Tuesday, January 16, 2018

Life as a Highly Sensitive Physician - Part One

A little over a year ago, I stumbled across an article about highly sensitive people.  I had never heard the term before, but as I read the article, it resonated very strongly.

Feel more deeply?
Emotionally reactive?
Take longer to make decisions?
Detail oriented?
Cry more easily?

That's me!  After reading the article, I went on to do a self quiz, and the answer that came back was basically "You fit this profile so perfectly, why did you even need to take the quiz?"

So yeah.  I'm a highly sensitive person.  Meaning that I tend to respond very emotionally to things, that I am very sensitive to criticism, and that I can get overwhelmed easily.  These were all things that I knew before reading the article (and the subsequent articles/blogs/books on the subject that I have read), but the concept of a highly sensitive person was helpful to me for the way that it presented my individual traits as something bigger, some complete personality type that described me shockingly well.

It also helped me by explaining why some aspects of work were much harder for me than for other people.  All through medical training (and into my first years of practice), I would look at the high achievers around me and wonder how it was that they were able to accomplish so much more than I did.  How could they work a long day and then come home and raise a family and do research projects?  And without hating their lives? 

Identifying myself as an HSP has helped me to realize that things exhaust me more than they do other people.  I engage deeply with everything I do, and so I use up a lot of energy doing my work.  One challenging conversation can deplete a lot of my emotional reserves, so when I have a day with multiple tough patients, it isn't surprising that I have no energy for anything else in the evening.  I'm simply done.

This happened to me last week, when I had to tell a long-term patient that he was dying.  That interaction was difficult enough, but then it was followed by a number of really tough disclosures about personal trauma from other patients.  I did everything I could to be present for my patients and to help them get the resources they needed, but by the end of the day I had nothing left.  I spent my evening on my couch binge-watching Top Chef and eating leftovers from the fridge, physically and mentally unable to do anything else.

When I tell stories like this to some of my colleagues, they look at me like I'm crazy.  It's not that they're not empathetic or that they don't care about their patients*, it's just that they don't personalize things in the way that I do.  They can detach from their patients and move on quickly, whereas I struggle to not be too deeply affected by my patients' stories.

But it's something I'm working on.  I have zero desire to burn out early, so I'm constantly looking for ways to do my work well without giving so much of myself.

Which will be a subject for a future post, because for the moment it's time to read a book and recharge for work tomorrow.

*Well....for some of them it is.

22 comments:

  1. This sounds like me. Another deeply-caring, overwhelmed healthcare professional who thinks she should have become a librarian (not the real kind, like at my library, but one that reads and shelves alone in the stacks) or a...someone that does work alone for many hours because I am just so exhausted by people, yet I appear to be good at this...
    Anyway, you are not alone and I will take the quiz to see what I already know!
    Thanks!

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    1. I totally want that imaginary library job!

      How did you do on the quiz?

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    2. Interestingly enough, I've known I was an HSP since my 20s and I became a librarian.

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    3. Ha! Has librarian been a good fit for you as an HSP? I would imagine that working with so many kids could be a challenge. I used to run a summer camp for kids, and it was a terrible match for me. I was constantly overwhelmed and overstimulated.

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  2. I scored 19 on the quiz, but I'm a guy. Since I am also kind of old I can see what a difference it has made over the years. Self-awareness and self-care seems to be the key to survival, but judgement from others is sometimes harsh. Screw 'em if they don't understand.

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    1. I imagine it would be vastly harder as a man. Women are "supposed to" be sensitive and understand other people's feelings, so being an HSP isn't quite so strange for a woman.

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  3. Being “sensitive” as an anesthesiologist is so not ok that people openly mock those who are, and brag about their own thick skins. It is thought that sufficient hazing is necessary to toughen us up. Sigh. I’m not *that* sensitive, but working in a culture where feelings of any kind are not permitted can be very draining.

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    1. The bloody toxic culture of medicine. Why is it always so toxic? I could never survive in a specialty that didn't allow for some expression of completely normal human emotion.

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  4. OMDG, I've had surgery twice and I was amazed at how different the anesthesiologists were In there people skills.

    I also tend to be pretty sensitive. It was a huge problem when I was younger.
    Anon in mass

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    1. Did being a sensitive person get easier with age/time?

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    1. Me too! Yay! (And ugh for being so sensitive)

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  6. I'm an 11 but I also don't know if some things apply to me and I just don't notice it anymore because I've removed myself from a lot of those situations that would give me data. I work remotely a lot of the time, without seeing or talking to people most days, and that's how I'm happiest.

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    1. It's definitely a spectrum more than an absolute cutoff between sensitive and not sensitive. If you're happier working at home away from people, there's a good chance you've got some sensitive tendencies at the very least!

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  7. I have had similar issues in my activism and my profession. I have had to work really hard to remember what is in my control and what I can do with my empathy. My empathy is a good thing, but, like all other traits, it needs to be properly managed so that I can actually go about my life. It's hard and you feel hard at first when you are implementing things to take care of yourself. But it is worth it.

    I really like the Captain Awkward blog. So much of it is her reminding people that boundaries are good and that people aren't doing X at you. It helps me to contextualize some aspects of life in much healthier ways for me.

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    1. I love Captain Awkward. I get excited whenever I see a new post from her. And yes, managing empathy/sensitivity is hard, but once you start it just gets easier and easier.

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    2. She legit helped me out so much when I was coming out, too. Such a wise and kind person.

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  8. I wrote a reeeeally long comment, but it vanished when I tried to post it so I'll summarize.

    I'll check out that blog.

    What is medical school and residency like for an HSP?

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    1. I'm so sorry that happened! Please don't stop commenting...I don't think it's an ongoing problem with the blog.

      The first two years of medical school were great, as they were mostly classroom-based, and I am good at paying attention for hours and then writing exams. The subsequent clinical parts (medical school and residency) were much harder, for many reasons. Ridiculously long hours, lots of criticism from jerky attendings, lots of difficult personalities to contend with. I could write a whole blog post about it! (And maybe will...)

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  9. Oh, have no worries about my possibly not commenting again. :-)

    Thanks for replying. Yeah I was wondering if it was like it is portrayed on television complete with "criticism from jerky attendings", being put on the spot to give answers to questions to said attendings in front of other residents, etc. I can imagine that would be very stressful.

    Glad you made it out alive!

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