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.
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
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.