It’s just after six o’clock on a Sunday morning in December. The barn animals have fresh hay and warm water. My wife and the dogs are asleep. The cats are gathered around me as I sit down to write. One of them has jumped up in my lap and is pawing and clawing my jeans.
The fire is roaring in the wood stove but the 1790 room is still cold. I have read the morning news on my iPad. Our house is quiet, always; we don’t have a television or a radio. We have more time to think that way.
I do a lot of thinking these days, even though I put in long hours at work. During my commute to and from the clinic and during the long winter evenings I have plenty of time to think about my role as a doctor at this age, in this place and in these times.
I never wanted to do anything else, and I never want it to end. I cringe when I hear things like the commenter on my blog who wrote “I am sick of it and intend to retire as soon as I am able”. What a shame, what a waste. Kings, Presidents, Supreme Court Justices, Popes and Archbishops don’t usually retire “as soon as they are able”.
In some fields, age and wisdom are valued, especially the combination of the two. In many areas of medicine, at least in this country, doctors aren’t feeling valued at any age or skill level. Many feel like pawns or cogs in big, corporate schemes.
We have allowed ourselves to be devalued, and we as a profession have lost our clarity of vision, our sense of calling. Because of how unappreciated and squeezed we feel, we are at risk of losing our love for mankind, without which we will completely lose our professional purpose. We are thinking too much about production and quality metrics and losing sight of our apostolic and archetypal role in the lives of the patients we serve.
We are too distracted these days; we are practicing medicine with our minds, but not always with our hearts. We need to remember why we are in this profession and we need to stop feeling sorry for ourselves.
Victims of psychological domestic abuse undervalue themselves, overestimate the power of their tormentors and underestimate their own options. They stay in abusive situations sometimes because they don’t see clearly what is happening to them. They become physically isolated and feel shame, isolation and loneliness.
Professional burnout has many similarities with these facets of domestic abuse. But doctors are not really as tortured and trapped as abused spouses. Some of us just feel and act that way. We have one of the most meaningful jobs in the world. What a shame that so many of us want to get out of it while they are still able to do it.
Others have thought and written many wise words, not so often spoken today, about finding meaning in work:
“No man needs sympathy because he has to work, because he has a burden to carry. Far and away the best prize that life offers is the chance to work hard at work worth doing.”
― Theodore Roosevelt
“He who works with his hands is a laborer.
He who works with his hands and his head is a craftsman.
He who works with his hands and his head and his heart is an artist.”
― Francis of Assisi
“The purpose of life is not to be happy. It is to be useful, to be honorable, to be compassionate, to have it make some difference that you have lived and lived well.”
― Ralph Waldo Emerson
A small taste of these ideas is what I wish for those of my colleagues who are unhappy this Christmas.
A Country Doctor Writes: 
Thank you, and Amen.
Well said!
Thank you. Sometimes we experienced physicians are portrayed as out of touch and behind the times, and maybe we are. But I agree that we should keep offering our knowledge and experience as long as we can be useful, and not devalue ourselves. Love the Emerson quote
All of this is extremely true, but unfortunately the reality is that regular citizens do not have any sympathy for doctors. Those of us who have taken a bold leap in the direction of reform such as embarking on a direct primary care journey must care for each other as physicians (direct care and usual model alike) , and care for our patients the best we can, then continue to hold tight as the tides slowly but surely change.
We rarely take care of people in their best states, often in their worst. To expect sympathy while running away from the profession isn’t pitiable, it’s pathetic. Apply grace in greasy handfuls and forgive yourself for telling people things they don’t want to hear. That’s the work physicians perform.
People who are leaving medicine almost universally suffer from burn out, or worse…maybe you could apply some of that “grace in greasy handfuls” to them, rather than labeling them as “pathetic”