Fighting Burnout One Day at a Time – Part 2

By: Gretchen Winter, MD

May 29, 2018

This is a continuation of Dr. Gretchen Winter's blog on fighting burnout. Read Part 1.

The medical training environment can be brutal, physically and mentally, but for many of us, especially the more sensitive breeds (myself included), it can be emotionally exhausting. We each want to be the best versions of ourselves and try to be open to feedback, but that does not take away the sting of criticism. And we do not just encounter the occasional negative Nancy.

The constant evaluation process can feel like an onslaught of haters trying to change everything about you. You may be too quiet and disengaged. You may be too loud, abrasive, or challenging. Your presentations may be too long or missing pertinent information. You may be too tall or short, too brunette, or wear the wrong glasses. It is impossible to please everyone, and that is OK. While constructive feedback plays an invaluable role in life, we must not let personal opinions of others drown us in self-doubt.

When confronted with negative words, examine them. Look for truth when present, whether in your actions or their interpretation. If and when you find truth, address it, but throw the rest away. If at the end of the day you can honestly tell yourself that you did your best and you are working on doing better, then the rest is garbage. Feedback is a gift, but self-doubt and degradation is malignant and a hazard to your health. You are a beautiful, strong, brilliant person who is working on becoming your best you, and that is enough.

I'm sure you've heard the old adage: you cannot care for others until you first care for yourself. It can seem impossible to find time for self-care or extracurricular activities amidst the long work hours and the demands research and studying put on our limited free time, but it is imperative to do so. Whether you find contentment in dedicated family time, exercise, music, or another hobby, making time for yourself is one of the best investments you can make.

I know at the end of the day the last thing I want to do is go out. It hardly seems relaxing to change clothes and go to a painting class or the gym when Netflix and The Vampire Diaries are calling. I fight my natural desire to binge Netflix in pajamas by scheduling plans regularly. It varies week to week, but I regularly take piano or ballroom dancing lessons, go to spin or kickboxing class, or just spend an evening with friends.

These are all things I wouldn't choose to do at the end of the day, but when I have an appointment to do so, I force myself to keep it. When I do engage, I am almost always happy I took the time to do so. Consider scheduling time for yourself and the activities you love, even only once a week, to ensure that you have an appointment for self-care.

One of the most important resources you have to fight burnout is your loved ones and your co-fellows. In this social media world where we strive to project the appearance of perfection, it can be difficult to show what we perceive as weakness. But burnout, exhaustion, and stress are not weaknesses, but signs that you are invested in caring for others and you are human.

We need to be able to talk to each other with emotional honesty. Share your stress, vent about your difficult rotation, and laugh about your crazy patient. Fellowship is a time of exponential learning and great stress, but it is also a time where you build friendships and memories to last a lifetime. Your co-fellows and family are your support group, and it is healthy to lean on them.

Despite the strides to fight it, mental illness is still stigmatized, and in this profession where we fear our ability to practice may be affected by a disclosure, it is hard to admit when we need help. However, as physicians fighting to treat mental illness and increase its acceptance, we must first be willing to recognize it within ourselves. Whether you are burned out and want to talk with a professional to help you through it, or you are suffering from the anxiety and depression that plague medical professionals, it is wise to seek that help. Your program is required to provide mental health services, and it is a sign of personal strength to utilize it.

Everyone in our lives has an agenda, whether it is a personal need from us, or simply to not upset us as their loved ones. A therapist is someone (a well-trained someone) who has no agenda except to listen and help you—I believe we could all use a person like that in our lives. 

Burnout is a complex issue, and not one that is likely to go away anytime soon. However, we are a generation of physicians blessed to be aware of the syndrome and able to fight it. So find those moments that remind you of your purpose and cling to them. Utilize feedback, but do not let it bury you. Make an appointment for self-care. Binge in a good venting session with your co-fellows over a bucket of ice cream (or brussel sprouts…I am supposed to be encouraging healthy habits here). And above all, know that the people in your life love you and are in the trenches with you. We can fight this together. I am by your side.

Gretchen Winter is a second-year pulmonary and critical care fellow at the Cleveland Clinic Foundation. Her clinical interests are in cystic fibrosis and asthma. Her research interests include patient-physician communication, medical education, and bioethics. She loves ballroom dancing and all things artistic, and she has more pets than are socially acceptable.