Burnout

The stomach cramps start Friday night. Earlier I’ve taken two Naproxen for the headache I normally never get, and I’m wondering if that’s what’s giving me the cramps. I feel lousy, so I’m hoping that I won’t get called back to the hospital tonight. I’m on call every other weekend, and normally I don’t mind getting called in. But tonight I’m in agony, and the thought of having to drag my sorry ass to the hospital and help another person while I’m in so much pain makes me feel even sicker. I go to bed at eight, wishing for sleep to obliterate the pain. 
 No such luck. I toss and turn restlessly, frequently torn from sleep when a particularly intense cramp is twisting my insides. Two hours after I went to bed I’m woken up by nausea and stumble to the bathroom to throw up. Afterwards I stand at the sink to wash my hands and rinse my mouth, and I’m appalled at my reflection: I’m pale with a green tinge to my skin, my eyes are bloodshot, and I have red spots on my cheeks and forehead. My stringy hair is pasted to the side of my head and my hands are shaking. 
I can’t bear to look at myself any longer, so I turn off the light and shuffle back to bed. 
 
I repeat this sad process several more times throughout this endless night, minus looking at myself in the mirror. Everybody has their limits, and I’ve reached mine when it comes to torturing myself. 
Fortunately I’m not getting called in either that night or all of the next day. While I’m staying in bed, carefully massaging my tummy and existing on ginger tea and dry toast, I wonder what could have caused this illness. I don’t have the typical diarrhea or fever that comes with a stomach flu. I know that it’s not food poisoning, because I had that before, and this is different. Besides, I haven’t eaten anything that may cause food poisoning, I’m sure of it. What’s going on?

I’m usually a healthy person. I have a robust stomach, no chronic pain to speak of, and my energy levels are decent for a 42-year-old woman. But lately I’ve been off. I had two headaches in a week, which is more than what I ordinarily get in a year. My joints are aching, and I have a constant back ache. I’m exhausted all the time, and I feel weepy and close to tears most days. I’ve been crying in the car to and from work for no discernible reason. Sometimes it’s the burnt trees from last year’s wildfires that set me off, sometimes it’s when I pass the section on the highway where my car hit ice a couple of months ago and I thought for one terrifying, heart-stopping moment I would slide off the mountain. Sometimes I simply cry because it releases some of the terrible tension inside of me.  
 
As soon as I enter my workplace I put the mask on. The mask of being friendly and smiley and cheerful. I’ve been brought up to leave my personal problems at home, to be professional and competent. 

My mom took it as far as to advise me to “never let them see the real you”, which is a philosophy I don’t agree with. But being professional at work is sound advice that has served me well. It’s been particularly useful working in healthcare over the last two years since the beginning of the pandemic. 

I’ve had to listen to rants about the vaccine mandate, conspiracy theories about “the plandemic (pLandemic because it’s been planned – get it?) being planted by the UN to eliminate 90% of the world population”, complaints about the cancellation of surgeries and reduction of services. People have regaled me at great length with their opinion about how masks are useless and don’t do anything, that the vaccine kills or leaves women infertile, how the government is a tyrant and tries to manipulate us all. And all the while I stay polite and noncommittal, provide the service I’m here for and don’t yell at them to shut the fuck up, which is what I yearn to do. I did understand their fears and frustrations at first. I was sympathetic and patient and listened, making them feel heard and validated. 
 
But lately it’s become more and more difficult. My well of patience has dried up, and I’m genuinely afraid that I will explode on someone. I’ve been working non-stop through the pandemic. I’ve driven through burning forests in the summer of 2021. We were evacuated for a week due to the wildfires, worried that we might lose everything. Roads have been closed on me while I was at work, making me panic that I might be cut off from home for days or weeks. We’ve worked short-staffed for months. I've unofficially been in charge at one of my hospitals with all of the responsibility and none of the compensation. 
I was on the highway that got completely destroyed by the flood on the day it happened, the angry water lapping at my tires, pieces of the road already broken off. Could I have fallen in the river and being swept away? I refuse to think about it. 
 
And all the while I’m asked to work more. 

“Can you help out?” 

“If you don’t take this shift your co-worker can’t see her fiancé." 

"You are the only one who is available, can you do it?” 

“Please help, please do more, please be a friend and team-player.” 

So I say yes and yes and yes, thinking I can do it. I’m strong, I’m resilient, I’m tough. I’m German, I was born and raised to push through, I’ve worked through period cramps and fevers and heartbreak and a depression I didn’t know I had.  

But every few months my body goes on strike. I will wake up with my neck seized up so painfully that I can’t move. I will be bed-bound for a few days, eating muscle relaxers like candy and being secretly grateful for the break. 
In 2021 I got such a severe, sharp pain in my upper left back that I was afraid I was having a heart attack. I went to the ER and got thoroughly checked out by my favourite doctor who wanted to make sure he didn’t miss anything. There was nothing wrong with me physically. I stayed for several hours until the pain had faded and was sent home with strict instructions to come right back should it start again. 
I was back at work the next day.
 
In 2020 I lost my voice for four days. It was completely gone. My husband had to call in sick for me because I was mute. 
In December of that year a friend committed suicide and my mother-in-law died four days later. I didn’t miss a single day of work.   
 
In 2019 I woke up during another call-weekend feeling like death warmed over: my entire body ached, I had stomach pains, I was hot and cold and shivery. I went to the emergency department of that hospital, got checked over, and again they couldn’t find anything. The doctor gave me a shot of Toradol and told me to rest, promising that she would try not to call me in. I went home and slept the entire weekend.  
 
I was the one who took the chest x-ray that diagnosed a patient with stage 4 lung cancer. She kept coming back to the ER with complications, and every time I saw her she had lost more weight and looked frailer. Three months later she was dead. I locked myself in the bathroom and cried when I found out. 
 
Right around the same time I x-rayed another patient who had a tumour in his lung. He had waited to come to the hospital because he was afraid of Covid. He also had end-stage lung cancer and passed away a few months later. 

One of the nurses I work with is also an ICU nurse. Her stories about what it’s really like to die of Covid are horrific. It’s an especially stark contrast when you go from having her stories fresh in your mind to a patient who insists that Covid is fake. I’d love to send these people to her to give them a much-needed dose of reality, but of course I can’t. Besides, they probably wouldn’t believe her anyway.     
 
Now it’s 2022, and I’m having these mystery stomach cramps that won’t go away. I call in sick for my shift on Monday and the pain eases a little. 
On Tuesday I have therapy, and boy do I need it. I start crying before I can even say hello, and she listens with great compassion. I love my therapist, and right now she’s what’s keeping me going. She’s my life raft in the storm, and I cling on with all my might. I’m telling her much of what I’ve recounted just now, and also the shameful secret I’ve been keeping: I’ve been contemplating to take a leave from work. It feels like the ultimate failure, and my parents would be appalled. 
 
But I’m at the end of my rope. I have nothing left in me to give. I’m mentally depleted and physically sick. My therapist encourages me to take the break I need. And then she says this: “You’ve been limping along with one leg in the bear trap. You have to stop. You’re bleeding out. You can’t go on like this anymore.” 
As soon as we are done I call my family doctor for an emergency appointment. Later that day, with much sobbing (I can’t seem to stop crying) I tell him about my physical symptoms and the disaster zone that’s my mental health. He diagnoses burnout and recommends taking a month off work. 
The next day I call work and arrange for the time off. I’m riddled with guilt and a profound sense of failure – lots to talk about in my next therapy session. 
But it’s done. And I suddenly notice that my stomach pain that started six days ago is gone. 
 
I swear my body is breathing a sigh of relief. ‘It’s about time you listen to me,’ I imagine it saying. ‘I didn’t know how to make it any clearer.’ 
Seeing it all written out like this, the signposts spelling out that I was doing too much have been there all along. But I didn’t see them. I thought all the good advice about self-care and putting the oxygen mask on first were for other, weaker people. I assumed I was tougher than them. I liked to say that I had a mental illness, it didn’t have me. My self-worth is so tightly bound to being hard-working and not lazy, the thought of having to take time off work was terrifying. 
 
Until I didn’t have a choice. Turns out that my body is stronger than my will. Smarter, too, which is a good thing. My brain can’t always be trusted because it’s not healthy. You wouldn’t run a race with a broken leg, would you? I’ve been relying on a broken brain to make sound choices for me. 
But that’s done. I’ve stepped out of the hamster wheel. I’m still. And I’m taking a goddamn break.

This is the first chapter of the book I'm working on. It's about living with anxiety, depression and PMDD, and about life as a healthcare worker during the pandemic. 

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