Physician, heal thyself.

That’s the unwritten rule, sadly, for us. I am a physician. I am therefore invincible and inhuman and all the things my patients cannot be. To seek help is a sign of weakness, and our profession has no place for the weak of body, mind or spirit. We work through illness because our patients deserve that and disease and suffering don’t take weekends off. Interminable hours on the wards, ERs and offices are de rigueur of our profession.

Generations that came before us did it the hard way, so naturally we cannot do it any differently or we are cheating, taking a shortcut, not being the man our mentor was.

If this sounds a bit extreme, you clearly haven’t been to medical school. Frankly, I envy you. I have been to medical school and to the hospital for the last 24 years out of medical school and spend more nights there than I do with my wife.

I am not the exception, all physicians sacrifice more and more in this age of “technological advancement” that has determined we must document electronically with imperfect systems that have never watched a patient die or that have a template for the impatient WebMD-expert patient or terrified first-time mother.

Yet we must satiate these and others in the name of customer satisfaction lest we be labeled a bad doctor. The art of medicine has become the business of bureaucrats who were busy getting trophies for participation while we were sweating match day or poring over pages of texts to pass the next test that wasn’t graded on just showing up. And after that, we were constantly barraged and belittled for our lack of knowledge on endless rounds with malignant attending physicians who thrived on watching us melt before them.

I wouldn’t trade a minute of it, but retrospectively no one should have to endure it. I’m a survivor, and I practice with others who made it. Sure, the first few years post-residency you are still basking in that glow of success. Newly boarded, now you command some respect among the staff or at least you work your tail off earning it and do it gladly. But you are paying with your soul. I’m not sure when I first realized this, but it was when I turned 50 that something clicked.

Colleagues were dying. I saw sickness among us. I had serious blood pressure issues despite exercise. I was falling victim to the mentality of invincibility. I had to finally face the fact I was human long before I was a physician and will die that way as well, and was on the accelerated path to the grave. I woke up tired, I worked tired, and there was no longer a reward to it. Work became simply a necessity.

I was saddened and angry at the same time forever getting to this point. It wasn’t anyone’s fault but mine, and so I did the unthinkable, I quit. Well, I should qualify that. I resigned my position of almost 20 years and have opted for a much easier pace and a job that will see me at home more than at work. I will miss the place, but I also will not die on the job, and I was on that path, I am fully convinced.

I grew up being told I could do anything, and in adulthood, that translated to working more than most and sacrificing my family for the job. I missed half the kids’ formative years. I missed anniversaries, Christmas mornings, vacations. I also was privileged to work with the best physicians in the field of emergency medicine and know I am a better doctor for that.

It is a sacrifice, and mine is no greater than your doctor’s or any doctor out there. It’s simply the way it is, and I hope all who read this understand and consider it the next time you wish to berate your doctor or complain about a wait.

I also hope this is heard by those who still embrace the old-school mentality and realize it is killing your colleagues, is archaic and frankly counterproductive to teaching.

Newly minted doctors already are stressed by financial debt and intimidation at the inevitable barrage of knowledge they must master in a short time. They don’t need what is tantamount to hazing by their superiors, but rather support and encouragement.

I didn’t learn to resuscitate a critically ill patient overnight nor with a grizzled, burned-out veteran doctor screaming at my mistakes. Yet I got to experience this on occasion and found it frankly unnerving and a waste of time. I vowed then that, given the chance to teach, I would never do that to anyone, and I won’t.

I hope those of us who survived the old-school dogma can see through it as well and embrace these future doctors who will one day be hovering over us.

Personally, I want the one who was treated with respect and encouragement, because in the end, we all deserve that. Good people will produce good providers, and that is key to the survival of medicine as it should be.

I fear a future where we trade compassion for frustration and autonomy for enslavement to bureaucracy’s untenable mandates.

James Nichols is a physician.  This article origially appeared in the Longview News-Journal.

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