The dream is always the same.

I’m pushing the ultrasound machine down a hospital hallway with an X-ray tech beside me. We’re on our way to do a portable exam when a voice crackles overhead: “Radiology to the ER. STAT.” She peels away toward the emergency department, and I turn back toward imaging alone. Then I can’t find my way back.

I step into elevators that open onto unfamiliar floors. I push through heavy doors into endless hallways. Every corridor looks the same. I move faster, panicking, certain someone is waiting for me somewhere while I’m lost inside the maze. That’s when I wake up, drenched in sweat.

Retirement was supposed to bring peace. Instead, four years after leaving health care, the nightmares still come almost every night. Sometimes I dream I’m alone trying to lift an obese patient onto a stretcher while no one answers my calls for help. Sometimes a breast biopsy goes wrong and a radiologist screams at me in front of everyone. No matter the version, the feeling is always the same: panic, failure, abandonment.

I have started to wonder if health care workers can leave the job physically but never psychologically.

My youngest son is now a nurse practitioner. Before urgent care, he worked nights in a trauma center ER and through the worst of COVID-19. Recently, I found myself talking him down after another brutal shift. Trying to comfort him, I said what health care workers are conditioned to say: “But look at the money you’re making.”

There was a long silence.

“Yeah,” he finally said, exhaustion flattening his voice. “But at what cost?”

At what cost.

That question cracked something open in me. The cost was never just exhaustion. It was marriages. Holidays. Missed childhoods. Anxiety that followed us home and stayed long after the shift ended. We traded pieces of ourselves to institutions that demanded loyalty but offered very little humanity in return.

That conversation with my son made me realize I needed to tell the truth about what health care work actually does to people. Not the inspirational version. The real one.

Two miserable years

I entered health care in the 1980s intending to become an ultrasound technologist. What I didn’t know was that at the time you first had to become an X-ray technician before you could even apply to ultrasound school. So I spent two miserable years in radiography training. And I was terrible at it.

Back then, imaging wasn’t automated the way it is now. You had to calculate settings manually, position perfectly, understand exposure techniques. I struggled constantly. Somehow, after endless studying and humiliation, I passed my boards and became an X-ray tech, though not a very confident one.

Ultrasound school was even harder to find. There were very few programs then, especially for working adults. Eventually I enrolled in a small evening program in Bergen County and spent three more years clawing my way through it. When I finally graduated, newly engaged and hopeful, I landed what felt like a dream job. There were only three of us in the department. We became inseparable.

For a while, it felt manageable. Human, even. But health care changes fast. As imaging technology expanded, so did expectations. Suddenly we were handling emergency cases, operating room patients, obstetrics, biopsies, specialized studies we had never been trained to perform. There was no Google then. If an unfamiliar exam came through the department, we grabbed textbooks and taught ourselves in real time.

And if we made mistakes? We were humiliated for them. Radiologists berated us for performing studies incorrectly, even when many had little practical experience doing the procedures themselves. Often they criticized us from home while we were the ones in the hospital overnight handling the emergencies. Over time, the pressure became constant. So did the staffing shortages.

Driving through blizzards at two a.m.

By then I was divorced with two young sons and a mortgage I could barely afford. I worked constantly. Weekends. Holidays. Overnight call shifts. Snowstorms. Hurricanes. If someone called out, we stayed. If the hospital was understaffed, we absorbed it. If my child got sick, panic set in immediately, because health care workers are expected to solve their personal lives quietly and never let it interfere with the job.

So I did what working mothers in health care have done for generations: I begged for help, found emergency childcare, and showed up anyway. Never late. Not once.

I still remember driving through blizzards at two in the morning for “emergency” gallbladder scans that no physician would even read until sunrise. Administrators insisted everyone report to work during storms, even when roads were dangerous. If we stayed home, we often weren’t paid. Meanwhile, my young sons would wake up in the middle of the night to help dig my car out of snow so I could make it to the hospital.

I think about that now and feel sick with guilt. What did they learn watching their mother sacrifice herself like that? That work mattered more than safety? More than family? More than them?

The dysfunction infected everything

Hiring took months while exhausted departments drowned understaffed. Raises were microscopic or nonexistent. After 10 years, I was told I had reached the salary “cap.” Translation: You’ve given enough already. We’re done investing in you.

Patient loads kept increasing because profit mattered more than sustainability. If the department had a slow day, management sometimes pressured staff to go home unpaid so productivity numbers looked better. As a supervisor, I hated it. Staff resented management. Management blamed staffing. Everyone was exhausted. And still we kept going. Because health care workers are trained to endure.

Then there were the doctors. Some were kind. A few were extraordinary. But many treated technologists and support staff as disposable. I spent decades working alongside physicians whose arrogance poisoned entire departments. If one of them disliked you, your job could become unbearable overnight. I remember locking myself in a bathroom at work, crying while coworkers knocked on the door asking me to come out.

35 years in health care. 35 years of adrenaline, sleep deprivation, impossible expectations, and fear. Toward the end, I became convinced the job would kill me before retirement did.

The people

And yet, this is the complicated part, some of the deepest relationships of my life came from those hospital hallways. My coworkers carried me through divorces, grief, financial crises, and heartbreak. We held each other together in break rooms over burnt coffee and exhausted conversations between patients. Those friendships were real. They may have been the only reason many of us survived.

That is what I miss. Not the institution. Not the administrators. Not the endless demands. The people.

Now, retired, I lie awake during snowstorms thinking about the health care workers still driving into the dark while the rest of the world sleeps safely at home. I think about my son. I think about the younger generation of workers who are beginning to refuse the sacrifices mine accepted without question. And honestly? I think they may be right.

Take the vacation. Call out when you need to. Protect your marriage. Protect your children. Protect the parts of yourself no paycheck can restore once they’re gone.

Maybe one day the dreams will stop. Maybe one day I will let go of the anger. But until then, this is my testimony.

No job should require you to disappear in order to survive it.

Phyllis DiSalvo Katz is an ultrasound technician.