#ADULTING, Part 3: On Burnout

And what do you benefit if you gain the whole world but lose your own soul? Is anything worth more than your soul? (Matthew 16:26, NLT)

As I've said before in the last few posts in the #ADULTING series, I wrote this series as a means of self-analysis, in order to regroup after a lackluster first semester of second year. I had many problems in December: I ate like crap, I didn't adhere to my morning routine or night routine, I spent way too many nights cooped up on my bed instead of being productive or even doing things I like (like exploring places and seeing friends). And part of the process of making sure that I didn't eat like crap or violate my morning routine this semester was to write the vision of what I wanted my diet or exercise or general self-discipline to look like, and then to make it plain (via the blog). But that didn't solve all of my problems. Last semester, I wrote out goals for the block each semester and put them on my door. I knew what I was supposed to be doing, and I knew why I was supposed to be doing it, but I just...didn't do it. I didn't feel like doing it. I could motivate myself to do just enough to pass all of my tests and honestly not much more. I figured it was just due to my general laziness.

When I was young, I honestly preferred cartoons, video games, social media, sports--really anything--to actual homework. Thank God, I had parents who pushed me to do my best and focus on my studies. My parents were the ones always getting me up and ready and pushing me to do everything and nothing less. That impetus, along with (some) intelligence, got me into college. College was the first time that I had to find motivation to work on my own. And to be honest, that was hard! I had been used to getting good grades without working super hard to get them, and when I'd flagged, my parents had always been there to push me. But that situation became untenable after a while--I had to find motivation and fast.

In the middle of college I hit rock bottom. I was deeply depressed and thought I'd lost myself. But then somehow, I got a hold of God and his Word, and he pulled me out of my abyss. I spent the rest of college in catch-up mode, regaining what I should've had freshman and sophomore year. My grades skyrocketed as I learned to apply myself for the first time. During my senior year, one of the academic highs of my life was studying for the MCAT. I knew that I had to do well because I didn't have the academic record to carry me through medical school. For a month, I studied from 10am to 12pm with 15-minute breaks for lunch and dinner, every single day, without getting distracted. To this day, I look back at myself during that period and wonder, "WHO IS SHE?" I proceeded to smash that test and the rest of senior year. By then I thought I had the work ethic thing down. But the problem with work is that you have to keep doing it.

My first year of medical school was kind of a continuation of senior year of college. Despite the gap year I took, I still had my college mentality of "catch-up time", and I worked very hard. As time went on though, I got tired, and I realized that I didn't need to do as much as I was doing in order to pass my tests. I had the same mentality that I'd had senior year: "you HAVE to do well! You weren't brought this far just to barely get by! You have to do the best you can, or else you've wasted everyone's time!" But as 2018 wore on, I became less and less capable of living up to those expectations. With every month I seemed to be "getting worse"--getting distracted more often, sleeping off earlier, not working as hard. I knew I was tired, but I also saw it as myself getting lazy again, just like I'd been in high school and early college.

I had a two-month summer break that was very restful. Then med school started again, and it hit me like a ton of bricks. I attributed it to a summer hangover...a summer hangover that lasted for two months. I knew I had to work, but I just wanted to rest...like, all the time. I didn't really take interest in the material like I had first year; a lot of it seemed boring to me. And it wasn't just academic either. Despite everything I learned in the summer about making friends (see the post "No New Friends"), I hardly ever made plans to see any friends; it just felt like too much effort in comparison to sitting in bed and watching Netflix. I did not like my extracurriculars at all; whenever I had to do something for my clubs, it always came as a surprise, like, "oh GOODNESS, I have to do yet another thing for this club?" It felt a lot of times like I was being dragged along by life. There was a bright spot in the middle of the semester, right after my two-month "summer hangover", where I hit a block of material that was interesting to me, I was motivated to get out of my "summer hangover", and I also had the good sense to plan a weekend trip for myself. That block went well, but after that, I sank right back into the abyss until Winter Break freed me from my troubles.

All the while, I never thought that it could be burnout. Burnout, I thought, only happened to actually hardworking people. Burnout happened to the people who studied until 1am every night and did seven extracurriculars and were going for AOA, all at the same time. Burnout, I thought, could never happen to lazy old me--I liked watching YouTube and Netflix. I actually slept every night. How could I get burned out? But as I was writing and self-analyzing this past January, I looked up the definition of burnout, and found this:

Burnout is one of those road hazards in life that high-achievers really should be keeping a close eye out for, but sadly—often because of their "I can do everything" personalities—they rarely see it coming. Because high-achievers are often so passionate about what they do, they tend to ignore the fact that they're working exceptionally long hours, taking on exceedingly heavy work loads, and putting enormous pressure on themselves to excel—all of which make them ripe for burnout.

Burnout is a state of chronic stress that leads to physical and emotional exhaustion, cynicism and detachment [and] feelings of ineffectiveness and lack of accomplishment...

(from Psychology Today, bolding mine)

Though I didn't suffer everything that the article said (thank God!), I saw myself in a lot of the words said merely in those two paragraphs. I couldn't believe it--I, Simi, lover of cartoons and video games and sports, had actually pushed myself hard enough to burn out. And I had suffered a whole year without even knowing it. I soon realized that I was far from alone. Apparently, my generation suffers from burnout in so many ways that people, starting with BuzzFeed News, have dubbed millennials "The Burnout Generation".

Essentially, the BuzzFeed News article argues burnout is "the millennial condition". Rich or poor, regardless of race and social class, many millennials have been raised in some way to be the optimal worker. In high school we take AP classes and do internships (at least in some high schools...I never did one); in college we do more internships and take on lots of extracurriculars and do research and take classes; we go on to grad school in order to make ourselves even more optimal for the workplace. And in the end, if we don't get stable jobs, we take on everything we can to "make it work". The article states:

People patching together a retail job with unpredictable scheduling while driving Uber and arranging child care have burnout. Startup workers with fancy catered lunches, free laundry service, and 70-minute commutes have burnout. Academics teaching four adjunct classes and surviving on food stamps while trying to publish research in one last attempt at snagging a tenure-track job have burnout. Freelance graphic artists operating on their own schedule without health care or paid time off have burnout.

And I can add with certainty that despite the comparative job stability, medical workers (doctors, nurses, MAs, medical students, residents) absolutely get burnout as well. 

The American Psychiatry Association estimated that between 300 and 400 doctors commit suicide every year. It's not the highest suicide rate (apparently that belongs to farmers!?), but it does mean that one doctor commits suicide every day. And coming from a person in the profession, it's not exactly hard to figure out why. In high school, you work your tail off to get the best grades in order to get into the best college. In college, you work even harder to do well in premed classes and get good research and get the best extracurriculars in order to get into medical school. In medical school you study mountains of material in order to pass your test (or get the highest grades if your school isn't pass/fail) and then restudy those mountains in order to get the best score on Step 1. Then you go into rotations (with a Step 2 exam) and that melts into residency, with 16-hour workdays and twice-weekly call where you work for 24-48 hours without leaving the hospital (at its worst--it gets better) for at least three years. And somehow, in there, it is expected that we will never suffer from burnout or feel detached from our work or wonder what the point of it all is, at any time. Yeah, right.

And yet for every doctor who does burn out or ends his or her life, there are thousands more who have gotten through all of the above and have continued into their careers with at least some degree of happiness. Medicine is an extremely rewarding career, and there is a way to do all of the above without losing yourself in the process, or else no one would do it. I am determined to do it that way. I can't afford to be burning out in medical school when I have at least five years left until I become a board-certified doctor, and a whole lot of life to live beyond that (by God's grace). Obviously, I need to work hard and do my best, but I need to do my best in a way that is sustainable. It's better to work at about 80% capacity and be able to keep that up for several years than to work at 100% capacity for one year and burn out the next year. Burnout and recovery from burnout takes a lot of time that I don't have anymore.


The United States National Suicide Prevention Hotline can help in times of crisis if you call 1(800)-273-8255.