I got drunk tonight instead of exercising. I'm a bad person.

What broke me?

I was actually doing really well in independent practice and what has broken me and continues to break down my self confidence little by little is hospital patient care. My family medicine group does "hospital rounds" where basically one of the 7 of us looks after the practice's hospitalized patients each week. I hate it. I have been on hospital rounds for the last 3 weeks. 2 weeks of "mentored" time and this week on my own. I find it so stressful I really want to quit my job to not have to go back. Seriously. The worst thing is getting the 7-8am phonecall that someone has been admitted to your service. Now you have to go in and try to see all the patients PLUS do an admission in the 3-4 hours you have before having to go back to the office to see afternoon patients. Today my admission was a shit show. Not what was handed over, way more complex, a story that didn't add up, way outside my scope. I spent all day struggling with this patient and finally asked for an internal medicine consult from the run of his feet internist because it all just didn't add up. HOpefully he sees him this evening in the midst of his 100 other things he had to do. I am not an internist. I wasn't trained to be one. My internal medicine rotations were mostly spent trying to discharge patient who were admitted for failure to cope. I'm not sure how much I actually learned. I hate this.

Not waving but drowning.

I may look like I'm waiving very enthusiastically at you all while I'm swimming in the sea of independent practice but I'm actually drowning and trying as hard as I can to keep my head above the water. I am burned out, tired, have compassion fatigue, feel lost, feel like I am/should still be a resident, feel overwhelmed, feel like I'm the first person and the last person to ever feel like this. I am neglecting my family, my friends, my exercise, my race training, my sanity. I'm regretting becoming a doctor. Working at anything else seems so much more appealing right now.

Excuse my tantrum. I'm going to bed now.

Nobody heard him, the dead man,
But still he lay moaning:
I was much further out than you thought
And not waving but drowning.

Poor chap, he always loved larking
And now he's dead
It must have been too cold for him his heart gave way,
They said.

Oh, no no no, it was too cold always
(Still the dead one lay moaning)
I was much too far out all my life
And not waving but drowning. 

Stevie Smith