House of God Book Review and thoughts on burnout

The House of God is a pseudo fictional memoir that takes a cynical look at the training of young doctors. The protagonist Roy Basch is a naive grad of BMS (best medical school) working as a first year intern at a hospital called the House of God.  The story chronicles Basch's year as his mental health spirals down due to poor working conditions, brutal superiors, long hours, and a severe lack of time to spend with friends and family outside the hospital.  

Shem drives home the point that internship takes up so much time and mental energy that doctors lose their humanity. They slowly get isolated from friends, family and even fellow interns- and when that isolation happens, they move from thinking this is crazy to I am crazy. One intern in the House of God commits suicide because he bottles up the madness of the hospital within himself, he eventually can't handle it, and has no other ways to release that stress.  

So the moral of the story - everyone needs to deconstruct all the craziness going on around them. Cope or perish.  

According to some quick some studies I pulled up on pubmed - 45% of physicians experience at least one form of burnout: emotional exhaustion, feeling unaccomplished, and losing empathy for humanity. Half of all doctors are feeling burned out!  That has to be terrible for healthcare?  On top of that, male physicians are 50% more likely to commit suicide than the general public, and female physicians are 200% more likely!  

Sidenote - Residency training may be when the stress of dealing with patients peaks, but what if the real root of the problem is earlier?  What if interns are arriving at their residencies already so burned out from med school that they're already on the highway to that depressed, burned out, suicidal hell?

white coat ceremony - the bright eyed days

Before I started med school someone told me to enjoy the first few weeks - everyone is bright eyed and happy to be there, still friendly, and tan from the summer.  Now, almost three months into school - no one's that tan, you can start to pick out the gunners, and the bright eyes are slowly fading to zzz.  

I've been getting a lot of that frustration and burnout myself. I drafted out an entire post complaining about being burned out, then I decided it sucked and wasn't up to public consumption.  Then I hated myself for being terrible at writing, and then I hated myself again for procrastinating instead of studying.  Self-hate has to be one of the top signs of burnout.  

The last block definitely burned me out.  I was talking with my similarly overwhelmed and burned out classmates - and we literally couldn't figure out what to do to unburn out.  I try to study all day and fail - I watch recorded lectures in the corner while checking gmail, MUSC email, facebook, grantland, the NYTimes, really I'd rather look at anything than the syllabus. 

Last block we had a lecture on physiatry - the cushiest specialty in medicine, you play volleyball every weekend, and you get tons of $$. Physiatry is looking better and better everyday.  

I need to come up with some half-baked ideas to fix physician burnout.  

See you on the other side, 

from ken

physiatry life