It was the last straw. After making sure all orders were put in and my colleague had an appropriate sign-out, I charged out of the surgical ICU. My chief of surgery, who was also a friend, called me and asked, “What's wrong, buddy? I heard you are done.” “I need a leave of absence,” I said. “I am just burned out.” As a good friend and boss, he understood and told me to take as much time as needed. I had not taken vacation in 3 years and was due for a break.
After years of having no support, no new staff to assist, and working endless shifts, I could feel my BP rising. You know, that pulsatile, straining feeling after working seven 12-hour shifts in a row? How about getting chewed out on rounds because your septic patient is still waiting on antibiotics from pharmacy? Or that feeling of having to cover another weekend because there is no availability? Unfortunately, I knew these feelings all too well. My motivation was winding down and so was my compassion for my patients. Something needed to change.
I was in my fifth year of practice working in emergency and critical care medicine. I had learned a lot and was surely on top of my game, comfortable managing any medical or surgical emergency, but like many PAs working 60 to 80 hours a week, my body was telling me I needed change ... and it had to be quick. Not just for me, but for my patients as well.
Two weeks later, I was home relaxing with my daughter, well rested and up at 7 a.m. on a Wednesday (which was rare because I went into work Monday through Friday at 6 a.m.). My mental health had improved dramatically. It was a sunny day, so I opened the shades to let the sunlight sneak into the kitchen, where it reflected on my daughter's face. I was in deep thought contemplating my career. I wanted to enter academia but also still practice clinically. I felt at odds with myself, wanting to find that passion again.
As I was reflecting, my father happened to walk by. He saw that the shades were open and came in to ask why he had heartburn while walking. He said he felt fine and would get some omeprazole if his symptoms came back. I thought to myself, “Hey, I may be on break, but I still know my stuff.”
I grabbed my stethoscope and said, “Dad, sit down; you are not going anywhere.” As with a new patient coming into the ED with the chief complaint of heartburn on the board, I went into full PA mode and began history taking. After a focused physical examination, I learned that my father's symptoms happened twice, but more importantly ended twice after he stopped walking. My father is pretty much a healthy guy, except for a significant family history of heart disease. I looked at my dad and said, “We are going to the ED right now!”
Your clinical intuition can figure out the rest. My father had a 95% left main occlusion, and he was treated successfully in that critical hour. He is alive and well today.
The incident revitalized me. At a time in my life when I needed a drastic change in my environment and work schedule, I read my body and recognized that I was burning out.