Four weeks ago, as I sat in the Anchorage airport waiting to board the first of three planes that would hurtle me through the sky towards another country, I was remembering the first time I had gotten a stamp in that little blue book, and the country with that honor was Costa Rica. In early 2023, a week after getting a moderate infection with COVID, I flew to Costa Rica for a retreat in the jungle with a group of sober women. The retreat, aptly named You Are That Light, was transformative, physically, emotionally, and spiritually. The question on my mind at the time was whether or not I could stay at my place of employment, having been beaten down by a misogynist and toxic work culture. I was burned out, emotionally exhausted, cynical, and felt inconsequential. The laughter and tears on that trip, the jungle hikes and ocean swims, cleared my soul. Several months after returning from that retreat, I gave my 90-day notice from my job.
A month ago, I was discouraged to admit that there I was, about to embark on another retreat to a foreign country, feeling the same as I did in 2023. While my current work environment is so incredibly supportive and not grossly toxic like my previous one, it’s still so challenging to work in healthcare. Emotionally exhausting, physically depleting, and on some days, so soul stripping sad. Trauma, disability, pain, addiction, despair seems to tip the scale day after day. Not my trauma of course, but I find that my empathic nature makes it difficult for me to care for my patients without taking on some of their trauma and emotional pain. If there is a way to avoid this secondary trauma, I have not yet learned how to do it.
So yet again, I was questioning my ability to stay in the practice of medicine. I am very happy to have moved to Alaska. I love the weather here, the mountains take my breath away, every single day, and though I have yet to live through a dark winter, I have hope that groomed cross country ski trails lit up at night will get me through the winter months. While I miss my home in Reno, I don’t miss the 100-degree temperatures, nor the fires, one of which this year occurred not too far from our home. No, it’s not the place I’m questioning, it’s the profession. While many of my friends wonder if maybe I just need to change the setting, move from inpatient care to outpatient care for example, or do non-clinical care that doesn't have direct patient contact, I know deep in my being that the external setting is not at the heart of the issue.
The question is: Can I be who I really am and the type of physician I want to be—open, compassionate, loving, kind, taking time with my patients, from without the container of modern medicine that is so fraught with administrative control, documentation requirements, financial decisions, and insurance interference?
As I got ready to board my plane to Seattle, to then catch a flight to Amsterdam, followed by a flight to Florence, I pondered these things. I was going on a retreat to Italy with another group of sober creative women. The title of this retreat was The Muse. I was hoping to get in touch with my own inner muse – that powerful creative woman that knows how to create the life she needs and wants. A life where I can use my power in a way that does not destroy me bit by bit.
Valerie, I hear you with my ears and with my heart. I just participated to a Secondary Trauma Resiliency Training for healthcare professionals. We addressed exactly what you are writing about. There is no solution though, just little mechanisms to stay above the water. I am sending you my love from Reno. Anamaria
I keep wondering if there's a place in medicine for position-sharing -- one month on/one off; or 6 months on/6 off. Does this exist anywhere in the world?
It is so many things. I’ve practiced medicine adjacent long enough to know how fantastic it can be and how impossible it is right now.
The systems aren’t sustainable for humans. You can feel like a line on a spreadsheet. Hard to feel hopeful even when you have the best self care home program ❤️