SOMETHING FOR THE PAIN: COMPASSION AND BURNOUT IN THE ER by Paul Austin, MD (Norton: paper, September, 2009)
What makes a doctor? What undoes a doctor? Time and sleeplessness are the relentless enemies of the person who would become an emergency room (ER) doctor. Paul Austin depicts himself battling these enemies in this collection of personal essays tracking Austin’s difficult development into an emergency room doctor.
Sally Austin, Paul Austin’s wife, is the unsung heroine of these stories. The unsung heroes of Paul Austin’s life are his children who get exceedingly short shrift from their egocentric father.
If you have read Vicki Forman’s THIS LOVELY LIFE (and I hope you have), Paul Austin’s stories stand in stark contrast to Forman’s courage in the face of dealing with the death of one twin and the horrendous physical problems of the other twin. The difference reveals once again how impenetrable is the wall between patients and doctors—as you probably know if you have already tried to climb it yourself.
Paul Austin’s primary goals are more sleep for himself and very secondarily more time for patients. Without these essentials, he goes through the motions of seeing too many patients, too quickly. Rarely does he see his family.
A recent JAMA (JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION) focuses on “Resident Fatigue and Perceived Errors” in a recent issue devoted to the problems of developing “great mindfulness—a quality of being fully present and attentive in the moment” as a means of averting physicians’ reported burnout. These articles echo Austin’s book. Nobody, but nobody has any cures for sleep deprivation and better patient care.
Austin’s choppy stories read much like a night in the ER. Young residents might read them but patients might steer clear.