Agraphia Medical Tragicomedy

6May/1016

The Breaking Point

I need to get the poison out.

I went into medicine for all the right reasons.  I wanted to cure people, to help them, to smooth their journeys through life.  And in the best of times, that's exactly what happens.  I love my job.  I love taking care of people.

And yet, residency is a huge toll.  I'm a low-maintenance person, but each of my vacation requests have been denied.  With the exception of 4 days off in October and a few days where I attended a national lecture series, I have been working straight since residency started.  80 hours a week is hard.   80 hours a week is harder when you realize that you haven't had a single Saturday/Sunday off for months and months.

The last straw was our lecture today.  Two lawyers came in to explain a recent malpractice case; it was a case where the doctors did everything right, and the plaintiff still died.  Just by virtue of there being a bad outcome, all the docs got sued.  I deal with death every single day, and my whole purpose is to try to stave it off.  But the idea that not only do I work my ass off to help people, but that I have a greater than 100% chance of being sued just because of my profession... well, that was just about enough for me.

I've been depressed all day.

Why, exactly, should I slave away, devoting the best 7 years of my life learning how to help people... giving up nights, weekends, vacation, free time... if in the end I'm going to be sued for the one time I make a mistake?  My friends from college right now are planning reunions I will never be able to attend.

It's too much.  I want just one day truly off, where I don't feel guilty for not obsessively reading about the correct treatment for strep throat, or the appropriate management of septic shock.

I need a break.

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  1. A resident in my program recently committed suicide. I didn’t know him (he was at a different distributed site in a different year) but nobody was surprised that a resident would commit suicide. Everyone sees the pressure of the job and the future but yet they still expect everything: devotion, perfection, dedication. My patients expect it too. Sometimes my best isn’t good enough and I make mistakes and then I worry not only about how I will ever live with myself, but also if I will be sued as a resident. Even when I get time off I obsess. I’m not sure what the answer is.

  2. I think the answer is to do what you love. In your case, that means applying to the specialty that will make you the happiest. Not the one that will make you the most money, or the one that will give you the most time off, but the one that will consistently interest you in the long run.

    In my case, it means finding enough time away from what I love to be able to appreciate it. I sincerely do think it’s one of the best fields in the world (who else gets to help people like we do?) but it can be so hard sometimes.

  3. Hang in there dude; sometimes the good people are the ones who suffer (a tad cynical but nevertheless realistic). Are you on a contract? Perhaps you can re-consider another institution who values their staff more. And there are certainly plenty of people out there who appreciate your work – they just don’t mention it and assume you know it already.

  4. I really, really hope you’ll get your next vacation request and make it soon! You deserve time off! The residency powers-that-be must know that guaranteed time off each year in residency exists for a reason. Residents need time to recharge to avoid burning out and feeling hopelessly trapped in their situation.

    During my internship I get 2 weeks off during the year, plus guaranteed time off at either Christmas or New Year’s, and then 2 weeks off at the very end of internship. I have to submit all requests this month, so it requires some planning, but it sounds like I’m getting a pretty good deal even if I have to choose alternate vacation dates.

  5. When do you get your vacation then? Most of my friends tell me they are assigned to their two week blocks. When are yours?

    Hang in there Zac. Intern year is almost over. I hear 2nd year is no picnic either, but it does get better.

  6. Oh yeah. Totally agree with what you are saying. I am from a different country altogether, but the scenario differs not.

    What can I say but hang in there mate!

  7. I’ve got no special anecdotes or wise words to share. I just wish good things for you. And soon!

  8. Gah, that sucks. Sorry.

    Does your program not give vacation? At all? I’m an ER intern; I had three weeks this year (a two-week block and a one-week block). It seems like most of my intern friends got two to four weeks, depending on the program/institution.

  9. I’m so enjoying reading your blog! I’m up to 2005 now lol..

    Don’t really have any advice to give cos I’m just someone hoping to start medical school soon, but yeah hang in there Zac (:

  10. Thank you to all who have commented. Who would have thought that my blog would be such a fantastic outlet for me to both vent my frustrations and garner support?

    In answer to a few specific questions: we do, of course, get vacation at my program. Unfortunately the months that I would normally be eligible for vacation were all understaffed. No fault of my programs, just bad luck.

    I have, on the other hand, heard of this happening to one of the other residents, so I’m almost tempted to argue for assigned vacation. That being said, in a perfect world, the way my program does it I think is usually better.

  11. What is a blog if not the *ideal* place to vent and garner support!? :)

    (And of course allow a forum for us to exercise our vain notions that people care what we think and/or find our writing interesting.) Hahahhah.

    Really enjoy your posts and am linking to this site as of now.

    Hope things are looking up.

    Cheers

    ABB

  12. I’ve read your blog for a while and never commented, but just wanted to say, sorry things suck right now. I don’t know how doctors do it-I bet the training is more rigorous than that of an Olympic athlete (and nowhere near as good for the body–have you considered switching to an Olympic sport of some kind?).

    Wishing you lots of strength, some good vacation, and deep sleep.

    M

  13. Please tell me that they at least paid you out for your missed vacation.

  14. Good point, and one that I should really ask about.

  15. But the idea that not only do I work my ass off to help people, but that I have a greater than 100% chance of being sued just because of my profession… well, that was just about enough for me.

    Yeah, it’ll happen–most likely with a patient you knocked yourself out trying to do right by.

    It has nothing, zippola, zilch, nada, bugger-all to do with your professional skills or behavior. (You know that, right?)

    Some people are on a continual quest for opportunities for legal settlements. Occasionally, these litigious assholes need medical care; eventually you will find yourself treating such a patient. (1) He will turn around and sue you purely because he can.

    Such people are not common, but they do exist.

    The take-home message from the lawyers isn’t that medicine is for chumps. It’s that you should (a) cover your ass, and (b) when it happens, don’t take it personally.

    ____
    (1) It occurs to me that such people probably have unusually lengthy records of filing civil complaints by the time they arrived at your practice. Does anyone know of a database of such information?


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