How to talk with a struggling physician colleague


My friend, Lello Tesema, and I were sitting in a restaurant in Harvard Square. It was the first, feverish bit of spring when it seems like the entire city has emerged en masse from their winter dens. We were sitting outside under patio lights, wearing regular clothes instead of our usual scrubs. I should have been happy.

As often happened in those days, I asked Lello if things were ever going to get better. My intern year was wrapping up, and I felt deeply alienated from the other doctors in my hospital. I could do nothing right. I was very depressed, I hadn’t found help, and I didn’t know if I wanted to be a doctor anymore. If this was my calling, I thought, how could I be feeling like this?

Lello seemed so far from these concerns. She was soft-spoken, gentle, thoughtful. She seemed to make even the most distressed patient feel at ease. I was in awe of her and couldn’t imagine that she had ever felt like I did in that moment.

“It will get better,” she told me. I looked at her. She was smiling softly, with deep sympathy in her eyes, and I burst into tears. “I’m so miserable,” I wept. She held my hand.

It wasn’t until Lello told me how she had struggled and gotten help that I believed her. To know that someone I admired so deeply could not only sympathize with me, but actually had been where I was, felt like a path through a thick wood.

As health care workers, we are problem solvers. We have to be. There are a handful of people whose lives I have saved with quick thinking. I wouldn’t trade those moments for anything. But wanting to jump to a solution means we sometimes fail to listen, to sit with a friend, patient, or colleague, and be a companion in their suffering.

A few months later, I sat with a primary care attending, Yamini Saravanan, in a cafe near the hospital. She was the kind of doctor I wanted to emulate. Her manner with patients and students was calm and forgiving.

I told her how hard things had been, how much I felt I was struggling to win approval. How hard it was to do the right thing for patients when there didn’t seem like the right thing to do. Yamini listened for several minutes before offering advice. She never tried to tell me my concerns or thoughts were invalid.

Yamini also told me about how hard it is to be the kind of doctor that she is. That giving everyone the time they need means always running late, with patients and staff sometimes aggravated at her pace, and the nagging feeling that she should go home. But trying to fit complex conversations into 15-minute chunks hadn’t felt right either, and she had come to embrace her practice style.

The few times we met helped me immensely. They put what felt like enormous conflicts into perspective. In residency, we are continually being evaluated and judged. When coupled with depression or anxiety, those judgments can take on outsized proportions and feel impossible to overcome.

I was on a medical podcast recently called The Curbsiders, speaking about depression among physicians, something at least half of us will experience in training. The hosts asked me how we should approach colleagues that are struggling. Maybe the causes and the stigma are particularly acute, but I think there are lessons from my experience for people across different disciplines.

“The conversations I think about are the ones that were healing for me,” I replied, conjuring Lello and Yamini in my minds. “They took the time to talk to me outside the hospital. They just listened to what I was going through, and shared their own struggles.” They didn’t try to fix me. They were companions in the long road I still had to walk.

I often feel as a doctor that I’m doing everything wrong. I should. Medicine is complex, our workplaces often unsupportive. It’s impossible for us to give everyone everything they need. I am drawn to those who try, who save lives without a sense of ego. Yamini and Lello are two doctors that saved mine.

Elisabeth Poorman is an internal medicine physician and can be reached on Twitter @DrPoorman

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