It was December 24, 1996. I remember it – well, sort of, like through a gauzy veil – as if it were yesterday. I was on the acute care neurology service, doing my third straight day of call. Since it was, nominally at least, “home call”, there were far fewer restrictions on the number of hours that could be done consecutively. Unfortunately for me, there was precious little time at home during those three days, but a whole bunch in the ER and on the neurology wards, attending to new stroke patients and unstable elderly folks with poor balance.
Being awake for almost 72 hours straight had made me forget what my wife sounded like.
At about 5 pm that Christmas Eve, my wife paged me to see what time I might be expected home, and whether we might make it to church services later that evening. I called the number on my pager. She said “Hi, it’s me”. And I had no idea who she was. Being awake for almost 72 hours straight had made me forget what my wife sounded like – and, for a few scary moments, her name. I felt like I was trying to think through a dense fog bank that just wouldn’t clear. She was, understandably, beside herself with worry for me and my personal well-being, and also for my patients, who were not going to be well looked after by a physician in training who couldn’t remember his wife’s name. She made me get a replacement for that last night of call– thankfully one was available – and came and picked me up so I wouldn’t have to drive home. I slept for 20 straight hours and missed most of Christmas Day that year.
It is my hope that my younger colleagues reading this will see it as a cautionary tale of a time gone by, one that has been supplanted by humane call schedules and by evidence-based recognition that a sleep impaired doctor is an unsafe doctor. But even if this is the case, there is so much more that still needs to be done when it comes to physician health and well-being. I won’t bore you with the stats – you already know the unique pressures faced by physicians who are in training or early in their careers – and if you are not burned out, yourself you know colleagues who are.
At no time in history has it been more stressful to be a physician.
Over 20 years later, I now work as the Vice President of Medical Professionalism at the CMA. Part of my portfolio includes responsibility for the work of the CMA in physician health. At no time in history has it been more stressful to be a physician. And we all need to do what we can to make things better. At the CMA, we are working on change at the system level to improve professional satisfaction levels. At the individual level, there is also much you can do – starting with making yourself aware of the resources and support services available to you through your university, provincial medical association or national representative body.
Please try and address issues of stress and burnout early on – before it gets to the point where you can’t recognize the voice of a loved one when they call you.
Dr. Jeff Blackmer is the Vice President of Medical Professionalism at the CMA. He continues to practice medicine part-time at the Ottawa Hospital Rehabilitation Centre. As the father of two teenagers, he spends most of his time driving kids to activities and worrying about curfews and handsy boyfriends.