Although I had never been diagnosed with anxiety, my career as a physician has always entailed a high degree of stress, and this has had consequences.

The stress of running a solo private medical practice

When I was running my solo private practice, there were always competing demands for my time: Patients waiting to be seen, patients or physicians on the phone waiting to talk to me, staff issues, scheduling problems, dysfunctional equipment or software, clinical issues my nurse needed resolved, medical issues I needed to read about, and sometimes daycare issues.

When I was in my office, I was perpetually stressed.

While I did not enjoy that feeling, it came with the job, and my training had taught me how to ignore (or repress) the stress to perform my job to the best of my ability.

When I was home, I did not want to feel that same stress. Of course, that was not always possible, as being married with two kids and pets will sometimes be stressful.

Nevertheless, when I could, I tried to avoid or mitigate potentially stressful situations.

I learned not to watch stress-engendering movies or TV shows, such as would occur when a person in the drama was about to experience physical or psychological trauma. When this happened, I usually walked away or changed the channel.

I learned to restrict my cinematic repertoire to mostly Disney or Pixar-like movies, animal shows (animals eating animals did not set me off), cartoons, romantic comedies, harmless YouTube videos, educational shows, etc.

And it was (and is) not uncommon for me to go to a movie with my wife and walk out as soon as the movie gets stressful. I will then bounce from movie to movie within the venue until I find an acceptable, non-stressful alternative and wait for my wife’s movie to end.

Unexplainably “stressful” theater, like a well-done version of Ibsen’s The Doll House or O’Neill’s Long Day’s Journey into Night does not engender that inner tension I experience when watching a flat screen. I know this is not rational, but that is how my body works.

Thus, for the first 3.5 decades of my career as a physician, I felt I learned how to manage the stress in my life.

The stress of being an employed physician

In 2019, I closed my private practice and began working as an employed physician in my hospital’s ambulatory endocrine clinic.

Unfortunately, the hospital’s bureaucratic policies prevented me from providing care to my patients at a level that met my personal and professional standards.

I made repeated entreaties to the hospital’s most senior bureaucrats that the office was being run inappropriately. I told them that the recent resignation of half of the clinic’s professional staff was objective proof that changes needed to be made, but my pleas went unheeded.

This additional and unexpected stressor convinced me that I had to retire prematurely from my loved career.

What I did not fully appreciate when I retired in 2022 but came to understand later was that the irreconcilable conflict arising from my hospital’s bureaucratic policies and my professional obligations led me to incur some wounds that have yet to heal. (See my essay on moral injury.)

My anxiety

Now, when I experience any anxiety-provoking event, my perceived level of stress is of a greater magnitude than I had experienced at any time in the past. And this new, higher level of anxiety has impacted my life.

For most of my adult life, I would occasionally wake at 2 a.m., read for an hour, and then go back to sleep, waking up refreshed to the sound of my alarm.

Now, I sometimes wake at 2 a.m. with a knot in my stomach and remain awake for several hours or even until the morning.

While I was always committed to improving the design and functioning of the U.S. health care system, the open wounds left from my most recent interaction with our health care system have convinced me to avoid these activities.

For example, in 2017, before the events that exacerbated my anxiety, I attended the MIT Grand Medical Hackathon, a conference devoted to developing innovative solutions for our woefully dysfunctional health care system. My team presented our “solution” to the judges at the end of the conference, but we did not win the contest.

In May 2023, I attended my second MIT Grand Medical Hackathon but left the conference prematurely as my anxiety made it impossible to concentrate on the discussed issues.

As any interaction with the health care industry now ramps up my anxiety, I plan to let my medical license lapse when it next comes up for renewal.

Moving forward with my anxiety

While I recognize that my anxiety is a trivial problem compared to the anxiety that occurs as a result of truly traumatic events, it nevertheless impacts what I can and will do.

I have not yet figured out how to eliminate my anxiety, but I have found that cycling and writing are helpful, whereas meditation is not. At present, I do not feel the need to consider either counseling or medical therapy.

So, three times a week, I “self-medicate” by cycling the Minuteman Bikeway from Somerville to Bedford and back under a canopy of trees, past the village centers, fields, and brooks, past the hawks, turtles, coyotes, rabbits, foxes, and owls, knowing that the ride will help quiet my mind, as too will the passage of time.

Hayward Zwerling is an endocrinologist who blogs at I Have an Idea.