In my first post in this two-part series, I presented an argument for why physicians and administrators need to work together to develop small-scale interventions to bring meaning to medicine while we continue to push for larger systemic change. In this post, I will explore some effective (and some less effective) themes for interventions for residents.
Of all the fulfilling and purposeful vocations to pursue, we’ve ended up trying to find our footing in the vast and ever-changing maze of medicine. Propelled by some combination of privilege, perseverance, and circumstance, we became doctors — many of us with the noble drive to heal and support other humans through the physical and spiritual struggles of life.
I am very pleased to welcome you all to a new academic year at the esteemed institution at which you find yourself, perhaps somewhat unexpectedly, thanks to the Match. Late June is always somewhat bittersweet, but it is a simultaneously exciting time in the academic year.
After reading the title of this article, you may think that I am one of those hospital higher-ups trying to peddle “social hour” as a miraculous cure for burnout rather than an ineffective band-aid on a broken system. I can assure you, I am not. I am one of the residents on the front lines.
My wife and I were preparing to move overseas so I could begin medical school in Israel. We both wanted children young. I grew up as one of five siblings, and we looked forward to a big family. I knew that having kids would change my medical education experience, but I had no idea how grateful I would be for the advice I received that sunny spring day in Alabama.
During my fourth year of medical school, I was completely unaware that I was suffering from clinical depression. Even now as I write this, I struggle to put my finger on how it all started. Was my appetite the first thing to go? Or the loss of enjoyment in socializing and sex? Maybe it was all three at once. It is truly too hard to tell.
Last May, Evan matched into a fellowship that will take him across the country for a year, beginning in August. Because he’s a little bit off in the head, he chose subspecialty training that will likely entail even longer hours than residency at the same pay scale.
Nurses in New York City are pushing back against hospital systems that put profits over patients and threaten their efforts to strike for safer staffing ratios. While nurses are fighting, physicians have thus far remained on the sidelines of this struggle.
Two months ago, I woke up one morning at 5:30 a.m., as usual. I played my gym motivation playlist in the shower, ate oatmeal for breakfast, and headed out the door, as usual. I swore at the car that swerved into the lane in front of me without signaling, as usual. An hour later, I pre-rounded on one of my favorite patients, a man with wide, childlike eyes who had a great deal of difficulty expressing his feelings.
My partner Evan’s third year of residency completed his trajectory toward what is commonly called “burnout.” Two out of the 10 residents in his class left the program. In an already understaffed department, the remaining residents picked up the slack, taking extra call and working longer days. The general misery index among his cohort skyrocketed.
Overwhelmed and exhausted, a resident recently came to me to ask, “Can we do something about call?” Defeat and despair had taken over his psyche. He felt unable to cope with the tasks of residency, including the seemingly never-ending demands of fielding consults, pages and patient needs. He imagined that the problem could be solved by taking less overnight call.
The faint glow that is the light at the end of the tunnel hits my face as I realize that intern year is almost over. One would think that having been through the personal loss I have — losing two beloved older brothers at a young age — that intern year would be more than manageable. Yet this past year has been, for me, a chaotic roller coaster ride.