Wednesday, March 20, 2019

When the Body Says No

Overwork crept up on my slowly.

Work has always felt busy to me, but over the past six months, the intensity has been increasing.  An extra patient or two added to each clinic.  A new computer system that is supposed to, but doesn't, make things easier.  An extra trainee to supervise each week.  Nothing particularly time-consuming on its own, but the cumulative effect has been a few extra hours of work every week.

At the same time, life outside of work has become busier.  I've invested a lot of energy into meeting people, and my social circle has expanded.  And on New Year's Day, I met my new girlfriend!  And I've started doing yoga.  And while all of these things are good (some of them really good), they all take time.

I started to notice the effects of being too busy right before my Christmas break.  At the end of yoga class, lying in shavasana (aka "corpse pose"), I'd often fall asleep.  On a particularly bad day, I'd cry.  I thought that I just needed a good break, but I felt just as tired and overwhelmed after my 10-day break as I had before.  The same thing was true when I returned from a recent week of vacation in Mexico.

The lowest point came the first week back from Mexico.  I was in the middle of my usual Thursday paperwork day when I started having an anxiety attack.  I couldn't focus on anything I was supposed to do, and all I could think about was how I could never possibly get done everything I needed to do.  I ended up having to leave early, because I was just desperately spinning my wheels while accomplishing absolutely nothing.

That night, I took a long and serious look at what had gotten me to that place.  (Also a long and serious look at my bank balance.  If it had been high enough for FIRE, that might have been the moment for me.  But alas, it's not even close.)  And I realized that I haven't done anything to protect my time and energy, even though I know that I am someone who gets (relatively) easily overwhelmed.

So my new phrase is "fuck no".  (The "fuck" part said inside my head, because of the aforementioned lack of enough money to retire.)  I have put an absolute moratorium on saying yes to anything else, and I've been getting rid of any commitment that I can possibly get rid of.  I've put a firm cap on my clinics, and when people say "Can't you just squeeze in one more patient?", the answer is "Noooooo".

Better to pare back now, when I'm not totally burnt out, than to be forced to do it when I am.

(I have so much more to say about this, but I'm exhausted.  Hopefully soon!)

11 comments:

  1. So there with you. It's been half a year of professional hell for me and more than that for PiC and we've been getting ragged around the edges. We're finally starting to see a light at the end of the tunnel for me maybe but only if I can hit a lot of deadlines between now and summer.

    I even stretched out for the first time tonight in literally months. May it all be a little brighter every day from here on out as we do what we need to but also defend our space and time.

    And yay girlfriend!

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    1. That sounds terrible. Why do we live in a society in which this is the expectation for work? Why can't we all go live in France?

      Yay girlfriend indeed!

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  2. No is a good thing. I have never been good at saying it to the detriment of my self-preservation, but now I am older and have less capacity so I have to. Learning to say it without guilt is also a learning experience and it's time to be a little selfish and make ME happy. Keep up the good work and be happy!

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  3. Balance is so hard to achieve. I teach, and the work can be overwhelming. I'm actually working with a career coach to help me get some balance. One key is not bringing work home. As I'm getting more time to recharge in the evenings, I find it easier to be productive at work (most days . . . ). This is an ongoing struggle for me too!

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    1. That's cool that you have a career coach! I have done some work with a "performance coach" and I've found it really helpful.

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  4. The timing of this post is so on point! Im going through burnout right now. Im studying for boards exams. Its horrible. I have to keep studying but my body say - no more!

    ugh.

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    1. Good luck! My boards were one of the worst parts of my whole medical career. It will get easier, eventually.

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  5. I'm so glad you are trying to navigate this balance in a way that protects your body and your anxiety. Our world is a lot, and we need people to have space to breathe.

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    1. Thanks! It isn't encouraged in medicine, but I will have a very short career if I don't take care of myself.

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  6. Rather than take on new patients, a way to deal with overload is to spend an extra minute connecting with each of your existing patients. Human interaction instead of assembly line treatment. You'll feel better for it and so will they.

    I'm sorry I can't cite the source for this information but it was an article regarding the results of a study on ways to address burnout in the medical community. It makes sense, maybe it can help you.

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