I’ve wanted to be a doctor since I was 12. Growing up, I idolized my pediatrician, Dr. Helen Nash, one of the first Black female physicians in St. Louis. Her warmth and competence left a lasting impression on me. Medicine became my calling, my purpose, and my dream. I worked tirelessly through high school, college, medical school, and residency to make that dream a reality. But no one warned me that the reality could turn into a nightmare.

Being a doctor nearly killed me.

The weight of the white coat

For years, I thrived under the relentless demands of medicine. I worked 80-hour weeks in the ER during the pandemic, answering every call for help while ignoring my own needs. The constant exposure to trauma, death, and suffering began to erode my spirit. I didn’t just witness tragedies—I absorbed them.

I’ve been in situations where police and paramedics brought in patients after horrific accidents or devastating events. Those first responders were required to undergo counseling before returning to work. But for me, there was no such mandate, even though I experienced the same traumas. Doctors are often expected to push through pain and exhaustion as if we’re invincible. We’re not.

I became overweight, burned out, and profoundly depressed. Thoughts of suicide crept in—dark whispers in the corners of my mind. During this time, a colleague, also overwhelmed by the pressures of the profession, took their own life. It was a stark reminder of the crisis we face: physicians die by suicide at a rate of approximately one per day. Each year, we lose the equivalent of an entire medical school class.

Despite being surrounded by health care professionals, I felt utterly alone. Help wasn’t automatic. Support wasn’t built into the system. And yet, it should have been.

From flatline to fulfillment

In May 2024, I gave a TEDx Talk titled Emotional Flatline, where I shared my journey through burnout and the emotional toll of working in high-stress environments. Speaking publicly about my struggles was cathartic, but it also ignited a deeper passion: advocating for change in how we care for the caregivers.

Doctors need support systems as much as—if not more than—the patients we serve. We need structured mental health resources, peer support programs, and systemic changes that acknowledge the emotional toll of the work we do.

What do you do when the dream becomes a nightmare?

When I was in high school, our cheerleaders would shout, “Go! Fight! Win!” That mantra feels oddly appropriate now. The fight isn’t over, but it’s no longer about surviving shifts or managing impossible workloads. The fight is about transforming medicine.

We must rage against the machine that treats doctors as expendable cogs in a broken system. We must reimagine medical practice and residency training to prioritize well-being. We must create communities where we share ideas and solutions, fostering a culture that values healers as much as healing.

I envision a reality where mental health support for doctors is not optional but automatic, where counseling after traumatic events is standard protocol. Where physicians have the tools, time, and permission to care for themselves.

A call to action

The stakes are high. This is a matter of life and death—not just for our patients, but for us. As physicians, we have the power to be changemakers as well as healers. We can advocate for an alternative reality where medicine is sustainable, humane, and fulfilling.

So, what do you do when the dream becomes a nightmare? You fight to rewrite the story. You go. You fight. And together, we can win.

Let’s transform the nightmare back into the dream—before it’s too late.

Pamela Buchanan is a board-certified physician, speaker, and thought leader dedicated to transforming health care and championing mental well-being. With more than 20 years of medical experience, she is a TEDx speaker known for her powerful talk on “Emotional Flatline,” which explores the emotional toll of high-stress professions, particularly in emergency rooms during the pandemic. As the author of The Oxygen Mask Principle and Emotional Flatline, Dr. Buchanan teaches self-care as a revolutionary act for working mothers, health care professionals, and high achievers.

In addition to her work as a physician advocate and ambassador with the Lorna Breen Foundation, her work extends to coaching and consulting, focusing on helping physicians navigate burnout and preventing burnout in medical students and residents. She strives to keep more physicians practicing. Dr. Buchanan’s mission is to help people break free from burnout, prioritize self-care, and live with purpose.

Dr. Buchanan is the founder of Strong Medicine and can be contacted for coaching, workshops, and speaking engagements. She can also be reached on TikTok and Instagram.