How burnout taught me to listen to my body

The first time it happened was in my second year of medical school. I was putting in eight- to 12-hour study days as I ramped up for board exams. It happened over the course of that day. First, my eyes began to sting. I squeezed them shut and tried blinking the discomfort away, but it did not abate. Then my hands and feet began to tingle. It felt as though my distal extremities were being zapped with very low power—just enough to notice, just enough to be concerned.

I was, in fact, concerned, but there were board questions to be answered and high-yield materials to be reviewed, and so I decided to forge ahead with studying for the day. Around evening, my body began to feel leaden. It was a strange feeling, as though I was slowly being enveloped by a dark, heavy cloud or lowered into fresh cement. By the time I left school that night, I could feel my brain and body slowly shutting down. My hands shook, my vision was blurry and I fumbled with my keys in the ignition, driving home on what felt more like rote memory than conscientious vigilance.

Somehow in the haze of my exhaustion, I knew this was my body signaling to me that I was well and truly burned out.

Navigating the vagueness of burnout symptoms

If one Googles the question “What does burnout feel like?,” one is sure to find a number of websites, articles and blogs that describe the various physical, behavioral and emotional signs and symptoms that characterize the exhaustion that is a hallmark of burnout. The signs and symptoms of burnout, however, also overlap with those of many other clinical and behavioral conditions that afflict people every day.

Prior to medical school, I worked in a blood bank, most of the time on the graveyard shift. That, compounded with years of staying up at night studying for all manner of tests, led me to attribute my periodic changes in mood and permanently exhausted state to night shift work and terrible sleep hygiene. I had heard people say they suffered from burnout. I had used the term flippantly before over the years myself, but that evening, I came to understand what it felt like to really be running on empty.

Becoming attuned to our bodies

For many of us, medical school is a grueling test of every ounce of our limits. Most of us find ways to rise above (or sometimes muddle through) many of the challenges thrown at us during this time. One of the ways I personally learned to navigate the obstacles of medical school was to pay close attention to the way I was feeling.

The scenario I described above was the first time I was consciously able to process what was going on in my body. For the first time, my body was telling me, practically screaming to me, that I needed more than just a break—I needed a hard reset. I got home, took a quick shower and went to bed. For the first time in as long as I could recall, sleep came in under an hour, and unlike other days, I slept through the night. I woke up the next morning feeling like a brand-new individual.

The next time it happened was on my second surgery rotation. It had been two weeks of waking up every morning at the crack of dawn and not getting into bed until hours past sundown. I was sitting in the lounge waiting on our next case when I felt my eyes tingle, a strange but now somewhat familiar sensation. This time, I was ready. I knew what my body needed. I understood what would follow, and how much time it would take before the dark cloud descended. I knew I had enough energy to power through the day, but that was it. After I finished for the day, I went home and went straight to bed.

The body keeps the score

One of the most fascinating books I read prior to medical school was “The Body Keeps the Score: Brain, Mind and Body in the Healing of Trauma” by Bessel van der Kolk, MD. The book describes how various life experiences help shape human development. It is a truly great read, but the title of the book is just as interesting. Our bodies are quite adept at telling us what they require from us, be it food, drink or mental rejuvenation.

Over the years, I have learned to pay more attention to my body. I am more attuned to the sensations that tell me there is something going on internally that I need to address. In those early days, when the dark cloud of burnout was imminent, nothing worked except for a good night’s sleep. But in the true spirit of resilience and adaptation that make the human body fascinating, I have also found other things that help me manage feelings of being overwhelmed or approaching burnout.

On long days in the hospital, a quarter-hour nap or alone time in a dark, quiet room usually recharges me enough to get through the day. A walk outside, breathing fresh air, listening to soothing music or a good book or podcast have also been good alternatives.

Little changes

I am now in the first year of residency in my transitional year. As an intern, I have incorporated several things into my day that help me identify and manage the periods when I feel I am reaching the end of my rope, both physically and mentally. The hospital grounds are a good place for a quick noonday walk, and if the weather is unpleasant, the hospital halls are a suitable alternative. Bathroom breaks allow a chance to breathe, respond to unread messages or just regroup before returning to the bustle.

Outside of the hospital, I now mostly exercise in the mornings before work instead of at the end of the day. This gives me something to look forward to upon waking up other than the workday ahead. It also saves me the trouble of finding the physical strength and mental fortitude to power through an evening workout. Instead, I spend the time catching up with my family as they settle in for the night on the other side of the country, taking an evening walk or watching some TV before bed.

I have also incorporated a very basic skincare routine into my day. This gives me time to slow down at the beginning and end of every day. I also enjoy the routine of doing something, however small, to keep my skin from being an unwitting bearer of the effects of my job. In addition, I challenge myself to read a non-medical book every month. Between audiobooks, e-books and physical books, this is one I have been able to keep up with fairly well.

Another huge step has been increasing the number of hours I sleep nightly. In medical school, I often only got four or five hours. These days, I shoot for six and a half to seven.

Finally, I take my close relationships very seriously. My intern year began three days after my wedding, and my husband and I currently live on opposite ends of the country. We try to be intentional about the time we spend together. I have made a few very dear friends this year, and I make time to catch up with them regularly. I am also blessed with mentors at and outside of work who have made space for me to break down, rant or seek advice as I move through my rotations.

Giving back to ourselves

As health care professionals, whether seasoned or brand new, we demand so much of ourselves. We give ourselves, physically and mentally, to our studies, our patients, our peers and our superiors. We push our brains and bodies to the limit. Inevitably, we hit the point where we can go no further. Some of us might attempt to continue even though there is no fuel in the tank. In such cases, we risk ending up in dire situations of physical and mental breakdown.

However, when we make an effort to listen, to pay close attention to our bodies, to understand what our bodies are trying to tell us, we will be better equipped to provide ourselves with the necessary replenishments and show up in full force for our work, our patients and ourselves.

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