That was it.
After you become a doctor, you're in for life -- that's what the hospital thinks. There's a mandatory retirement age for, say, airline pilots, but we let surgeons operate into their 80s. Two of the surgeons in my residency had cardiac arrests (fortunately, people were close enough to start CPR) and then went back to work after getting heart surgery themselves. Two attending surgeons had cardiac arrests, and one had a heart attack (but not an arrest), and every one of them just went back to work as if nothing happened.
When I was a junior resident, I had pneumonia with a fever of 103. I was told that the policy said I was supposed to go home for 48 hours, so as not to infect anyone, but I was on call 36 hours later. I've been stuck with needles -- from an HIV-positive patient, from a Hep-C patient before there was a cure -- and showered in blood, and the biggest concern was figuring out who was going to pay for my own subsequent ER visit. Turns out my health insurance did not.
That's not to establish pity. It's to illustrate the biggest problem doctors face: pure burnout.
The symptoms of burnout are changes in appetite, anger, anxiety, guilt, worthless feelings, isolation, loss of enjoyment, detachment, irritability, and apathy. But "burnout" is not a clinical entity. It's just our word for it. There is a clinical entity that encompasses the same subset of symptoms: PTSD.
When I was a third-year resident, I removed the gallbladder (this procedure is called a "lap chole") of a woman who had a young child. The case went fine, she went home the same day, and three days later she came back with a major complication. For months afterwards, I was afraid to do lap choles.
After every patient complication or death, a resident has to create an M&M ("morbidity and mortality") presentation which they'll broadcast to the whole department of surgery during a weekly session. While writing this, I took a look through all my old M&Ms. There were a couple strokes, pulmonary embolisms, big complications. But I didn't even remember them until I read through the slides. Are there soldiers who have personally killed so many people that they can't even remember them all, or is that just in movies?
For resources on physician and medical student depression and suicide prevention, visit afsp.org. Ryan Menezes is an editor and interviewer here at Cracked. Follow him on Twitter for bits cut from this article.
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