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Every month More Voices invites readers to contribute short nonfiction prose pieces of 40 to 400 words on a healthcare theme.

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Stress and Burnout

Sertraline for Diabetes

 

She was here for her diabetes.  Her blood pressure was high, she said, because she expected me to scold her.  She hadn’t brought her log, but her sugars were in the 200s overall.  Not good.  She hadn’t been exercising, but she had been taking all her medications.

Again we talked about options: cut out carbohydrates, increase exercise, add medicines.  She admitted a predilection for bread, and I talked about mood eating: how stress can drive us to eat.  She smiled back at me, shaking her head.  I mentioned our counselors and the option of coming just to talk.  She shook her head again, but her smile broke and her eyes closed.

Her one son, whom she brought here as a six-year old, had been deported back to a country he doesn’t know, where he has no one, where life is dangerous.

Expectations

 
Before the start of every school year, from the time I was nine up through middle school, I would make the same school-year resolution: to become shy.

I have always been too enthusiastic. Out of all my classmates, I sang the loudest at birthdays, I laughed the longest at jokes and I asked more questions than anyone else. In fifth grade, a firefighter visited my class; after I'd asked my third question about how fire suits actually work, I remember hearing some classmates groan and seeing my friend Thom lift his arms up and, in mock agony, flop down on his desk. I tried to be shy, really. I would go for a few days sitting on my hands during lessons, but, inevitably exhausted by my inauthenticity, I would soon find my excitement uncontainable once more.

Choices

 
My current life as a locum tenens--a doctor who travels around to fill in for vacationing or ill physicians--is lonely. I spend endless days in hotel rooms, away from my family. But I chose this existence as an antidote to the professional exhaustion that threatened to end my surgical career. Regular panic attacks, maladaptive coping behaviors and compassion fatigue had turned me into a person I did not like or recognize.

Reverse Burnout

 
I have a long commute to the hospital where I work. I've been doing this for a long time and have thought about retirement. So when I'm stuck on the turnpike in morning rush-hour traffic, when it takes me 60 to 90 minutes to get in to work, I often say to myslf, "Why am I doing this? Why not just quit, retire and enjoy life at home? I don't need this aggravation."
 

My Puzzled Self


“It is no measure of health to be well-adjusted to a profoundly sick society.” -Jiddu Krishnamurti

How many times have I tried to begin writing about my experience of stress and burnout?

I’ve lost count.

Each time I begin to write, detachment renders me into pieces like a jigsaw puzzle. Where are the straight edges? Where is the frame? What is supposed to be where all of these empty spaces are? Where is the box lid with a picture to guide me?

A few years ago the medical library where I had worked for six years relocated from a building outside the hospital to a space inside the busiest area of a busy hospital. Prior to the relocation, I rarely entered the hospital or did so only when my energy felt sufficient to handle whatever I might see, hear or smell. It helped that I worked an evening schedule. After 5:00 p.m. the hospital was almost unpopulated.

Confessions of a Recovering Insurance Addict

 
When I hear other physicians talk about burnout, I often feel a little guilty. Sometimes I sit in meetings of physician associations where they are discussing ways to help physicians deal with the stress of the job and the increasingly complicated demands for documentation and billing. I think to myself, "Don't physicians always talk about prevention being better than treatment?" Yet most of what I hear about are measures to deal with the aftermath of burnout.

Seventeen years ago, I was in an environment seeing thirty patients per day, spending more time on documentation than patient care, and longing to focus on just spending time with my patients. I hated the rushed appointments, the endless coding and the administrative burdens. I interviewed practice managers, read a lot of practice managment magazines, and interviewed a lot of physicians. One thing was clear: 99% of the frustrations came from filing insurance.

Weary and Wishful

 
I was living just two blocks away from my parents, but I spent more time at their condo than I did at my apartment. I shopped for them and cooked, cleaned, and did laundry for them. I took them to appointments. I tried to help them lead lives of quality. Every night I went home feeling tired--after all, I was in my sixties--but also feeling glad that I could support them after all the years they had supported me.