Recently, on an average workday, my hand brushed against the small safety whistle clipped beside my ID badge. Most days, I don’t even remember the whistle is there, a “Happy Doctor’s Day” gift from a few years ago. I dutifully clipped it on, but I can’t say it makes me feel safer.

I remember shrugging when I received it and thinking, well, it’s more practical than pizza.

I also recall how it made me feel—expendable.

But I didn’t dwell on that. I did what doctors always do, what we’re trained to do. I put it out of my mind and saw the next patient.

Another memory surfaces. About a decade ago, at a conference, in a small group session where I was the only physician, a nurse turned to me and asked, “What happened to you all? How do you go so quickly from these idealistic, altruistic young people at the beginning into what we see you become? Which is, well, the opposite?”

The first thought that came to my mind was sleep deprivation. It’s well known that sleep deprivation is a form of torture, yet somehow, it’s become a rite of passage for medical trainees.

I vividly recall my first night of on-call duty as a third-year medical student over twenty years ago. It was a mysterious black box, as I didn’t truly understand what happened when one was “on-call” overnight in the hospital. The only thing I knew for certain was that it would mean working all day, then all night, then all day the next day—a 36-hour “shift.”

What I most feared wasn’t forgoing sleep but that my body would let me down. At my core, I was terrified I would be revealed as too “weak” and that my most secret fear—that I didn’t belong and had somehow been allowed into medical school by mistake—would be exposed.

I remember telling myself that no matter what happened, I would make it through. I would never show any weakness, and I devised a plan for myself. I would stick like glue to the intern I was assigned to and do whatever they asked. “No matter what,” was my mantra as I entered the hospital that morning.

Then, 5:00 p.m. hit, and we became officially “on-call.” The night flew by, busy with admissions and cross-cover. I’m sure I was a thorn in the side of my intern, but I stuck to my mantra: never asking when or if I could have a break or go to the call room and doing whatever task I could to help, no matter what.

When 8:00 a.m. rolled around, I felt a fierce sense of accomplishment. I’d done it. I will become a doctor now, I thought. All it took was suppressing my human bodily needs and pretending I didn’t feel them.

Now, when I look back, I can’t help but think how cultish it all is.

I’m glad for today’s trainees that work-hour restrictions have made things a slight bit better, but my understanding is that currently, residents and students are limited to 24 hours on duty instead of 36. This is still beyond what the human body and mind should be expected to repeatedly endure (for years) or what’s done in any other industry or profession. It’s a deterrent to trainee health, let alone patient care.

Back to that conference. I didn’t have an answer for that nurse. Because the answer was impossible to convey in a sentence or two, which is why I turned to storytelling. In my second novel, The Committee Will Kill You Now, an intern’s life is upended when he makes a terrible medical error born from sleep deprivation and trauma. In the book, I strive to incorporate some of the true-life medical history that shaped medical training programs and how the system changes the people who come out of it.

In some ways, I started conceptualizing this book a decade ago when that question was posed to me: “What happens to you all?”

I also decided to include the tragedy of physician suicide in the book. I was recently asked why, and the simple answer is that I couldn’t honestly tell the story of medical training without it. Because when the training programs acknowledge up-front that we have a higher risk of dying of suicide than any other profession yet do nothing to mitigate this other than maintain a culture of stalwart “strength,” the implication is that the leadership fully knows and understands this, yet risks the lives of young trainees anyway. The “hidden curriculum” is that the strong will survive. So, the unspoken message is to “be strong.” Don’t be “weak.”

Is it any wonder we become the people the nurse asked me about in that conference? We are exhausted, cynical, short-tempered, guarded, and, in some ways, ruthless. We must become so to survive.

The problem is that we can also become this way outside of the workplace.

Some of us, like myself, will delve into our experiences only years later and find a way to let down the armor that protected us in those years—an armor that was necessary for survival but also can isolate us from the rest of humanity.

Ironically, when I now write about this, I commonly receive angry comments and emails from other physicians accusing me of being—and I can’t make this up—”weak.”

In medical culture, weakness is a word we wield as a weapon. It’s been deeply ingrained in our psyche as something to avoid at all costs. Sacrificing our humanity is modeled as the price to pay. Speaking this truth to the world is, to some, considered a betrayal. To those who still feel this way, I invite you to unplug from the Matrix and join me.

Because we, as doctors, young and old and everywhere in between, deserve more than pizza and safety whistles. We deserve to work in a system that maintains, restores and celebrates our humanity.

To colleagues out there, from new trainees to seasoned attendings, I invite you to join me on National Doctor’s Day in embracing your “weak” side—a.k.a., being human.

Your patients and loved ones will never think less of you for it. I promise you.

Jennifer Lycette is a novelist, award-winning essayist, rural hematology-oncology physician, wife, and mom. Mid-career, Dr. Lycette discovered the power of narrative medicine on her path back from physician burnout and has been writing ever since. Her essays can be found in The Intima, NEJM, JAMA, and other journals. She can be reached on Instagram, LinkedIn, Facebook, and Mastodon.