One night a coworker in the emergency department, who also aspires to be a doctor, asked me if I was worried about becoming jaded as I worked in health care. I answered confidently that I wasn’t worried about becoming jaded, my hope for humanity waning, or burning out like so many medical professionals do. He was skeptical, but I am certain of only that one aspect of my future.

Defining Jaded

Especially late at night when most patients are tired and grumpy, the drunks roll in after exhausting the bars, and the patients held for mental health evaluations decide to spend the early morning hours holding yelling matches that involve nonsensical accusations against staff, it’s easy to see how one can grow tired of working in a hospital (and specifically the emergency department). In medicine, we take care of everyone, even if they’re jerks to us, because the fundamental principle of health care is that we serve all people.

Not so long ago I was greeting patients in the waiting room at the emergency department. We had around 20 folks waiting for rooms, the rooms weren’t changing over, and the wait times for many were over 2 hours. That’s a recipe for an unpleasant experience as a greeter, and the recipe was rich that night. I had a parent repeatedly insult the staff, including me, and ask why we hadn’t brought her child to a room yet. That was annoying, but manageable. What got to me was when she stormed up and demanded to know why we brought back “a drug addict” (her words, not mine) before her child. Her argument was that her child had a bright future while that person was a lost cause. Of course, I couldn’t tell the hysterical mother just how awful it is to watch a person go through withdrawal shakes and then seizure. That’s something you can only understand once you see it. I couldn’t tell her about the alcoholic who came to us one night shaking so badly he couldn’t drink water from a cup. I couldn’t tell her how he had looked me in the eye and told me he wasn’t human anymore. That mother was choosing to believe him, but I knew that that patient was human even if he didn’t feel like he was. That angry mother in the waiting room clearly had never seen a person beat an addiction—winning the daily fight to not give in to a drug or alcohol for years. I have.

It’s not the job of medical professionals to pass moral judgment. Sometimes we are weak and tired, and we do judge our patients’ life choices. But if we were to slip into a world where we used our personal morals to decide who should receive care, we would betray the heart of medicine. Medicine was never meant for only a select few.

In my view jaded is another way to describe losing empathy. There are many presentations—impatience, anger, and hating work to name a few. These feelings come when we are too tired and too worn out to see patients as humans. They come when we no longer find joy in the small things about the job that are awesome. And jaded becomes the norm when we give too much. It’s easy to work hours no one else would dream of working when you’re in health care. Each hour is rewarding because we help someone feel better, but the hours take a toll on the giver.

Considering all the above, how am I so certain I won’t become jaded?

1. My empathy comes from selfish sources, so I don’t expect that it will fizzle. The first source is curiosity and the second is a love for stories and puzzles. Each human has a story. Each sick person is a puzzle. The curious mind can’t help but wonder about the story plot and the answer to the puzzle. These two factors are some of the main reasons I veered down the medical path in the first place.
2. I know that I’m brave enough to step away and recharge as well as to shake things up when caring for patients under specific conditions becomes wearisome.

How do I know I am brave enough? Paraguay. While living in the land of Guarani, I cultivated an ability for self-reflection and the bravery to face fears because they were required to survive the Peace Corps. Paraguayans also showed me the value of letting yourself be still. In America, we are so determined to be productive we schedule every moment. I think running around all the times makes everyone miserable no matter what their profession. I also think those who become jaded forget to reflect and change. They fail to see that their job is draining them until it’s too late and, then, they lack the courage to change their work so it’s fresh again. It comes down to the best professional advice I was ever given. When I asked a presenter in one of my undergraduate classes how she knew when it was time to leave a job (she had an awe-inspiring, lengthy job history) she said, “You’ll know. You know when it’s time to leave.”

She was right. We do know when it’s time to mix things up. The hard part is taking the steps to act upon what we know. But, if we do take those steps, then jadedness can never catch us. The moment she gave me that advice, years ago now, I promised myself I’d be strong enough to change my course whenever I “knew” it was time. That strength sent me to Paraguay and brought me back to Vermont. So, no, I’m not worried about becoming jaded. I’m just excited to see where my adventures in medicine bring me.