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.

13 comments:

  1. Burnout is terrible.

    I don't really have anything useful to add, because I am there too. Unfortunately I am still in training, and have no control over my workload. The one thing I am hanging onto is that I "only" have 18 months (and a terrifying exam and a masters paper) left before I can escape.

    After that, who knows? I have learned that I definitely need a better work life balance for happiness than what I have now. I'm hoping that a combination of more control over my hours and frugal lifestyle habits will make that happen for me.

    ReplyDelete
    Replies
    1. I am sorry that you have so little control. It does get better when you're an attending (at least, it did for me), but it becomes harder to deal with the times when you're overworked, because they aren't temporary anymore.

      Living frugally definitely helps. It was comforting for me to know that, if I had to, I could walk away.

      Delete
  2. I can relate that to my personal life, but yeah, all of a sudden you find yourself at the end of your rope and something has to give. Glad you are okay and can make some changes to save yourself. Then you can get back to saving others. Take care.

    ReplyDelete
    Replies
    1. Thanks! It's amazing how we ignore the signs until we really can't anymore. I think we all need to get better at recognizing them earlier.

      Delete
  3. Big hugs. One of the reasons I find academia works for me is the summer time to do other things. I'm still anxious, and work creeps in more than it ought, but it buys me time to recover from the burnout. I'm glad someone offered you a hand, and I hope it buys you what you need.

    ReplyDelete
    Replies
    1. I'm glad you get to recharge in the summers. I have 11 days off in just under a month, and I'm hoping it's going to replenish my energy stores.

      Delete
  4. Thank everything for that colleague who was willing and able to take those three weeks for you!

    I'm feeling like that's where I am now - the verge of burnout. I need to find my outlet.

    ReplyDelete
    Replies
    1. I worry about you every time I read about how busy you are! I hope you can find a way to take care of yourself.

      Delete
  5. Time off is so important. Have you ever considered working part time. Just because.

    ReplyDelete
    Replies
    1. Sort of? I'm definitely in the process of reducing my workload, but I don't know if it'll be enough to qualify as "part-time". We'll see when the dust settles!

      Delete
  6. I'm so sorry you're going through this... you are definitely not alone and though I'm sure it was difficult, but by putting these words down you might be saving someone else.
    Very glad you were able to not do those 3 weeks of call, and I hope you can find a path forward.
    Nice to see you back on the blog, missed your voice and wondered about you when you were gone.

    ReplyDelete
    Replies
    1. Thanks! That's so much of the reason I write this blog - because other people have helped me by telling their stories, and I hope that telling mine can do the same for others.

      I am starting to see the way forward, most of which is 1) being willing to sacrifice a lot of my income and 2) working a heck of a lot less. My current mantra is "Happiness is more important than money", and I think it's helping me to make better decisions.

      Delete
  7. Burnout is a pain! I can soooo relate.

    Ditching the conference sounds like something I also would have done if I were in the same situation. I'm glad that your co-worker was able to help you out.

    I've recently realized how trapped I am at my job and the only way I can help myself is to give myself more options in the short and long term.

    I hope the break does you a world of good!

    ReplyDelete