Physicians Anonymous

Dr Beethoven

Dr Beethoven: An ED Doctor’s Burnout Story (Part 2)

(For the beginning of the story, read Part 1.)

Eventually my spouse and I made several big changes and I’m happy at work for the first time in many years.

Why am I happy now?

Eventually my spouse and I made several big changes and I’m happy at work for the first time in many years.

Changes in our life circumstances allowed us to make these moves unencumbered. I completely understand how at the age of 45 you might feel “trapped” with kids in school and aging relatives to look after. Many of you are on the treadmill of 50-60 hour weeks, mortgage, car loans, school loans, private school or college tuition, club membership, etc. Our kids are on their own now and our aging relatives have passed. I’m glad we were there for all of them and now I’m glad we uprooted and started fresh.

Could we have uprooted sooner? Yes.

This would have required our relatives to move with us since we were the primary caretakers. This makes moving significantly more complicated but not out of the question. I was willing to be patient. I wasn’t depressed or suicidal and I functioned well at work. Knowing relief was coming made a difference to me. So we waited.

Change something

If you are depressed, having significant emotional distress, not functioning well at work, or just chronically unhappy, you need to do something to rectify this. There are doctors who have entered coaching, counseling, or therapy, made modest changes in their lives, and become happy again.

If you are depressed, having significant emotional distress, not functioning well at work, or just chronically unhappy, you need to do something to rectify this. There are doctors who have entered coaching, counseling, or therapy, made modest changes in their lives, and become happy again. The path I chose will not be right for everyone. I did much more than change my address.

My spouse and I were in full agreement about the state and county where we wanted to live. Over three years (I had the luxury of being patient) we looked at communities and finally settled on a short list of three options. Then, and only then, I began looking at urgent care jobs, knowing that the job I would like may require travel. The job was secondary but not unimportant.

We now reside in a small town and live relatively simply. I’m more likely to encounter my neighbors and friends at the hardware or ice cream place than some fancy event. Getting live bait is an occasional worry but not much else. I drive to a larger city and work at an urgent care about ten days a month. I often get seven days off in a row without asking. I still see some sick patients but without the usual drama that comes with EMS, police, boarding, and psychiatric clearance. A big thing for me is no more nights. On a perfect day for me (and this is most) I only talk to nurses and patients and rarely am I interrupted. And when our administrator stops by, he always asks me what he can do for me. And he means it.

Do we need opulence?

Kids may do fine in public school. Is the Ivy League really necessary? Do you need a $40,000 car? Do you need a 4500 sq ft home? Do you need to belong to a country club. Do you need to vacation in Europe? Do you place your happiness and mental health below these things?

I’m nearing the end of my career and have “put in my time” in the ED. But who says any of us must put in our time. One of the docs in my group is in his 30s. He’s happy. He sees and knows his kids. He’s putting in the time that works for him and his family. I should have been so enlightened in my 30s.

If you are considering uprooting, this should be well-planned and priorities should be reset. You may be at a point in your career where don’t live an extravagant lifestyle. Others may live in opulence. Either way there will always be some expenses that can be trimmed.

Kids may do fine in public school. Is the Ivy League really necessary? Do you need a $40,000 car? Do you need a 4500 sq ft home? Do you need to belong to a country club. Do you need to vacation in Europe? Do you place your happiness and mental health below these things? Do you really care what anybody outside your family thinks about your life?

The decisions we make

I’ve lived in three states. Is moving a hassle? Darn right. Is it expensive? Darn right. Would I do it again? Darn right. Our lives have been fuller for having friends and experiences in various cities and states. The hassle of moving is long forgotten after you settle in and make new friends. Plus, you are forced to sell or give away all the junk you don’t need. Do I miss our cherished friends we left behind? For sure. But we visit each other.

So I changed jobs, changed states, and I changed my spiritual life. I mention this because there must be more than work and family. It doesn’t have to be religion, but it was for me. I don’t just attend services. I’ve gotten to know the clergy and we are friends. I’m working hard to meet other parishioners and participate in church life. This has become very important to me. Maybe for you it’s a service club or a hobby such as photography.

The finite hours.

The decisions we make.

Long-term happiness

We all do tasks that in the short-term make us relatively unhappy. I didn’t really want to work that Saturday but I did it to help out. I didn’t really want to spend a weekend at the summer baseball tournament but I knew our son wanted to be there. That’s part of family and work life. Long-term happiness is another matter. If every day is a struggle, start the conversation with your spouse and children. There is a solution, and just like most things in life, everyone is going to need to give up something.

Your family may not know you are unhappy. Or they do and are afraid to raise the issue. My spouse was surprised when I revealed, after leaving a job, that I was always tired when I worked there. Whatever you do to improve your life, spend the time to make good decisions. Research your options. Talk to your family. Possibly someone else is unhappy and would welcome change.

I spent time with a former partner recently. We worked together early in my career. That job was extremely important to me and our group enjoyed great success turning around a flagging emergency department. Except for him, there is nobody left at the hospital who remembers me. Like I was never there.

That job was extremely important to me and our group enjoyed great success turning around a flagging emergency department.  Except for him, there is nobody left at the hospital who remembers me.  Like I was never there.

Chew on this for a few days, re-read this essay and start the conversation.

I’m not a counselor or coach, but I’m happy to talk with you via your comments.

Blessings and peace to you and your family.

Dr Beethoven

Dr Beethoven

I practiced full-time emergency medicine for 31 years. I am writing not because of my own current burnout, but because I made it to the other side without abandoning my medical career.

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