The lessons no one formally taught us
Your pager goes off in the middle of the night. You slip out of bed, trying not to wake your spouse, and call the emergency department back from the guest room. You hope it was a missed page so you can return to sleep, while knowing a misfired page will feel almost as frustrating as the interruption itself.
It is the end of clinic, and you are looking forward to your son’s soccer final. Your nurse approaches with an urgent lab value: platelets of 16,000 in a patient with recurrent ITP. You know what needs to happen, but the call, prescription, and instructions may mean missing the first half of the game.
The work is urgent. People depend on you. Meanwhile, other signals become easier to ignore: hunger, exhaustion, uncertainty, frustration, the need to use the bathroom, the feeling that something is too much.
Real physician voices, twice a week
Free, and one click to unsubscribe.
No one sits us down and says, “Your needs matter less.” We learn it through observation and repetition.
We hear stories about the doctor who always answered her pager while on vacation, or gave patients her personal cell phone number. People often tell these stories with admiration: She is such a good doctor. We see their availability, endurance, and willingness to carry more held up as examples of what good doctors do.
Some self-sacrifice is part of the job
Sometimes we do have to sacrifice our own needs in a specific moment. The unstable patient needs your attention now. An end-of-life conversation may extend longer than planned. A family needs to know things have deteriorated before it is too late to reach the bedside.
The problem is not sacrifice. It is losing the ability to recognize when sacrifice is actually required.
Over time, the exception becomes the default. You do not only stay late for the unstable patient. You stay because there is one more email, and you begin postponing your needs whenever someone else wants something. We may fear letting people down while also liking being the hero, the one who always comes through.
The physician everyone wants
We entered medicine wanting to help people, and service is praised when we say yes, take the extra patient, cover the shift, respond immediately, or serve on another committee. We are commended when we do our work without complaining or asking for too much.
Usefulness is rewarded. Not maliciously. Systems reward what is useful to them, and they give more responsibility to people who show they can carry it.
But external rewards can eventually become internal expectations. At some point, nobody is asking you to carry more. You begin asking it of yourself. You begin trying to prove that you are useful enough to deserve praise, belonging, and reward.
Eventually, we stop distinguishing “I have to” from “I should”
Medicine contains genuine obligations. But when we benchmark our value against what the system rewards, self-sacrifice becomes habitual. Then everything can begin to feel obligatory.
It progresses from: A patient needs me; my colleague needs me; my team needs me; this email needs an answer; I need to make sure this goes well; all the way to: I should be able to handle this.
Over time, the nervous system does not necessarily distinguish between an actual clinical emergency and the discomfort of not meeting expectations and potentially disappointing someone. We can begin to mistake discomfort for danger: saying no, disappointing someone, not knowing, or letting someone else handle it. So we keep carrying it all even when it is much too heavy.
What medicine does not teach us
Medical education teaches us how to gather evidence, assess risk, make diagnoses, and care for patients. Its hidden curriculum teaches us how much we should be willing to sacrifice to be a good doctor. That hidden curriculum is conveyed through both what medical education contains and what it omits.
Medical education doesn’t include how to tolerate discomfort without making it mean something is wrong. Nor does it teach us how to navigate uncertainty in our careers and lives without demanding certainty before we act.
These are skills of self-trust. Self-trust is the capacity to stay connected to what you know, need, feel, and value while remaining open to new information and the needs of others. It is not about being selfish or caring only about your own needs. It allows both realities to exist: The patient matters, and I matter too.
The physician who trusts herself is not less committed
Many physicians worry that if they stop sacrificing themselves, they will become selfish, less ambitious, or less compassionate. They worry they will become a “bad doctor.” But this is not an either-or.
We can care for ourselves while caring deeply for others. We can be ambitious while honoring our needs, pushing forward when we have the capacity and resting when we need to replenish our reserves for the next push. We can be compassionate toward our patients and ourselves, seeing the humanity in their struggles and in our own.
Self-trust might mean staying late for the patient who genuinely needs you and leaving when the work can wait; helping a colleague while recognizing when her problem is not yours to solve; or accepting responsibility without automatically taking on all responsibility. When you trust yourself, you have the steadiness to weather the ups and downs of medical practice without responding to every circumstance or demand.
A different curriculum
Medicine will always require sacrifice. That is not going away, nor should it entirely. The work is not to eliminate sacrifice, but to examine the meaning we attach to it and what we teach physicians it says about them.
Perhaps the question is not: How do we teach physicians to sacrifice less? It is: How do we teach physicians to recognize when sacrifice is necessary and when it is not? How do we teach physicians that caring deeply for patients does not require abandoning themselves?
We spend years teaching physicians how to care for other people. We should also teach them how to remain connected to themselves while doing it.
Christine Kempton is a physician, certified coach, and former academic hematologist who spent more than two decades caring for patients, mentoring physicians, and leading in academic medicine at Emory University, where she holds emeritus status.
Today, through Christine Kempton Coaching, she works with high-achieving women in medicine who look successful on the outside but often find that work and life feel heavier than they expected. Many learned to handle pressure by pushing harder, carrying more, being the responsible one, and looking outside themselves for certainty. Over time, those strategies can erode self-trust and leave them disconnected from themselves.
She helps women reconnect with themselves, rebuild self-trust, and create a more sustainable way to lead, practice, and live without giving up ambition. Her work draws on her experience as a physician and leader, along with evidence-based coaching and emotional regulation, helping women create success that feels as good on the inside as it looks on the outside.
Her research spans patient-reported outcomes and quality of life in people with hemophilia, racial and ethnic disparities in hemophilia care, differences between men and women with hemophilia, immune tolerance induction, and representation in clinical trials. Her work has appeared in Blood Advances, Haemophilia, and the American Journal of Medicine, where she has also written about burnout in health care. She shares updates on LinkedIn, Instagram, and Facebook.
