Right now, I may be in a void of doing; but at least, I am no longer in a void of being. Physician shame is real. Avoiding help is too. Here’s one physician’s story from the heart.
Back in March 2021, it was a different story. Like a TV show I’d seen in which aliens invaded and controlled the behavior of human beings, I was invaded and controlled by the default program of blindness. Soul blindness.
I was blind to my needs, blind to my limitations, blind to my pain, blind to my unwellness.
One Sunday morning that month, I asked my husband to take the kids out so that I could “catch up” on charts and pending results. Catch up? That was masking the truth. What I really meant was: make a quasi-invisible dent in my workload.
He gathered up the kids, and after their muffled voices disappeared behind the front door, there was silence. Capital S silence. I stood up, made a coffee and sat down dutifully at my desk. Every fiber of my being ached deeply in resistance. Somehow, my body knew that working more was not what I needed.
I did not understand the message, therefore I did not listen to it. I was concerned with being dutiful – I am a physician, people are depending on me to carry out my responsibility, I “need/must/should” work. Irrespective of how I feel, right? How I feel is neither a rational nor productive variable in the equation of work.
However, when I started scrolling through my outstanding charts and results on the EMR, something happened. Resistance hijacked me. I couldn’t look at the EMR anymore – my body was drowning out the call of duty. Crazed tears started streaming down my face, but I still didn’t understand what I needed. I switched tabs and searched on Google: “other careers for doctors.” I spent the next two hours sobbing and reading stories about alternative careers and blogs written by doctors who were also unhappy in clinical work.
When my family came home, I told my husband that I had been unable to work. I might have verbalized the idea that I needed to change careers. I went outside to sit on the steps and called a very close friend, who happens to be a physician.
She said: “You know, I think you need to speak to your family doctor and take some time off. I think it’s one of the signs, you know, when you start wishing you had another career.”
I didn’t ask a sign of what. I knew what she meant. Burnout.
Awareness didn’t merely wash over me; awareness rammed into me, into the pit of my stomach, and lodged itself there.
Faced with her words, I now had to accept that something was wrong. But… what was wrong? If something was wrong, then it must be wrong with ME.
My automatic thoughts went something like this: I’m unfit for medicine, I can’t handle stress, I’m not efficient, I can’t manage my time, I’m too perfectionistic, I’m too weak, I value the whole person too much for modern medicine. There is something wrong with me and because of that, I have failed. I have failed as a doctor. I am a defective doctor. I am the only defective doctor.
This is called shame. Shame makes us believe that the failure is us and that it is our fault. It keeps us stuck in a place of painful isolation and exile. It doesn’t allow us to budge – not even to call out for help – because then, we fear, we will have to endure public humiliation in addition to private shame.
Unable to bear the shame of being the “only defective doctor”, I resisted and resisted.
No, I told myself, I don’t need time off, I can’t take time off. Read: if I take time off, everyone will know that I’m unfit for medicine; I can’t handle that physician shame. So instead, I compromised with the awareness lodged in the pit of my stomach and decided that I would make an appointment with my family doctor. I told myself I was doing that out of respect for my husband and my friend. But I won’t take time off and I won’t call the physician’s help program!!
This is where the story changes gears. I have the utmost and absolute trust in my family doctor. The compassion and understanding she had displayed to me under other circumstances had sealed the deal: she was on my side. Because of this trust, when I did have the appointment, I was able to tell her what was going on. I concluded with: “But I don’t need to take time off, I just need to decrease my workload.”
She said something along the lines of: “I suggest you take time off. See it as burnout prevention. If you don’t take time off now, in 1 months’ time you won’t be able to get out of bed. And I want you to call the physician’s help program.”
Wham. Wham. And wham.
Do you know what gave me the courage to follow through with her advice, to take time off, to face up to what was happening and to call the physician’s help program?
My trust. Her non-judgmental compassion, compassion, and compassion. And I knew, doctor to doctor that she “got” me.
This is where I stop telling my story, because the point I want to get at is the following. Chances are you are help-averse or help-hesitant, like me. Chances are you are help-averse or help-hesitant because somewhere, among all the noise/thoughts/emotions, you feel that you should be able to heal yourself or to deny your needs away. Somewhere in there, you probably also believe that you are the only defective doctor.
You should know: shame is a very, very bad master. And shame does not deserve your respect, because shame is a liar. Physician shame is also a huge problem in medicine.
You should also know: forgiveness has the power to instantly dissolve shame, irrespective of the size or duration of your shame. Forgiveness makes you feel like you belong, again. Whether you opt to practice self-forgiveness, or you opt to turn to someone who facilitates forgiveness, it is what will save you from the yoke of shame.
And finally, humility and courage.
Humility and courage are what it takes to cross the bridge from help-averse to help-hesitant to help-accepting. That bridge is painful – I’m sorry that there’s no other way around it.
When you are ready to leave the small cell that physician shame keeps you imprisoned in, please, please reach out. So many of us are waiting, just outside your window.