Fighting burnout is a daily struggle
Sharing this because so often what we show on social media is our put together super achieving selves. But the truth of the matter is we all have our daily struggle, and many of us struggle with energy expenditure versus energy restoration. So I’m sharing some personal struggles and insights to remind anyone in a similar place, that we all have to put on our oxygen masks first. And it is 100% okay to do so.
Burnout is an important topic these days. The COVID-19 pandemic brought to the forefront the inadequacies of our healthcare system as well as the insufficient support for those who work to help save lives of the most vulnerable and sick in our society, illustrating healthcare worker burnout on a level greater than before. It extends beyond healthcare workers, however, and into all of society. We have experienced the great resignation as people look for something more with their lives. We are inundated with the greatest challenges of history (incredible societal divisions amplified by media and social media systems that divide us rather than unite us to take on global warming, conquering the pandemic, and the perpetuation of racial inequities, as well as an unjust war in Europe).
I think for many of us — in and outside of healthcare — we feel a sense of wanting to make a significant contribution to the world. And when we feel stifled or unable to do so, or we fail to live up to our own expectations in this regard, that this is a major accelerant to the fires of feeling burnt out. We cannot wait for others to solve the problem. We will not be saved right now by others. Mark Zuckerberg and Facebook does not have our mental health in mind with the upgrades to their platform. We cannot wait for our CEO, or President Biden or Congress to make the changes necessary to protect our mental health right now. We do need them to help us confront and take on these challenges (the stressors) and affect real change, but we also need to be able to deal with the stress of the moment right now and preserve our health.
As I have a written about before, it is so important to take care of ourselves, and honor of the pillars of health not only when we advise our patients, but also when we tend to our own needs. It’s like you gotta put the oxygen mask on yourself before you put it on the kid next to you. But so often, perhaps due to personality type of being of the ilk to serve others ahead of ourselves, or because of how we were raised, in the system where you sacrifice yourself through residency and then fellowship, and then give up your own sleep on 36 hour shifts we often put our own oxygen mask on last.
These past few months, our nonprofit entered a really exciting time. It is our 10-year anniversary and we are taking a hard look at what we’re doing and where we want to be headed. Putting this together required a lot of work behind the scenes, and ongoing work under the hood. This is work that is so necessary, and so fulfilling, but also for lack of a better description — emotionally dense. The reason for this is because we are doing what we can to serve people in need. And so of course that is fraught with responsibility and accountability. In addition, personally it continues to be a challenging time at work. We are still working in a pandemic, and the nature of my field is that people can be very sick. Some have gotten more sick due to inability to access care during the pandemic. And these are people that we have grown to love. These are people that you take care of for years, so we cannot help but feel it when they get sick with COVID-19 or when their disease gets worse. It breaks ones heart.
So the past month, my training in my own health suffered. January was like lightning. My fitness was getting better. I put my training first and seemed to accomplish what I needed to do at work. I felt on top of the mental acuity and mindfulness. And I saw the progress (getting fitter). I felt the progress (leaner, stronger). And then February became a return to the bad habits. Suddenly, like an alcoholic taking their first sip of alcohol and then returning to drinking, a workaholic/perfectionist can return to somewhat destructive bad habits of martyrdom complex and start saying things like, “Just one week off. I’ll get back to training as soon as we’re done with the summit.“ And then “I’ll get back on my bike as soon as we are done with Grand Rounds. “ And soon you find yourself running from fire to fire, neglecting to do the right things for your own health. And so what happens: You lose sleep (too many nights getting up at 2 AM and deciding to might as well work), you start to eat poorly seeking energy replacement or escape, and definitely don’t have the energy to exercise. I have at least gone for a walk every day to move my body, but definitely lost the ground from January.
And then it slips to thinking “How can I ever expect to be an athlete?” And “I just need to be a doctor. There are more important things than riding my bike.” And you lose perspective. In the moment, nobody else will come in and tell you otherwise. Most people outside of ourselves don’t see the full picture to know they could. So the pattern perpetuates itself. Until we ourselves choose to stop it. How do we stop it? How do we apply the tourniquet to stop the bleeding of our own life energy.
New month, new week, new day. Be a friggin’ goldfish and let’s go.
We take a step back. Make an honest self assessment. Set our top goals, and in that top goal list put our own health. That’s how. And then we choose tactics to go after it.
So now, with the beginning of March, and with my friend and I having completed Grand Rounds (which was a blast, by the way), in addition to all of the summit work in clinical work, it is time to reset. Oxygen mask. Health, exercise, sleep, nutrition, and then clinical work, program work, and the nonprofit. I’m telling myself right now: Take care of yourself. Do what you can each day and then be done. Rest and recover. And ask for help. And health first and then the rest (and not the other way around). And I’m going to set some weekly metrics to hold myself accountable here. Let’s see how it goes.
Life is short. We all will die. We have to enjoy the gift of time we have and doing what we’re doing while we’re doing it. There can be joy in struggle (see ultra endurance racing in the dictionary). And my hope is that with this hard work that maybe there will be something positive left behind on this world after I’m gone. That in some way, I helped make something even a little bit better. But each and every day, as we live out whatever we are called to do, we have to fight for our own health. We have to go for those pillars of health: sleep, fuel, exercise, and mental health. We have to surround ourselves with people who are loving and supportive, and be judicious with who we put in our crew vans. And at the end of the day, if we take care of ourselves, we will so better serve others. We can then work to advocate for the systemic change we all need. We can better take care of our patients, friends and family. We will be even more effective in this race to make a difference in the lives of others.
Write it on your heart
that every day is the best day in the year.
He is rich who owns the day, and no one owns the day
who allows it to be invaded with fret and anxiety.
Finish every day and be done with it.
You have done what you could.
Some blunders and absurdities, no doubt crept in.
Forget them as soon as you can, tomorrow is a new day;
begin it well and serenely, with too high a spirit
to be cumbered with your old nonsense.
This new day is too dear,
with its hopes and invitations,
to waste a moment on the yesterdays.
― Ralph Waldo Emerson, Collected Poems and Translations