7. Overwhelmed

That’s a strong word right there.  How many times have you felt this way?  Pulled in multiple directions, not sure where you are supposed to look to next.  Be a good husband.  Be a good father.  Be a good physician.  And somewhere in all of that you aren’t supposed to tear at the seams.  Lose yourself for a moment and the rest may go pulling away.  

In medicine they refer to it as “burn out.”  A lot of physicians suffer from it.  Physicians have one of the highest suicide rates out of any profession, closely followed by divorce and other life-tearing events.  But to be honest, I have never been a fan of that terminology.  So much of it is a focus on your day-to-day job that it rarely includes everything else outside of it.  We blame it on electronic medical records, which makes patient visits longer due to all the red tape you have to go through to get a note signed.  We blame it on dealing with insurance companies, which makes it harder to care for our patients in the way we feel is right.  We blame it on patient numbers, always being pushed into getting in one more patient for the day.  And the term “burn out” makes it sound like we have used up all the fuel in the tank.  Nothing is left.  No more to give.  A spent candle needing to be dipped in wax only to start anew.

There is so much more to it than that.  In today’s world of working as a physician, technology has created more than the exam room, phone calls, signing off on notes, sending out prescriptions, waiting on hold to hopefully get a prior authorization to go through with insurance, and everything else that pulls us in multiple directions.  There is the never-ending onslaught of emails.  Licenses you have to get renewed.  Meetings you are supposed to attend, which somehow have skyrocketed in numbers thanks to on-line platforms.  Information you have to stay up to date on.  Deficiencies you have to sign off on at the hospital.  Technology has advanced our world in so many ways; however, in many aspects it has made things much worse.  Ever since COVID-19 began I have received dozens of emails a day on new data, research, opinion pieces, laws, regulations, etc, that I am constantly having to read, digest, and be able to reproduce when my patients have had a question about it.  When the latest news headline gets released, I am expected to know every detail about it AND the data it supposedly represents because I know I will be asked about it later that day. Tack that on top of all the things we were already doing, and eventually your brain feels overloaded.  

In our family’s life at home the onslaught of technology continues.  Social media.  Emails.  Text messages.  TV on demand.  Video games.  Notifications on your phone.  No matter what we are doing our brains are constantly being pulled in different directions.  And amongst all of that we try to communicate with our spouse or partner.  We try to bond with our kids.  We try to give ourselves downtime to recoup.  We try to find time for sleep.  Heck, we try to find time to use the bathroom.  And somehow, we try to be perfect amongst it all.  

When I get home after work, I tend to look back on what I did with my patients that day.  Did I make the right diagnosis?  Should I have pushed that teenager to talk about home-life a little more?  Did I get that splint set right, or is the orthopedic physician going to laugh at what a poor job I did when my patient goes for their follow up this week?  As physicians we tend to be perfectionists.  And to that end we tend to beat ourselves up about work, no matter how hard we tried.  We do the same as parents.  We do the same as a husband, wife, or life partner.  The overwhelming onslaught of that feeling of guilt from being imperfect tends to bury any sense of positivity that may be going on around us. 

This week, I was overwhelmed.  I am not sure where the tipping point was, but it was there.  In those moments, I was not present in the now.  I couldn’t enjoy the small victories of the day.  I couldn’t enjoy the fact that my kids actually ate their dinner.  The overwhelming feeling of the constant pull had taken over.  

After everyone went to bed that night, I pulled out my study Bible from Confirmation.  It has always been my favorite one, with all my hand written notes and stick-its marking favorite verses.  I blindly opened it up and it fell to 1 Kings Chapter 8.  To summarize, it is basically Solomon discussing the Temple to God in Jerusalem.  The dedication.  His speech.  His prayer.  None of that has to do with me being overwhelmed or “burned out.”  But what it does represent to me is that the Temple was where all things were to be focused in that moment.  For me, my focus should have been on our temple – our home, with my family, and all the positive things that are to be found there.  Allowing the outside world to consume my emotions pulled me out of that space.  Too often do I focus on past or future events and not enough on the present. 

Burn out is a common physician concern.  However, burn out comes in many forms with parenthood as well.  Sometimes that overwhelming feeling can take hold, and it feels like it will never let go.  Finding ways to cope with it is important.  Sometimes, you just have to own it.  Let yourself feel the emotion, understand it, and accept that it is sometimes part of life.  Once you do that, I think it makes it more manageable.  My release that night was time to collect my thoughts.  I cried a little.  I read my Bible.  And I typed.  The sensation is not fully gone, but I can accept that it is there.  

When you feel overwhelmed, how do you cope with it?  Do you turn to a religious outlet?  Do you turn to friends or family to talk about it?  Meditation?  Writing?  Or are you still searching for that one thing that helps you to accept the feelings of being overwhelmed and help you move past it?  

If you have a friend or loved one in the health field, give them a pat on the back (or whatever you can do in today’s age of social distancing).  It may be all the need to sew their seams back together.  

Imperfect Dad, MD

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