[2022-09-21] Where you are
Today, I read an interesting article in The New York Times: A Rural Doctor Gave Her All. Then Her Heart Broke. Sent to me by a friend, the piece was about family doctor Kimberly Becher, who had worked in rural West Virginia until she burnt out, suffering what felt like a heart attack.
Tests soon revealed that she had a rare disease called takotsubo cardiomyopathy, which forces the tip of the heart’s left ventricle to stretch. Most cases occur in older women who have recently experienced some type of intense physical or emotional distress, like the loss of a loved one or a serious accident. It has gained a catchy moniker—broken heart syndrome—but its causes remain unknown.
Dr. Becher was worn down by working long hours (seven days a week, most weeks), taking on more and more (seeing more patients, blogging, advising local government, sitting on more boards, making more home visits to people unable to drive to the clinic), and facing increasing frustration (with insurance companies, the community's lack of access to healthy food, and her patients' distrust of COVID science and her medical judgement). Everything changed when she got sick.
That April, when her heart broke, Dr. Becher stopped seeing patients. She quit every board she was on. For a couple of weeks, on bed rest, she tried to figure out what had gone wrong. "Why had I said yes to doing so many home visits?" she later wrote on the blog. "Why did I work so hard to make food accessible in this town that I don’t even live in?" And: "Why did I keep saying yes to everything anyone asked me to do?"
Dr. Becher does take some responsibility for making commitments that she said almost killed her, admitting, "No one put me in this position. I applied to medical school, I sought a job in rural primary care and I poured my identity into it."
This story reminded me of a conversation my daughter and I had had while on a lunchtime walk today. Melanie told me that before I stopped working to deal with ovarian cancer, I was burned out. I think she's right.
I sometimes wonder what would have happened to me had I not been diagnosed with a serious illness. Would I have continued to push myself, doing what had to be done in the midst of the pandemic?
I also worry about people who are still consumed by long hours, undue stress and unrealistic expectations—whether their own or those of the people around them.
Like Dr. Becher, who accepted some responsibility for her burnout, I must also assume a portion of the blame for the circumstances in which I found myself back in 2020. I worked as hard as I did because I thought I was capable of doing so—believing that I could burn the candle at both ends, particularly as I watched so many other people attempting to do the same.
Dr. Becher's story reminded me of the situation I left when I started medical leave. And it reminds me to avoid getting anywhere near the level of commitments I had accepted early in the pandemic. The New York Times article states:
In early 2022, Dr. Becher moved to a more administrative role at Community Care of West Virginia and reduced her time in the clinic to one day a week. "I am shifting my focus toward helping other physicians learn from my mistakes, which means I have to actually tell my story," she wrote in her blog in February. "I am definitely a work in progress, and I am always on the edge of a cliff, at risk of jumping back into being angry and putting myself in a position to be hurt again. But at least now I know there is a cliff."
There is value in sharing our struggles, as Dr. Becher does and as I do from time to time in this blog. Perhaps my story will lead someone in a predicament similar to the one I faced in the months before my cancer diagnosis to stop and think about where they are in life and whether that place is still right for them.
