Why we're not going to kill ourselves this year

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pageantry

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So, back in the days of sincere blogging efforts (I'm old), I used to write an annual post entitled "Why We're Not Going to Kill Ourselves This Year." I was an emotional poetry major and each year as dark weather hit I wrote it mostly for me, but, you know, also for the community.

People loved those damn posts. I'd reel off lists of inspirational thoughts or a full page of alternative ideas to killing ourselves, healthy living tips and general encouragement. I guess it worked, because no one killed themselves those years. But it was pretty sad, because year after year I'd find my friends and me back in the depths of the despair, and then I'd have to write another post.

Years flash by and I don't blog anymore. I went ahead and got actual therapy and started practicing Zen and went back to school and now I'll be going to medical school in August (hooray! ) so things are generally much better. For me.

But two days ago one of my old poetry buddies wrote me and very sadly, sweetly asked me if I would consider writing another one of those posts. For her.

I'll tell you what, as a former writer and future doctor ("I wanna helllllllllp people!"), I was in HOG HEAVEN. I wrote for two days straight. I didn't shower. I barely ate. THIS IS LIVING. Half a dozen drafts later, I had something written down, a set of ideas compiled from all the psychiatry and other forms of therapy I'd received. I felt like it was as kind and as true as I could make it. And it basically said, "You can't run from this pain, you can only learn what it has to teach you."

A couple years ago, I had a Zen sensei who was a former psychiatrist. I asked him if he regretted anything from his medical career and he said, "No. Well. Except. I wish I'd not tried so hard. I wish I'd let people do their own healing."

Everything I have learned through hard pain and despair has come down to that. There's no other way through our own excuses and sadness, no matter how unfair they may be.

So I posted this thing my friend asked me to write, this writing that took me the better part of four years--essentially--to be able to conceive. And my friend wrote back, "Ah. Yes. That is beautiful. Feel the feelings. Thank you. I'm feeling a bit fragile right now but that's very nice of you."

.........:(

What's on my mind right now are all my doctor friends who have spent those long hard years becoming doctors and are now so burnt out. All of them talk about how hard they worked only to be ignored by pill-popping patients who do not want to be told to eat right and exercise. They talk about having to give medications that won't help in order to avoid being sued over the care the patient thinks he deserves. Hell, I watch people lose their minds with frustration over other people's self-pity right here in pre-allo.

I know my friend wanted the usual list of helpful breathing exercises when she wrote me. And there's nothing wrong with helpful breathing exercises. But after all this work and time, that's not what I want to offer right now.

I feel nonplussed, is what I'm saying. I feel my future.

I was wondering if this future worries any of you too, if you've had thoughts about this. Do you have ideas for how your career won't end up just being a really expensive speed bump on other people's highway to heck?

Would love to hear your thoughts.

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What the **** are you talking about?
 
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Actually, at first it seemed like anyone I met was jaded an burnt out, but over the past year, I've met some of the most inspired, passionate and compassionate ppl ( and they've been doing this for a very long time). Also, after I watched a certain TED talk, found a person who I strive to be like. He's dead now, but his name is Sherwin Nuland and he's written amazing books and has such a heart and passion for this field. If you're ever on the brink, he's a definite go-to
 
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My job as a clinical research coordinator for projects that focus on community outreach has taught me to accept that you can't help people who don't want to be helped. I stressed about it for a long time and I still struggle to fully accept it, but knowing this calms some of my fears about feeling unhelpful in medicine. Celebrate the help that you can provide.

My bigger worry is that I'll get swept up in the competitiveness and gun for something that doesn't necessarily fit me, but I go for it because I think I'm supposed to. I'm naturally pretty competitive, so it's difficult for me to allow myself to fall in love with say, family medicine, even though I feel like it might be a great fit for me. I think SDN probably exacerbates our competitive tendencies because of the exposure to a biased sample, so I'll probably gtfo SDN after next summer (want to stick around long enough to help disadvantaged applicants next cycle).
 
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What the **** are you talking about?
okay, it was a really long post that was basically about three things:

1) my own experience of working hard and painfully to learn something useful and having it fly right over the heads of the people it could help.

2) the thing I notice on SDN of many people being extremely frustrated merely by some random poster displaying self-pity... Aren't these people concerned about experiencing that frustration in daily practice?

3) the common burnt-out state that all this leads to in many doctors, and my question: what are people's thoughts about how they'll sidestep that fate? Will it be through choice of specialty? Change of perspective? What?
 
i can't afford the funeral !
 
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2) the thing I notice on SDN of many people being extremely frustrated merely by some random poster displaying self-pity... Aren't these people concerned about experiencing that frustration in daily practice?
Do we really care about the frustration people feel when they can't empathize with someone else? I don't.
 
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Thanks for that response, @TraumaBlonde. I have to assume it's not necessary to reinvent the wheel on this issue. Will definitely check that guy out.

My job as a clinical research coordinator for projects that focus on community outreach has taught me to accept that you can't help people who don't want to be helped. I stressed about it for a long time and I still struggle to fully accept it, but knowing this calms some of my fears about feeling unhelpful in medicine. Celebrate the help that you can provide.

My bigger worry is that I'll get swept up in the competitiveness and gun for something that doesn't necessarily fit me, but I go for it because I think I'm supposed to. I'm naturally pretty competitive, so it's difficult for me to allow myself to fall in love with say, family medicine, even though I feel like it might be a great fit for me. I think SDN probably exacerbates our competitive tendencies because of the exposure to a biased sample, so I'll probably gtfo SDN after next summer (want to stick around long enough to help disadvantaged applicants next cycle).

That's a good point, dude. I hadn't considered the competitiveness pitfall. And I appreciate what you said about focusing on the ones who do want help. I think I just surprised myself because I'm usually so, "it's all about the journey" and had this great all-consuming time writing and giving my best, knowing as I do that I can't really count on outcomes. But in the end I was a little disappointed. And that first little touch of petulance, despite all my preparation, makes me nervous...
 
Do we really care about the frustration people feel when they can't empathize with someone else? I don't.
I do in that I think, jeezus, this is exactly what medicine does not need.

But we do need doctors. Idk, maybe contempt for one's patients will turn out to be one of the true great coping mechanisms. Life's a b, as they say.
 
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knowing as I do that I can't really count on outcomes. But in the end I was a little disappointed.
We are so much alike.

The awesome thing about medicine is that there are so many different fields and they each offer very different things. Some fields allow you to have control over your day-to-day operations with relatively predictive results, while others are the complete opposite. Some fields allow you to see relatively immediate results of your work and others do not. I love that I went the non-trad route because I know that I need to see the results of my work, interact with patients and go into a field with a good work/life balance. Knowing that I can cross off the specialties that don't provide those things really calms me.
 
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We are so much alike.

The awesome thing about medicine is that there are so many different fields and they each offer very different things. Some fields allow you to have control over your day-to-day operations with relatively predictive results, while others are the complete opposite. Some fields allow you to see relatively immediate results of your work and others do not. I love that I went the non-trad route because I know that I need to see the results of my work, interact with patients and go into a field with a good work/life balance. Knowing that I can cross off the specialties that don't provide those things really calms me.
Yeah, dude, oncology calls to me in part for all those reasons. Not to mention all that wonderful patient compliance. Dark, but so real.
 
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As a medical assistant at a primary care clinic, there are already days like this. But the doctor gave me a piece of wisdom that gave me a big epiphany. He said, "Most of the patients are very grateful - it's usually just one or two patients a day who are mean to you. If I see 30 patients on a given day and 2 people are not nice, then I probably don't have to mind them. It's so easy to let those two ruin your day, but the truth is they don't represent how my day went as a whole at all. You gotta have perspective."

I think we will still have days when we wonder why we are doing this job and feel like no one appreciates what we do as physicians. I don't think there is a way to prevent that from happening. What we CAN do is to not let those bad apples define what we do and what we stand for. That, I believe, can only be done with practice. And being patient with yourself :)
 
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I volunteered for pediatric hospice for years and felt like oncology was my calling- but then I fell into emergency medicine, and now I know peds icu crit care is whre I belong, I think both oncology and some critical care specialties definitely overlap
 
This post reminds me of a quote I heard once (not sure where it came from) that went something like this: "You are hopelessly optimistic in your 20s, get settled in your career in your 30s and start a family, and by your 40s you are jaded and hate your job."

Anyway, I've met physicians that were extremely jaded, hated their careers, and were obviously bitter. However, I also met those who came to work with a smile on their face and made genuinely positive impacts in their patients' lives. Even though they had to handle a lot of stress and bull, the impacts they make in the lives of others got them through the day. When I see that and see the patients, I am reminded of some formative experiences in my past.

I may very well be a hopelessly optimistic fool, but damn does it feel good to be one.
 
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