My Physician Burnout Story
Trigger warning: this article discusses suicidal thinking in a medical doctor.
In this article, I present my personal physician burnout story, and how it led to my co-founding Physicians Anonymous. This could be the story of over 60% burned out of US doctors in 2022.
I have wanted to be a doctor since about the age of 4 or 5, or so my parents tell me. Maybe it was because I had a severely disabled younger sibling. Maybe because the doctor up the road always seemed more financially secure than my family. Perhaps it was my love of biology at school and my aptitude for the sciences and people.
Doogie Houser MD, ER, Gray’s Anatomy, and Scrubs (don’t judge me!) clearly played a role too.
Whatever it was, I was determined to get that MD after my name. So I worked and worked, got into a good med school, worked part-time to fund my studies, specialized, did a Ph.D., and continued on the conveyor belt. Got married, had kids, found a good job at a busy hospital. Carried on research “in my spare time”. Sat on charity boards and the PTA. Dabbled in health tech start-ups before health tech was a thing.
Until the wheels came off.
I was at one point “suicidal with planning and intent”….A carefully thought out cocktail and a sea swim would result in a tragic “accident”.
Hard stop — the rock bottom my physician burnout story
My career and life crashed to a halt after ~25 years in clinical medicine. A combination of a particularly shameful addiction and recurrent depression became too much and I hit rock bottom.
I was at one point “suicidal with planning and intent”. And I had the means and knowledge to do it so that ( I thought) the insurers wouldn’t find out it was suicide and my kids would get paid out.
A carefully thought out cocktail and a sea swim would result in a tragic “accident”.
Medical knowledge in the hands of a suicidal physician can be deadly.
Awareness
As an affluent, respected physician, confident in my position, well-liked and admired by society, yet suffering inside, why did I not seek help? In my case, I knew something was wrong. My spouse and my best friend said so. So did my Mother.
I ignored them and blamed work.
Perhaps if I’d taken an online burnout or depression screening test, I may have recognized it.
- The Oldenburg Burnout Inventory online. An intuitive but less validated burnout tool can be found on Mindtools.
- Here is a validated depression screening tool from Mental Health America.
So why, with all my training and knowledge of the body and mind, why did I not reach out?… Shame, denial, guilt, fear…
Indeed, why do so many of us suffer in silence? What are the barriers to us physicians seeking help?
The reasons, as happens so often, are complicated and multiplex. Shame, denial, guilt, fear to start with.
Guilt and shame
What’s the difference between guilt and shame? I only understood this in recovery.
Guilt is that feeling about the behavior being wrong.
Shame is that feeling that we ourselves are wrong.
Guilt about my behavior became shame over time. I became the problem. Shame was so deep-rooted and in the shadows, and I had built up such strong defenses over the years, that I almost didn’t feel the shame anymore.
Also, my life was comfortable. There was no way I was going to look under the hood to investigate that occasional burning smell in my car.
Fear — the driver of my physician burnout story
Fear of disclosing to my hospital, State Licensing Board, insurer, Family Physician. I did not want a well-meaning colleague or manager to refer me to an impaired physician program. I did not want my registering authority to know.
Fear of appearing less than perfect or competent. Guilt that my decisions and behaviors had led me to this point — “how could I have let it go this far?”.
Not even my spouse or friends knew how far down I had fallen. I felt completely alone.
I felt completely alone. It turns out I was not alone. Thousands of my fellow physicians were struggling. Some of them were crashing and burning like I was….
Conclusions
In this article, I have described my physician burnout story: from the heights of (conventional, Western-defined) success to my rock bottom. This included suicidal thinking and planning.
Thanks to the support of fellow physicians, therapy, and a 12-step group, I was able to see that suicide was not the answer — or indeed any answer. I thank a power greater than myself that I am alive today in order to do this work with my fellow doctors in distress.
More to follow in Part 2: Recovery.
Thanks for reading!
DC
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