My fourth year of OB/GYN residency there was an essay contest about what it meant to be an advocate for women’s health while preserving your sense of self. I sent a screenshot of the contest to my then-boyfriend, now-husband. He replied, “You want to add something else to your to-do list?” He was joking, but he wasn’t wrong. Just a few days prior, I was hyperventilating from all the things on my to-do list in between my 80-hour resident work week. What helped me catch my breath is rewording the phrase “have to” to “want to.” They’re items that I’ve encountered by deciding to be a physician advocate in women’s health. They’re not just for me, but for the collective. In other words, my key to preserving my sense of self and my patient’s well-being? Equating the two as one and the same.
As a forgetful intern, I used to keep a written to-do list of notes and orders. As I’ve advanced, it became a mental checklist for better patient care: admit, listen, teach, be present, be patient, triage, eat, get her a blanket, discharge, check on her again, drink water, answer questions, make sure nothing is missed, support her, and go to the bathroom. When leaving the hospital, we are taught that it’s best to compartmentalize and leave the patients behind, yet I’m often driving home going through the list again. Did I miss anything? Do I have anything planned for dinner? Is she going to be OK? Not the best compartmentalizing, but I try to avoid feeling weighed down by patients. Instead, I balance my importance and theirs.
I think the misconception is that since most of my to-do list is not about me that it is therefore not for me. Do I get nothing out of advocating for my patients, making a sick patient smile, helping a patient understand her care, or double-checking orders to ensure my patient’s safety? When I come home after a bad workday, my complaint isn’t just that I didn’t get to eat enough. More often, it’s that I had a negative patient or colleague interaction leading to impaired patient care, or worse, losing a patient.
Work takes up most of our day, so it makes sense that it heavily affects mental health. When I’m burning out, it’s usually because I’m going through the motions. Wake up, go to work, and spend every second counting down until I’m home. The work I do stops mattering, and consequently, taking care of myself also stops mattering. We can’t take adequate care of others if we don’t take care of ourselves, but also vice versa. Self-care doesn’t have to be a mutually exclusive ideology from patient care. What fulfills me is when I am trying to be the best of all versions of myself: physician, writer, painter, friend, girlfriend, daughter, Netflix-watcher, etc. A to-do list filled with things to advocate and support the women in my community may not directly be about me, but it equally supports my and their well-being. Checking off “get nails done” fulfills my sense of self, and so does “submit essay.”
Camille C. Imbo is an obstetrics-gynecology resident.
