Saturday, June 15, 2019

When the Body Says No, Really

When I wrote this post three months ago, I thought everything was going to be okay. I had turned down a few things that were stressing me out, and I'd shuffled around a few patients so that I was only overbooked for the next two months instead of the next four, and I thought it was going to be enough.

Except it wasn't.

The stress kept getting worse.  I went from feeling anxious most of the time to feeling anxious all of the time.  I was constantly aware of all of the work I still had to do, and no matter how many extra hours I logged, the amount kept getting bigger.  I would push myself hard for days to get sort of caught up, but then a single busy call shift or clinic that ran over would undo it all.  I eventually stopped trying to get caught up, resigning myself to being perpetually behind and overwhelmed.

And then I started fantasizing about leaving.  Not random, fleeting thoughts of "I wish I could spend this beautiful day outside instead of in the hospital", but whole days of thinking "If I liquidate all my assets and live on a mustachian budget, how long can I go before I'd have to work again?"

I might have been able to hold things together if I'd actually stuck to my plan to say no to everything, but I didn't.  An offer came for me to present at a national meeting, and it felt like turning it down would have a hugely negative impact on my career.  So even though I was at my limit, and doing so would mean days of preparation and travel and time changes, I said yes.

The presentation went fine, but I was so tired afterwards that I could barely force myself to leave my hotel room.  I tried to go to conference sessions, but the speakers' words turned to static in my brain, so I wandered Montreal aimlessly when I should've been at the conference.  I bought books and sushi, and I spent almost an entire day devouring them both while hiding in my hotel bed.  I didn't want to be a doctor anymore. 

It was a week later that I crashed completely.  The weekend after the conference was Pride, and I decided to do all the Pride things all weekend, which is not a recipe for introvert happiness.  By the time I dragged my beer-soaked Blundstones home at 10 PM on Sunday night, I was a wreck.  And I couldn't sleep.  At 2 am, wide-eyed and jittery, I made my way to the computer and emailed the nurses to say I was cancelling a clinic.

11 years of clinical training and practice, and until then I had never missed a day of work for anything other than the direst of medical situations.

It was (at least, I hope it was) the wakeup call I needed.  It was my moment of realizing that slowing things down a bit in a few more months wasn't enough - I was in trouble now.  I could maybe muddle my way through six weeks of clinics until my next vacation, but there was no way I could do that and do two weeks of inpatient call.  I could not keep pushing myself.

The two weeks since that moment have involved a lot of soul searching and a lot of conversations with people who have thankfully been incredibly supportive of me.  The biggest thing - the thing that saved me and for which I will be ever grateful - is one of my colleagues took three weeks of my summer call.

Three weeks.
Of call.
In the summer.

I hope that someday in the very distant future I will be in a position to do someone such a huge favour, because if he hadn't done that, I'd be on stress leave right now.  Taking those weeks of call from me has given me a way forward, a bridge to a time when I can actually scale my workload back enough to make it tenable in the long-term.

He quite literally saved me.

There is so much more to say, but as I write that line and let the truth of it sink in, I can't think very far past it.

I am so glad that every time I'm in darkness, someone brings me a light.