Quitting has a lousy reputation for physicians.  It makes sense; we became physicians by just not quitting.  We didn’t quit our educations after high school; we went on to college.  And then from college to medical school, residency, and sometimes to fellowship.  Sometimes we “not quit” our way into advanced degrees.  When my training got difficult, I learned to give myself the “I can do anything for (insert hours to weeks to months)” pep talk.  Practicing medicine requires a commitment to lifelong learning, so “not quitting” is woven into our profession.  Maybe it’s not so much that we don’t quit; it’s just that we never finish.     

“You need to set boundaries” is a common refrain to burned-out physicians. I heard it so much that it became a thought running through my mind whenever I opened my email inbox. Whenever I got a request to give a lecture, join a workgroup at my hospital, or put my name in for a professional organization’s subcommittee, “I need to set boundaries.” It even started to run through my mind whenever my text messages would ping (or, Heaven forbid, my cell phone rang when I was at home for the evening). Common parlance is that we have around 60,000 thoughts a day, most unconscious (otherwise, we would not be able to function). So if “I need to set boundaries” was a conscious thought that often, I have to wonder how often it was an unconscious thought, rolling around in the recesses of my brain, taking up energy and leading to feelings of helplessness that were boiling just below the surface.

“Altruism” is the “practice of…selfless concern for the well-being of others,” according to the New Oxford American Dictionary (via Google, of course). The site also notes that in zoology, altruism is a “behavior of an animal that benefits another at its own expense.” I don’t remember the day in medical school when I learned that my patient’s needs came before mine. But I remember gradually learning to moderate my liquid intake lest I need to use the restroom during rounds or in the OR. Ignoring my aching bladder merged into ignoring my grumbling stomach, and eventually, those two sensations just stopped happening. When I’d overeaten to a BMI of 35 because I couldn’t tell when I was hungry? Maybe that’s when I started to exemplify the zoologist’s more-aggressive idea of altruism.

Service weeks can feel difficult. We know patient care is the priority, but the in-hospital and out-of-hospital world doesn’t stop. This guide assumes your service week starts on Monday, but you can modify it however you need to for your service schedule. With that, here’s how to have your best service week yet!

July 1st can feel like New Year’s Day in academic medicine. As new learners take the place of the seasoned ones, it’s a natural time for us to take stock of what we’ve accomplished over the past year and think about what we’d like to do differently in the upcoming year. Yearly evaluations with division directors can serve as a jumping-off point toward achieving those goals.

Stay with me. I’m writing this as a human who witnesses suffering first, then a pediatric intensivist, and then a clinical ethicist. So, like this:

Human > Pediatric Intensivist > Clinical Ethicist

I’m writing this with the utmost respect for all the physicians, nurses, and ethicists who have researched this topic and are trying so hard to help us out of this burnout hole we find ourselves in.

My husband and I are re-binging the first two seasons in preparation for the new season of Ted Lasso being released. For the uninitiated, Roy Kent (played by Brett Goldstein) is an angry, foul-mouthed curmudgeon of a soccer player (ah, apologies, footballer) who (spoiler alert) turns out to have a massively huge heart.

How many times has this thought crossed your mind? I can start the day with the best of intentions and then get to the end of the day feeling that I haven’t accomplished a single thing (even when “the end of the day” comes an hour and a half after I’d intended the day to end).