Medical

Overwhelmed In Training

Recently, my husband’s residency class was required to take a “Risk of Burnout” questionnaire. At the end of the assessment a number flashed up on the screen–a hotline for suicide prevention and therapy.

I think it’s safe to say that most doctors-in-training, and even medical professionals, are burnt out or have extensive periods of feeling overworked. We all are aware of the terrible consequences of burnout and overwork on the medical community: depression, divorce, loss of perspective and hope, self-destructive thoughts and habits (like addiction), and sadly, suicide.

Did you happen to see the “Humans of New York” post in December? See it here. It basically summarized how a bright-eyed newly accepted medical student quickly went from wanting to improve people’s lives and make a difference, to being completely depressed and checked out. In a relatively short amount of time, this person stopped caring and became numb. Of course not all medical students and residents feel this way, but I think at some level the sentiment is very relatable for everyone.

Basic time constraints and stigma that prevents many doctors-in-training from seeking help. They often feel that they will have to report treatments they are receiving. The lack of time to take care of themselves coupled with the avoidance of getting help, has horrible consequences.

My spouse and I personally had a friend in medical school who took his own life right after finishing his first year of med school. It was absolutely devastating. According to his family, one of the reasons for his suicide was his feeling of not measuring up.

His dream was to be a doctor. He worked hard to be “the best” but when he entered medical school, he was surrounded by “the best” so he felt average. He started to fall behind in his expectations for himself and then spiraled down feeling that if he wasn’t the best anymore, he never could be, and thus, was no good at all. This mental crisis coupled with the incredible demands of medical training left our friend with a total loss of hope. He felt that there was no longer any point to it all. It was, and still is, incredibly heartbreaking.

So why bring this up? Because this time of year often offers a time of reflection, an air of renewal in goals and dreams. It’s a chance to check in, take stock, and hit refresh.

How is your spouse/partner doing? If they’re struggling, how do you know if they’re experiencing general medical training overwhelm, a bout of depression, or something more serious?

How do you help your med spouse cope? And how do you cope? It’s not easy to watch and it’s not an easy position to be in, especially if you’re feeling overwhelmed yourself. I’ll address the question of burnout now, and will discuss more ways to help your spouse and help yourself in next month’s article.

I see two important parts of dealing with being overwhelmed in medical training: time and perspective.

Time. Your spouse may have recently had a reprieve from the demands of medical training with some holiday time-off or visits from family and friends. For some, there was no break, but for others, they had at least a long weekend or maybe even several days to catch a break.

These breaks are so important. Time off can help remind your spouse that there’s a whole world out there outside of medicine. There is more to life and more to them, than medicine.

I’ve also seen time and time again that our medical spouses no longer know how to “take a break” or “relax.” Unless your spouse is a super cool cucumber and isn’t phased by all of this, your spouse has likely programmed themselves to just charge along without thinking about the state of their lives. If they pause for too long, the whole thing feels depressing.

Time is vital, but so is perspective.

Our friend that took his life, did so after a leave of absence. We saw him a at party a few weeks before and we talked at length with him about traveling and getting some renewed perspective. He seemed excited at the possibility and so hopeful. But then after some dreaming, I think the reality of medicine kicked back in. His dream was medicine and he felt like that dream was dying.

For most, medicine has been a life-long goal. One stepping stone at a time to get them to their “dream job.” The hard reality is that sometimes they will fail, or fall behind and struggle. Sometimes it’s not what they thought it would be, or they’ve built it up with so much hope and expectation that when it’s not what they want anymore, they crumble.

Our spouses are incredibly fortunate that they don’t have to go through this alone. They have us, their partners, to support them. We are ready to swoop in to help when necessary. Not all people show signs of burnout or suicidal tendencies, so it’s in no way solely on your shoulders to prevent this. You can’t control the situation; all you can do is be attuned, ask the hard questions, and encourage them to seek support and help when needed.

Whenever I am reminded of suicide in the medical community through a conversation or an article I’ve read, as awkward as it is, I ask my husband point-blank and straight in the eye: “Are you ok? Would you ever consider this?”

It’s hard to put him on the spot, but I need to see if his answer is solid, or if he squirms a bit. If there’s even a slight squirm, a small chance that he’s feeling like he needs “an out,” I want us as a couple to address it head on and in the open. No sweeping it under the rug or skirting around it. If help is needed, we must find a way. We must make the time to gain a fresh perspective.

“Help” can start simply with scheduling in dedicated time for self-care or social time, finally using some sick days for a little break, or doing something bigger like taking a leave of absence. Most of the time, an open and honest conversation is all that is needed. You sharing your concern and asking how you can help. It’s a reminder that someone sees them, has their back, and is in their corner. You are there for them.

An incredible talk that I highly recommend both you and your spouse listen to is Brene Brown’s “Listening to Shame.” It addresses these issues head on.

This article is not meant to create any unnecessary concern. It’s meant to address the elephant in the room. The point is to remember that nothing is set in stone, including a commitment to medicine. If your spouse feels lost or like they need a break, that absolutely can be addressed and arranged. Plans and timelines can be flexible and altered. Forget about the money, debt, or consequences. If your med spouse is seriously struggling, do what you need to do to turn the ship around.

Check in next month for more strategies for how you, as the partner, can cope with an overwhelmed medical spouse and get the support you need. In the meantime, I’ll leave you with this paraphrased quote by Theodore Roosevelt:

“Do what you can, with what you have, where you are.” Stay courageous. Stay flexible. Let your compassion and love, not your fear, guide you both on this journey.

A
Amy Rakowczyk is a medical spouse, mother, writer, singer, and former voice instructor. She currently resides in Galveston, TX with her husband and tw...