Finding Humanity in Provider Burnout, and Other Stories of Perseverance

Statistics don’t tell the full story of healthcare burnout, maintains Jessi Gold, MD, MS, of the University of Tennessee Health Science Center in Memphis. People do.

“Sometimes, even in the world of healthcare, mental health professionals don’t advocate for themselves and their needs,” observed Gold, author of the new book How Do You Feel? “Maybe it’s stigma, maybe it’s that emotional exhaustion is somehow viewed differently than physical exhaustion, but in so many spaces we don’t even have a voice.”

“If telling my story allows people to acknowledge that the work affects them and maybe let other people see that, too, I will have done my job,” she said.

In How Do You Feel?, Gold — chief wellness officer at the University of Tennessee system, associate professor of psychiatry, and Medpage Today editorial board member — takes readers on a journey of self-reflection. She describes how she reached a personal breaking point and shares the stories of four other healthcare professionals, and what they taught her about the struggle to maintain mental health.

MedPage Today spoke with Gold about what she hopes healthcare workers might learn from her experiences. An edited version of that discussion follows.

You described how you reached a breaking point that prompted you to reassess your personal mental health. Can you talk about that experience?

Gold: In so many ways, for a lot of us, [the problem] is subtle — until it’s not. We push down the less obvious signs and the ones that are not interfering with our job, and just keep going because we’re good at work. Sometimes, we think if we just keep going, it won’t happen — like we can somehow “will” ourselves out of feeling bad. So for me, I just didn’t notice, until a couple things all happened at once.

The biggest one is that I forgot I had met a patient before. People might probably think that’s not a big deal — but in psychiatry, forgetting someone’s name who just told you their trauma the last time they saw you could really, really be a big problem. I’d never that done before, and it showed me that I was not as with it as I had been.

It didn’t feel good, and it made me aware I wasn’t practicing in the way that aligned with my values and who I think I am as a doctor.

Why did you decide to write this book?

Gold: I have a unique perspective because I see healthcare workers; not everybody has both the experience of being someone who’s actively burning out and seeing the same thing in other people. The things my patients were talking about were highlighting things that were going on with me, and would bring that to the forefront, even if I tried to fight it.

In writing the book, I wanted to tell our stories in a way that made clear how the [burnout] process dehumanizes us, but in the same respect, how we can stay ourselves.

In your book, you share the stories of four healthcare professionals at various stages in their careers — a medical student, a resident, a pregnant nurse, and an emergency medicine physician. Why was it important to include their stories?

Gold: There’s a belief that we’re all the same in so many ways, but every stage has its own problems that we don’t talk about out loud. Every stage has its own challenges that are worth a conversation and worth reflection. And it was really important to include a nurse as well, because their experiences are really important.

I would hope it feels like a robust picture of the issue, instead of just my experience.

What role did the COVID-19 pandemic play in all this?

Gold: Obviously the pandemic was a particular point in time, but this is not a pandemic book. There are aspects of it that call back to my experiences in undergrad, my experiences in training, and all that stuff that happened way before. The pandemic is a unique stressor that made the problems in the system more evident, and a lot of those problems affected our mental health.

It’s important that we really look at our systems and create change. Cultural change takes time, but there are things we can do to have ownership of how lost we can feel in a system that feels broken at times.

I think our stories can change culture, and we don’t talk enough about that. I could give you a paper and some statistics, and you might get part of it. But if I put a name on that paper and their lived experience, you’re much more likely to remember it or feel connected to it. Over time, I really realized the importance of the story aspect to the conversation.

A lot of people are experiencing things that are hard and keeping it to themselves. I would hope a healthcare worker would resonate with that and feel seen by the stories in my book — and maybe even identify burnout in themselves that they hadn’t seen before, and get help for it.

Do you hope your book will inspire others to open up?

Gold: I hope it at least starts the conversation because I think that we need a better culture around emotions and caring for each other in the workplace. Things like fixing Epic — or our salaries or all this stuff — are really big and monumental changes that will take time and may never happen, unfortunately.

But we can change the stigma around mental health in our field. We can change how we talk to each other. We can change how alone you feel in your experience when so many people are experiencing it.

I would hope something like this book would open at least a crack and allow people to share — and share in a way that feels safe — which can slowly change the narrative.