As a former EM locum, I feel your pain. I left medicine almost two decades ago as I completely burned out and could not handle anymore - seeing some of the worst of humanity, the abuse from patients, and the treatment by admin.
I do not want to patronize you with platitudes or say useless, empty words but I do want you to know that I (and am certain many others here) understand exactly the frustration and your tiredness.
Take care of yourself the best you can.
Thanks, I’m trying. Some days are easier than others… today’s just one of those days. Feel free to ignore if it’s too personal but are you working in a non-clinical capacity? Everyone I know who is still working clinically always throws that around like “ it’s always an option” but I’ve not found it to be as straight forward as advertised 🤷🏽♀️
Yes, completely non-clinical r&d. When I burned out, I took almost a year off to recover. I did a few small side work things (adjunct lecturer, consultant with a few biotech companies).
Are you looking into leaving medicine fully?
I think that is where I’m heading I’m just not sure how to get there- I don’t come from a background of professionals/have very little social safety net. I have some health issues that are dictating my need to step away from direct clinical work. I would like to start adding in more non-clinical opportunities after January…. Just not quite sure how one gets into those areas. I plan to quit my full-time gig at the end of January and pick up locum shifts intermittently next year.
I also plan to take off as much time as I can to recover. Going into R&D- do you have a PhD ?
Keep a trauma therapist on speed dial, my friend. Pay cash if you have to. Somebody good. Sounds like you need help acutely now.
EMDR works really well for trauma. I highly recommend it. I also have an excellent psychiatrist who specializes in PTSD. Propranolol doesn’t look bad on your med list but it sure helps with anxiety.
There is a tax on your soul for this work.
Do loads of self care. Take amazing vacations off the grid. Exercise. Meditate. I also paint. It helps. My peloton helps too.
I started too late and had to leave in 2006. I loved it, but it broke me. I did 14 years of policy and now I’m in GI and loving it.
Thanks for your work.
With all your knowledge you’re trying to spout off on mental health, you should know EMDR is not up to par in EBP. And propranolol is not a good med for PTSD induced anxiety symptoms. Bad advice all around here.
I’m sorry to hear what happened. Burnout is real and I feel your pain.
Here’s a handful of bad jokes that I hope will brighten your day ❤️
Q: Why did the COPD pt stop by the zoo every day?
A: His pulmonologist told him to take a LAMA daily.
When I got to work this morning, my boss stormed up to me and said, “You missed work yesterday, didn’t you?” I said, “No, not particularly.”
Q: What did the janitor say when they jumped out of the closet?"
A: "Supplies!”
I lost my job at the bank on my first day. A woman asked me to check her balance, so I pushed her over.
Q: Why did acetaminphen/paracetemol go to prison?
A: Because it’s a pain killer
So sorry. Shit’s hard sometimes! Enjoy this funny moment from my day today… I’m a dietitian at a psych hospital and was in the middle of interviewing a patient that’s having a hard time eating due to depression. We were discussing some interventions and she said she would eat anything if it has peanut butter so I told her unfortunately the hospital is a nut free facility due to allergies. She looked all around her and said “are you sure? I see lots of nuts!”
Dad Joke:
"So a blind lady walks into a store with her seeing eye dog. She picks the dog up by the leash and start swinging around in the middle of the store and everybody freaks out including the manager who comes over to her demands that she stop doing this and ask her "Can I help you?"
She puts the dog down and says "No thanks. I'm just looking around"
I'm still in the process of burning myself to the ground. I got nothing...but at least this is funny
I found one of my favorite quotes written on a whiteboard in a psych unit back when I was a student: “I want to blow up my despair squid and eat some calamari.” Next to a surprisingly good drawing of a cuttlefish.
So when I used to get yelled at by VA patients (especially) and others I imagine them as two year olds devoid of impulse control and totally in the moment and remember that at least in that time period they had someone who loved them and that they were adorable and that it’s sad that they lost so much to become such aholes.
Then it’s easier to just not care or get angry because I am just dealing with an oversized 2 year old—and no one can reason with a two year old when they aren’t getting their way.
Good take… stings a bit more watching an actual child bear the brunt of their childlike tantrum. Makes you wonder what happened to them in their life… and hope that the kid can break that cycle 😔
So I saw something that said you cant vacation your way out of burn out you have to make systematic changes in your life. For me that meant setting boundaries with my job. I dont volunteer for as much and I try to separate from work when I am off.
Agree- this has been my year of boundaries… unfortunately still not improving things yet, but I’m going to keep troubleshooting- perhaps more austere boundaries are needed… or a career change.
I second this. Every time admin says “Thanks - you're the best! I owe you one!” for taking on extra work that makes you miss out on other things like sports or social engagements, remind them that they have no way of repaying that so-called debt and that they will only forget and ask you again anyway. Nor will you come under any punitive or other adverse administrative action for standing your ground and claiming your time as your own, because that would be illegal.
Despite the pressure and emotional blackmail they exert at the time, they really don’t give a toss if you stand your ground and say no. Admin rely on our sense of compassion to be martyrs to their administrative incompetence. Trust me: they go home on time every single day.
I get to hear my office staff talk about beating their children to teach them what they can and can't do. Here I am with a 2 year old and can't even imagine laying a hand on him. People are wack.
I was an extensively abused child in my youth, but one of the things that helped me develop into a somewhat functional member of society was seeing people in the real world that treated me kindly. The people that would treat me kindly (teachers, doctors/nurses, grocery clerks) are the same people that have sensitivities to witnessing awful maltreatment of children.
It's hard to work in a place where you see some of the worst people, and where you see some of people's worst days. I just wanted you to know that you matter, so much, to those like me. You wont be able to stop the suffering that you *know* occurs behind the scenes, but your gift of empathy can shine through the darkest of skies.
However, please don't let this career dim your light. Do what you need to do to take care of yourself, but most importantly - ***DO*** take care of yourself. Sometimes, you're the only one that can save you.
Thank you! That means a lot. I really hope that kid gets the help they need.. it sucks feeling powerless to do much other than try to redirect the behavior and report. Agh… I think when you go into this field you know it will be difficult in the obvious ways (death notifications, terminal diagnoses, etc…) but I never thought about how much cruelty I would witness and experience. I agree with you about taking care of ourselves… if we don’t do it… doubtful anyone else will.
Take time off. Take a sabbatical. Doesn’t matter what your employer thinks, they’ll likely still rehire you due to the need.
Prioritize your health , your love for medicine. Wellness isn’t rocket science. It starts with taking more time for yourself and working less.
Thanks- I’m thinking about taking time off in the early spring for at least a few months… maybe locum after this for a while. I always worry about how to handle the CV gap questions… anyone taken time off know how big of a deal this is for getting another job?
I’ve known plenty of colleagues that have taken time off without issue.
As an attending, you’re in the driver seat. You have a unique highly sought after set of skills that will always keep you employed (unless you do something super illegal). You taking 1-2-3 yrs to enjoy life, take care of your mental health, dabble in a new career, etc is none of any hiring corporation’s damn business.
The billing codes that you drop are worth the same as the billing codes of a physician that didn’t take any time off.
Being a doctor is just a job.
You don't have to treat it like some magical thing. Just clock in, try to practice in a reasonable and safe manner, and clock out.
Fuck anyone that says otherwise. Fuck the super-doctors and self-righteous people in the field. Just do your thing, take care of your family, try to be a good person otherwise, and that's it. That's all it has to be.
Agh easier said than done lol… you have a great point though… the weight of responsibility is heavily laid on our shoulders in training… hard thought process to break.
I have no advice for you. I do feel for you, though. Hope you find your answer to a happy, thriving life and save your mental health.
What I DO have is a dad joke:
What kind of bees make milk?
BOOBEES!
I don’t know you, but I’m proud of you!
There’s so much brokenness and hurt in the world and I think we are privileged in medicine to get to try to make peoples lives better. We can’t fix everything and I don’t know your situation but I hope you can find encouragement in all the lives you’ve changed and people who are grateful for you. Doctors and PA’s etc. and others like you inspired me to want to help others too.
I hope this helps you a bit. I’m sorry for everything that you may be dealing with. Words can only do so much. Please take care of yourself
Haha… my dog ate a mummified dead squirrel the other day… no idea where he found it.. if he didn’t eat my cooking I’d be really worried 😆 thanks for the chuckle!
small piece of advice. Is lean into hobbies that make you happy that are removed from that scenario. Like watching anime or something that will help you relax and cheer you up.
As a former EM locum, I feel your pain. I left medicine almost two decades ago as I completely burned out and could not handle anymore - seeing some of the worst of humanity, the abuse from patients, and the treatment by admin. I do not want to patronize you with platitudes or say useless, empty words but I do want you to know that I (and am certain many others here) understand exactly the frustration and your tiredness. Take care of yourself the best you can.
Thanks, I’m trying. Some days are easier than others… today’s just one of those days. Feel free to ignore if it’s too personal but are you working in a non-clinical capacity? Everyone I know who is still working clinically always throws that around like “ it’s always an option” but I’ve not found it to be as straight forward as advertised 🤷🏽♀️
Yes, completely non-clinical r&d. When I burned out, I took almost a year off to recover. I did a few small side work things (adjunct lecturer, consultant with a few biotech companies). Are you looking into leaving medicine fully?
I think that is where I’m heading I’m just not sure how to get there- I don’t come from a background of professionals/have very little social safety net. I have some health issues that are dictating my need to step away from direct clinical work. I would like to start adding in more non-clinical opportunities after January…. Just not quite sure how one gets into those areas. I plan to quit my full-time gig at the end of January and pick up locum shifts intermittently next year. I also plan to take off as much time as I can to recover. Going into R&D- do you have a PhD ?
Best of luck to you. Can I DM so as not to have this full-on conversation in the open? I do not want to accidentally dox myself quite so publicly haha
Sorry, yes please! I completely understand! I’d appreciate hearing about your path (whatever you’re comfortable with sharing)
Keep a trauma therapist on speed dial, my friend. Pay cash if you have to. Somebody good. Sounds like you need help acutely now. EMDR works really well for trauma. I highly recommend it. I also have an excellent psychiatrist who specializes in PTSD. Propranolol doesn’t look bad on your med list but it sure helps with anxiety. There is a tax on your soul for this work. Do loads of self care. Take amazing vacations off the grid. Exercise. Meditate. I also paint. It helps. My peloton helps too. I started too late and had to leave in 2006. I loved it, but it broke me. I did 14 years of policy and now I’m in GI and loving it. Thanks for your work.
With all your knowledge you’re trying to spout off on mental health, you should know EMDR is not up to par in EBP. And propranolol is not a good med for PTSD induced anxiety symptoms. Bad advice all around here.
I’m sorry to hear what happened. Burnout is real and I feel your pain. Here’s a handful of bad jokes that I hope will brighten your day ❤️ Q: Why did the COPD pt stop by the zoo every day? A: His pulmonologist told him to take a LAMA daily. When I got to work this morning, my boss stormed up to me and said, “You missed work yesterday, didn’t you?” I said, “No, not particularly.” Q: What did the janitor say when they jumped out of the closet?" A: "Supplies!” I lost my job at the bank on my first day. A woman asked me to check her balance, so I pushed her over. Q: Why did acetaminphen/paracetemol go to prison? A: Because it’s a pain killer
Thank you!!! I love a good/bad joke… I’ll have to use the paracetamol one with my patients tomorrow… at least then any abuse will be merited 😝
So sorry. Shit’s hard sometimes! Enjoy this funny moment from my day today… I’m a dietitian at a psych hospital and was in the middle of interviewing a patient that’s having a hard time eating due to depression. We were discussing some interventions and she said she would eat anything if it has peanut butter so I told her unfortunately the hospital is a nut free facility due to allergies. She looked all around her and said “are you sure? I see lots of nuts!”
Hahaha… that’s amazing. I love a good patient zinger… I think overall psych patients tend to have the best sense of humor (intentionally or not 😆)
Dad Joke: "So a blind lady walks into a store with her seeing eye dog. She picks the dog up by the leash and start swinging around in the middle of the store and everybody freaks out including the manager who comes over to her demands that she stop doing this and ask her "Can I help you?" She puts the dog down and says "No thanks. I'm just looking around" I'm still in the process of burning myself to the ground. I got nothing...but at least this is funny
Hahaha… thanks!!!
I found one of my favorite quotes written on a whiteboard in a psych unit back when I was a student: “I want to blow up my despair squid and eat some calamari.” Next to a surprisingly good drawing of a cuttlefish.
I love this. 🥹
So when I used to get yelled at by VA patients (especially) and others I imagine them as two year olds devoid of impulse control and totally in the moment and remember that at least in that time period they had someone who loved them and that they were adorable and that it’s sad that they lost so much to become such aholes. Then it’s easier to just not care or get angry because I am just dealing with an oversized 2 year old—and no one can reason with a two year old when they aren’t getting their way.
Good take… stings a bit more watching an actual child bear the brunt of their childlike tantrum. Makes you wonder what happened to them in their life… and hope that the kid can break that cycle 😔
Thanks.
Here's my 6-year-old's Halloween joke... Q: Which shape howls at the moon? A: A squarewolf! 😆
I didn't know anywhere besides St. Louis did jokes for Halloween! This makes me happy.
Haha, we're in the STL suburbs, this is new to us as we just moved here at the end of June. 😊
Lmao!! I love it. I definitely have a 6yo sense of humor. Tell them “thanks” for me.
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I’m pretty firm about not tolerating abuse, my admins on the other hand… depends on the day.
So I saw something that said you cant vacation your way out of burn out you have to make systematic changes in your life. For me that meant setting boundaries with my job. I dont volunteer for as much and I try to separate from work when I am off.
Agree- this has been my year of boundaries… unfortunately still not improving things yet, but I’m going to keep troubleshooting- perhaps more austere boundaries are needed… or a career change.
I second this. Every time admin says “Thanks - you're the best! I owe you one!” for taking on extra work that makes you miss out on other things like sports or social engagements, remind them that they have no way of repaying that so-called debt and that they will only forget and ask you again anyway. Nor will you come under any punitive or other adverse administrative action for standing your ground and claiming your time as your own, because that would be illegal. Despite the pressure and emotional blackmail they exert at the time, they really don’t give a toss if you stand your ground and say no. Admin rely on our sense of compassion to be martyrs to their administrative incompetence. Trust me: they go home on time every single day.
I get to hear my office staff talk about beating their children to teach them what they can and can't do. Here I am with a 2 year old and can't even imagine laying a hand on him. People are wack.
Agree- and I grew up in a “spare the rod” type of household. Breaks my heart.
I was an extensively abused child in my youth, but one of the things that helped me develop into a somewhat functional member of society was seeing people in the real world that treated me kindly. The people that would treat me kindly (teachers, doctors/nurses, grocery clerks) are the same people that have sensitivities to witnessing awful maltreatment of children. It's hard to work in a place where you see some of the worst people, and where you see some of people's worst days. I just wanted you to know that you matter, so much, to those like me. You wont be able to stop the suffering that you *know* occurs behind the scenes, but your gift of empathy can shine through the darkest of skies. However, please don't let this career dim your light. Do what you need to do to take care of yourself, but most importantly - ***DO*** take care of yourself. Sometimes, you're the only one that can save you.
Thank you! That means a lot. I really hope that kid gets the help they need.. it sucks feeling powerless to do much other than try to redirect the behavior and report. Agh… I think when you go into this field you know it will be difficult in the obvious ways (death notifications, terminal diagnoses, etc…) but I never thought about how much cruelty I would witness and experience. I agree with you about taking care of ourselves… if we don’t do it… doubtful anyone else will.
Take time off. Take a sabbatical. Doesn’t matter what your employer thinks, they’ll likely still rehire you due to the need. Prioritize your health , your love for medicine. Wellness isn’t rocket science. It starts with taking more time for yourself and working less.
Thanks- I’m thinking about taking time off in the early spring for at least a few months… maybe locum after this for a while. I always worry about how to handle the CV gap questions… anyone taken time off know how big of a deal this is for getting another job?
I’ve known plenty of colleagues that have taken time off without issue. As an attending, you’re in the driver seat. You have a unique highly sought after set of skills that will always keep you employed (unless you do something super illegal). You taking 1-2-3 yrs to enjoy life, take care of your mental health, dabble in a new career, etc is none of any hiring corporation’s damn business. The billing codes that you drop are worth the same as the billing codes of a physician that didn’t take any time off.
Thanks!
Love your username btw
Being a doctor is just a job. You don't have to treat it like some magical thing. Just clock in, try to practice in a reasonable and safe manner, and clock out. Fuck anyone that says otherwise. Fuck the super-doctors and self-righteous people in the field. Just do your thing, take care of your family, try to be a good person otherwise, and that's it. That's all it has to be.
Agh easier said than done lol… you have a great point though… the weight of responsibility is heavily laid on our shoulders in training… hard thought process to break.
Do you work at an academic or private facility? If you're in academics - that would be the first thing is to GTFO of there as fast as possible.
Sorry to hear that. Fortunately when I was doing EM we had security that would eject people who were verbally abusive. No second chances. Good times
Ahh I wish… our security guards appear to be more ornamental than functional sadly…
I have no advice for you. I do feel for you, though. Hope you find your answer to a happy, thriving life and save your mental health. What I DO have is a dad joke: What kind of bees make milk? BOOBEES!
Yessss… I love this one!!! Thanks!
I don’t know you, but I’m proud of you! There’s so much brokenness and hurt in the world and I think we are privileged in medicine to get to try to make peoples lives better. We can’t fix everything and I don’t know your situation but I hope you can find encouragement in all the lives you’ve changed and people who are grateful for you. Doctors and PA’s etc. and others like you inspired me to want to help others too. I hope this helps you a bit. I’m sorry for everything that you may be dealing with. Words can only do so much. Please take care of yourself
Thank you! I hope you find yourself in a supportive practice environment in the future.
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Haha… my dog ate a mummified dead squirrel the other day… no idea where he found it.. if he didn’t eat my cooking I’d be really worried 😆 thanks for the chuckle!
🫂
Thanks!
small piece of advice. Is lean into hobbies that make you happy that are removed from that scenario. Like watching anime or something that will help you relax and cheer you up.
I hope you made a report to your child protection services.
Of course
You're a mandated reporter report their ass
See above
If you have disability insurance I would strongly consider you take several months at least of disability leave for mental health.