The ‘Medical Treadmill’…

Burnout for me was essentially the brakes being slammed on in my life. I suffered a series of debilitating panic attacks (which I had never in my life experienced before) and just couldn’t even get out my front door. Thinking back now, I can still remember the suffocating feelings of fear and overwhelm. There is almost something comforting to knowing those feelings now. I remember them so well that I know I will never let myself get back to that point again. 

This is an excerpt from a blog post that was originally published on my website about 18 months ago. 

I am a good doctor, an empathetic doctor. The sort who listens intently to you and tries to reflect back what I’ve heard you say with a mixture of comprehension and gentle advice. I’ve spent the last 15 years either training towards or being a doctor. ​But right now, I am a doctor who feels jaded and empty. Like the ‘doctor’ light globe inside me has gone out. The weighty responsibility of trying to help people in their darkest hours finally causing my legs to buckle under me. An unfamiliar mixture of panic and despair stopping my whole being from even getting out the door to go into work. To a job I am good at. A job that helps people. A job that (outwardly at least) appears so fulfilling. So why do I feel like this? 

In the last three weeks that I’ve been hiding from the world since panic set in and stopped me in my tracks, I have come up with a variety of explanations. My amazing GP helpfully offered “Anxiety likely secondary to burnout” as a reason for taking some time off. Seems reasonable. Right now I am incapable of seeing a patient. One, because of what it evokes in me (the afore mentioned fear, dread and panic for the most part). And two, because it is not fair to patients for me to be seeing them right now. There is a certain amount of resilience and strength required to take the worries and ailments of others and help them carry this burden. Have you ever stopped to consider the health (both physical and mental) of your doctor the last time you went to see one? We are all human also. There is no special course at medical school that takes the fleshy vulnerability of humanity away from us. We, like you, sometimes struggle to sleep with worry (which in my case is often about you, my patients). We feel that sickening sense of overwhelm and fear that we may make a mistake while at work. Except in our cases, people lives are the fragile cargo we carry. We also deal with all the behind the scenes issues that everyone else is, family, money, life in general. 

I feel as though I am standing in a doorway. Three weeks ago, all I wanted to do was close the door and hide inside. In the last three weeks, I have found some satisfaction in the fact that I no longer want to do that (everyday at least). Some days I am quite content to remain standing in this open doorway, pondering the space in front of me. 

​I write all this not to garner sympathy, but simply to muse and offer support to those walking a similar path. A silent call into the ether of the internet to encourage those reading to look outside themselves. Consider whether the job they’re working, the life they’re leading, is congruent with their values and self. And maybe, just maybe, as I stand here in what feels like a doorway of change, waiting to see what path there is in front of me, I may begin to contribute to the world in a way I had never imagined.

This was only a few short weeks after I had stopped work. Little did I know it then, but there was an immense journey ahead of me. A journey that in some ways I think I’ll always be on. This path of life that we all walk, I now walk more intentionally. No longer swept just onto the ‘treadmill’.

​Some people are fortunate to have the self awareness to have always been on this intentional path. Yet for many of us, this path is in fact a treadmill. A moving conveyer belt on which we feel sometimes passively shifted along. The ‘Medical Treadmill’ has such inertia from school, to medical school, to internship, residency, unaccredited positions, being a junior reg, senior registrar, fellowship and eventually consultant. Don’t get me wrong, there are huge life decisions to be made in that time. 
“Which college do I want to join?”
“Will I have any say into where I go?”
“When will I have time to have a family?”
Ultimately however, this process does tend to move along in a fairly linear pattern. Unless we are forced to or choose to step off.

What do we say to our colleagues who express a desire to ‘step off’ the treadmill at any point? Whether for a short break or even forever?

I experienced a lot of well intentioned encouragement not to do that.
That I would have to work too hard to “get back”. Or that I would “miss opportunities”. That it would be a “waste of my skills”.

The dialogue here is really important I think.

As it turned out, I ended up needing to ‘step off’ for a while anyway. Perhaps I could have done this in a more intentional way sooner? Perhaps not. 

For me personally, I am immensely grateful for the journey I have been on as a result of the last couple of years and my ‘burning out’. That doorway I felt myself standing in all that time ago was in fact this doorway into working to support the wellness of the healthcare workforce. Healing the healers. Caring for the carers.

I am excited and hopeful for the future. 

If you are feeling swept up on the medical treadmill, passively shuttled through your professional life towards some seemingly far off goal, I’d encourage you to try and familiarise yourself with the concepts of mindfulness.
Of presence.
Of perception.
Of non-attachment. 
Of self compassion.

Self awareness comes as we take our consciousness inwards to become more familiar with our own internal environment rather than only focussing on those things outside of ourselves and our control. 

Sometimes it involves some time “off the treadmill” for self reflection. And that is OK. 
Sometimes it involves staying “on the treadmill” but building a support structure around you so that you can lean on that and just lift your feet up every now and again. 
Sometimes it involves the speed and incline being turned up so far that eventually you end up flying off the end of the treadmill, unable to keep up anymore (like I did…). Look, it’s not ideal- but that too is manageable.

The most important thing to realise is that ultimately, you control the treadmill.
​Even at the times when you feel like you don’t, you always have the choice to step off for a while. 

by Emily Amos

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