Physician residency is tough. There's no question or mystery about that. It's one of the most difficult voluntary experiences that a person can go through. There was a study comparing levels of PTSD in residents and people who served in the military, but I can't seem to pinpoint it - I'll have to ask the colleague who told me about it.
Anyway, when you combine the difficulties of residency with personal difficulties, it can all become too much. You've seen this happen with me. Today I saw it happen with a colleague of mine.
She had recently 3 of her family members over the course of a few days about 2 weeks ago. She returned to work a few days later in the medical ICU. Our medical ICU is much tougher than most: we work 6 days per week (in other residencies, 4-5 days per week is the average), 12 hours per day plus signout time of around 1 hour, and have a high patient to resident load. That's what you get from a resource-poor hospital like mine.
This morning, one of her workmates made a joke about her (the workmate's) team of patients was easier to manage than her (my colleague's) team of patients. My colleague blew up at her, stating that she works very hard, to the point where she was managing all of the patients on both teams at certain times, and this is not something to joke about. The workmate ended up crying.
Although my colleague did sometimes express her stress out loud, this type of explosion was uncharacteristic of her. In our subsequent texts, she kept repeating how she didn't care about anything anymore, and at one point even mentioned that death would be better. Naturally, this was very concerning to me. I talked her through this, strongly acknowledging her perspective and emphasizing that her mental health matters, and ended our conversation with a light joke, and she did seem calmer.
Nevertheless, I reached out to our chief resident and told him that my colleague is very stressed and had recent deaths in her family, that I'm concerned about her, and that the medical ICU may not be a good environment for her right now. I did not go into any further detail than that because I don't want her to have negative repercussions, just a little bit of help during this rough time. Possibly even a little bit of time off to process her grief and stress.
Hopefully I did the right thing. My intentions here were obviously pure, and I did it without divulging anything that she did not tell some other people publicly, nor anything that would potentially get her into trouble (i.e. her explosion or the mention of death). I think it's a proper balance of intervention on my behalf.
Our chief was attentive to this and reached out to my colleague and to our leadership. If my colleague wishes to divulge further details beyond the very surface content that I touched upon, it'll be her prerogative.
I just want to see her mental health in a better place before our inhumane, pressure cooker environment destroys her completely.