything so much better. I totally agree that it’s protective! And thanks … it still feels weird to be the boss sometimes but it’s also really fun. Usually.

I have started to consider what each learner is teaching me in addition to worrying about what I should be teaching them. I have learned so much from our residents: how to mindfully prepare for the future, how to seize the opportunities that life has to offer, how to smile graciously under pressure, how to keep on trucking despite the profound stress and sadness and injustice.

So if I cannot muster empathy and evidence and resiliency just because they are the right things to muster, maybe I can muster them because I am being watched and imitated. Maybe our burned out residents can muster these things because they are being watched and imitated by the medical students. Maybe, just maybe, we can fake it for others until we truly make it.

Lisa Sieczkowski is a pediatrician. 

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