Facing Reality

Underlying Chronic Burnout and Career Misalignments

August 12, 2022

“I am collapsing inside.”

I wrote that just 3 weeks before life as I knew it came to a screeching halt.

I was already struggling, but managing to hold on in hopes that “things would be better” after fellowship.  It’s very possible they would have, in many respects.  But I was dying inside, and had felt that things were “off” since well before starting residency. I had already experienced a pretty severe energy crash during my clinical years of medical school. I wasn’t getting the time I personally needed to just sit and think, to reflect on my processes each day or week (or even, month). I was moving forward in a daze. Right before Match Day and subsequent pandemic levels of chaos, there were some family issues (and a family death) that occurred which drained out whatever “extra” energy one is supposed to acquire in their internal reservoir during the 4th year of medical school. Honestly after all the traveling for interviews and trying to still prove myself for letters of recommendation during that year, my tank never refilled fully after the crash during clinical rotations.

After starting residency, I felt duped at having matched where I did where, as it turns out, many core issues had been building for years and more tasks pushed to residents who were gaslit for attempting to point out problems and express the tipping point which toppled even before the pandemic. But of course, none of this was obvious to me during the interview process. I kept seeing or hearing people say “it will get better when…” But what if the “better” didn’t come until it was too late? What if the internal bomb of exhaustion and resentment was set off before things got to “better”? What if “better” still meant living less than optimally for my deeper set of values and personality characteristics?

The very weekend that my world turned upside down was the weekend I started to seriously reflect on my career path and what it was requiring of me. I downloaded Chelsea Turgeon’s “5 Steps/Days to Career Clarity” – a super helpful (free) resource on her website. This would become just the beginning of my time following her prompts for internal reflection on career paths and purpose.

Two days later my reality was flipped. The very next day after “it” happened, I wrote, “I need a sabbatical. I don’t feel like I can make it through boards…I hate it here. I feel like I tried SO hard to analyze things properly and make a good decision (regarding my Match list). I instead don’t belong here. Maybe ‘here’ is [that town], maybe it’s any form of medicine. I feel like I could do very well if I can make it to the [post-fellowship] part but I despise this process. I want to think about other things.”

After that I kept writing in an attempt to process what had happened that night, but I stopped mid-sentence. It was the very beginning of another intense month on the more stressful rotation which was magnified by the multitude of problems present within that department.

Long story short (maybe for another post), I put my head down and tried to make it through the rest of the month until my Women’s health appointment which was, thankfully, coming up soon. When I arrived 2 ½ weeks later for that appointment, I told them what happened, how I had gone to multiple other resources in the immediate aftermath which bred only more confusion. I was ridden with shame and self-directed anger. I told them how much I was struggling with my tasks at the hospital.  How exhausted, confused, and anxious I had become over the past 3 weeks. My healthcare is through the VA currently, and I need to give them a shout out because they swept in around me, made sure I started the process for FMLA (Family Medical Leave of Absence), made sure I did not leave the building that day without necessary consults, and did so in such a way as to maintain my dignity and privacy. More than that, they saw my complete exhaustion and took care to make the transitions between appointments that day as smooth as possible. I was starting to think that maybe I just needed to keep my head down and keep working, that it was “no big deal.” They, in contrast, helped me to see the urgency and would not let me leave without a note providing a couple of initial days off to start recovering from everything.

I returned to work for a couple of days, in a daze of exhaustion and confusion, to get the necessary paperwork and have the requisite meetings with people who needed to know.  I hadn’t immediately told my program director what had happened, for multiple reasons, so I filled him in and discussed some initial possibilities of how things might work when I returned.

That presumed that I would return.

I presumed I would return. I figured I wouldn’t even need the full length of FMLA to be ready. I thought I could plan my healing. I was so wrong.

I think it was less than a week after I officially started on leave that I signed up for Chelsea’s Authentic Career Alignment program. I had finished some of the reflective activities from the other packet which had gone suddenly unfinished whilst I figured out my next steps in the aftermath of this chaos.

I was simultaneously participating in intense and focused PTSD therapy while starting the work of deeply examining my career values and where things may have been misaligned. Some days I would come home from my appointment, in time to prepare for the group coaching. In the very beginning the fatigue was so profound. I would be almost falling asleep by the end of it and it wasn’t even noon yet.

I was starting to wonder how long this process would take to get back to normal, back to the woman I was BEFORE everything was dismantled.

I’m interested to know if any of this resonates with you. Please feel free to share below.