“I need you to do me a favor,” my nurse asked me at the end of our day on Friday.

“Sure,” I answered, “what do you want?”

“Please have a better week next week,” she said with a pained expression. “I don’t think I can handle another one like this week.”

It was a bad week.  There was cancer, there was anxiety, there were family fights, there were very sick children.  It’s not that it’s unusual to we see tough things (I am a doctor), but the grouping of them had all of us trudging home drained of energy.  Spent.

I think that this is one of the toughest thing about being a doctor (and nurse, by my nurse’s question): the spending of emotional reserves.  I am not physically active at work, yet I come home tired.  I don’t have to be busy to feel drained.  It’s not the patients’ fault that I feel tired.  They are coming to me to get the service I offer to them, and I think I do that job well.  The real problem is in me.  The real problem is that I care.

I find myself wishing I didn’t care so much.  I wish I could just do my job and then go home.  I talk to teachers I take care of, and they feel the same way.  Wouldn’t it be nice to have a job that was “just a job?”  Wouldn’t it be good to be able to go home and get things done?

This is certainly also true for counselors, social workers, and other professions that “take care of people.”  It sucks the life out of you.

The catch is, of course, that those of us who spend our emotions at work are not the kind to view our work as “just a job.”   Most of the people choose these professions because they want to help people.  The option to suddenly not care about the people you “take care of” is not an option at all.  The minute you stop caring is the minute you want to quit for good.

It does help to get pats on the back.  It helps when people show appreciation.  We doctors have it lucky, because people are not stingy with their thanks.  It’s not that thanks makes hard days easier, it just makes it easier to get up for work the next day.

This drain on our emotions adds potency to the other things that give stress.  This is part of the equation when I gripe about insurance companies, drug prices, and all of the other friction I face on a daily basis.  My nurses probably add “having a stressed out doctor” to that list.

So, I say to all of you out there who feel spent at the end of the day: thank you.  Thank you for caring.  Thank you for not being satisfied with “just doing the job.” Thank you for the emotion you spend on me, my kids, my problems.

I’d buy you a brewski if I could.

Rob Lamberts, MD, is a primary care physician practicing somewhere in the southeastern United States. He blogs regularly at Musings of a Distractible Mind, where this post first appeared. For some strange reason, he is often stopped by strangers on the street who mistake him for former Atlanta Braves star John Smoltz and ask “Hey, are you John Smoltz?” He is not John Smoltz. He is not a former major league baseball player. He is a primary care physician.

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  1. The job is hard enough without the policy wonks telling me how to document to get paid, without JCAHCO telling me how to be safe, without people who do not touch patients telling me how I need to do my job FBO the feds or the hospital or the insurance company or the malpractice insurer.
    But all of you who love this blog, who love computers, who love government, and who love telling doctors what to do are the ones who steal my time and energy and leave me with less for the patient. Less time. Less compassion. Less investment. You are in my way. Pushing the system out of the way so I can take care of the patient is harder every year.
    When you are the patient you will not like what you see between you and the doctor. It might look good from your desk in Washington looking down. But looking up from the bed casts a different shadow.

  2. Right after college I worked an internship at Disney World. Happiest place on earth, right? Well, it could be, but then there were the days when the guests felt like unruly cattle just waiting to stampede at a moment’s notice. About the hundredth person who complained about the weather or the line, and you sometimes felt like just shouting right back at them. The break room was an inner sanctuary: tears, anger, whatever, you could express it there. Then when your break was up, you put a smile back on your face and braced yourself for the masses. You went home tired, and prepared yourself to do it again the next day.
    But then there were the guests who made you feel like the most important person in the world. Once I had a Make a Wish child in the front seat of my ride, and when it was over, he thanked me and handed me a gift: an angel made of paperclips and string. I still have it. I’m tearing up just remembering him. Sometimes the people in line made your life easier by singing songs or even laughing at the corny jokes you tried to tell. There were families who obviously loved each other and made a special effort to be gracious and kind. Those types of people reminded you what a cool job you really had: granting wishes and making “magic” happen. I spent that Christmas Eve working the “snowy” Streets of America helping people enjoy Christmas lights and music. It was crowded and cold, but the people were so happy, the joy was contagious. Those good feelings helped me get through the Christmas rush the next day.
    The shift enviornment at Disney meant I didn’t have to worry about the guests after I left for the day: my fellow cast members would take care of things in my absence. I didn’t have to deal with the worry that the professions you mentioned do (though I’ve seen my parents deal with it in both their professions as a teacher and minister). But I do appreciate the struggle you discuss to keep your spirits up. Little kindnesses really do make a difference.