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The curse of the excellent doctor

Dr. Damane Zehra
Physician
April 6, 2024
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The reward for good work is always more work. The employer becomes dependent on the quality of work that you do because he knows that you, as a person, are a workaholic and perfectionist. You put your heart and soul into everything you do. No other employers can do the kind of work that you do. But don’t ever think that you would be appreciated for your hard work. You are digging your own grave, and you will be burdened with the clumsy work done by your co-workers as well.

This concept is equally applicable in the lives of our doctors and nurses in our hospitals. The doctors and house officers who perform better than their colleagues always get more work to do than others. I don’t know if this happens in the West as well, but it happened everywhere that I worked.

I am a perfectionist and a very efficient doctor. My documentation is a lot better than my coworkers’. I can write more precisely and legibly than many other doctors and that too in a very minimum time. My consultants depend on my notes and clinical skills more than most of my coworkers in the department. They just come and countersign the plans that I make.

Since my internship days, I have been considered a very heavy-footed doctor. A heavy-footed person is used as slang in our hospitals, meaning a person who always attracts more work. Whenever I entered an OPD or ward, more and more patients started coming in. I always had to manage a lot more patients than my colleagues. Nurses and paramedics were always worried about my duty because they always noticed that I attracted more patients on my duty, like a magnet. Stable patients became very sick on my call. We have limited ICU beds in our hospitals, which are always full. In my duty hours, wards were literally turned into ICUs. The case is still the same with me. When I was working in a public sector hospital, a lot of patients who were stable in the ward always suddenly became so sick that I had to start them on inotropic support in my ward with only a dial flow because we didn’t have fancy infusion pumps nor could we afford them in the public health care setup. I had to go to ICUs frequently just to ask them for vials of Dobutamine and Dopamine because my patients needed them. I had to do this so frequently that whenever I entered the ward with my friend, who was always on call with me, a nurse would jokingly say, “Here comes the pair of Dopa/Dobuta.”

There were always a lot of expiries on my duty. I had to sign a lot of death certificates, and the staff was always ready to perform CPR at any moment. A staff nurse used to call me ‘Azrael’ (the angel of death). I always used to do the triage first on any call, and I still do this to date. I always figured out who would be needing my care the most and which patients could wait a little bit. That has become my habit and my skill.

These kinds of incidents improved my clinical examination, history-taking, documentation, and communication skills a lot more than other doctors. Whenever a fussy attendant came in my duty, I was sent to the spot because my seniors knew that being an attentive and non-judgmental person, I was able to make the situation a lot better. And I handled patients with such love and care that our patients still come to thank me when they get better and are discharged home. I listen to all kinds of stories of the patients without any judgment, whether they are about their disease or irrelevant. I can never interrupt or scold them when they are speaking their heart out. My consultants are always complaining that I waste a lot of time listening to the irrelevant stories of the patients. Writing all this means that I have a lot of confidence in my skills, and I know that my work is always up to the mark.

But unfortunately, the people who do a lot of hard work always attract more work in return. There is a verse in Urdu poetry:

“Maktab-e-ishq ka dastoor nirala dekha,
uss ko chutti na mili jiss nay sabaq yad kia.”

that translates into

“The school of love has strange ways,
The brightest ones are always put in detention.”

In my limited understanding of the words, this verse shows how the rules of the schools of love are mysterious. In the real world, once you are done with school, you graduate. You don’t have to go back to school if you don’t want to. In fact, there is only so much schooling you can engage in before they kick you out. On the other hand, for the more mythical/mystical schools, you can stay in and will probably be kept in if you are good at what you do. This is equally applicable in the real world too.

This was my case. I sometimes felt so frustrated that I considered my luck as bad. I became irritable as I saw a lot of patients. But I never compromised on the quality of my work. But it drained me out at the end of the day. It sucked out my happiness and my liveliness at my workplace. I started getting burdened by more and more work and rectifying the mistakes of my coworkers. The only good side to this story is that I learned more than anyone else, and that too in a limited time. I just want to appreciate all the doctors and health care workers, the brilliant nurses who are so good at their work that patients become comfortable in their duty hours, who are dependable and trustworthy for their employers. These people learn faster than anyone and never compromise on the quality of their work. I want to convey the message that no matter how much you love your work, please take some time for yourself as well. Your health is important. Your lunch break is important. Your bathroom break is important. Otherwise, you will burn out faster than anyone else. You need that compassion for yourself the most, that love that you distribute so easily amongst your sick patients, you need that selfless love for your own self too.

Damane Zehra is a radiation oncology resident in Pakistan.

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