In medicine, we are trained to recognize risk in our patients. But we often overlook those same risks in ourselves. Sometimes, the system overlooks them, too. During residency, performance is expected and endurance assumed. Health often declines quietly and almost invisibly. We label it “dedication”; we claim “resilience.” In reality, it is often neither. I learned this lesson over 48 hours, two days that would reshape both my career and my life. Have you ever been pulled in two directions at once, both urgent, both time-bound, both impossible to delay?
That was my reality in late March 2009. I was a pregnant, final-year internal medicine resident preparing for United States Medical Licensing Examination (USMLE) Step 3, the final hurdle before independent medical licensure. On March 26, 2009, I completed Part 1 of the exam. I was focused, determined, and nearing the finish line after years of training. Like many residents, I operated at full capacity: clinically responsible, academically driven, personally stretched. The expectation was clear, finish strong, push through, and transition seamlessly. I was already scheduled to deliver our baby girl on April 11, 2009, after my exams.
Then came the call.
“You have gestational diabetes, diagnosed late. Your baby has likely been exposed to elevated blood sugars, which could pose serious risks.” Unbeknownst to me, my glucose test had been abnormal for months. I was not notified. This was before patient portals such as MyChart. Results could be delayed or lost in the rush of care. Communication relied on fragmented systems and human follow-up, three elements rarely aligned in complex environments.
The collision of patient and physician
In that moment, I was more than just a physician. I was also a patient. The implications were immediate. My physician recommended urgent intervention, including a cesarean section. But another reality was unfolding at the same time. I still had to complete Part 2 of my board exam the following day. What followed was one of the most defining 48-hour periods of my life.
I stood at the intersection of two nonnegotiable responsibilities: to my profession and to my health. Finish the exam or stop everything for urgent care. Both critical. Neither optional. There was no algorithm. No guideline. No attending available. Responsibility fell to me, alone. Only judgment, timing, and consequence.
For 12 hours, I lived in that tension, quiet, internal, and deeply consequential. The kind of moment many high-performing professionals encounter but rarely articulate. In medicine, we prioritize our patients, not ourselves. But we are untrained for the moment when we become patients. With careful coordination and careful balancing of timing, risk, and logistics, I completed Part 2 of my exam on March 27, 2009. Less than 24 hours later, on March 28, 2009, I was in the operating room undergoing an urgent cesarean section.
The quiet crisis of trainee health
Today, our daughter, Kaira, is 17 years old. As she approaches her final year of high school, and as my husband and I prepare for a new transition, I reflect not just on those two days but on what they continue to teach me. Time reframes intensity. What once felt like pressure becomes perspective. What once felt like a sacrifice becomes meaningful.
But reflection also brings clarity. Health is often discussed in terms of outcomes, numbers, metrics, and diagnoses. These matters do not capture the struggle of meeting professional demands while facing health challenges. They do not capture the delayed lab result. The missed phone call. The decisions we make under fatigue. The quiet negotiation between professional identity and personal well-being.
What happens when critical results are delayed, not because of intent, but because of system gaps? What happens when individuals must make high-stakes decisions under compressed timelines while still meeting expectations? What happens when the caregiver becomes the patient and still feels compelled to perform? My story is not unique. It is simply visible. There are countless quieter versions, unspoken, undocumented, and normalized. Resident doctors often delay care due to rigid schedules. Trainees downplay symptoms to avoid burdening colleagues. Physicians accept exhaustion as part of their professional identity.
Building a healthier system
These are not isolated behaviors. They are signals. As July approaches, bringing a new cohort of residents, we have an opportunity and an obligation to do better. Training programs must move beyond reactive care and build systems that support trainees’ health and well-being. Health cannot be only an individual responsibility where collective performance is expected. Programs should ensure that their residents and employees prioritize their health and well-being, including structured follow-up, and access to care that does not depend on navigating already overextended schedules. Access to care should not be delayed due to lack of personal time, scheduling constraints, or competing demands.
Residency demands sustained, high-level physical, mental, and emotional performance. We often act as if trainees can defer their health indefinitely without consequence. Health cannot depend solely on self-advocacy, especially within environments that demand constant output. Behind every delayed result is a potential consequence. Behind every trainee is a human being navigating their own health alongside their professional responsibilities. Looking back, I do not remember that time as a moment of balance. There was no balance, only prioritization, adaptation, and decision-making under pressure.
But I do remember this. The choices we make in these seasons, however imperfect, are shaped by what we value most. And the systems we build determine how difficult those choices are. Over time, what once felt like pressure becomes perspective. What once felt like a sacrifice becomes meaningful. But meaning should not require unnecessary risk. Our systems must evolve not only to treat illness, but to actively protect the health, dignity, and longevity of those within them.
Because behind every statistic is a story. Behind every story is a season, often a penultimate one, that shapes everything that follows. Next week is Black Maternal Health Month. Let us use this time to commit to concrete action: implement system reforms that ensure timely results communication, easy access to urgent care for trainees, and create meaningful accountability for trainee health. Let us support our colleagues, trainees, and team members who are too wired, too tired, and too busy to prioritize their own health and well-being. Caring for others should never come at the cost of caring for ourselves. Let us commit to building systems that not only heal, but empower every member within them, so that the stories that shape us lead to a healthier future for all.
Chinyelu E. Oraedu, also known as Dr. Yel’Ora, is an academic hospitalist and nocturnist based in Stamford, Connecticut, with more than 17 years of experience in night shift medicine. She currently serves as a per diem nocturnist at Stamford Hospital in Stamford, Connecticut, and MidHudson Regional Medical Center in Poughkeepsie, New York. Board certified in internal medicine, she earned her medical degree from the University of Nigeria and completed her residency at SUNY Downstate. She previously served as an adjunct professor at Quinnipiac University.
Dr. Oraedu is the founder of the Dr. Yel’Ora Night Shift Hub, a lifestyle and obesity coaching program focused on improving the health and well-being of night workers. Her work translates the science and lived experience of circadian disruption into storytelling and practical wellness strategies for shift workers. She is a media contributor on circadian health, coauthor of Thriving After Burnout, a compilation of burnout stories from 50 U.S. female physicians, and the former host of The Night Shift Lifestyle Show. Her current scholarly work includes a pilot night shift quality improvement study examining job satisfaction among night shift workers.
She shares insights on night shift wellness through LinkedIn and Instagram.
