Welcome!

Allow me to introduce myself, and the journey I am on.

Hello. My name is Shailla, and I am a burned-out physician. I am an expert in burnout, which I am not proud of. I call myself a burnout expert because I have burned out so many times. As they say, live and learn! I am still learning and here to share what I have been learning.

In retrospect, my first brush with burnout was during my first year of medical school, maybe even during our first anatomy block. I remember one weekend, coming back home to my parent's house. I walked through the door, dropped my bag in the foyer, and went straight up to my childhood bedroom, turning off the Holly Hobby light and climbing under the sheets of my teenage bed. I shut down completely. I could not move; I did not know why, but my body could not take anymore and said no.

Of course, my mother became worried that I was depressed. She worried about everything. Maybe she was concerned about a few other things as well. She was watching history repeat itself, hoping for a different ending.

My mother was the first female student from her town to attend medical school in the late 1950s. She dropped out and was taunted for being unable to handle a man's job. That would not happen to me; the world had changed by the 1990s. (A rhetorical question for those in the know). I believed I could handle it, and whether I wanted to. After jumping through the hoops of admission, it was not even a thought I wanted to consider. It was a job, a good job. It afforded safety, or so I was hoping.

Good jobs were hard to find in the 1990s in Nova Scotia, where I grew up on the East Coast of Canada.  A recession had hit us, so business was struggling, and with the baby boomer generation occupying the most stable jobs, getting into the job market was near impossible. It was reality, which is also why we could relate to the cast of Friends sitting around a coffee shop all day, running between their precarious employment gigs. So, getting into medical school seemed like a golden ticket. I knew it would be hard work, but I also knew no matter what I did, it would be a struggle.

And I struggled. I thought I was alone in this, all by myself, as I entered class every day.  My classmates seemed to find everything so cool and exciting. No one else seemed overwhelmed with the volume of information we needed to learn and digest, the responsibility. They seemed excited by it. As time went on, I realized that a few of them could have been shot in the foot, and they would have thought it was the most exciting thing that ever happened to them. From the get-go, I thought I was different from them, and I began to question my choice. After working so hard to get in, how could I not want to be here? Amongst all the others who were grateful to be here, outwardly confident and inwardly willed, I certainly didn't want to reveal my perceived incapacity. It was just the beginning, and I couldn't let my guard down so early. I knew I had to meet the challenge and test my strength. It was expected of me and all of us.

I could see it was about to get harder when I saw the students of the classes ahead of me. When they returned to the medical school on their half-day-back from their hospital rotations, they appeared as the zombie versions of themselves - bloodshot eyes encircled in grey, dragging their feet with fatigue, wasted musculature struggling to hold up the cup of coffee that fuelled them. If you can believe it, the residents appeared worse. Their physical unwellness was so visible. Paradoxically, we were there to learn how to mend the sick, not to learn how to keep people well, let alone maintain our well-being.

As I write these words, it's laughable. How can you treat someone when you are not well yourself? We do it as doctors, nurses, and helping professionals. It is our duty. Yet, it is not sustainable. No one mentioned burnout. No one discussed our mental and physical well-being. No one even talked to us about dealing with and processing the tragedies we were about to witness. It was Keep Carry and Carry On before that became a popular meme.

At that time, the culture of stoicism was still strong, leaving many doctors stiff and unfeeling. That is not to say that things were not changing. There were attempts to change the medical culture. It started by accepting what they classified as more well-rounded, "humane" students who volunteered in the community and pursued the arts alongside the sciences.

The problem, as I see it now, was that we were indoctrinated into a hierarchical, patriarchal, stoic culture. In the end, it just meant that we well-rounded, touchy-feely types got exposed to more trauma than our empathic neural pathways could handle. Being told to suck it up and keep going put salt in our wounds. Many of us just learned to grin and bear it but at a cost. As we shall review, the research shows being more empathic may have put us at a greater risk for burnout. Luckily, the studies also show us the antidote - compassion.

Culture change is slow, and it must start somewhere. Often, it starts with the youth. So, the efforts to change medical culture were not made in vain. At my medical school, there was even an emphasis on the Art of Medicine, the humanities component. Spearheaded by the Dean of Medicine, Dr. Jock Murray, Dalhousie's Medical Humanities program kept the history and the healing arts in medicine at the forefront of our education. Hanging on our walls, amongst the patriarchal figures of our profession, were the paintings of Robert Pope, whose brush strokes depict his perspective as a patient with cancer. We read the poems of Glen Downie. The one about an elderly woman with dementia named Louise still sticks with me: "And the nurses say shoot me If I get like that." We read the stories of Dr. Perri Klass and her experience of holding space not just for her patient's suffering but also her own as a witness to it all. The art - the stories, the poems and the paintings, mirrored back and helped me define my feelings. Seeing the experience through someone else's life helped me validate my own experience. It allowed me to keep that part alive until there was no more time to do so,  which sadly happened during the intensity of residency.

My education and experience practicing medicine shaped the person I have become, and they have also affected my health and capacity. As I mentioned, I am a burned-out doctor, unsupported by the system that hired me and is now begging me to stay. I still love helping people, but I have been forced to scale back and sometimes stop so I can tend to myself.

I share this work, these stories, and my journey through healing because I can. I hope others can relate to it and realize they are not alone in feeling however they feel. As we talk about it and share the craziness of it all, I hope we can find compassion for ourselves. As more people join in to practice compassion for themselves, self-compassion will seed itself and grow. When we recognize our suffering, we can act to relieve it. When we act compassionately to alleviate our suffering, we can sustain compassion for others and alleviate their suffering. It is how we lead change in medical culture.

Join me on this journey.