She became one of those patients, and I managed to get her through a lung resection, a fistula repair, a bout of sepsis and other long-forgotten complications. Along the way, I learned about her teenaged children and her love for them, her antebellum house and her extensive garden. The physician–patient relationship is an odd form of intimacy; her friends and family all knew who I was, although I had never met any of them.
I know that now, because when I met them at the memorial service, each of them knew exactly who I was. I could see the look of puzzlement melt into recognition when they heard my name, and I was greeted warmly, like a long-lost cousin arriving at the family reunion.
In church, at some point during the service, there is a ritualized greeting. The minister, standing at the pulpit, looks upon the congregation, and intones, “Peace be with you.” The congregation then murmurs back, “and also with you.” The call-and-response is so ingrained in my mind that if you greeted me with the same words in the middle of the street, the response would come, even before I had completely registered the incongruity.
These words echoed in my head during the memorial service, when I noticed that I had fallen into another ritualized greeting of sorts. “Thank you for coming,” each family member would say. “I am sorry for your loss,” I would respond. And thus, I met, for the first time, my patient’s mother-in-law, her siblings and her two children, who were old enough to be expected to attend the service, but not old enough to say goodbye. Meeting her daughter was the hardest. As she spoke, her words were almost trapped by her trembling lower lip, and I could see the tears glistening in her eyes. I fell silent. I had no words for her.
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Burnout is a prolonged response to chronic emotional and interpersonal stressors on the job, and is defined by three aspects: exhaustion, cynicism, and inefficacy. Rates of burnout and depression are substantially higher among physicians than they are among the general population.1
The concept of physician burnout is becoming widely recognized, even by the lay press. A story by the CBS News Division stated: “If you’ve ever worried that your doctor seems burned out on the job, you may be right. Physicians are busier than ever, and hospitals are worried that as their staff gets overwhelmed, the quality of care goes down and medical errors go up.”2 Bento Soares, the senior associate dean for research at the University of Illinois College of Medicine in Peoria states, “We have been predominantly concerned with the technical skills and the knowledge that are required for the practice of medicine, but we forget that there’s an individual that’s delivering that care.”3
