Dr. Jeff Kane: The weary healer
Imagine you’re a patient in a teaching hospital’s intensive care unit, just now waking from your coma. The first thing you see is a young physician trying to adjust your IV drip while fighting the tendency to drift into her own coma.
After being on the job 24 hours, her brain is currently a loaf of tired neurons connected by thin strands of caffeine, and your life is in her shaky hands.
This issue, the overworked resident physician, dependably appears in our media every 10 years, like a cicada cycle. Shocked, we gasp and ask how we allow ourselves to be treated by docs who need exhaustion treatment themselves. The irony is undeniable: our healers need healing, stat!
So we write letters to editors, email our representatives, call for congressional hearings. Outrage dominates headlines for a week. Authorities study the situation. A year later they recommend limited work hours. And very little changes. The issue burrows underground again for a decade.
This disquieting life cycle persists only because our culture actually prefers to overwork doctors.
It’s not hard to identify attitudes that drive this surprising tradition. One is overachiever mentality. A few years ago I attended a meeting at a Midwestern medical school in which the faculty announced new rules for resident physicians. Shifts were to be limited to 10 hours, overtime work would not be permitted, and residents were to take two consecutive days off every two weeks. To my slacker ears this still sounded like work ethic squared, but several residents objected, as though the changes were punitive.
“This is a teaching hospital,” several complained. “How are we going to face our board exams with so few hours?”
No one said, “Gosh, thanks. Maybe now I’ll be able to lead a humane life and give my patients more mindful care.” If you like speed, pressure, and exhaustion, take up medical training.
Another cultural value we might want to question is our popular view of healing, which we see as a zero-sum game: the patient improves to the degree that the caregiver is depleted. If your caregiving doesn’t dangerously drain you, you haven’t done enough. This especially describes nonprofessional caregivers, by the way. You can probably name a half-dozen relatives of sick people who worked themselves into sickness.
We need to ask ourselves whether caregiving is service or sacrifice. Can we imagine a health-care system in which all players feel better for their efforts?
Jeff Kane is a physician and writer in Nevada City.
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