It’s been one of those days. It all started at 4:30 this morning, when my 3-year-old son crawled into our bed, naked except for the diarrhea dripping down his leg. Turns out, this was his way—quite effective, I might add—of telling my wife and me that he had had an “accident.” After an hour of carrying soiled sheets to the washer, child-bathing, and Weimaraner coat-scrubbing, we relaxed to the sound of our 1-year-old daughter’s blood-curdling screams.
Upon examination, we found that the night had mysteriously transformed our precious little button-nosed bundle of joy into a tangle-haired, snot-nosed bundle of melancholy. Where her face used to be, there now hung something approximating the mask from that Scream movie. Additionally, her throat was raw, olive-sized lymph nodes populated her neck, and her nose had taken to perpetual booger-manufacturing. A rapid strep swab would later reveal the culprit, but at the moment, our differential tilted toward demonic possession.
That Dripping Feeling
Moments later, my wife and I picked 6:15 a.m. as the time to discover that we both had 7 a.m. meetings and no time to drop the kids off at daycare, especially when factoring in the 10-minute “discussion” we had about who was going to drop the kids off at daycare. All of this preceded my 7:10 a.m. arrival time for the 7 o’clock meeting with a hospital executive team to discuss our HM group funding for the next year—an encounter that left me feeling as my son must have just prior to crawling into bed with us that morning.
Now 8 a.m., I had to meet with a surgeon eager to unveil his “great idea” for our hospitalists to admit all of his patients. “It solves our problem of no interns, and allows you to play a meaningful role in the hospital!” he exclaimed.
“The meaningful role of intern?” I replied. Again, I had that dripping feeling.
It was 8:30 a.m. and I was ready to round on my patients. The first patient, a lovely woman, was stricken with un-insure-ia and a deep-seated belief that the inequitable health system that rendered her unable to get her surgery was clearly the result of some moral failing on my part. Next up was a spectacularly intoxicated male who welcomed my caring touch by belching a bit of breakfast burrito onto my cheek. Then it was a floridly bipolar patient whose apparent life mission was to drop her pants to show me her new mesh thong.
Figure 1. Maslow’s Heirarchy
Burnout, Respect, Satisfaction
And so it continued until 1 p.m., when I had a meeting with a resident mentee of mine. It turns out that he wanted to tell me that despite his desire to be a hospitalist since his fourth year of medical school, he instead was going to apply to a rheumatology fellowship. After talking to several practicing hospitalists, he’d decided it just wasn’t for him—discussions he summarized as too much burnout, too little respect, and not enough satisfaction. Again, that dripping feeling.
Stuffing my face with a vending-machine carb-load that doubled as both breakfast and lunch, I sat down for a few minutes of e-mail. First up, a journal rejection of a research paper we’d recently submitted. Oh, the fulfillment of academics. Next were two e-mails that enzymatically trebled my “to do” list for the day. Sandwiched between those e-mails and one from a friend reminding me not to be late for a dinner that night that I was clearly going to be late for was an e-mail from a nice-appearing Nigerian man wanting to give me millions of dollars; at last, my day was turning around.