Signout is hospital slang for the transfer of information between patient care teams. It is also the name of this blog, which represents one of the less dysfunctional ways in which Dr. Signout copes with her participation in a U.S. medical residency program.
Lately, I seem to be having a bit of the writer's block. Yes, I'm still working, and yes, crazy things continue to happen on the job. It just feels as though it's been a while since I had a meaningful reaction to a patient or colleague interaction. I'm a little tired of feeling other people's pain.
As I often do when I'm not sure whether my findings are within the expected range, I did a literature search. It turns out my impending nervous breakdown is going to happen right on schedule--maybe even a little late. This study published in 2002 found that sixty-one otherwise well-adjusted internal medicine interns had marked increases in depression, fatigue, and anger peaking in February of their intern year. The investigators also found a decrease in empathy that they couldn't completely explain with the other mood disturbances.
It's quite possible I'm having some empathy fatigue. Some commenters have been very generous in their readings of my actions as I report them, but honestly, if I'm nice these days, it's probably by mistake. Because it's harder to write about my beastly side than it is to write about my smooshy side, the empathy fatigue translates to writer's block.
Perhaps my upcoming vacation will improve things, but it's unlikely: the same authors that published the above study followed the residents through graduation from their residency program. In reevaluating their mental states after three years, they found that although most of the mood disturbances had improved over time, empathy remained low.*
The only way to keep this blog going is to get into the ugly parts, too. Watch this space for less flattering self-portraits in weeks to come.
*I can't make PubMed link to the article, but you can find it yourself by searching http://pubmed.gov for this article ID number: 15671323.
Comments
No, Dr. S, you're not alone. Welcome to the state known in my house as Beaten Down.
Posted by: EGM | April 26, 2007 12:41 PM
"Because it's harder to write about my beastly side than it is to write about my smooshy side, the empathy fatigue translates to writer's block."
Hey, I know that phenomenon. Hang in there and keep writing as you can. I think it does a body (mind?) good.
Posted by: katherine sharpe | April 26, 2007 12:51 PM
Dearest Dr. S! You are definitely not the only late bloomer as far as the intern doldrums are concerned. I'm currently in the process of pulling my trashed psyche up from the dirt after a soul-obliterating Med month. Current theory in this household is that having the opportunity to switch gears and also care for kids has allowed for the delay of the well-described intern slump. Thoughts?
Posted by: TLR | April 27, 2007 3:10 PM
"Watch this space for less flattering self-portraits in weeks to come."
By all means. We're all human here.
Posted by: geena | April 27, 2007 11:16 PM
Damn, you are totally late! I got the intern blues last August. Who am I kidding?...July even. Funnily (
Posted by: slander | April 28, 2007 2:50 PM
The intern blues are completely normal, because internship sucks, and you can only do something that sucks for a limited period of time without starting to get a touch demoralized or getting a little empathy fatigue.
Any vacations coming up soon? That helped me.
Posted by: Midwife with a Knife | April 28, 2007 9:20 PM
Posting the underbelly will make it more interesting. The fact is, we all have them whether we're willing to admit it or not. I was actually beginning to wonder when we'd start to see some darker posts...
LF
Posted by: Anonymous | April 29, 2007 11:36 PM
Am so glad to read your colleagues' remarks joining you in chorus. You produce beautiful poetry even when in the slumps!
Love, Mom
Posted by: Anonymous | April 30, 2007 7:47 AM
Thanks to ALL of you for the chorus of support.
Fellow interns: Right back atcha. We're almost done. And TLR, I think the switches do distract somewhat. Although it's usually on the peds side that I get most depressed. We will eventually discuss.
To everyone else: you rule.
And Mom, I love you, too.
Posted by: Signout | May 2, 2007 10:38 PM
Signout, though I am not in the medical or in any related field, and therefore have little knowledge of what you speak except for what I read in these blogs, I would say that perhaps your present lack of empathy is not that much of a problem. As long as you continue to do your work effectively and your patients are (on average) in better health after you are done with them, you are doing fine.
I would much rather be cured of an affliction than have a shoulder to cry on.
Posted by: valhar2000 | May 4, 2007 8:41 AM
Just curious: have you discussed this with anyone else in your program (other than the other interns) and has anyone offered you any real help like couseling? I ask because, it's a little early, but you may be starting the burnout track and it is of concern to the medical community in general, and for female physicians in particular (given the high rate of female physician suicide) that there be a system in place to monitor and intervene when doctors get too stressed out.(Venting may make for good blog posts but doesn't do much for your personal life.) With regards to the darker side, be careful, there is a saying that goes:"What you focus on expands."
If it's of any help, check out the "Burnout", "Suicide and the Single Female Doc" and "Meditation" posts on my blog.
Posted by: docwhisperer | May 4, 2007 10:25 AM
Now, I'm worried!!
What say you?? Mom
Posted by: Mom | July 21, 2007 2:49 AM