Self-care for physician burnout: What does that mean?


They say you learn a lot from your clients. Not in anesthesia, where I frequently feel great empathy for my sick patients and their families. Our connection in the peri-operative environment is too short-lived for this, I believe.

But in therapy, where the relationship is both critical and deeper, and where I have more recently turned my attention, I have come to appreciate that observation personally. I specialize in “burnout,” that popular moniker for overworked and under-appreciated, part repercussion for a culture of perfectionism, where being human is considered weak, and emotions are deliberately blocked off. I also deal in the currency of vicarious trauma on multiple levels. I attend to my own experiences as an anesthesiologist to those of my therapy clients in the medical profession, as well as my clients in inpatient addiction, where I intern towards completion of a master’s degree in clinical mental health counseling. There were times in medicine when I, too, felt powerless, helpless, overwhelmed, cynical, and angry. And those feelings pointed me on a path for which I am so grateful. I have learned the power of being witnessed and took back my power, no small feat in contemporary medicine. I learned boundaries; I learned how to grieve, how to feel my emotions deeply, and carry on effectively. I deepened my connections with patients and felt my way forward in anesthesia with a new perspective and in a new profession mid-career.

I have learned that courage comes in many forms. For example, recognizing a need for help and reaching out, especially for those accustomed to being the helper (I’m looking at you doctor). Courage is also seeing those around us quietly suffering and reaching out instead of harshly judging. Courage is acknowledging our flaws, our faults, and our mistakes, which can have fatal consequences, accepting our imperfections head-on and showing up anyway. Courage is accepting the absolute unfairness of being sued by a patient’s family when we had an agreement and a bond with our patient, and coming to work every day during this excruciating process. And finally, courage is returning from the pure hell of addiction, which many physicians quietly struggle with until coming completely unglued. In my many discussions with physician colleagues, I have come to appreciate that we all struggle to a degree despite hiding this fact so well, that we are relieved at an opportunity to be heard, that we are relieved to be able to say we are not, in fact, perfect. And we are so relieved to be appreciated for the simple fact of our work, that despite our imperfection, we keep showing up to take care of others. This is the true courage I have heard from so many doctors, nurses, and physician assistants.

Self-care is the new vernacular to combat “burnout.” Some mistake this for yoga, pedicures, eating out, and hot bubble baths. These are all important leisure activities, but they are not the core of the self-care required to maintain equanimity in a high stakes profession such as medicine. Self-care means you too deserve oxygen, and if you don’t oxygenate yourself first, how are you going to care for those who depend on you. We use this analogy in inpatient addiction, and it always brings that sudden look of stunned understanding, which so gratifies clinicians. This can be practiced in so many little ways that add up. And then there is therapy, a powerful tool to revisit and find once again our self-worth. It’s not perfect, and I’m OK with that.

Maire Daugharty is an anesthesiologist.

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