Burnout from Flame to Ashes

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 Avoiding the stress inducing pitfalls that can lead to a wipe out.

This is a story of my transformation


Transformation From Transformation To
A proud & exuberant   EM PGY 1 A disgraceful PGY2 who saw no esteem in EM


A cheerful, kind team player A grumpy bully insulting doctors and nurses


A pleasant doctor helping patients An angry man lacking empathy for dying patients



Social extra-curricular enthusiast An isolated Anhedonic


Encouraging interns to take up EM


Dissuading interested interns – ‘EM is a hellhole’


I was over worked, working even after my shift was over. Not because my seniors demanded it, but because I was obsessed with my work. I came well before time and left well after. Soon, I expected everyone to do the same.


It felt like I was the only one working while the rest of the hospital was relaxing.  There was no time to eat or drink on my shift as I though there were still some patients to be seen in the ED, and the world will come to an end if I took a five-minute break. I stopped others from taking breaks.

Eventually, I realized I was fighting too many wars — most of which were meant for an administrator instead of a resident doctor. I lost the ability to comprehend my failures, despite my kind seniors’ advice.

For the little time I spent out of work — I indulged in unhealthy “de-stressing” activities:

“ De-stressing” strategy My rationale
Four-hour sitcom sagas with junk food I should relax in a fantasy world, away from EM


Lack of any physical exercise


I was too ‘physically exhausted’ for it
No meditation/yoga No time for such a boringly slow activity


Inadequate sleep < six hours I don’t feel sleepy and heroes don’t need much sleep, do they?


Not talking about my issues at home


They just won’t understand
Binge Drinking When you can’t fight it, forget it…temporarily



Finally, I sought help from a psychologist. I practiced and preached burnout and wellbeing strategies during the subsequent years. Here are some of them:

  1. Sleep hygiene for daytime sleeping: Dimming the light in the room, a warm water bath, a glass of milk, almonds and walnuts and no gadgets in the bedroom! It really works.
  2. Diet on night shifts: A hearty calorie rich ‘breakfast’ at 8 p.m. just before the shift to keep yourself energized. A high protein compulsory ‘lunch’ break at 2 a.m. This prevents from overeating at the end of the night shift while also helping to stay awake and content for the second half of the night shift.
  3. Adequate hydration: I coupled two activities — a big sip of water and picking up a new patient’s case sheet. Initially this was done deliberately, and gradually it became a reflex (like Pavlov’s!) and I ended up drinking more than a liter of water on every shift.
  4. Coping at the end of a bad day at work: Replacing ‘serial Netflix watching’ with ‘serial guitar strumming.’ In the bargain, I not only felt calmer, but honed my music skills!
  5. Preparation for a shift: Before every shift, I did three minutes of yoga and three minutes of meditation. This has become a ‘ritual’ for me now.
  6. Research and seminars/workshops on emotional wellbeing: This helps me keep myself updated and accountable to practice what I preach.

I feel like I have been given a second life. The ED, my colleagues and my patients, all look different now that I am more aware of myself and paying more attention to emotional well-being at work and home!

This is now a story of my survival: of hope and a purpose — to help other residents before they need to make a transformation of their own. As they say wise people learn from their own mistakes and wiser people learn from others mistakes.


Murtuza Ghiya, MD, MRCEM is an Assistant Professor of Emergency Medicine.

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