Taking a One Month Break From Medicine
A few years into my first faculty position, I recognized taking a week off for vacation wasn’t enough time. I’d spend the first couple of days getting used to being on vacation, two days enjoying myself, and then 2 or 3 days getting anxious about returning to work. This spring, I looked at what all of my colleagues’ July schedules were doing and realized that I could take the entire month off without any of them having a horrible schedule to accommodate my absence. The break came at a serendipitous time: I was ending the academic year with a lot of overtime shifts, so I had a long stretch of clinical time without a break. I was tired and verging on burnout. I was also admittedly using work as a distraction from grieving a death in my family. A month-long blank calendar looked like a vast, open space of possibilities. Time to do house projects that had laid idle for far too long. Time to read books. Time to see friends I hadn’t seen in years. Time to mourn that loss. Time to “take care of myself.”
I spent the first week just resting: getting up when I wanted, napping when I wanted, and going to bed incredibly early. I know the jury’s out on whether we can repay sleep debt, but I can honestly say that my brain started functioning better. I stopped having word-finding difficulties. Lists stayed in my working memory longer. I stopped feeling so reactive; I didn’t immediately have internal hissy fits about minor inconveniences. With the cumulative 8 to 10 hours I had awake (nope, not joking), I started working through the list of books I’d wanted to read. The “do not disturb” feature on my devices helped immensely with this.
Once I felt better rested, I started tackling my massive non-work to-do list. I found something unflattering: slowly and insidiously, I’d let my self-worth get wholly tied up in my ability to check things off of a to-do list. I didn’t get the cupboard over our refrigerator organized. I didn’t get our garage completely purged. I only got one-and-a-half closets (out of a planned three) sorted. The things I wasn’t going to get done began to drive me crazy as the end of my time off neared. They remain undone now that I’ve been back at work for a month. Shockingly, it seems that it doesn’t matter. I’m able to carry on quite well. Nobody’s actively dying. The world keeps spinning, which I never would’ve thought given the mental space the tasks were taking up during my time off. The things on that to-do list only “mattered” because I ruminated on them so much.
Academic medicine trains us to judge ourselves by what we get done in a day. The metrics of academic medicine don’t fit nicely into the quantitative measurements of productivity that workers had in the industrial age: if my job was to make 15 widgets in a shift, and I made those 15 widgets, I’d done a good job that day. We create yardsticks for ourselves because knowledge work does not have measurable metrics that can be evaluated in a reasonable time (like at the end of a workday). That then spills over into life outside of work, and we end up judging our worth by how much we get done in a day. But the problem is that life's work is never done. There will always be progress notes to write, learner evaluations to fill out, spaces to clean and organize, appointments to make, and on and on and on. The to-do list will never be done until I am (deep breath) mortally done.
It took me a whole month off, but I learned two things. One, I must prioritize sleep. Two, tying my worth to a to-do list just sets me up for failure. Many of us are so used to using to-do lists to evaluate our value that not having that metric will be disorienting. It was, after all, just a to-do list that got us through school, then training, and then up and up in the professional ranks. So what about this: What if we just decide that we are worthy simply because we’re humans in this world? It doesn’t cleanly lend itself to a to-do list, but that’s the point. At the end of each day, I can ask myself, was I happy? Was I kind? If the answer is no, then I re-adjust. But when the answer is yes, I get to feel good. I get to be worthy. All while letting those one-and-a-half closets stay unorganized.