Everything in life starts as a dream. Big or small. My dream was to become a physician since I was quite young — the first one in my family to walk the path. I wanted to understand the science of the human body and help the sick. Heal with my skills, knowledge, and empathy. Hold my patients’ hands with care and confidence. My work was to be like none other. To be based on the relationship between vulnerability and compassion. My journey of becoming a physician started with ardor, humility, and dignity.

I embraced my noble trade.
“Physician,” my true accolade.
Sanguine with humble pride.
I sacrificed, and worked hard.

My late hours at the library and sleep deprivation were well worth it. No hunger or thirst. “Routine in life?” There was none. I put off my social life. Delayed starting my family. I became the master of making decisions on the spur of the moment. Slept in cold echo rooms when on call.  Many a time, stared at death face to face – trying to do everything to keep my patient alive. I cried inside when I failed to save. But, not for too long as there was no time for me to mourn the loss of my patient. I quickly rushed to hold the hand of the next anxious patient who is eagerly waiting for me to place a defibrillator in her as she miraculously survived the near-miss event. Thanks to the EMTs!

I carried my triumphs, losses, and my patients’ stories home, every single day. I covered calls and learned to be alert 24 hours or more those days. I had my family to care for – games to cheer, bedtime stories, attend to aging parents, and a dinner date with my supportive husband.  I can go over the protocol of changing from scrubs to a formal outfit in few minutes and smile to complements, “You clean up good!” I never complained too much. I said to myself, “It’s all worth it because someone has to help those ailing.” My patient needs me. I need my patients.

My dream found a routine, but the world around me changed. It gave me a jolt and woke me up from my dream to wide-awake reality. By the time I could fully comprehend, my path was forced to take detours. These elements slowly crept on my dream, determination, and duty. I was already a master of multitasking, but that seemed not enough. I stretched myself emotionally and physically to the inhumane limits. The harsh reality burdened me to do more and more. “Prioritize in life?” But everything is a priority! My resilience started to crumble. With exasperation, I lamented at this nightmare – not a dream anymore. I am on the verge of breaking down. They call this “burnout.”

Suffocated by bureaucracy,
EMR, insurance naysayers.
Money. “Bill more RVUs.”
“Patients are just numbers!”

I spent hours pondering at this if and when I could find the time. Introspection. “Start a side gig or quit!” My mind nagged me. My mental exhaustion and defeat questioned the very dream that led me down this journey. I wept. I couldn’t express it. I was always trained to think independently. I am trained to be the daily warrior. My patients and my work are part of me and my life. My soliloquy continued. Should I? Could I? How can I? Who will guide me? The last question gave birth to reassurance. I am not alone in this. I have my team!

My colleagues.
My family, mentors.
My skill, and kindness.
My duty toward my patients!

I can fight this! With the support and unity from my comrades – peers, nurses, staff, and too many who all have invested in this selflessly, to work as a team to help patients. The patients, along with this team of mine, will help me find a solution. Every good intention has to have a good ending. I think of all my patients; they need me as much as I need them. For them, I will fight this with a unified voice. My patients’ stories echo in my mind:

A father who I successfully resuscitated,
gives a gift – a box of chocolates.
“These are for you for not giving up on me.”

A young mother, cardiac arrest survivor,
returns with tears of gratitude.
Proudly lets me hold her infant baby!

An avid runner comes for defibrillator check,
after intensive care, prolonged hospital stay.
Hugs me, “Can’t wait to run again!”

A wife walks in with homemade jam,
“Made this for you and your family.”
“You gave me my husband back!”

A daughter calls me,
“My father passed, he loved you!”
“Can you please join us at his funeral?”

While money can build expensive walls and buy technology, without the human element, the industries and corporations will collapse. Foundation for the health care industry has three major legs: patients, clinicians, and non-clinical staff. None of these can be substituted. None of them can exist without the other. While health care economics are important, they have no meaning if all the above three pillars are not taken care of or burned out.

“Medicine is not an assembly line,” I stand firm.
“The relationship between my patient and I,
is based on healing, trust, care, and empathy.
I don’t need an outsider to validate this!”

Kamala Tamirisa is a cardiologist.

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