Lifestyle of a Doctor: Burnout and Social and Family Issues
Like any other regular day, my eyes barely open, hair unkempt, keeping an apron on just to ensure my identity and enforce my pitiful authority, I rush towards the door and right into the wards premises, I’ve got to take an over, day in and day out to ensure I know everything about the poor beings who would depend on my knowledge. Being a house officer , my projection of my workplace doesn’t really count for I may witness heavens dropping in hell or hell violating heavens all in the space of one day, I maybe shouted at, cursed, offended or on a lucky day praised and admired in front of the very people I am supposed to treat. My response regardless of the case scenario has to be a nod, hiding behind the most powerful and the most helpless three letter word on this planet “Yes “.
I might joke around as much as I want to about it , being too serious really takes the passion and fun out of it , but the truth is, this field has an incredible journey that will lift you off your feet or bury you six feet under , irrespective of how qualified or how blessed you are.
Oh well, my story begins with a lot of stutters and stammers, and it ends pretty much there as well. So here I was, all excited after getting through my MB.; B.S., the entry test of Aga Khan University (AKU), Karachi, Pakistan internship cleared, all set to begin a new life with the hope that things would be so easy henceforth, considering the fact that I won’t have to study for anymore weekly tests or exams at least for an year; but little did I know of the turmoil I had gotten myself into: the volcano I had jumped into all enthusiastically thinking I am about to ice-skate. It began nicely, the first three days we, and by we I mean my “inmates”, were given lectures and free meals. Things were ideal till the third day ended, I felt like I were in heavens and was finally gifted for my years of self proclaimed hard work. However, the feeling of euphoria ended on the 3rd day and all hell broke loose. We were made to pick our own jails also known as rotations; the ones who were familiar with the less provoking ones were wise enough to pick them, others like me were euphoric and just played along, going deeper down into the volcano. Ahh, with little knowledge of the ward setup and the least of knowledge of how to tackle it, I was fortunately unfortunate enough to pick Neurosurgery as my first rotation. And so it began the great internship program.
Those surely were the longest 60 days of my life and I can assure you I started counting backwards right after my 1st call; I was robbed of my senses, If I knew the patient, I made sure I would lead the team to a different bed, If I knew the bed, I made sure I would recall somebody else’s history and be confident enough to stammer out the most retarded of explanations, My only hope were my fellow interns and luckily I got the finest ones. They would help me out each time I got stuck, teach me everything I was unfamiliar with, and sadly I was unfamiliar with everything. It was a totally different ball game, and I was holding a cricket ball while everyone was inclined to play soccer. Time kept making me a bigger fool every day, but it did pass. To make things even more entertaining I was given this pager, the pager is probably the biggest mental torture an intern is made to go through, and that sound “Beep Beep” will haunt you for the rest of your intern life. So this pager, my first impression being, “Ok wow I’ve got a pager”; A few days passed and then I wanted to break it and honestly, the sentiments never changed. The deadliest of weapons, and perhaps being the staff’s biggest line of defense and aggression towards an intern. It won’t let you sleep; it won’t even let you calm down, because every time you do, the pager would sense that peace from within your body and then dedicate its existence to destroying it.
The Neurosurgery rotation ended and I heaved a sigh of relief that no earthly place could bring. My next rotation was Emergency Medicine but much to my surprise, this rotation was ideal for me. With so much to learn, for once I felt like, I knew what I was doing. I guess it got easier with time because I had understood the system and by now I know what I had to do, getting smacked and scolded was but a healthy routine and it was nothing to feel disrespected or disheartened about. Immunologically speaking, the “Bayzati” syndrome (Insult) immunity had developed. The rotations thenceforth weren’t as difficult as the first one except for Pediatrics, and I still wish, that everybody I hate in this world should get a chance to work and do calls in the Pediatrics Department (No offence to the Department). Oh of course what I mean to say is, it would make them a better human being. Having said that , with all the beautiful experiences this place offered me , I still was unable to understand the logic behind a 36 hour call. I always considered it nothing short of inhumane, the idea was bizarre, it’s not about testing the waking skills of your health professionals , and it’s about treating the patients, some of who are actually paying their life time to get treated. If the duty requires more, and it sure does, wouldn’t it be wiser to hire more doctors rather than hurting both the patients and the doctors with such bizarre duty hours. I don’t think it was a secret to anybody and I am sure a lot of residents and interns have had days when they don’t sleep at all or maybe a single hour and they still keep on working for the next day because that is what they’re asked to do.
It would be highly ungrateful of me if I were to go on and say I had learnt nothing from this whole years work experience, I have learnt so much and I am sure I will benefit from it greatly in the years to come, but my feeble mind, and a very stupid one too always thought there were things lacking in the programme; as it it’s just so hard to satisfy the human brain. Perhaps a few workshops like surgical skills etc could have done the trick. Oh well, apart from all the difficult times you’ll have to go through, it is only by the end of the internship that you realize the new man you’re turning into. I couldn’t understand that initially but as time passed, my confidence grew and I grasped what I had learnt at least passively. Every single day when you walk on the same passage that fate has spotted out for you, you will be made to deal with the emergencies with or without your consent, every time the condition worsens you’ll have to be on your feet, keeping your calm in the most stressful situations whilst all others are in all sorts of distress, and the first to make a decision, The decision however has to be correct for its a human life you’re dealing with. This is what you’re trained to do; this is what you’re paid to do.
The responsibility is un-parallel, you’re there to save lives, and you have to be at your best regardless of your physical or mental condition. You have to bid farewell to your social and family life, shift gears maybe, The hospital is your new home and you can consider your house as just a place to sleep, sounds a bit too extreme I suppose? Oh maybe I was in that sort of mood. Ah well days passed by, and soon we were given the internship certificate at our graduation., The year that had started with the impression that it would never end , actually ended with the blink of an eye, gifting us with memories and experiences that we would long benefit from. The relations amongst us interns, the bond was rather one of a kind, courtesy the same humiliation we had gone through, and there was a sense of sadness involved that we were separating from each other, each of us heading finally into the professional life alone. There are no friends at an auction, as they say.
The medical profession undoubtedly is one of the most difficult professions that you could ever choose, not just because you have to work hard for it, the myriad books you’ll have to open and digest, the number of never ending years that you’ll have to spend just to get the two letter appellation behind your name ” DR” and be respected and paid for it. However, these mentioned predicaments are nothing compared to what the profession has in store for you, once you make your way into the game. BooooM .. there’s an explosion in your head , Tadaaa Greetings Mortal ” the ward takes the troll” , and then you figure out what has happened, it is then that you realize what being a doctor actually means, The words “Responsibility” and “Wisdom” launch a Spartan attack on you , You fall down , You get up, You fall again, you’re dragged , pulled , pushed , you make a complete fool out of yourself, The job is difficult , impassible, There are times when you start losing yourself , Depression, Rejection , whilst many would get through wisely , some would still be detained by it asking themselves if this was the right decision, if they can ever be good doctors, asking themselves as to who or what they are but as days pass , you grow, and the fact that you started from scratch makes you a time bomb, makes you an unstoppable machine, Your decisions go firm , Your hands go rigid, You begin to understand your place in the ward, You don’t have an identity crisis anymore, You get the answers you were seeking “You realize that you are a DOCTOR and that’s what you are.
A lot of us never figure out the key factor of an ambition, the passion , which of course renders our spirit wilted. The key no matter what the scenario is never to not give up, it is like Rocky Balboa saying, ” It’s not about how hard you hit, It’s about how hard you can get hit and still move forward, how much you can take and still move forward, that’s how winning is done. Giving up is always the easiest option, staying in the game, tolerating the pain, surviving the agony, that’s what shows the true worth of a professional. There always is a long route for excellence and yet always room to improve your perfection. It comes with perseverance for those with an ambition. Each step takes you closer to your goals. If you have the ability to dream , then is rest assured you have the ability to achieve it , be the goal to become a great doctor, a great engineer or even a boring professor only if you stay the course , learn from adversities and keep going. That’s what the books have to say. Our lives and circumstances however reveal a different story.
Best of luck my fellow upcoming doctors!
About the author: Samad Hussain is a medical graduate of The Isra University, Hyderabad, Pakistan. He recently completed his internship at The Aga Khan University Hospital (AKUH), Karachi, Pakistan. He will be applying to the Internal Medicine residency programme at AKUH. He can be reached at [email protected]
About this article: This article is competing for the JPMS International Medical Writing Contest 2012 for the theme: Life of a doctor: Burnout and medical life; social and family problems faced by doctors due to hectic life style
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