I was approaching 24 hours in the hospital and waiting for my partner to come into my operating room so we could do “hand-off.” That’s when I spend 15 minutes going over all of the events of the surgical case and explain my patient’s health history, his current status, my current treatment strategies, the heart ultrasound findings, and our plan for the rest of the case. As I was awaiting my colleague’s arrival, I received a text from my son.
AP: Mom, S hit me.
Me: Why? Can you please be nice to each other? I will be home soon.
AP: We need to make lunches, when will you be home? Are you taking us to school?
Me: Pls make sure everyone is awake and make lunches stat
AP: S2 is still asleep. He’s refusing to wake up.
Me: Can you PLEASE wake him up and make lunches. Also, get the papers on the island ready to hand in — they were there two nights ago.
Two nights ago, the last time I was awake in my house.
In comes my partner, and we chat. I tell him about my night since I have last seen him and the patient in my care. We review the anesthesia record and the current surgical state. I say goodbye to the surgeon, the third one I have worked with in 24 hours. He thanks me for my help through the night and wishes me a good day. I wonder when the case will end, and when he will get some rest. He is a friend and we look out for one another.
I do a five-minute change and rush home, going into mom mode. I call home on the way and put out sibling fires and rally the sleepy preteen over the phone. When I arrive, AP (my second oldest and “the Commander”) has delivered: everyone is dressed, half-eaten cereal bowls show evidence of breakfast, and there are water bottles and lunches being thrown in backpacks. I kiss everyone hello and tell them I have missed them. I drive them 15 minutes to school and hear about yesterday’s events and today’s plans. They exit the car, and I kiss them again. A little pang goes off in my heart; I just said hello, and now I am saying goodbye.
This is your physician.
When I finally get home, I try and decide: sleep, shower or coffee? And in what order? Should I empty the dishwasher, go through the mail or just ignore it until later? Should I catch up on emails, or crash into a few hours of sleep? The dog is following me around, whining. He has missed me. Should I run errands? After al – I’m awake. I see a list of groceries my husband has left me … we are out of coffee.
God bless America.
This is a very typical day in my life and in most physicians’ lives. And I recognize this does not just happen to doctors; it happens to many of us who work in areas like health care, emergency service personnel, military and law enforcement. We feel honored to care for other’s sisters and dads and brothers and friends, yet we are all of those things to others, and find it a difficult balance.
In the last two years out of complete necessity, I have studied professional burnout. After experiencing clinical burnout myself and nearly quitting the practice of medicine, I knew I needed to get a handle of my professional and work life integration. I don’t use the term “work-life balance” anymore. I recognized that the 10-year quest for “balance” left me empty, defeated and more stressed than ever.
So this is what I did:
I embraced the suck.
Literally and figuratively.
I stopped trying to be a “doctor” at work and a “mother” at home. I am both. All the time. And they are integrated. I stopped worrying that if I talked to my son about his homework over the phone at work and someone heard me they wouldn’t think I was serious about my job because I am a woman “momming” at work. I stopped trying to hide in my bedroom to answer a consult at home or help someone who needed me at the hospital on the sidelines of the soccer field. I just embraced that I was both of those things, and people who respected me would have to as well.
I am Dr. Shillcutt. I am mom.
How freeing is that?
I can tell you that burnout, in any profession, will steal your empathy and your innovation and, well, YOU. You will feel less engaged, less motivated, physically and emotionally exhausted, and start to withdraw. It is a dangerous path and can lead to very costly problems for individuals, institutions, and your family. Over 50 percent of physicians report burnout, and the suicide rate is 1.5-2.3x higher in physicians than the general population. This is a real problem, and one I try and address in my little area of the world.
For me, when I started embracing that my work would flow into home and my home would flow into work suddenly my work became much more manageable. Now, do I answer questions about homework during an emergency at work? Of course not. Do I answer phone calls from work when my son is about to take a penalty kick? Heck no, I am cheering on the sidelines and it can wait 10 minutes. Do I have best friends who I also work with that I meet and have coffee with and decompress about a case that I’m struggling to let go of? Absolutely. Do I invite my mother to hear me speak professionally, so she can understand what I do? Absolutely. Do I write manuscripts on the sidelines of soccer practice when I have down time? Of course.
It is important to leave work and be a sister, a friend and a dad. It is important to shut down devices and decompress and connect with your loved ones. I’m not promoting a 24/7 work life. I am promoting embracing the fact you are ONE. One person, who is many things. And it is OK to be all of yourself — at all times. My patients and my work colleagues deserve my best self. That person is a mom, a wife and a friend.
When I stopped trying to separate everything, it took a huge amount of pressure off of me professionally. I don’t apologize when I am at work and my child needs me. I also don’t apologize when I am at home and a patient does. And what I have found is that I have developed resilience and respect from my colleagues by being fully me.
I now speak professionally on burnout and overcoming professional failure. I help others develop skills and learn how to navigate integration of their work and personal life. Let’s stop judging people; rather let’s encourage them to be their whole selves. Not half and half — whole.
It is where freedom lives.
Sasha K. Shillcutt is an anesthesiologist who blogs at Brave Enough.