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Physician, Keep Your Head Up

Please Doc, can you refill my Norco?

Really? How can you say no to my pain meds?

Why are you being mean? Can you not see that something is really going on with me? I really need my pain meds!

Physician, heal your patient and do no harm. That is the oath we took. Physician, listen intentionally. Physician, intelligently answer their questions and address their concerns without making them feel less than human. That is what we were taught.

But today, it is be their drug dealer, not their healer. Today, it is be their preacher, not their teacher. It is be their light-bearer when their way is dark and oh by the way … Xanax bars are great for all that ails them, too.

And now the world is wondering why we no longer want or desire to practice medicine, why we are “burned out,” brain fried, brain tied (yes, tied, not tired), traumatized, undeniably fatigued, uniquely fed-up, and literally “over it.”

There is no rest for the weary. What is that? When is there time to rest? And when do you propose we try to get the rest accomplished? And where should we actually rest?

At work? No—there are questions from nurses and business calls, beeper notices and emails, EMR notes and EMR labs. Then, there are meetings to attend and portfolios to complete (at least if you ever want to be promoted). There are arguments to have (if you want to prove your points to your male colleagues)….

At home? No—after you feed your flock, converse with your spouse, and catch up on your favorite show, it’s time for bed. This should be real relaxation, but it comes with its own stressors … If we copulate cautiously and often with our spouses (many studies have shown doing so reduces stress and improves sleep), then we need more time … to spend in the mall at Victoria’s Secret … to try something on, try out something new, try to ensure it’s not all the same….

In the face of work-related stressors and personal fears, we must learn to lean on each other and learn to love and laugh to release all the tension. Laugh instead of cry. Smile instead of frown. Love instead of hate.

Don’t get me wrong: physician burnout is real shit, forgive my French. And it is traumatizing. Believe me, I have been there and I am still dealing with it. But the enemy cannot win because if it does, then those of us who truly are called to the war that is medicine—we lose. And we cannot allow “donkeys” to win. We must learn to love our craft again. We must learn to smile when we want to scream. We must learn to live after the rain. We must learn to dance, sing, and run in the midst of the storm and rain.  

Physician burnout is real but the art of medicine is real, too. So, physician, keep your head up. Learn to watch out for the setbacks because they will come, and you will need tools. My tools are love, life, laughter, and a dash of comedy (and sprinkles of profanity).

What works for me may not work for you and of course, “shit happens.” But, at the end of the day, it happens to us all and how we handle it, that is what really matters.


Cynthia L. Brown-Manning, MD, FAAFP, ABFM, is an Assistant Clinical Professor at LSU Medical Center Monroe. She has practiced Family Medicine for 23 years and previously had a private practice for over 10 years. She reports no conflicts of interest.

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