Everybody dies. And doctors can’t change that reality.
But we’ve created a system where we lead people to believe immortality is possible. We expect clear-cut answers to health questions. We’ve been trained to look for multiple-choice questions with an answer key that tells us the correct solutions. As doctors, we’re expected to be selfless, altruistic superhuman helpers who always know the answers and will sacrifice ourselves to benefit everyone else. And this system that we’ve created is squeezing us to our breaking point.
COVID shined a bright light on this expectation. When the pandemic began, everyone expected doctors, science, and medicine to have the answers immediately, and to know how to fix it right away, like the superhero who saves the day. The world expected it of us, and worse, we expected it of ourselves.
But that’s not how life works. Life doesn’t have right and wrong answers. When we expect to have the answers, and we’re wrong, we experience a profound sense of shame.
Shame researcher Brene Brown describes vulnerability as uncertainty, risk, and emotional exposure. She asks the question, “Are we willing to show up and be seen when we can’t control the outcome?”
But for doctors, this type of emotional exposure can leave us devastated and ashamed when the unexpected happens. We feel that we have failed our patients, our colleagues, and ourselves. We see ourselves as “helpers,” as the fixers. Our greatest fear is of not knowing the answer, of getting it wrong. And it’s a true fear, because when we get things wrong, the consequences can be catastrophic.
As a doctor, I was trained to believe that medicine was a science, all of the answers are out there, and that if we do the right detective work we can solve every case.
I also believed that if doctors and patients work together, they can solve every health mystery. We can always find the right diagnosis, the right treatment, and the right cure so everyone can live happily ever after. This idealized utopian world is filled with grateful patients praising heroic doctors.
But what I see today is a world where doctors are burnt out, patients have lost trust in their doctors, and many doctors don’t even trust each other.
We’re not just tired, we’re depleted. We have nothing left to give. And somehow, the harder we work, the less we seem to accomplish.
But it’s not just the workload that’s draining us. We were also taught to be detached from our patients and our work.
We’re above the patients. Experts. Helpers. Problem solvers. We know all the answers, and we can just fix everything.
We go through decades of education and training so that we can know more than everyone about everything. And we do – we really do know a lot about science, medicine, and human physiology. We try so hard, and we care so much. So when we tell our patients what they need to do in order to get better, it’s coming from a really good place – a place of caring, knowledge, and experience.
The problem is, we’re broken and burnt out too, and there’s nobody there to fix us.
Underneath it all, we’re not superheroes. We’re just people. Smart, dedicated, passionate, exhausted, scared, emotional people, just like everybody else. The reality is that human life isn’t a multiple-choice test, and there isn’t one right answer.
We surround ourselves with emotional armor. We act tough. We hide our fears with more and more scientific facts. We pull away and separate ourselves. We listen to our patients, but we hide our own hearts behind walls, keeping plenty of distance between us and them.
We give, and give, and give. We give our time, we dedicate our lives, and we pour our hearts and souls into this work, never asking for a two-way relationship in return. Not from our patients and not from our colleagues.
We give, but we don’t share. Instead, we hide behind our expertise, behind the science, the knowledge.
What we don’t realize is that our patients are smarter than we are. The reason they don’t trust us is that they see that we’re holding back. We don’t share, and we don’t ask for help. And a one-way relationship hurts the receiver just as much as the giver.
I believe the way to bring meaning back into our medical practice to not just allow but actively encourage doctors to get personal and vulnerable with our patients and our colleagues.
We need to acknowledge that the practice of medicine is not black and white, and we don’t always know the answer. We can do our best, use all our skills, and tap into decades of research and the latest scientific tools and knowledge to help patients, but we cannot control the outcome.
At the end of the day, everybody dies. Nobody gets to live forever. Which means that if “fixing” and “saving” is how we measure success, then ultimately, we are all doomed to fail.
This view of ourselves as helpers is so ingrained in our self-identity that when we’re unable to fix everything, it diminishes our own sense of self-worth.
In Rising Strong, Brown writes, “The danger of tying your self-worth to being a helper is feeling shame when you have to ask for help.”
I recently reconnected with Jerome, a friend and colleague from my intern year of residency. Like many other doctors, my intern year was one of the hardest of my life, and I struggled with feeling inadequate as a doctor, wife, mother, and friend multiplied by the constant feeling of burnout. I remember looking at Jerome and thinking he was not only brilliant and fun, but always on top of everything. I was jealous of how he seemed to manage everything with grace and ease, and wished I could be more like him.
He recently told me that when he thinks of me during that time, “You always seemed to have your life all figured out compared to so many of us that were floundering and complaining.”
The truth is, we were all drowning, alone, and hiding behind the image of perfection. Clearly, each of us secretly thought that the others had it all figured out. We were so afraid of admitting weakness or asking for help, so we kept it to ourselves and muddled through, burnt out and miserable, terrified of being judged for our vulnerability.
When we negatively judge ourselves for needing help, we end up judging others who need our help too.
Our patients feel this undercurrent of judgment when they ask for our help. They don’t want to face that vulnerability because they too feel judged.
Asking for help and facing our struggles with honesty is a sign of courage and compassion. It is human nature to need each other and to feel connection.
Maybe if we’d all been a little less armored, more vulnerable, and shared our struggles with each other, our cohort of future doctors could have leaned on each other to cope better back during our intern year too.
And maybe if we learn to accept our own vulnerability and our own humanity, our patients and colleagues will be willing to trust us and each other and step into the uncertainty together with us. I truly believe that we will all benefit from better relationships resulting in better patient outcomes and less burnout.
We don’t have all the answers. And as soon as we accept that, our patients can too. And we can all accept the fact that we’re all human, and life is messy, and it’s not a multiple-choice quiz.
Jordana Rothschild is a preventive medicine physician.
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