” … an erosion of the soul caused by a deterioration of one’s values, dignity, spirit and will.”

After my annual evaluation last night, I went back over some of the things I had been discussing with Ann and our team leader Bethany.  Some of the things I was saying really didn’t sound like me:  tired, purposeless, sometimes hard to remember why I came here in the first place.  I do get fatigued here, as much from the cross-cultural differences as from the work itself.  But why was I sounding so negative?  The cross cultural stress inventory didn’t paint a pretty picture.Screen Shot 2015-05-20 at 10.53.50 PM

I got to thinking about burn out.  In the US, physicians experience real burnout at some point in their careers at close to 100% incidence.  Cross cultural living and working also has a pretty high burn out rate.  Hmm, so if I’m a physician in a cross-cultural setting, any chance at all that I might be experiencing a little burn out?

There’s a website call happymd.com which discusses the topic at length.  If any physicians reading this want to learn more about what to look for, I’d recommend you visit.  I can’t speak for other professions, but as a physician, you either have been, are, or will be burned out at some point in your career.

The website defines burnout as being depleted to the point where you don’t bounce back from normal stresses after a day or weekend away from work.  There’s a double edged sword here when in medical work that is also a ministry:  there is no end to the need, no obvious point at which you should go home, say no to another responsibility, or go on vacation.  Serge, our sending agency, is quite intentional about avoiding burnout.  I guess you have to actually listen and take the leadership’s advice for it to work.  But it kind of feels like you’re letting down yourself, the hospital, your patients, your agency, and of course, God.

A researcher named Maslach investigated physician burnout, and describes its effects in terms of physical, emotional, and spiritual depletion.  Burnout leads to fatigue, depersonalization, cynicism, and lack of efficacy.  It has effects on work, marriage, and relationships with family and friends.  She described its effects as ” … an erosion of the soul caused by a deterioration of one’s values, dignity, spirit and will.”

Maslach created an inventory, or questionnaire, to look for and determine the severity of physician burnout.  Just for a laugh, I though I would take the test.  I kind of wish I hadn’t.Screen Shot 2015-05-20 at 10.55.23 PM

On all scales, of physical, emotional, and spiritual burnout, I fell into the “severe burnout” category.  Not good.  Really, quite a wake up call.  I feel like I’m tired, not at my best, but this really tells me I may not be functioning at a very high level.

Thankfully, there is a lot of good work done on what to do with burnout.  Less time at work isn’t necessarily the answer, but looking at what parts of work are depleting, and what parts are energizing, is vital.  The key is to structure the day, week, month, and year, to find ways to engage with those parts of the work which are invigorating, knowing that other parts of the day will be “soul eroding.”

How to reconcile this workaholic, all-responsible, soul-eroding lifestyle with a life of following Christ?  You really can’t.

The message of the Gospels never promises an easy life, or lack of suffering, when following Christ.  But they do offer hope:

I came so that everyone would have life, and have it in its fullest. “(From the Gospel of John).  Or, from the Gospel of Matthew, ““Come to me, all you who are weary and burdened, and I will give you rest.  Take my yoke upon you and learn from me, for I am gentle and humble in heart, and you will find rest for your souls.  For my yoke is easy and my burden is light.”

I have to admit, right now I’m not feeling I’m having life to the fullest, or finding the yoke easy or the burden light.  I can identify pretty strongly with the weary and burdened part, however.

So my plan is to take some steps to get back to the enthusiasm and energy that brought me here in the first place.  I’m very thankful that taking care of patients has always energized me.  Being part of a team that comes alongside the sick or injured in the healing process, talking with families, working with residents and other trainees, will always remind me of why God put me here on this Earth.

I’m heading off on an outreach trip beginning Sunday, so I will be gone for a week with some Kijabe colleagues.  I’ve been to this hospital before, and find it extremely challenging and energizing.  This small hospital, outside of a small town, in the middle of a large desert, is really striving to provide excellent and compassionate care.  I will have the privilege of doing surgeries with the resident surgeon, as well as teaching a one day seminar on the treatment of orthopaedic surgical emergencies.  I’m excited and grateful to be part of such a trip, and this is definitely part of the work which invigorates and fills the soul.

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7 thoughts on “” … an erosion of the soul caused by a deterioration of one’s values, dignity, spirit and will.”

  1. Colleen Gibbs

    Mike- I’m sorry to hear you’re having such burnout, and not at all surprised. I will be doubling up on my prayers for you. Despite how you rate yourself spiritually, your relationship w God shines forth in the way you recognize God’s presence in all people and in your work. And even if you’re not feeling humorous, you still bring it in your writing!
    I’m afraid to ask where you and the crew are going for the week. Please be so careful. xoxo

  2. Mike – What Coll said. I am so sorry you are going through this. I’d say the Catholic thing and say “offer it up”, but dammit, you already are. When I read your post I thought of Oskar Schindler’s lines in Schindler’s list and it made me so sad for you:

    Oskar Schindler: I could have got more out. I could have got more. I don’t know. If I’d just… I could have got more.
    Itzhak Stern: Oskar, there are eleven hundred people who are alive because of you. Look at them.
    Oskar Schindler: If I’d made more money… I threw away so much money. You have no idea. If I’d just…
    Itzhak Stern: There will be generations because of what you did.
    Oskar Schindler: I didn’t do enough!
    Itzhak Stern: You did so much.
    Oskar Schindler: This car. Goeth would have bought this car. Why did I keep the car? Ten people right there. Ten people. Ten more people.
    Oskar Schindler: This pin. Two people. This is gold. Two more people. He would have given me two for it, at least one. One more person. A person, Stern. For this.
    Oskar Schindler: I could have gotten one more person… and I didn’t! And I… I didn’t!

    That made me so sad, Mike. I’m praying for you. But another line from the movie gives hope:

    Itzhak Stern: It’s Hebrew, it’s from the Talmud. It says, “Whoever saves one life, saves the world entire.”

    I continue to pray for you (not nearly enough). Take care of yourself.

    • Maureen Mara

      What Coll AND Kath said, very very well.
      One thing you can do is ask all of us in your real and electronic worlds to pray with and for you, very specifically for your return to greater meaning and purpose and lightness in your work and life. Your gifts are so important to the world that it’s a burden to you…while a blessing to all those you touch, in Kijabe and around the world. The least we can do is sustain you in prayer. Peace, brother!

      And please please be safe in wherever you are headed this week…

  3. Gail Juranek

    Hi Michael…Gail Juranek from Sunriver, OR visiting with you this morning. I love reading your blogs and especially your deep thinking and also the glimpses of what your day has been. Gives those of us safe and sound at home in OR a good perspective of your journey. You may not know this about Rod and I, but we lead many teams to Romania with NW Medical Teams…..doing construction work in orphanges and building a Bible camp. One time it felt like everything was falling apart….trial after trial. A wise man gave me this verse to claim as my own….Joshua 1:9 “Be strong and courageous. Do not be terrified; do not be discouraged, for the Lord your God will be with you wherever you go.” Believing it is God’s will that you be in Kijabe at this time…you are in line with His will. You are a success in God’s eyes – and His opinions last forever!

    We admire you greatly! Thank you for serving. Sending you a big hug….. Do what you love and love what you do.


  4. Michael, thanks for this blog post on your present situation, and the honesty with which you presented it. Sheri and I attend Antioch and are involved with Life Impact, the missionary and pastor care org providing respite and processing to Christian workers in hosted places, we call “Oases”. From your post it’s obvious you realize you are part of a cadre of many of us who have experienced this type of depletion because of ministry work and life in a cross-cultural situation. (Should we start issuing badges to each other because we’ve made it through?) Glad your org takes time for the care of workers and glad you are on the upward track.
    I have a blog that about 200 missionaries follow called, http://www.ThriveMentor.com. I post issues that I feel could be valuable to pass on to them after our 40 years in international mission work. Would you give me permission to use your blog on that site? Because of your honesty in what you are going through, I believe it could be helpful to others in their situations. Let me know and I won’t move on it until I hear from you.
    Many blessings on your next trip — getting you out of your present sitch for a little while — and we’ll pray for perspective on your life and energy expenditure as you gain a little altitude through travel. (Just don’t go into a war zone, or that strategy might not work! 🙂

    • Dave, Thanks for your encouragement. Of course I would be honored to have you use this blog. I will be sure to spend time reading yours in the very new future.

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