I chose a career in medicine when I was 3 years old. Or so my mother used to tell me. I graduated medical school in 2003, and could not wait to get out on to the wards and start my career. Almost 20 years, three children and one pandemic later, I am not sure where that enthusiasm disappeared to, but I haven’t seen it in a long time.
The technical term is burnout. It is fueled by chronic stress, and in turns fuels my depression. Those of you who have been following for a while know that I didn’t have a perfect childhood by any stretch of the imagination. My father was a narcissist and both my parents physically and emotionally abused me. I learned very early not to process my emotions but to hide them away, that being the best was the only way I would survive in this world, and that the rug could be pulled out from under me at any time.
I am fully aware that mine is not a particularly unique or unusual experience. Many of you can relate to this story. We grew upbelieving that we could never say no, that we could never give up, and that we couldn’t ask for help. I thrive best under pressure, when I am distracted from dealing with all those pesky emotions that get in the way.
I chose a career that was seemingly “important” and gave people the illusion that I was busy doing meaningful work so that they never questioned me. Looking back, I got married and had children young, which is actually quite common in narcissistic abuse survivors (my husband is one too). I was good at appearing to be in control and holding it all together.
Until things started unraveling in 2013 when my youngest was born and my mother died. No, wait. That’s untrue. They unraveled long before that. The first time I attempted suicide, I was 17 years old. In fact, looking back, I’m not sure they were ever raveled in the first place.
Stress tends to lead to hyperactivity and anxiety.
But chronic stress can have the opposite effect and cause us to withdraw. The first time I recognised the signs of burnout, I started going to therapy. After 18 months, I took a few weeks off with stress before starting a new job. I thought I was better. I finally had insight in to my mental health and I was working on old habits and was dealing with the traumas of my past.
So why the hell and I off sick with burnout again 3 years later? The answer is simple. I can go to therapy and do the work and put in all the effort, but it’s not going to prevent this from happening over and over again. Why? Because I still spend my life running on empty and there isn’t a damn thing I can do about it.
You see, I’m the kind of doctor who cares about their patients. I can’t just phone it in. I can’t ignore those who need more than a few minutes of my time. As far as I’m concerned, I either do things properly or I don’t do them at all. But I work in a job that demands absolute perfection from met at all times. And the stakes are high. One mistake could cost someone else dearly. But that has always been the case, and yet burnout and suicide rates among doctors have never been higher. What’s changed?
I think the answer is the way perfectionism shows up.
Once upon a time, doctors were allowed to make mistakes as long as they weren’t being unethical or negligent. But nowadays, the punishments for my mistakes are too high. Litigation changed everything. We all work defensively now. We know that doing the best we can doesn’t really matter once the lawyers come calling. And believe me when I tell you that they will come calling.
Presenteeism is a problem too. This country is short on doctors. I mean, seriously short. It’s not our fault – the blame lies solely on the shoulders of the government that is desperately trying to privatize the NHS by squeezing the life out of her. So we’re expected to show up no matter how it affects us personally. The powers that be use our patients as mean of guilt tripping us in to going above an beyond the call of duty. Because if we don’t do it, who will?
These are some of the key traits of white supremacy culture.
So now my brain and body have turned to mush. I am exhausted and can barely keep my eyes open. Everything aches.I am making silly little mistakes that make me a danger to my patients. I am trying to find excuses to leave work early because I can’t face being there the whole day. This isn’t healthy. I love my job. I love my patients. But somewhere along the line I lost myself, and now I have to start the process of rebuilding from scratch.
This sucks. And the worst thing is, I have no idea how to prevent it from happening again in the future. Any ideas?