“Hi Dr. Wible, I am a fourth-year resident in a combined five-year program and I am burned out. Last month, I totaled my car as I sleepily drove home after my 8th night shift in a row and am lucky to have walked away with only a broken clavicle. Of course I was required to show up the very next day despite the fact that I was so traumatized I broke into tears suddenly multiple times that day. The following week, my 28-year-old co-resident nearly died after having a seizure while on inpatient medicine due to sleep deprivation and intolerable stress. A patient on our team died yesterday and my first thought was, “great, that’s one less person I have to take care of.” I know it’s not safe to continue practicing like this, but this has become the norm. Everyone around me is like this and it becomes almost normal. But is it humane? I don’t know what happened to the younger version of me who wanted to comfort a dying patient or save a life or decrease a patient or family member’s suffering. I don’t know where I became lost, but after so many years of living as a cog in the wheel, I have become the hardened resident they trained me to be. And for that, I suffer and so do my patients. Thanks for letting me vent. Feel free to share my story but please omit my name because I would still like to graduate residency, if it doesn’t kill me first.” ~ Michelle
* * *
Dear Michelle
I am so very sorry that our medical education system has destroyed your love for medicine and your compassion for your patients, that your residency nearly killed your colleague and almost took your own life. You do not deserve to be treated this way. Here are my thoughts.
1) You do not have “burnout.” You have been abused. Your human rights have been violated. You have not been allowed to sleep or eat properly, to take care of your own bodily needs (which you must do to stay alive on this planet). This is basic human physiology. Burnout is a victim blaming/shaming term that has been used to deflect attention to the victim and deflect attention from the perpetrator—your residency. Please use the correct terminology. We can’t solve a problem if it is shielded in euphemisms.
2) Your story matters. I am beyond grateful that you have the courage to share your pain with me and with the world. If we all keep pretending that this is okay, the mistreatment will continue. There is no excuse for a health care institution to place human beings in harms way. Sleep deprivation causes medical mistakes every day in every hospital. Sleep deprivation kills young doctors in the prime of their lives. We must all stand up and say enough to the rampant human right violations in medical education (especially residency).
3) You are a beautiful person who has been wounded. You care. You love. You have compassion for people innately. Your training program has snuffed that out and is sucking the very love our of your heart and the very joy out of your soul for healing and serving others. How? Because you have no time to care for yourself. You have been forced to live a fight-or-flight life. You are struggling for your very own survival (which is why you are having trouble caring for others).
4) The younger idealistic humanitarian still lives in you. You may need therapy to pull her out again. You are welcome to come to our retreats (scholarships available) so do let me know if you have any time off or want to set an elective in Oregon. I am here if you ever need to talk to me. I just tried to call you. No answer. You are probably at work. You can get your life back. You can once again comfort a dying patient. You can eventually help others with their suffering after you heal from the trauma of your medical training. Please know not all residencies are like this. I absolutely loved my residency. We can do better.
5) You are loved. Don’t ever give up. So many people love you. I am here for you. We are all here for you. Reach out to those of us who are resourced, who have survived what you are enduring now, those of us who are standing up to humanize medical education so that future generations of doctors do not have to suffer. Your life is too precious to give up. I have so much more to say. I’ll wait for you to call me. 541-345-2437
Pamela Wible, M.D., reports on human rights violations in medicine. She is author of Physician Suicide Letters—Answered.
We survivors of abusive residencies stand with you, Michelle. You ARE loved, you ARE appreciated, reach out for the hands that are reaching out for you.