Everyone Else Seems Fine

So Why Do I Feel Like a Hot Mess?

You may feel like a hot mess inside, filled with doubt, inadequacy, and a sense that you are more anxious than other physicians.

I can’t tell you how many times I have heard this from physicians. We have a strong belief that everyone else is doing fine, maybe even thriving, and that there is something wrong with us because we don’t feel fine and aren’t thriving.

But what you don’t know is that chances are high other people think you are killing it, that you are confident, composed and brilliant.

High-achievers are very good at masking how they feel. We put on our doctor-persona, like a jacket, and go to work. And others are usually none the wiser.

So the fact that you are surrounded by people who seem to be doing fine, despite being over-booked and under-resourced is not helpful. And it’s likely not even true.

We are a culture of people who were taught to mask up. Shove the feelings aside, do the work, be grateful that you have the privilege of caring for other humans. 

But you can’t see into other people’ brains. You don’t know how much anxiety they feel, or that they go home and numb out, or fantasize about quitting and becoming a barista. You don’t know that they wish they could set better boundaries, say no, reduce their workload, delegate more or have more autonomy.

There’s nothing wrong with you; there’s a huge problem in medicine (insurance structures that only reimburse patient visits and not patient care, for-profit healthcare systems paying CEOs huge bonuses and cutting front-line salaries, patient-satisfaction metrics akin to amazon-reviews, training programs that teach you to ignore your body and mind). And our huge problems in medicine are hard to fix; but it’s easy to put pressure on caring professionals, such as yourself, and keep you in the belief that you don’t fit in and need to improve your performance. 

Health systems thrive on your lack of boundaries.

Health systems thrive on you being hypervigilant about your inbox because they are understaffed.

Health systems thrive by making you think it’s you and having you believe that you just need to work harder.

There are very real pressures on us all the time to do more, expect less from others, not be greedy, not have boundaries or needs. And if you don’t like how this feels, you are NOT alone. But you work in an environment where culture discourages speaking up (and appearing weak or needy), comparison is rife, assimilation is expected, and schedules and call-structures are still built as though we are all married men with a stay-at-home-do-it-all partner who doesn’t expect us home for dinner until late.

You are normal for having needs.

You are normal if it feels very hard to keep up with what is expected of you in the face of rising demands, worsening access to care and ever-shrinking resources.

But they aren’t going to fix it for you. You have to decide for yourself, give yourself permission to not hold yourself to impossible standards.

Set boundaries that work for you, and let go of what “everyone else” is doing.

Decide what areas of your life and work just need to be “good enough,” and work on loosening your standards.

Put caring for yourself on your list; you need movement, sleep, laughter/play and good nutrition to fuel your highest-functioning self. Yes, all of those things.

Let’s stop holding ourselves hostage to the belief that we are broken and need to do more to meet the mark. Chances are high that if you start doing these things, your colleagues will notice and start giving themselves permission to do the same. Let’s start a revolution where physicians are setting boundaries, taking care of themselves, and letting go of the idea that we aren’t working hard enough, aren’t doing enough. The failures in the healthcare system are not your fault. And they aren’t going to be fixed by your ongoing sacrifice.

Give yourself permission to take care of you; you’ll see that others may just follow you.