I logged on to our EMR from home last night.  That is one of the “benefits” of EMR – access to information from home and the ability to finish your charts when at home instead of hanging around the office to do it.  It really is a benefit; it’s also an anvil.  Seeing the long list that had accumulated over the weekend and my Monday day off, it was deflating.

Yes, get out the violins and play a sad song.  Dr. Rob has a very hard life being a doctor!  Poor doctor who gets every Monday off!  All hearts should bleed for his terrible plight, right?  No, I am not trying to pluck heartstrings or pretend there are not incredibly great things about being a doctor.  I don’t blame people who get impatient when they hear doctors trying to paint themselves as martyrs.

I am no martyr; but I do sometimes feel the weight of my job full force.  Normally, I am enjoying the day to day interaction with patients, the joy of helping people, and the intellectual challenge enough that the burden is offset.  There are other times when that burden threatens to drag me down, pull me under, burn me out.

If I ever quit being a doctor, it won't be because I don’t like taking care of people.  It won’t be because of paperwork or dissatisfied patients.  I won’t quit because they don’t pay primary care doctors enough or because specialists don’t send me their consult notes.  It's not facing suffering, pain, and death that saps my strength.  All of these things are trouble, but not trouble enough to turn me away from a job.  The real threat is the slow and steady drain that I felt when I logged on last night.

If I quit, it will be because I love what I do and care about my patients.

What saps the drive is not the weight of the burden, it is the fact that it can never be put down.  When I have been away on vacation I come back to a long list of things that couldn’t be handled in my absence.  I know these people, I ordered the tests or started the medications; they are my patients.  Yet the burden is not even the work, it’s the emotion invested.  I do care about my patients and want to do them good.  The wonderful fact that I am meeting patients’ needs is followed by the shadow of patients needing me.  I am never let go by that need; or rather, I don’t let go of it.  I think both are true.

Parents of young children know the feeling; you can’t ever really get away.  Teachers know the feeling as well.  I have spoken with some very good teachers who, at the start of the school year, wonder how many more times they will be able to pick up the burden of that emotional investment they make in their students.  The best teachers don’t see what they do as a job, they care about their students.  The best parents are the ones who take the responsibility seriously and invest themselves in the child.  The best doctors are the ones who are doing it for more than money, prestige, and pats on the back; they do it because they care.

Sometimes I wish I didn’t care so much.  I wish I could go into work and punch the clock.  I wish I could help people without becoming emotionally invested.  I fantasize about really getting away from this burden.  But I know that I cannot step into my office without taking the next step.  I can’t not care.

So as I look at the labs, phone notes, consults, and hospital notes on my desktop I sigh deeply.  I wish they would just stop needing me.  But they aren’t just labs, phone notes, consults, and hospital notes; they are all people.  They are people who need me – people I care about.  It’s what I asked for, and it’s what I keep encouraging when I set foot in my office.  Would I really want to be without this burden?

No way.  I just wouldn’t mind a break every once in a while.