by Kathy Tsapos Parmele, MD, FACEP, IFMCP

I always knew that working in emergency medicine was going to be stressful. One of the biggest reasons why I chose emergency medicine was because I enjoyed the adrenalin rush of a busy ER and preferred moving quickly through my shift, bouncing from patient to patient. I knew that stress was unavoidable, but a small amount was also enjoyable. It showed me that I was strong and able to overcome obstacles, doing good for the world.

Life became more complicated after I had children. A two physician-parent household meant that either one of us was going to need to make a change in our work schedules or we would end up hardly seeing each other or the children. Afternoon shifts made family interaction almost impossible. So, I decided to take the hit (as ER had the most flexibility) and switch to full time nights.

In the beginning, 4 night shifts a week, 11P-7A, were tolerable. I’d usually leave on time, get home reasonably early, and be awake early enough in the afternoon that I could hang out with my family, cook dinner, put the kids to bed, and then go to work. Later on, though, as the kids got older and the ER got busier my life got more complicated. I’d start leaving the ER later and later in the morning, then had to get up earlier in the afternoon to help coach soccer. Sleep deprivation started to kick in. I initially was able to readjust my schedule by Saturday, but I started sleeping in later and later on the weekends. I’d typically wake up after 11AM. Then Monday afternoons I’d need to go back to sleep in order to start the whole cycle all over again.

Monday afternoons were becoming a problem. I’d try to avoid the end of the weekend and the official restart of the work week, so I’d sip white wine on the porch prior to my afternoon nap to help “ease me into sleep.” Eventually one glass became two, which became three. I’d wake up from my nap still feeling sluggish with the tang of Sauvignon blanc still on my breath. Fortunately the shifts in those early years started at 11PM, which gave my body time to metabolize the alcohol. Yet this was definitely signaling a problem.

My husband-at-the-time wanted me to cut back my hours. He could see the toll that 4 night shifts were taking on me. Yet I still  had the typical tough ER mentality. If I’d drop down to part time I’d be considered weak. I did not want to be weak.

Eventually I’d find myself crying every Monday afternoon, lamenting the end of the weekend and the beginning of another work week. I was truly burned out. I decided that I didn’t care if others thought that I was weak. I couldn’t keep up that schedule. I loved emergency medicine and didn’t want to leave my job, but I couldn’t do 4 shifts anymore.

Eventually four shifts went down to three, which went down to two a week. Even at two a week I still struggle with occasional glimpses of burnout. Yet I’m much more resilient now, and I have burnout itself to thank.

It may sound farfetched, but hear me out.

We all start out on a common path. After high school, college. After college, med school (or PA school, or nursing, etc). Then work…. until retirement. We stay on our paths until we are forced off the track. Burnout forced me off the track. I was initially the typical full-time doc with high aspirations. I was the high school valedictorian and the Harvard graduate who everyone expected would “do something great someday.” Yet I couldn’t make that work with my family and personal life. My marriage was disintegrating. I felt like a failure. I had succumbed to weakness.

When I hit the burnout wall it careened me over to a different path. This path is unique to me now. It may not be what I had originally envisioned, but it’s much more fulfilling and balanced than it was previously. I have been able to explore many different aspects of life that I didn’t have time to explore before. I dove happily into triathlon. I can honestly call myself an endurance athlete. I’m delving deeper into nutrition and home cooking.  I’m practicing yoga, mindfulness, and meditation on a regular basis and I’m trying to share these tidbits of wisdom that I’m learning with all of you. As a consequence I’m much more resilient now and I have burnout to thank.

I’ve started this website and turned onto this path because of burnout. I’ve survived the stressors thus far, and have recovered enough to begin to thrive. Now I’m here to share what I’ve learned and hope that you too have a story that you’re courageous enough to tell. It’s definitely worth telling.

If you find yourself staring at burnout in the face, don’t give up. Think of that as the beginning to the unique part of your career that defines you best. What are you going to do that helps you regain balance? When is your track going to deviate from the main track?