YOUNG PHYSICIANS SECTION
Keeping the Flame Lit Michelle Romeo, MD
R
traveling, indulging in the art and food scene were all at the top of my list now that Covid has subsided, but so was restarting therapy, getting in a healthy workout and sleep routine, and incorporating meditation daily. Once I was in a space where I felt more whole and overall less anxious, I could do the work that I deemed necessary to help care for patients as much as I possibly could. I signed up to lead a lecture series for the second year residents. I dedicated the series to the social determinants of health with lectures devoted to understanding more about gun violence, the housing crisis, health of people suffering from homelessness, transgender health and more. There is no sense in being an advocate if you don’t understand what history has shaped where we are today. So along with the residents, I learn why I’ve always compared the emergensome patients, some communities, cy department to being the pulse and our nation may suffer uniquely My first year as an attending left of the community it is housed in. compared to other societies. I me feeling anxious, uncertain, and overall Moving to Philadelphia and starting connect with community experts, depressed on the outlook of my ability to my work as an attending in two and not just those in Philadelphia. do this job for a long time… I knew I loved Philadelphia neighborhoods where this work though, so I wasn’t going to let my I look back at those I’ve met during violence and drug use are some of my training: alumni, nurses, social flame burn out. the most common comorbidities of workers and understand the work our patients has been quite the adthey are doing outside of the ED. justment for me. There is the stress Whether it be research to underof being the one in charge, the stand morbidity of living on the stress of the continued shift work, streets or setting up a van to help the stress of learning new systems, with needle exchange and laundry, and the stress of making a home learning more about their initiatives and real-world implementations in my new city. I find these stressors easily palatable. I love the energy allows me to figure out what holes in our system might be able to be filled of the ED, the hours allow my personal life the freedom I crave, the new and who we would need to talk to about it. systems to learn now are comfortable, and Philadelphia’s food and art I’ve become more curious about politics than ever before. Understanding scene swallowed me whole. What the unsavory part of my job entails that politicians can control our state’s Medicaid dollars versus physicians are the discharges at 4:00am to the street because there is no social or hospital systems was definitely an eye opener. Voting has never been work on hours or intake shelter that is open 24 hours a day, the AMA of more important to me, and advocating patients to vote and understand a patient who does not have health insurance and rather risk their life how it can affect their health has become entwined in my fall clinical than be forced into an unmanageable hospital bill. The intolerable part days. I’ve learned that having an MD after your name makes your voice is watching young people die by violence, directed at them or not, and instantly a bit more credible, though we have seen how it can be abused. hearing their families recount how guns have ruined their communities. I’ve learned that being silent is no longer an option when it comes to It’s demoralizing to watch 20-year-olds come in with wounds so severe my opinions on gun reform, public housing, and Medicare for all and they end up with an auto amputation of their limb but leave the hospital before completing antibiotics because their withdrawals are a new degree writing has been not only a powerful outlet for my mental health but provides a message to the public of the reality we face in the emergency of unmanageable. department. My first year as an attending left me feeling anxious, uncertain, and overI’m not suggesting you start submitting to the NYT or try to create new all depressed on the outlook of my ability to do this job for a long time. I social initiatives overnight in your hospital, but I am asking you to exwas never trained on answers for housing insecurities, being uninsured, amine your own “burnout” if you think you are experiencing it. What is or managing family loss in the midst of a uniquely American gun probdemoralizing to you about the system? Is there a way to educate yourself lem. I knew I loved this work though, so I wasn’t going to let my flame and others about it? Find out what your city and hospital may be doing to burn out. I knew I had to find ways to keep it lit. assist in efforts to combat these issues. In doing this work, you may just The first objective was taking care of myself. Seeing friends, family, find the spark that keeps you going. ecently, the New York Times published an opinion essay, “Doctors Aren’t Burned Out From Overwork. We’re Demoralized by Our Health System.” It outlines what I presume many people would describe as burnout—this idea that we are losing a sense of purpose in our workplace and feeling that the work we do in actuality is not what we idealized it to be. The argument is that our demoralization stems from the systems we work in versus the conditions or patient care. The number of physicians suffering from some sort of burnout is staggering across the country and it forces us to take a lens to not only ourselves, but our departments and our country’s health care practices as a whole.
COMMON SENSE MARCH/APRIL 2023
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