Burnout Is A Fight For Your Soul
How The Reasonableness Trap Sneaks You Into Burnout
I met Joel* on a hospital ship a few years ago. That year, the Africa Mercy, as that ship is called, was docked off the coast of Cotonou, Benin. Joel had just arrived from the US—California, specifically—having flown some 36 hours to get there. It was a Sunday night, and he was making himself a sandwich.
I’ve been working on these hospital ships for nearly two decades now. They’re like a second home to me.
To new volunteers like Joel, however, the Africa Mercy can be a labyrinthine, creaky place with walls imbued with the weird accumulated smells of five decades in operation, air conditioning that runs either too hot or too cold, and salads that taste oddly of chlorine.
“First time here?” I asked, pulling up a chair and setting my own plate of chlorinated vegetables down in front of me.
“First and last,” he said. “Probably. Just found out I have colon cancer. It’s what made me finally decide it was time to retire.”
Over the next two weeks, Joel and I would spend scores of hours bent over an operating table, changing dressings on the wards, and exploring Cotonou’s restaurants. You get to know someone really well in a short time
.Joel had been an ENT surgeon for only seventeen years. In that time, he’d already had to miss his kids’ recitals, his wife’s birthdays, and even his father’s funeral (in his defense, he was on call, it was a holiday weekend, and he and his dad hadn’t been close for almost a decade…that’s a different story).
“All because there were bills to pay,” he said. Every missed recital and delayed holiday barbecue went toward financing two mortgages, saving for three college tuitions, and repaying a practice he’d borrowed literally a million dollars (!) to buy into.
Ten years in, he was already ready to get out. To do something different. “Always said I’d do this when I finally had time,” he told me, gesturing vaguely at the ship, at the patients, at the life he’d imagined. “I got into medicine to serve where it really mattered. Use these hands for something pure. Like, to do medicine like it’s supposed to be.”
The diagnosis brought all that to a halt. He knew he needed to get help, and had onboarded a new surgeon into his practice.
He also knew this was the one time—the only time—he could be on the ship.
Joel died fourteen months after I met him. Because the world of global-health-ENT is small, I know some of his former residents. A couple of years later, on a different hospital ship, one of those former residents told me that Joel’s two weeks on the ship were never far from his mouth. He said it was the only time in his career that Joel had felt truly alive.
The Reasonableness Trap
Nothing—not a single thing—about Joel’s decisions is unreasonable. He made the right decision at every turn.
But that’s the thing about burnout in general. Whether it’s in medicine, in entrepreneurship, in marriage, or in midlife: Burnout is reasonable.
Nobody sets out to become burnt out. Instead, we follow very logical steps, steps that everyone expects us to follow, steps that we were taught to follow—and steps that make absolutely perfect sense at the time.
Every step might be leading us to deeper into exhaustion, but—sadly—“I’M ABOUT TO BURN YOU OUT” isn’t emblazoned on them.
Kids need braces. Someone’s get to go to the soul-crushing administrative meetings because who else will advocate for patient safety? Sure, the job is toxic, but the health insurance covers your spouse’s medications.
Not a single one of these is a trivial concern. Each of them is real. Each one matters.
And each may be a step on the road to burnout.
Not dramatically. Not all at once. But slowly, methodically, one completely reasonable decision at a time.
The Math Needs To Math Better
Early in my career, I got to spend six months on that same hospital ship, under the mentorship of a surgeon 20 years my senior. I’ve spoken about him a lot—he’s in my book, he’s in my TED talk because that’s the sort of impact he had on my life.
Dr. Gary Parker spent his entire career working as a surgeon on those hospital ships. When I met him, I was just starting my career; he was right in the middle of his.
Over a similar dinner of chlorinated vegetables, he gave me a piece of advice I heard him give so many others after me:
If this is what you want to do with your life, you’ve got to make decisions now to make that happen.
Maybe, he said, don’t buy into that practice.
Maybe don’t get a mortgage—even if that’s what everyone tells you to do.
Maybe choose a fellowship that’ll give you the skills to work in Africa.
Maybe—even—don’t get married to that person who doesn’t share the same vision, no matter how much you love them.
It shocked me, that advice. So, like so many of his mentees, I didn’t follow it.
Not right away, at least. I got into that full-time practice. I was married to a doctor (an absolutely brilliant doctor, mind you) who didn’t share my same mission.
Meanwhile, something ineffable—something I might call my soul, if that word doesn’t make you uncomfortable—was steadily extracted from me, milliliter by milliliter, like a slow (and reasonable) bloodletting that we’d just come to tolerate. Because what other choice did I have?
We doctors and nurses, we’re honestly terrible at this calculation. We can calculate base excesses and med dosing down to the decimal point, but we can’t quantify what it costs when we stop recognizing ourselves in the mirror.
What does it cost when you snap at your partner because you have nothing left to give? How much have you lost when you can’t remember the last time you felt genuinely excited about your work?
I used to find myself hoping to get sick, to break a leg, to catch a cold— nothing serious, but enough for a few weeks off.
How much did that cost?
Joel had also done all the “right” things. He had a successful practice. His kids would go to college without debt. His retirement account was fully funded. He was winning, by every metric. Every trackable metric.
Except the one that mattered.
The Great Unbecoming
If burnout was just exhaustion, a few well-timed vacations would fix it.
It’s more than that. Burnout is, fundamentally, an unbecoming.
It’s the slow dissolution of everything you thought you were working toward. It’s discovering that you’ve been so focused on surviving that you’ve forgotten what you were surviving for.
I see it in every physician who tells me they’re “fine” while their marriage crumbles. In every nurse who insists they can “handle it for just a little longer” while developing their third stress-related health condition. In every one of my potential clients who’s an expert at explaining why they can’t possibly change anything right now.
Now’s not the right time. The bills are real. The obligations are real. The financial pressures are real.
But so is the fact that you’re disappearing.
What does it profit a man to gain the whole world but lose his soul?
The Second-Best Time To Plant A Tree
There’s an adage I love, from the world of investing:
The best time to plant a tree was 20 years ago. The second-best time is today.
The concerns you’re facing—they’re real. I’m not going to minimize them. I’m not going to tell you to just quit your job and “follow your bliss,” because a) that’s for 25-year-olds with trust funds, and b) the kid’s braces and the practice payments and the insurance payments don’t get paid in bliss.
But I am going to tell you this.
If you, like me, made the “reasonable” choices that led you into burnout, you can’t go back and change them. But you can start plant a tree today.
Ignoring the insurance payments and the college educations is unrealistic, but so, too, is staying burnt out.
Wait, no. That’s a lie. Staying burnt out is realistic. But it’s unsustainable.
It’s a debt you’re accumulating that will eventually come due, and when it does, the interest rate is devastating.
The reason I like the imagery of planting a tree is because it’s slow. It’s undramatic. It’s a small step that can lead to big rewards.
The path out of burnout is similar. It’s not achieved through dramatic gestures. Instead, it comes by making different calculations, making different choices. Ones that seem slightly unreasonable. Ones that factor in not just financial ROI but soul ROI.
You Can Win The Battle For Your Soul
Joel waited too long to do what he truly wanted to do. And in the end, he got to do it for two weeks.
If you’re reading this and thinking, “Dang, this is me, but I can’t do anything about it! Not right now. I’ve got…”—I want to stop you right there.
It’s not true. You have more options than you think. You’re not as trapped as your inner judge tells you.
How do I know? Because I’ve been there. Three times.
And because I’ve helped others find their way out—through practical, systematic steps that honor both your real-world obligations and your obligation to your soul.
Stop trading your essence for survival. Let’s help you find your way back to yourself.
Because you deserve more than two weeks of feeling alive.
You deserve a life that doesn’t require you your retirement for you to start living.
*(name and identifying details changed)
If you’re ready to work with someone who understands both the science of burnout and the art of navigating the “reasonable”, I’m here. Not to tell you what to do, but to help you find your own path back to a life you love. Here’s how:
→ SUMMER SALE. For the month of July ONLY, the first fifteen health professionals to sign up for my master course on getting out of burnout get the whole thing for 50% off! I’ve never given a deal this big, and probably never will again. Click here to apply!
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