Emotional Enriching Fatigue

In residency, intern year was so exhausting because we were bombarded with new information and situations everyday amid long hours. In addiction medicine fellowship, while the hours are closer to a 40 hour work week, I can feel the emotional fatigue from walking with patients through unimaginably hard experiences and burdens. Motivational Interviewing requires the clinician meet the patient where they are at, but this nuanced skill takes time to hone and requires the clinician invest themselves into engaging the patient as a whole person. I leave each encounter enriched by the partnerships I form with patients to make small or large steps towards recovery. But I also find myself needing time to sit, process, and rest after each story I bear witness to. Lives and narratives more tragic and heroic than any story Hollywood can drum up. I find my mind and heart growing with each new encounter. I wonder how much caloric expenditure my brain is spending on each case and whether it’s more energy expensive than the medical calculations I made with blood pressure, diabetes, arrhythmia anticoagulation, and cancer prevention management decisions I needed to make. (Don’t worry, I dont plan to give up Family Medicine!) Experientially, right now it feels like the addiction narratives are more taxing. I don’t leave the encounters tired, I actually leave them somewhat inspired. But I do find myself sleeping and dreaming more. If dreams are really the place where the brain processes information too complex for conscious cognition, then maybe I am burning more calories now. Who knows. Regardless, I’m enjoying this fellowship experience. It is truly an honor to be trusted by so many patients to participate with them in their lives, and I can tell they each are investing and growing me as a person each day.