21 Oct 2015

I am tired today.

It was a call night, after a full day of operating. The pages came in steadily. I don’t mind the ones that have to do with patient care. Most are just from people trying to do the right thing for the patients. But the calls about whether the patient should be observation or inpatient at 3 am push my button. My internal ire rises after the call and I can’t fall back asleep right away, stealing at least 20 minutes of precious sleep. I wish these things didn’t bother me, but they do.

I’m tired of having to negotiate with the OR desk to get my patient in the operating room. I’m just trying to fix a problem. This isn’t about getting to a golf course. It’s about the patient and their family being in pain and fear. If you are too nice, you get put in line behind the surgeon who yells and stomps their feet, even if your patient is more urgent. Negotiating takes energy, and I have none left.

I am tired of insurance companies telling me what I can or can’t do for my patients. Even if they “pre-authorize” the operation, they retroactively refuse to pay for the operation. Why should I be the bad guy sending a bill to the patient for their cancer surgery in the midst of chemo for the insurer’s doubleback? I’m just trying to take good care of the patient.

I’m tired of the EMR making things harder instead of easier. The only thing worse than dealing with the EMR is trying to take care of patients when it goes down.

I am tired of patients not showing up for appointments and even operations. Please don’t send me suggestions about appointment reminders, billing for no-shows, etc. We do all those things. They still don’t show. Until they arrive in the emergency room. With a non-emergent problem that needs elective surgery. Demanding it be done now. On my night of call.

I’m tired of eating processed food from a package in my coat pocket because there’s no time for sitting to eat. Getting to the gym means subtracting from the small bank of time with my family or sleeping even fewer hours than I do already, and I’m just to tired to climb on some piece of equipment and make it move.

Sigh….Pager went off again. Someone needs a surgeon. Wake up and do the job. It’s a privilege to serve. Even if you are tired.



Danielle Walsh, MD, FACS is a pediatric surgeon and Associate Professor of Surgery at Brody School of Medicine at East Carolina University. She is a past president of the Association of Women Surgeons.

6 Replies to “I. AM. TIRED.”

  1. well…in fact u have only a few things to be tired of of …on my side …apart from the many things that are to be done,i am tired of proving my existence of being a female surgeon with kids and family.Still i liked the ur sharing of thoughts.

  2. Dear Danielle
    I am so proud of you for hanging on. I read and feel your tiredness and inner tension which is totally understandable and appropriate. Thank you for sharing and venting out.
    The flip side of this is your great deal of commitment that you have, courage and stamina!
    The dynamics of surgical responsibility are meant to build up an escalating strength and stamina which is necessary to achieve mastery and excellence in anything, particularly surgery.
    You said it right, it is a privilege to serve and keeping an eye on your mission is how you could pull from a possibility. By being who you are is such an inspiration for all of us.
    Thank you for doing what you are doing and being who you are 🙂

  3. Very timely! I am reading this as I am about to go in to my fourth gall bladder in 24 hours. I was up all night with semi urgent cases. Instead of sleeping I had to have an academic discussion at 2am with anesthesia regarding why my urgent case for an ongoing infection did not need cardiac clearance. The anesthesiologist suggested I was trying to do the case for “sport.” BTW it was another surgeon’s complication at another hospital and I was trying to do right by the patient. Love your blog and could not agree more. Tired comes in so many shapes and sizes that most normal professions never have to see.

  4. It’s a decision you made after rotating with seniors and surgeons already in the field. So either you made a gross miscalculation of the facts, or you were careless in your decisions. Of course you couldn’t have missed the fact that MOST surgeons like to sulk and simultaneously glorify their profession as ‘incomparable’ to others – so my question is – why must you carry on that same sulking-and-glorifying tradition – why not be the one to pick one – either it sucks, or it does not. If it sucks, suck it up or quit, and if it does not suck, stop sulking! Now that’s a simplified algorithmic approach for you, AWS approved or not. Ambivalence doesn’t help.

    1. I guess I would think that this is an honest response that we all feel from time to time. Despite our love and our passion for our job, there are times that we all feel worn down, burnt out. Being honest about it helps us acknowledge, accept and yes, vent, and then move on. It doesn’t mean that we want to quit. It’s just that there are some days when our lives are not just roses and butterflies. It is the reality of a job that requires a lot emotionally and physically.

  5. Hi, Danielle,
    Really good post. Shows how frustrating it can be at times. I like how you ended it. You are so right. We are in a profession where we get to serve people on a daily basis. And yet, we do need to vent – and if not here, then where can you be honest? At least everybody else here understands exactly what you mean. You have shown how quickly we have to pull ourselves together, when called upon to do something for a patient. Just make sure that you don’t burn out!

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