I suspect they may be true.
Part of the problem is that we see life and death all the time, and you burn out.
But a bigger part is the institution: The emphasis on efficiently processing "health care clients"...not caring for a sick, often frightened patient... and then spend time documenting everything so the institution can be paid...not hanging out discussing trivia with other staff while our subconscious mind is processing what has happened in the past few hours...
I have written before on how such "efficiency" destroys the human touch for our patients. Similarly, it takes a toll on the doctors, who lose positive feedback from patients, their families, and the staff...this is not so bad in Family Medicine, where we know patients for years. But in an Emergency Room, you see terrible things. You often have to break news to a patient's family--and then are expected to immediately go and suture a cut or read someone's X Ray with no time to emotionally adjust to what we have done...as a result, we get hard, and the emotional toll goes under ground, to come up in depression, fatigue, and divorce.
The result is burnout... we ignore that we, too, have needs...but we aren't allowed to have needs...duh.
Ironically, the latest pope puts his finger on it when he criticizes those who stress the divide between agape and eros: making agape "good" and eros a bit dirty...
But, after pointing out that erotic love is usually associated with a deep agape for the loved one, he says: "man cannot live by oblative, descending love alone. He cannot always give, he must also receive. Anyone who wishes to give love must also receive love as a gift..."
In other words, pure agape, pure unemotional giving, is not enough...we are human and cannot ignore our own emotional needs. And being human this includes the idea of reciprical love...the emotional satisfaction of being loved and cared about by another...
That, I suspect, is part of the problem that the efficiency experts are not noticing...we are in a culture of curing that demands we give and give. But there is no time for "taking"...talking and joking or crying with our patients...sitting and drinking coffee with the staff, which not only lets us feel part of a team but lets our subconcious mind process and digest what we have seen in the previous hours.
We also need to remember that medicine is not an escape from real life: we also need to find time for our families, where we should be finding our primary emotional support. This does not mean a full time "desperate housewife" (I'm old enough to remember those problems) but the idea that two professionals have to commit time and energy to family first, not careers...alas, until we realize 40 hour weeks are not "part time work" this will continue to be a problem for physicians of both sexes...
The last part of the "receiving" is knowing that we are loved by God...
No, this is not a theocratic mumble jumble...what I am saying is that we need to remember the wisdom of the past to put our own lives into perspective.
It is the implicit idea behind the long roots of the Hippocratic oath: the idea that we are one of a long line of healers, not merely a cog in a machine.
When I was in school, our Jewish instructors implied that any work we did was a mitzvah, a good deed that was smiled upon by God...similarly, Catholic tradition is that when we do something good and helpful, we are priveledged to be essentially God's hands in this world, and such deeds are prayer...
As I have said before, most docs don't go around praying in public or even going a lot to church. (indeed, the cliches of much of what passes for sermons and tv evangelism is worse than useless for those of us facing life and death every day). So where can we go to find this wisdom, to place things into perspective....this idea that what we do is important, and that our actions are meaningful? ....In the wisdom of those who passed before us...
.. THIS list would be a good place to start....and it might help if older docs remind their young students that we are healers, that our actions are more than mechanical treatment of a thing, but a noble deed that sings to heaven.
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Followup LINK to essay on making medical care big business...
"It's not about Sick People"....
"...There weren't that many of us in the old days. We felt needed because we were, and being needed is a powerful drug. It kept us up working all night, every few nights, for five years as residents. It's really the same drug that keeps parents up with a sick baby, ministers up with a desperate parishioner, or soldiers up taking fire to save their buddies. But now my administrator says that the guy down the block will do the job if I don't persuade that patient to come to me. So what do I offer a patient who, we are told, really doesn't need me? A multi-million dollar lobby. The Boss saw what was really behind that glitzy facade, and he saw what lay ahead as well. And of all the things that take the joy out of practicing medicine, that is perhaps the most insidious...."
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