The Emotional and Psychological Struggle of Being a Doctor

Apr 01, 2020 at 11:45 pm by pj




I remember standing motionless in the doctors’ lounge, staring at my hands. Things had changed. I was someone different, someone my family and friends might not recognize if I let them in, really let them see my true soul. But that wasn’t possible. Not for me. I was too guarded, always guarded, always in control. It wasn’t just today that had changed me. It had been everything.

All I wanted to do was see my kids. I wanted proof that they were safe at home; I wanted to see them alive and well, laughing and playing. Instead I was alone, feeling the frantic drone of a busy emergency department. There was no time for reflection or emotion; patients were waiting to be seen. Trauma Room 11 had just given me a cold taste of reality. No superhero saves or knights in shining armor – just the simple fact that sometimes really bad things happen.

In the background, the TV mounted in the corner of the room played ESPN baseball highlights. With exaggerated excitement, the commentator extolled the virtues of Alex Rodriguez because he had hit yet another home run. He makes close to $58,000 every time he steps to the plate. I guess he deserves it, the pressure and all. I didn’t take note of who won the game, I can only recall Alex.

I stood like a zombie in the middle of the lounge, numb, like the poor zebra you see on Animal Planet after having one of its legs chomped off by a hidden crocodile during a compulsory river crossing in Tanzania. The look, that look, on the zebra’s face always struck me as a bit misplaced, because it was devoid of any apparent emotion or concern. Moments from death, tripodding on the far shore, the zebra appeared totally detached and dissociated from its dire predicament. As I stood there, I felt the same as that zebra, vacant of any emotional content. I understood the look. I shouldn’t have been able to push my emotions aside, not if I possessed some small fleck of compassion or empathy. Because this wasn’t normal. This wasn’t what people experienced day to day. At least not normal people.

But I had been trained to be this way. No panic, just a calm approach to a problem, like a mathematician working an equation. Years of preparation, acquiring a skill set, building up my vault, had readied me to stand in the lounge like a zebra.

And so, I stared at my hands to see if I was actually here, to see who I was. Maybe I was hoping to see something different. Anything, really. A tremble, a shake. But I saw nothing. Just my hands. Steady. Solid. Quiet.

Even though it didn’t look like it, deep down, the last thirty minutes had kicked my ass. From the outside I was calm, but somewhere inside, the hideous reality of death and suffering screamed and rattled in my well-guarded cage.

There was a picture on the internet that went viral not too long ago.  A photographer had caught a shot of a doctor in scrubs and a white coat, crunched down with one hand on the wall and the other on his face.  The doctor had just lost a patient.  He clearly was shaken and had availed himself of a quiet moment outside. 

The image went viral was because it showed compassion, feeling, and the emotions of a doctor.  People, seeing the picture, were not only moved but surprised.  Moved for obvious reasons, but surprised because the doctor was showing such despondence and pain. 

This should not be surprising. Doctors are affected.  It’s hard to be around death.  It’s hard to be around the uncertainty, the randomness and the reality that anything can happen on any given day. And once it happens, there’s the magnitude of loss and devastation that follows.

Out of necessity I had been trained to deal with anything that walked through the ER doors. And I can remain calm, zebra like, in almost any situation. 

But that isn’t real. It’s fake. A con job I pull on myself. Because when the exhaustive day is done, and I come home to a quiet and dark house, I am left with my experiences.  Sometimes these experiences can become demons.

Hovering around death is like hovering around a black hole.  Sometimes you can’t escape.  It draws you in, too far if you let it. At times it asks too much, like gravity relentlessly pulling away every photon of light. 

This is why medicine can be so costly.  It is why divorce, depression, PTSD and suicide affect so many providers.  But there is hope. 

Life’s fullness is created at the extremes. The good, the bad and the ugly.  What I’ve come to realize, is that I need it all.  Medicine has been a gift rather than a curse.  I’ve been given an exclusive and extreme spectrum that is beyond anything I could have ever imagined.    

Right there, on the cusp, the event horizon opens everything. Devastation or exhilaration. You need to tiptoe on the edge of despair to know life. The fear and loss open up joy and amazement. It’s like one leads to the other. Let me rephrase that: one allows the other.

So, I may seem cold at times, dealing with an unimaginable situation. But truly, I am moved. And if I manage it correctly, I’m moved to be a better person, father and husband.  I’m moved to hug my kids a little longer and kiss my wife with a little more passion.

Life is fragile. And because life is fragile, the spectrum is immense. It allows me to see beauty in chaos, grace in tragedy and the hope that lives in between.


Shannon Sovndal, MD, is the author of Fragile: Beauty in Chaos, Grace in Tragedy, and the Hope that Lives In Between. Dr. Sovndal is a board-certified doctor in both emergency medicine and emergency medical services (EMS) and serves as a physician and medical director for multiple EMS agencies and fire departments. Dr. Sovndal has a wide range of career experience, working in tactical medicine (TEMS) with the FBI, as a team doctor for the Garmin Professional Cycling team, and as a flight physician. As the producer of the podcast Match on a Fire: Medicine and More, he is the founder of 3Hundred Training Group, which focuses on educating and training pre-hospital providers.

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