Introduction

April 2016

A training room in Las Vegas, Nevada

We were all asked to attend this meeting. There were about thirty of us.

We came from various paths. I can see that some had their own practice before joining the group. Some were like myself who has been an employed physician since day one.

We were there to relearn medicine. Not about how to take history and exam the patient, not about how to come up with a diagnosis, it is about how to get paid.

From my own orientation to this new job few weeks ago and this meeting, I feel paralyzed. Just like in the past when I went to see the golf instructor asking him to help me hit the golf ball better. Keep your head still, keep your eye on the ball, keep your left wrist flat, keep your left elbow straight. When I think of those instructions, many time I just top the ball and the ball roll to a few feet in front of me.

In the present medical lingo, it is like: Did you do the spirometry? Did you do the EKG? Did you ask about advance directive? Did you do the PHQ-9? Did you do the mini mental state exam? Did you recheck the blood pressure? Did you look at the cardiology notes? Did you ask about family history? Did you reconcile the medication? All of these in front of an elderly patient who is crying and walk in with a cane.

The healers are sick. How do I know? I am one of them. Physician burnout is becoming an epidemic. Physician suicide due to depression is true and real.

It is my hope, that in writing this book, I can share the story of my own burnout. If we are waiting for our elected officials to fix the problem, it is not going to happen. They live in a different world. After they do the lip service during election, they forget about what the citizens are going through. They do not see the elder mother sitting in my office, with a son and daughter-in-law who are in agony, not knowing what to do with their mother who is very demented. They, the officials, live in an insulated world.

Any Day

Any day

Albuquerque, New Mexico

2015

As usual, I drove passed the office building, make a left into the parking lot. As usual, I parked the car facing east, the Sandia Mountains. Some days, I can see beautiful pink and light blue colored sky. It is the blessing of living in the high desert. We do not have clouds all the time. When they come, it is always dramatic.

I walked the usual path towards the building. I swiped my card and got in. Some days, there will be a worker next to me. We will make some small talk, like the weather or payday. Some days, it seems that that is the real reason why I park my car there and swipe the my badge, payday and paycheck.

Many times, I try to cheer myself up. Hey Ben, look, you are better than many people. You have a house, a nice family, a car and a job. Remember the AMERICAN DREAM? You have it!

That self talk will last for a few hours, or even shorter. Just like when I return from a vacation, I am so geared up for a good work, with my gas tank for of recharged energy. But it only takes one patient encounter to see the energy evaporate.

I got to the lobby, waved to the early birds at the check in counter. Some times, we also have a short small talk. Then I punched in a code to get into the office area. Then I used my key to enter my office. Another day.

Another day starts with paper work. There is always a stack of paper in front of my nurse. We came up with a way to deal with it. The ones to the right are the urgent one. The ones to the left can wait. And to the left of those papers, at the end of the counter is the waste basket, a big one. And to the left of the big waste basket is the bigger blue recycle bin. It swallows the papers that I cannot trash openly, meaning, it has patient information. And next to the blue bin is the multitasking machine for faxing and copying. Two tasks that are essential survival. When they are not working, you can see the extra line of wrinkle in my forehead, or on my nurse’s forehead, followed by a sigh.