But everyone has a breaking point.
Mine seems to come after about being awake over thirty hours. If I have worked all night and sometimes the day before, I leave my house Dr. Jekyll and return as Ms. Hyde.
Dr. Anne Jekyll knows she is just tired. She can look at dishes in the sink and know that they can be done later, after a long nap. Email can wait. She knows she doesn't need to run with the dog right now, even though it is cool and light outside- a rarity in the Phoenix sun. She can recognize that even though she was up working all night, it is okay for others to be sleeping, doing nothing productive except restoring themselves.
Ms. Anne Hyde is unglued about dirty dishes in the sink. She thinks, "if I have been awake and working for the last umpteenth-and-a-half hours, at LEAST have the kitchen clean before I get home." She feels like she needs to immediately start her daily duties and rest later. She scowls at those that have been sleeping all night, expecting others to at least achieve partial productivity in the many hours that she has been gone. She has no patience for hearing that someone hasn't slept well, and even less patience for hearing that someone has.
Dr. Jekyll and Ms. Hyde are both predictably, undoubtably me. These characters of duality persist across level of training, rotation assignment, and seasons. And I have medicine to thank for introducing me to Ms. Hyde...I don't know if I ever would have experienced such impatience, discompassion, and crabbiness if left on a normal schedule. I don't think I would have believed that I could feel this way, that these emotions and thoughts could come from the person I thought myself to be.
I think many doctors struggle with this, and it partially fuels the burnout of medicine. Like Mr. Hyde in Robert Louis Stevenson's original novella, our meaner selves can grow from a part-time appearance to an ever-present alter ego. Dr. Jekyll saw the transformation too late, and lost himself to Mr. Hyde. Doctors enter medicine for all the right reasons, and, sensing their bitter change too late, leave for all the wrong ones.
They say recognition is the first step to recovery. Well, I don't know if I can ever completely recover. But I can recognize Ms. Anne Hyde, acknowledge her for who she is and the place of exhaustion that she comes from, and choose to go to sleep. I can wake up as Dr. Anne Jekyll, kindness and patience restored, ready to see another patient.