I had an amazing conversation with a wonderful friend tonight. The conversation was about life, mental health and the all round messiness that often surrounds both those things. 
She said "I wish people talked about this more".

I couldn't help but agree.

For a long time I didn't talk about it openly. 
I certainly helped my patients with their mental health and I think I was good at it. But I honestly didn't see my own impending burnout. I couldn't see the looming storm clouds heralded by 3am wake ups and unfulfilling sleepless nights, by constant worry about making a mistake, by bone aching empathy fatigue. 
I couldn't see it, because I was so blinded by my compulsion to help others. 
A noble compulsion for sure, but a blinding one none the less.
I also couldn't see it, because so many of my friends and colleagues were exactly the same as I was.

There are obviously individual factors at play here as most of my colleagues haven't (officially) burnt out despite my observation that so many of them were and still are feeling similarly. 
Is that a marker of resilience? Perhaps.
Or is it a marker that my path was just going to be a different one? 
That the barrier between me and change was thinner?
My yoga teacher training introduced me to the concept of ahimsa, of doing no harm to other living beings. 
But here I was unwittingly harming myself everyday by my inability to place caring for myself high enough on my own agenda to protect my own mental health.

So when it all came crashing down, I crumbled into a series of debilitating panic attacks. The first one lasting almost 48 hours. An entire weekend of sheer internal panic that left my aching body depleted and empty. 
I thought to myself in that moment "OK, I'll take a week off work".
One week off work, booked in 2 weeks ahead of that date because I was already booked up with patients for those two weeks. 
Looking back now I can't believe that I was still unable to see the storm that was now gathering ominously overhead.

I still didn't know I was burnt out. I just thought I was stressed. That I needed a holiday. 
The second panic attack put an end to my plans to see out the two weeks of patients that were booked in.
I was dressed and ready for work, the kids all ready for school. 
I went to walk out the front door of my house, when all of a sudden I was gripped with completely unmitigated fear. 
The vice around my chest and throat told me that this wasn't going to be like that first panic attack that I could quietly implode inward with. 
This one literally brought me to my knees. My 3 and 5 year old children worriedly watching on while I burst into panicked tears at simply the thought of being outside my house. The thought of leaving it's safety, even though I had rapidly come to realise that even my home didn't provide me sanctuary from my thoughts. 
The rising heat in my chest, the crushing feelings of suffocation. 
I had this unrelenting sense that I needed to run away, yet no where to run and an acute awareness that this feeling would follow me wherever I went.
To remember that feeling now still brings tears to my eyes. 

Since that time, I've been re-building myself. I've been immensely fortunate to have a supportive family, colleagues and friends in this time.
I have talked very openly about my struggles.
Burning out and even more than that, my process of active decision making as to the path I take forward since then has formed such an integral part of the person I have become that I do feel grateful in a sense that it happened to me.
I now know where my 'peak operating point' is. Perhaps it's lower than other peoples? That's OK.
Because ultimately, I know what happens when I go beyond it. 

The path back from burn out is no easier than the path there. Both fraught with uncertainty and fear.
But one is more active. The dark clouds begin to gather overhead again and you ease back the throttle, mindful that it was lack of self awareness that contributed to me arriving there in the first place.
The compassionate voice in my head now reminding me to slow down, to notice the physical warning signs of stress and allow them to complete their journey through my body rather than carrying them with me, unheeded, forever held and accumulated.
I am more mindful. Content. 
We are all on a different path in life. My goal is no longer to 'keep up'.
The 'doorway of change' that I sensed when I burnt out is now wide open, with the expanse that lies in front of me both exhilarating and unnerving.
My hope now is that I can continue to speak my truth and to walk beside others who find themselves on this path to burn out and back again. ​

Blogging for me has been an interesting thing. It’s so easy to think that the thoughts I have and the problems I encounter are mine alone. To identify myself with them and define myself by them. To think that no one else in the world has these thoughts or problems.
Blogging has opened my eyes to the fact that this really isn’t true.
We share so much of our humanity with those around us, yet often we feel like we must keep those ‘uncomfortable human bits’ to ourselves. To project our best self forward only.

Thinking back on when I burnt out, I remember how I felt then.
Alone.
Overwhelmed.
Tired. So tired.
Depended on. Suffocated.
Yet, I was still functioning.
Outwardly at least, I was ‘good’. Perhaps slightly ‘stressed’, but ‘good’.

When in fact I didn’t even know how ‘not good’ I was.
I remember saying at the time that I felt like my “doctor light globe had gone out”.
I was still happy at home as a wife and mother, but my fuse was shorter.
I wasn’t depressed, but my sleep was affected. I would wake most nights in the early hours and lie there, unable to get back to sleep. But I was productive in those early morning hours. Ever the lark, I got work done to maximise my bodies inability to hold onto the fitful slumber of those cold moments pre-dawn before my household and the world awoke.
I had started a new business. I had done all the branding and marketing myself. The website a shining example of my early morning exploits.

My body’s subtle calls to slow down and find balance were duly noted.
I threw the full force of over a decade of personal mindfulness practice to bringing mindful awareness to myself and what in hindsight was my impending burn out.
I practiced gratitude and self compassion.
I journalled.
I practiced my beloved yoga. In fact, ever the Type A person I was, I was in the process of undertaking a full 200hr Yoga Teacher Training. So yoga too had become a ‘job’ to me.
I ate well, I went to bed early (to counteract the 3am wakefulness).
I saw a psychologist.
I did everything that I told my patients to do when they found themselves in these difficult times.

But I still burnt out.
Why?

In the time since then, I’ve been blessed to be able to spend a lot of time in reflection on this. I’ve also been graciously supported through an intense period of personal growth and discovery by my husband and family. I feel like I have a better understanding of the stones that paved the path towards burn out for me.
This is of course only my path.
Perhaps others may find a stone or two common with their own and find these reflections helpful?
Perhaps not.
But here are some of the things that I have learned by walking this path to burn out and back again.


That a step back is often infinitely harder to make than a step forward in life.
Life has a certain inertia to it. Each day rolls around, as the seasons change, the world keeps turning. Life keeps moving on.
Even in the most untenable situations there is still momentum to time alone.
In choosing to take a step back from work, socialising, the online world, what ever it is we are considering taking a step back from, we are innately aware that these ‘worlds’ keep going without us. Nothing is on pause.
Stepping forward, in whatever capacity we can, continues to indulge us in the idea that we are ‘keeping up’.
Stepping back (or even sideways) involves the reality of falling behind.

Now I know that this isn’t a bad thing. Logically, we ALL know that this isn’t a bad thing. But I want you to think about the last time you turned down an opportunity or opted to take a leave of absence. How did you feel?
For most of us, the FOMO is strong!
And when we inevitably return to our own forward path in life, we are acutely aware of the momentum we feel we’ve missed.
Again, this is not a bad thing. Simply my own observation as to how I felt pre ‘stepping back’. That sometimes continuing to do something, even if we know it is bad for us, seems easier than making a change.

There is a threshold at which my brain functions optimally.
When I stress my operating system above that threshold, all functions tend to suffer. I and I alone am the one who knows where that limit is and therefore I and I alone am the one who must honour that limit.

That flattery of the Ego will often cause us to go beyond what we know we are capable of.
Is this a good thing or a bad thing? I guess it depends how much point 2) affects you or not?

That the thing that hooks our Ego in the first place, often begins to harm our Ego when we use it as an excuse to go beyond our optimal functioning limits.
For example, for me as a doctor it was helping people, a noble cause for sure. But when it became something that I allowed myself to make excuses for continuing to cause stress to my body as I watched it crumble around me, it was in fact merely a ‘hook’ that kept my Ego in the game. Helping people isn’t something you do as you’re drowning, that’s ‘saving’ people. And when your Ego is in the game, it becomes less about helping and more about saving and being a saviour.
Think about it, there’s got to be something valuable on the table to keep playing as you watch your world falling apart around you.
Now this was an uncomfortable truth for me to learn. My Ego story made it very easy for me to talk myself out of this fact. The praise and adulation of those around me made it even easier. But the more I made friends with my own Ego, seeing it not as a ‘bad’ thing but simply a construct that I had built around me over time. A reflection of the stories the world had told me and that I had absorbed about myself.
I was a ‘good person’.
I was smart.
I was a helper.
I could put aside my own needs for the needs of others.
As I began to see my own Ego as a small child in want and need of protection and affection. I saw that this steadfast push beyond even what I knew I was capable of at the time was not in fact ‘personal growth’, it was survival. Survival of an Ego and a person simply doing their best.

And this brings me to my final point.

No amount of mindfulness or yoga can outweigh a lack of self awareness.
Self awareness is about knowing when to say ‘no’ more than it is about knowing when to say ‘yes’.
It is about learning where that ‘optimal functioning point’ is for your brain and respecting it. Not about never going beyond it (after all that is where we are able to grow) but more about bringing mindful awareness to when you are existing at your growth edges. Being in control of that time. Knowing when to pull the throttle and when to hit the brakes.
It is about making friends with your Ego. I mean true, laugh until you wet your pants kind of friends with your Ego. About seeing your Ego with the most compassionate of eyes and thanking it for always being there to protect you when the chips were down. About loving it and then carefully strapping it into the back seat so your True Self can take over from now on.
Awareness of the Self is about knowing that we are beautiful, dynamic and complex creatures who need to commit to a daily practice of exploration and compassion as we move and grow over time.

Like I said, this story is not all burn out stories. It is just mine.
It is however, a road I walk with many other travellers and I’m sure there is a step or two we may walk together on.

What I’ve realised in the process of break down and re-build is that some of the best things about me exist in those ‘corners’. My creativity for one. My self awareness- that innate sense of who I am and what I need. My ability to connect with other humans in a really meaningful, two-sided kind of way. My unquenchable thirst for knowledge in the most obscure and broad ranging topics.

Specialty training programs. Hospital jobs we have to apply for each year. The way "things have always been done". 

It's easy to think that we need to be 'round' to fit in and succeed in medicine. To some extent we do. The medical world has a way of doing things and there is always going to be round holes that we cannot change. What we can change is how we talk about this and how we support people who like I did, find the endless round holes of the medical world to be exhausting at times.

Since burning out I found that there are a lot of people with advice on how to avoid burning out. Usually, it’s people who themselves have burnt out. I’m no different really. I’ve been through an immense amount of pain, I’ve been exceedingly fortunate to have been well supported during that time and I have come out of the other side passionate about preventing someone else from also going through this experience.
Except this isn’t that kind of advice. This isn’t about burn out. This is about self-awareness. 

My self awareness existed in one of those all important corners that I had shaved off on my path towards trying to “fit in”. I didn’t realise that I had lost it and therefore didn’t realise how much of myself I was compromising as I tried harder and harder to make myself happier or less stressed. I had jumped onto the "medical treadmill" (the seemingly unstoppable inertia that takes us through graduation from medical school, through internship, residency, specialty training and beyond) without ever giving myself permission to consider other paths until I was so burnt out I needed to step away for a while. The thing about losing your self awareness (or not having it to begin with) is that you don’t know why you feel awful. You can’t see what it is that is making you so unhappy and you begin to feel like you just have to "keep going" because you've lost sight of any other options.

So here I am telling other empathetic individuals it's not about simply "not caring as much" to avoid burning out (which I was told more than once in my career)  but rather about giving yourself the space and permission to really 'know' yourself, what is important to you and what you need. About having the courage to be introspective, even if it means you might find things about yourself that you wish were different (for me personally it was that medicine was perhaps never the "calling" that I thought it was for me) and holding strong and healthy boundaries based on that new found knowledge. 

This is a story from a square peg, about finding happiness in a world full of both round and square holes without compromising yourself or expecting others to change for you. It’s an encouragement to keep searching both within and outside of medicine until you find fulfilment in places you might not expect, without shaving off the best parts of you. The Creative Careers in Medicine website is an amazing place to check out if you end up finding yourself searching for other avenues within medicine. Or you could seek out mentors who might not be professionally where you aspire but personally they have a lot in common with you to seek their guidance in how they made their path work. But mostly, it's to let you know that you're not alone.

Because there really are enough stories from round pegs about how everyone just needs to be flexible and change to fit into round holes to avoid burning out. It’s not what I needed to hear. And it’s not my story.

By Dr Emily Amos

Right now I'm meant to be feeling all the feels of a recent business set back as I re-build myself after burning out in clinical medicine. 'Wallowing' was the word I used when talking to a very dear friend who was coaching me through it.

Admittedly, I'm actually terrible at sitting still for long, but I did have every intention of letting this feeling wash over me and set up shop for as long as it needed to for me to honour it.

Then I had an idea.

What if I could build a resource to bring together health care professionals as we question our lives outside of work? What if I could help others negotiate the discomfort around our growth edges?

What is a 'growth edge' you might ask?

Well a growth edge is that point at the limit of our abilities. It's the imaginary line around us that delineates "success" from "failure". It's the line that most high achieving individuals are terrified of ever finding. It's the line I found when I needed a break from my work as a General Practitioner after burning out. It's the line I've found again as I've begun to realise that my life in clinical medicine isn't the right path for me right now. It's an uncomfortable place to be.

We're hard wired to avoid failure. The thing about doing our best to avoid ever failing though is that we never actually know how close we are to our limits. We stay in the 'safe zone', only taking on tasks that we know we can succeed at. We never grow.

I really don't know what will come from this endeavour. But I do know that the last 12 months of introspection I've done and growth I've had as I've worked my way around this growth edge of mine has allowed me to really begin to know myself. A 'Self' outside of my identity as a doctor. If I've learnt anything in the last 12 months it's that there are many, many people who feel exactly like I was feeling within the healthcare industry right now. Feeling lost in my profession, sometimes robotic in my work and not sure how to find meaning in my life that was independent of my ability to help others. And with the current COVID-19 pandemic, I know that even more of us are feeling overwhelmed and alone than ever before.

The Healers Health Collective is the product of my desire to help others, my affinity and utmost respect for my colleagues and my gratitude for the journey I've been on.

I hope that other healthcare professionals will find this page of service to them in their own journeys of rediscovery.
I hope that others who find catharsis in writing feel drawn to submitting anonymous blog posts for publication here.
I hope that from this humble beginning a wonderful resource may grow.

Because, even the healers need healing sometimes.

​Emily