Ever feel like your heart just isn’t in it anymore?   Maybe you have pursued a line of work that  once really meant something to you.  But now, you find that you can hardly make yourself show up to do your job. No matter how hard you swing, you never feel like you connect with the ball.  You never feel satisfaction in your workspace, even with a task that is done well.  Maybe you feel so tired that no amount of sleep refreshes you.  You get up every day, feeling tired. Or maybe you’ve just gone numb.  If you are a caregiver, you’ve noticed that you are missing the empathy that you once had for those that you are trying to help.  Perhaps you even catch yourself laughing at something horrible.  You used to be a sensitive person, but not anymore. You have developed callouses, somehow.  Whatever could have happened to you?

There is some good news here.  If your heart tells you that it isn’t in it anymore, then your heart is alive and well.  And your heart has something important to say to you. 

In my profession, there is a growing consciousness of a phenomenon that has been called ‘burnout’. It has been observed in many occupations, but it is something that has been documented in over half the doctors in my specialty of critical care, and in plenty of other specialties, too.  If you ever take a test for burnout, you will be asked if you have developed trouble feeling a sense of accomplishment at work.  You will be asked you if you have gone numb, or if you need to escape from your feelings.  You will be asked if you feel isolated, or if you even avoid connecting with your colleagues, or your patients. Burnout is when your heart just isn’t in it anymore.

Burnout is not a diagnosis.  Burnout is a symptom.  More than that, burnout is an invitation for us to enter our interior.  If your heart isn’t in it anymore, it is because your heart knows something that you may not know yet. 

There are many surprising things to be found in our interior, and symptoms like these only hint at what might be wrong.  And of course, we live in a society that does not allow anything to be wrong with doctors.  In my profession, state licensing boards, hospital staff applications, and insurance carriers all ask the same kind of questions: “Have you been treated for alcoholism, or substance abuse? Have you been treated for mental illness or depression?”  But when society takes a fearful view of things like depression, addiction, or PTSD, it makes it almost impossible for physicians to ask for help.  This is why the rate of suicide in doctors ranges from 2-4 times greater than the general public. 

The system we have been working in has made it feel like it is not safe for us to ask for help.  But this is beginning to change. There is a growing recognition that physicians are not super human.  We are merely human beings, and we have the same right to privacy and self-care as our patients.

As physicians over the past decades, we have been increasingly good at recommending physical self-care, like smoking cessation, weight loss, and exercise to our patients.  But there is another kind of self-care that is equally essential.  It is a kind of fitness that is focused on our interior. This sort of self-care begins with listening to our own hearts.

When our heart tells us to abandon the work that we have trained for our entire lives to do, we have received an urgent invitation to journey inward.  And what will we find if we go inward?  On the surface, we might find an imbalance between our work demands and our need for sleep or self-care.  If we dig deeper, we also might find wounds from the trauma that we have witnessed in our workplace, or from litigation that we have faced.  We also might find a need to be understood, and to reconnect with our colleagues, the way that we perhaps once did when we were in training.  If we go even deeper, we may find that some of us are actually struggling with PTSD, depression, or addiction.  If this is true, then help is available. And if we go further inward, we are likely to find something even more.  We will discover within our own interior, the same struggles that we help our patients face every day.  This is a life journey that faces everyone.

Sometimes burnout produces new life.  In 1988, scattered through the ashes of the legendary Yellowstone forest fire were found a special kind of pinecone. These pinecones were so tightly sealed with resin that they would normally stay closed for years, except under one extreme condition.  Forest fire.  The extreme temperatures of a forest fire are enough to open up the pinecones from the lodgepole pine. This is how the devastated Yellowstone wasteland of ash became colonized with new life. In the year following the fire, green lodgepole seedlings covered the blackened landscape.

Burnout may produce the heat that can help us to open. If your heart tells you that it just isn’t in it anymore, it might contain the seed for something that is ready to germinate.