A Doctor’s Burnout

A Doctor’s Burnout

By: @JaaneWoman

It is 6 am and I have just woken up. The workday will soon begin. The only problem is I have no clue how long it will be.

For starters, from 8 am to around 12.30 pm, I will be managing patients at the hospital’s Out Patient Department (OPD), which gets more than 200 of them on a daily basis. Next, those patients who need to be admitted will have to be attended to. 2 pm onwards, I will be managing the emergency room, which in any case is always teeming with patients. On the days that I am ‘on call’, my shift will end only after 12 noon the next day

There are times I sleep on the stretchers in the operation theatres. I carry my toothbrush and a small towel with me all the time. Finding a bed to sleep is a luxury on most days. But that is better than sleeping during surgeries because that happens, too. Ironically, the only days that post-graduate residents get a break from work is when there is a strike to protest the meager salary, the working conditions, particularly physical assaults against us, usually by relatives of patients.

A resident’s travails start with the abysmal doctor-patient ratio, sometimes as high as 1:200 during peak hours in the emergency dept. It’s a ratio that has the doctors not just outnumbered but scared for their safety should things not go the way the families want. Patients coming to the tertiary hospitals are often from far-flung areas, usually exhausted by the effort of accessing some sort of healthcare. The overworked doctors, too, have little patience left to focus on communication. It is an incendiary combination.

Most of the time doctors do more than just attend to patients. We fill forms for the patients, many of whom are unlettered, fetch test results, arrange blood and even shifts patients around for an X-Ray or a CT scan — all jobs that ward boys are supposed to do. The acute shortage of ancillary staff is wearing down doctors. Emergencies are the worst. It means that the resident doctor has to be available throughout the night. On such days the work stretches up to 36 hours and they come sometimes three times a week. And the room that we retire to, if we ever have the opportunity, is anything but welcoming. Seven to eight residents are often cramped in a 100 sq-feet room with no clean washroom facility insight.

Depression, too, is widespread. We leave our personal lives behind us at 18. Our parents want us to get married but where is the time? We are willing to serve the patients but don’t we deserve a shot at a normal life too?

Doctors burn out not because they are incompetent but because they are at the mercy of a healthcare system that is not fit to take care of patients. They burn out because the majority of the time they bear the brunt of such pathological system failures. They burn out because they are the face of that system that needs dire resuscitation. They burn out because most of the times people forget doctors are not the culprits, they are the casualties. Casualties that manifest in the form of strained relationships, broken families, difficulty communicating, constant anxiety, severe depressions, marked suicidal tendencies, temperamental issues, failing health.

To address this fairly common notion among the general masses that doctors don’t attend to their patients seriously and their gross negligence, I am going to break some common myths.

One, it is more than enough mental work just for any normal person to witness deaths on a daily basis. Coupled to it the guilt of not being able to save someone’s life or cure them permanently is too much for the conscience. So stop tugging at my conscience, it died the day my PSM professors blackmailed me into donating blood for extra 5 marks in final exams.

Two, there is a reason why Hippocrates, not Aryabhatta is the father of medicine. Medicine is not arithmetic. Here two plus two do not equal four. Myocardial infarction plus nitrates do not equal life. Charcoal roasted lungs plus few hours of oxygen do not equal the minute ventilation of an athlete. A lifetime of drowning in alcohol cannot be cured by a night of antibiotics. Two treatments do not necessarily add.

Three, shouting at doctors and creating ruckus is not going to make me transplant my own lungs into your patient. No ventilator means no ventilator. You can check my pockets. I swear I never hid one in there.

Four, there are no counseling centers for microbes yet. If your patient’s infection is not responding to antibiotics, no amount of complaining and cussing is going to make staph or strep change the production of their toxins overnight.

And five, as opposed to the contrary belief, I admittedly do get to eat and pee sometimes. I know it is against the Code of Hammurabi but then those guys are busy ruling middle earth, I might take advantage of the moment and instead follow the code of human physiology. It does help me in giving ‘gut feeling’ at times.

And yet, amidst all the bleakness, the lack of a personal life, poor compensation, and being treated badly, there are the occasional moments of light. When someone gets better and even acknowledges our effort, it makes up for all the hard work.

Happiness, after all, doesn’t result from what we get, but from what we give. Most do not understand the price. Mortals rarely do.