This post describes how an EM resident’s perception of wellness takes a turn after he recognizes the symptoms of burnout in himself. It was submitted as part of EM Wellness Week.
Honestly, I’m not really into this “wellness” stuff. I don’t get it. I like what I do – yes, it’s hard, but it’s worth it. All I hear from the “wellness” crowd is talk about burnout, depression, failure, errors, quitting, crying, etc., etc. Does anyone still like this job?
That’s what I might have said last July, when I was fresh into my residency and busy picking up every teaching pearl and academic opportunity I could find. Of course, I procrastinate like everyone else, but once I isolate myself in a coffee shop and start working on a project, I usually wonder why I had been avoiding it – it never takes as much time or effort as I had anticipated. Thus, my solution to work-related stress, whether clinical or not, has often been to stop thinking about it and just get started. And that worked well … until it didn’t.
I thought the first half of PGY1 would be a blast – I was starting with three Emergency Medicine (EM) rotations, followed by several “lighter” ones (you know the ones…). Up until October, I was right.
Getting to practice EM, after years of admiring those who did, was incredible! On my next few rotations, I planned to use my free time to build up my core EM knowledge by flying through books, articles, blogs, and podcast I had saved up; except that didn’t happen. I also planned to work on several projects, but those also went nowhere. Additionally (of course), I was going to restart my med school workout routine, while finally making sleep a priority. Well, I definitely slept more, 7-8 hours each night plus a daily nap daily after work – the most sleep I’d gotten since high school – but I never felt rested. My Nespresso cups were disappearing, my to-do list got longer, and my “days without exercise” record kept rising. I even stopped wearing my Fitbit.
Now, if there is anything you need to know about me, it’s that I never lose a Fitbit challenge. I’ve gone running in -20C, on a Sunday night, on a full stomach, in order to beat a friend’s step count. If he had known that I was not wearing my Fitbit, he would have known that something was up. But he did not know, because at that time, despite all my free time, I was not feeling particularly social. Probably just the lack of sunlight, I told myself.
Soon after, a family member made a simple comment about how many shows I seemed to watch, and that struck me as odd. I had not owned a TV or watched Netflix in over 4 years, and now I had unwittingly become an expert on Frank Underwood, Westeros, Schmidt, Demogorgons, and European football (i.e. soccer). I can’t say I regretted watching these masterpieces (that’s right, even New Girl), but I was not particularly happy watching them. Most of the time that my eyes were on the screen, my mind was busy worrying about the work I was neglecting.
Then the final straw: February 2, my niece’s first birthday. Exactly one year before, the day she was born in Toronto, I was literally across the country, in Vancouver, preparing for my last (trigger alert…) CaRMS interview. I had regretted being away during that time, but recognized the necessity of it.
I had told myself, however, that once I started residency program, family would always come first. And they had – I had seen my niece almost every weekend from July to February, but I had no idea how she had gotten to be 1 year old. Sure, “they grow up so fast”, and so on and so forth. Still, that sense of missing out remained. I decided something had to change, and so I took a break! That’s right: light rotations, minimal work, watching Netflix … and then a break.
I’m glad I did though. My “break” came in the form of a non-clinical elective rotation, which surprised most of my colleagues (“Not ICU??”). Obviously, I worked during this elective – free time is not my definition of a break (see previous paragraphs) – but the time away from hospitals, patients, textbooks, and projects gave me time to think, to actually sit and reflect (woah…), on what I was feeling.
There was no epiphany, but with time and retrospection, I thought to myself: maybe this is how burnout feels. I don’t know, I have never had it before, and I am not sure if I have had it now. On the other hand, I definitely have never slept so much and still felt so tired, or felt so unmotivated, especially after listening to Tony Robbins or Lewis Howes.
Clearly something had to change. For me, that non-clinical elective was ideal. It provided a short break from patient care and just enough time to re-build some healthy habits. During that time, I also attended (hesitantly) a few “wellness” sessions and discovered things like the Calm app, Saje roll-ons, and the benefits of a grayscale smartphone screen. Nothing magic, but I liked that. I didn’t have to become a “wellness” advocate to appreciate bird sounds and fruity smells. I could just enjoy them and move on.
Most importantly, however, I felt a renewed sense of purpose and desire to return to the clinical setting.
Are things perfect now? Have I found inner peace? Do I read Rosen’s in a cross-legged position on the shores of an empty beach? No. I just wrote this to reflect, to try something I’m skeptical about, to be vulnerable for a moment, and to possibly encourage you to do the same. There was no tragedy or major revelation here, and no one has commented on how radiant I look now (unfortunately). But Fitbit knows that something has changed. Fitbit always knows.
Gerhard Dashi is a PGY1 in Emergency Medicine at the University of Toronto. Having just read “Kitchen Confidential”, he now self-identifies as the “Anthony Bourdain of Wellness”: blunt, disgruntled, refusing to conform with the field, but still willing to accept all of it’s benefits. Especially a travel deal.