The humanist at rest

This bird has flown.

Thu, 4 Mar 2010 17:29:18 -0600

Somehow I’ve found the courage, or become deranged enough, to give notice and secure a departure date from the corporate craziness I’ve been working in. It has taken few folk by surprise; this shuttering has been a long time coming. So what comes next? I’ve been back to looking at Albert Schweitzer in this last few weeks, and found the most arresting quote from him: “I became a doctor so that I would not have to talk.” It would have been easy to snort dismissively and say, “Surgeon!” in years past, but the context of the remark is important. The man was a theologian, a university professor. He was all about talk. Being a surgeon in a foreign land was really an antidote to years of words and academic arguments, in addition to being his next avenue of service.

What I find rather hilarious and poignant all at once is that I, as a doctor in 21st century America, am profoundly tired of talking. The irony is not lost on me. I went into this profession with the clueless notion, which cluelessness I have detailed in prior posts, that there was some separation between action and discussion. Please. I was young and naive. I have come to realize that communication in medicine means everything, that it means immersing oneself and all one’s senses into the interview and physical, but also means sitting back after that information is gathered and going over it in detail with the patient. It is demanded of me to teach. After the interviewing and the physical exam and the teaching with the patient, it is absolutely incumbent that I dictate as lucid and complete a note as possible about that encounter, so that anyone can understand my findings and thought process. This ends up being a fair amount of verbiage by the end of any given day.

And so, I am tired, and needing to stop for awhile. I’m going to take a little time to let other parts of brain and body have their day. For anyone who wants to know, “what’s next?”--I’ll let you know as I find out. It’s a scary, necessary time, finding the next avenue of service, or letting it find me. Here’s to us all being found by the work which is ours to do.

Can you spell “burnout”?

Fri, 8 Jan 2010 18:44:28 -0600

If you take the time to look over quotation resources on the Internet, you will find very few quotable quotes about burnout. There’s lots of advice about how to avoid it, or deal with it, and there is a truly sobering survey called the Maslach Burnout Inventory if you feel the need to quantify the amount of your discontent. So I began to wonder, as a disenchanted physician in corporate American medicine, whether or not burnout was even a recognized entity until fairly recently. Then I stumbled on the above quote from Albert Schweitzer and remembered again why I like the guy so much. It’s helpful to me to recap some of that today, after a pleasant but frank meeting with our benefits person about leaving my current job. The bottom line is--burnout is expensive--and I’m not sure it is always preventable or undesirable.

Let’s look at Albert himself as an example, as an interesting case study in second careers. He was an established theologian and organist in search of another form of service, and he looked around for awhile before finding something that seemed to suit him. He dropped letters in the mail to a bunch of his friends announcing the fact that he had resigned his post and was off to medical school and thence to Africa, and naturally many of those friends thought he had lost his mind. He went off to Africa to start his clinic in Gabon, but continued writing theological works and supporting his jungle doctoring with tours and organ recitals. He had his major epiphany about “reverence for all life” while stuck in the middle of a river waiting for a group of hippopotamuses to move out of the way of his boat. This was a guy who, by all accounts, walked the walk. Evidently he was also a fellow who had experienced the “inner fire” going out, and could speak to its rekindling, as well as the wonderful things which can come about after that.

Why does this resonate with my burned out soul? Because shortly after I left my last job I had my first opportunity to read Dr. Schweitzer’s autobiography. It was not the story I thought I knew, and I found it helpful then, as now, to remember that no one’s story is a straight line, and to recognize with great humble thanks that I am surrounded with people who “rekindle the inner spirit.”

Back in the saddle...looking for a different horse.

Fri, 1 Jan 2010 20:15:05 -0600

I’m more grateful for recent events than I thought I would be...and there have been so many recent events. The trip back to Texas in November got me my first pair of long-overdue cowboy boots and hopefully the attitude to go with them. It gave me a chance to visit with a dear old friend and two wonderful professors who all changed my life for the better so many years ago, and it provided me with a more profound understanding that other people have faced the challenge of needing to go away and do something else with greater or lesser grace than I have managed so far. I am mindful of the cautionary tales. I am also ruefully aware that up to this point in my present situation, my caution has only gotten me kicked in the teeth again and again. So I came home from Texas feeling like a good Texas woman.

The next day brought the abrupt onset of significant parental illness, which we as a family have been dealing with ever since. The roller coaster of recovery and relapse has mirrored my awkward two-step of trying to figure out when to intervene, when to console and translate the medical terminology, and when to back off. Once my parent’s doctor addressed me as “ma’am” I figured I had made some impression, either as just a crotchety old gal or as a medical colleague who would at least need to be placated. There will be plenty of need for placating if he ever says again that the symptoms which prompt an ER visit might be mental. What the hell? I had such hope for this young man; now that he has “ma’am”ed me I can’t think of him in any other terms than “young man”. I wanted to tell him he has tipped his hand, that he clearly does not know his patient; and yet he does not know what he does not know, and at some level it will impair his ability to doctor. So instead of threatening him with bodily harm, or insulting him in as grievous a way as his patient felt insulted, I spoke to him in the ER about symptoms and history, leaving out my suggestions for all the other ways that he might have said he did not have a ready explanation for what was going on. For the truth of it is, the lack of an explanation, and his discomfort at not having a ready answer, is what drove his response. I have that T shirt and could teach him several other honest ways to clothe himself...ways that don’t hurt someone else. I’m reminded of what happens when you try to teach a pig to sing--it just wastes your time, and annoys the pig. But I’m not above annoying pigs when barbecue is not an option.