Shobha W. Stack, MD, PhD

Disclosures

June 08, 2021

“I look forward to reconnecting with neglected friends and picking up old hobbies ...”

I was only a few years into my career as a hospitalist when I read my colleague’s retirement announcement and realized I was on the same track. But unlike them, would I even have any friends left to reconnect with? My guitar and mountain bike were sold long ago in exchange for textbooks and question banks. Am I still waiting to pick those things back up? Throughout medical school and residency we mourn the decade lost to board exams and call nights in the hospital, but comfort ourselves that this temporary lapse in our personal lives will pay off. My situation was not looking temporary.

After residency, I became a hospitalist at a tertiary care hospital for patients throughout the Pacific Northwest. I worked with specialists to arrive at zebra diagnoses that actually panned out. I helped patients who had run out of options for chemotherapy find new goals. I met a wide spectrum of people from refugees to rock stars to rural Americans. My days were full, and my calling was strong. The problem was there wasn’t room for much else.

As a hospitalist, we are constantly reexamining our schedules to address burnout. The Society of Hospital Medicine frequently surveys its members on how many consecutive days we work, hours, and service structures. In trying to find that magic formula, we are trying to fit our lives into our work. But, maybe, we need to fit our work into our lives. This philosophy has the potential to benefit us all. For example, the National Bureau of Economic Research reported that coordinating our life with when work happens could provide the added benefit of cutting the gender wage gap in half.

A full-time hospitalist often works 7 to 14 days in a row every 1 to 2 weeks. For those with the glass half full, this means 26 weeks off per year. What took me a few years to realize is that this also means an inconsistent presence outside of work. Maybe I could attend church twice a month if I wasn’t exhausted from a stretch of service. I could make it to half of my son’s soccer games while the other parents bonded on the sidelines weekly. Making friends outside of work was tough too. I didn’t know what to talk about anymore besides being a doctor. If I managed to be interesting enough to meet again, my response of “Yes! I’m free next month,” was not exactly inviting. I soon realized my closest friends were at work. Yet with their equally intense schedules, we saw each other outside of work 2 or 3 times per year at best. I couldn’t seem to create the availability needed to maintain a connection.

An increasing number of studies show the necessity of friendships for maintaining good health, and conversely, the mortality risk of chronic loneliness. So much so that our surgeon general, a hospitalist himself, has made this one of his signature issues. Yet how do we pull away from our calling to nurture these aspects of our lives? Bunderson and colleagues found that our professions often win this tug-of-war. In their study, people who “found broader meaning and significance in their work” were more likely “to sacrifice pay, personal time, and comfort.”

Growing to realize all of the above, I rewrote my story. After paying off my loans and earning enough to make a down payment on a house, I changed my schedule to part time. These days I know the other parents at after-school pick up, regularly attend a weekly book club, and exercise more days than not. As a result, I’ve found that I am more present with my patients and more creative with my rested brain. My glass feels fuller. Yet, I wonder how those who do not have the option to cut their hours make life work. I can’t help thinking, shouldn’t the expectations of full-time work already account for our calling to others and the necessity to nurture ourselves?

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About Dr Shobha Stack
Shobha W. Stack, MD, PhD, once a mechanical engineer, is a physician in palliative care and hospice medicine and a former hospitalist and assistant professor of medicine at the University of Washington. Outside the hospital, you can find her running with her family, attempting to make her kids laugh, and appreciating the ever dynamic Pacific Northwest sky. Follow her on Twitter: @shobhastack

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