I am tired. But I still love emergency medicine.

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I love being an emergency doctor. I loved my residency, my co-residents, and my attendings.

I love my training: watching, learning, treating.

I love the emergency department, the vastness, and the variability of emergency medicine.

But I am tired.

I am tired of feeling like a workhorse, a production line made to just churn patients in and out.

I am tired of being told that my worth as a doctor is based on my time to doc, time to discharge, time to needle, time to antibiotics.

I am tired of being told I am not fast enough, not efficient enough.

I am tired of the metrics.

I am tired of being told I don’t listen enough; I don’t sit long enough; I am not compassionate enough; I don’t smile or accommodate enough; my patients are not satisfied enough.

I am tired of my popularity rating.

I am tired of being told I don’t see enough patients; I don’t supervise enough mid-levels.

I am tired of being told that I admit too many patients and that I consult too many services.

I am tired of being asked why I have so many bounce backs and why I didn’t admit in the first place.

I am tired of receiving emails that my charts are overdue, that my charts are insufficient and underbilled, yet scribes are a wasted resource.

I am tired of worrying I did too much.

I am tired of worrying I did too little.

I am tired of worrying I missed the diagnosis.

I am tired of worrying I was too late.

I am tired of being yelled at and abused by patients that I try to keep safe by not overprescribing opiates, by patients and families that don’t understand why I don’t have a clear diagnosis for their chronic symptoms despite multiple ED visits and countless specialists.

I am tired of being told that science is not real and that my protection makes me a mindless pawn in a worldwide conspiracy. I am tired of watching my college friends buy fancy cars and multimillion-dollar vacation homes while I pick up extra shifts to pay off my student loans.

I am tired of the days.

I am tired of the nights.

I am tired of the flips.

I am tired of not knowing what day it is, let alone what time of day it is.

I am tired of missing fun weekend getaways.

I am tired of the missed holidays.

I am tired of missing my babies, my husband, my family, and friends.

I am tired of being told to be happier, to exercise more, to meditate more, that my burnout can be better if I tried harder.

I am tired and exhausted by the thoughts of not being enough.

I am just plain old tired.

Yet, I continue to love the department, my colleagues, the medicine, this path, this specialty and this life I chose.

I continue to love it despite being tired.