In pursuit of happiness (or a life well-lived)

A few weeks ago I had to take some days off work because I was sick. I had just come back from visiting family in Las Vegas and I suspect I caught something from my brother-in-law. The brief vacation, plus sick days and two weekends in between, meant that I did not work for 10 days.

By the end of that period, I was ready to go back to work. It did not matter that I was not 100% better. I was better, and as grateful as I was for the rest, I couldn’t wait to get back.

Now, I often joke about feeling burnt out (and, as I am very fond of saying, jokes are half-meant), so for me to feel that way came as a surprise to me.

First, let me explain why, after only 4 years of full-time practice, I am feeling a bit burnt out. Frustration seems to be an almost daily occurrence now. I get frustrated when there are delays in the treatment I prescribe because of insurance companies. I am frustrated by patients who are habitually late or noncompliant, or worse, drug seeking. I get frustrated when I think my office staff is not doing things efficiently.

I get frustrated when my judgment is questioned not on the basis of its lack of merit, but on the basis of a mistrust of my age, gender, race, and stature. I’ll bet neither one of my bosses gets called "honey" or "little girl," nor, I suspect, are they regularly asked for their age. My guess is that I get more overt signs of disrespect than they do as well. A patient once said that I could not wear heels and not expect people to stare, as if my fashion sense negates my medical degree and training.

I get frustrated when I can’t help patients: When their osteoarthritis is so far advanced that nothing helps; when I’ve tried every single approved biologic but their psoriatic arthritis is not responding; when those with polymyalgia rheumatica can’t get below 9 mg of prednisone; and when they somatize and have hyperbolic symptoms that are wildly disproportionate to the degree of arthritis.

For all the vagaries of our chosen profession, I have more than once wondered at my boss’s resilience and admired his ability to let things slide off his back when I constantly find myself at the brink of collapsing under the weight of the world’s expectations of me, including my expectations of myself. (Who’s being hyperbolic now?)

But when I missed those 10 days of work and was so eager to return, I realized the inescapable reality that, to a degree that I had not previously appreciated, my doctorhood defines me.

Doctoring is a privilege. We would not be here if we didn’t possess the gifts of intellect, talent, industry, and altruism. Because we have those qualities, we are in a unique position to belong to such a noble profession, to belong to the ranks of people making other people better, to stand on the shoulders of the giants who came before us, looking at a horizon that they could not have imagined.

If you consume pop culture like I do, you are familiar with the injunction to "find your happiness," as if happiness is a good that can be acquired. I’ve long struggled with this concept. I’ve wondered what, if anything, I was missing. I wondered if I was being disingenuous by not pursuing an appropriately low-paying-but-oh-so-antiestablishment job that was purportedly my passion (writer, musician, artist, organic farmer?).

But I think I’ve finally figured it out. Happiness is not a good, it is a byproduct of a life well-lived: to make a difference in our patients’ lives, to earn the trust of colleagues whom we respect, and to treat people with kindness and generosity. This is a meaningful life from which happiness derives.

Dr. Chan practices rheumatology in Pawtucket, R.I.

A few weeks ago I had to take some days off work because I was sick. I had just come back from visiting family in Las Vegas and I suspect I caught something from my brother-in-law. The brief vacation, plus sick days and two weekends in between, meant that I did not work for 10 days.

By the end of that period, I was ready to go back to work. It did not matter that I was not 100% better. I was better, and as grateful as I was for the rest, I couldn’t wait to get back.

Now, I often joke about feeling burnt out (and, as I am very fond of saying, jokes are half-meant), so for me to feel that way came as a surprise to me.

First, let me explain why, after only 4 years of full-time practice, I am feeling a bit burnt out. Frustration seems to be an almost daily occurrence now. I get frustrated when there are delays in the treatment I prescribe because of insurance companies. I am frustrated by patients who are habitually late or noncompliant, or worse, drug seeking. I get frustrated when I think my office staff is not doing things efficiently.

I get frustrated when my judgment is questioned not on the basis of its lack of merit, but on the basis of a mistrust of my age, gender, race, and stature. I’ll bet neither one of my bosses gets called "honey" or "little girl," nor, I suspect, are they regularly asked for their age. My guess is that I get more overt signs of disrespect than they do as well. A patient once said that I could not wear heels and not expect people to stare, as if my fashion sense negates my medical degree and training.

I get frustrated when I can’t help patients: When their osteoarthritis is so far advanced that nothing helps; when I’ve tried every single approved biologic but their psoriatic arthritis is not responding; when those with polymyalgia rheumatica can’t get below 9 mg of prednisone; and when they somatize and have hyperbolic symptoms that are wildly disproportionate to the degree of arthritis.

For all the vagaries of our chosen profession, I have more than once wondered at my boss’s resilience and admired his ability to let things slide off his back when I constantly find myself at the brink of collapsing under the weight of the world’s expectations of me, including my expectations of myself. (Who’s being hyperbolic now?)

But when I missed those 10 days of work and was so eager to return, I realized the inescapable reality that, to a degree that I had not previously appreciated, my doctorhood defines me.

Doctoring is a privilege. We would not be here if we didn’t possess the gifts of intellect, talent, industry, and altruism. Because we have those qualities, we are in a unique position to belong to such a noble profession, to belong to the ranks of people making other people better, to stand on the shoulders of the giants who came before us, looking at a horizon that they could not have imagined.

If you consume pop culture like I do, you are familiar with the injunction to "find your happiness," as if happiness is a good that can be acquired. I’ve long struggled with this concept. I’ve wondered what, if anything, I was missing. I wondered if I was being disingenuous by not pursuing an appropriately low-paying-but-oh-so-antiestablishment job that was purportedly my passion (writer, musician, artist, organic farmer?).

But I think I’ve finally figured it out. Happiness is not a good, it is a byproduct of a life well-lived: to make a difference in our patients’ lives, to earn the trust of colleagues whom we respect, and to treat people with kindness and generosity. This is a meaningful life from which happiness derives.

Dr. Chan practices rheumatology in Pawtucket, R.I.

A few weeks ago I had to take some days off work because I was sick. I had just come back from visiting family in Las Vegas and I suspect I caught something from my brother-in-law. The brief vacation, plus sick days and two weekends in between, meant that I did not work for 10 days.

By the end of that period, I was ready to go back to work. It did not matter that I was not 100% better. I was better, and as grateful as I was for the rest, I couldn’t wait to get back.

Now, I often joke about feeling burnt out (and, as I am very fond of saying, jokes are half-meant), so for me to feel that way came as a surprise to me.

First, let me explain why, after only 4 years of full-time practice, I am feeling a bit burnt out. Frustration seems to be an almost daily occurrence now. I get frustrated when there are delays in the treatment I prescribe because of insurance companies. I am frustrated by patients who are habitually late or noncompliant, or worse, drug seeking. I get frustrated when I think my office staff is not doing things efficiently.

I get frustrated when my judgment is questioned not on the basis of its lack of merit, but on the basis of a mistrust of my age, gender, race, and stature. I’ll bet neither one of my bosses gets called "honey" or "little girl," nor, I suspect, are they regularly asked for their age. My guess is that I get more overt signs of disrespect than they do as well. A patient once said that I could not wear heels and not expect people to stare, as if my fashion sense negates my medical degree and training.

I get frustrated when I can’t help patients: When their osteoarthritis is so far advanced that nothing helps; when I’ve tried every single approved biologic but their psoriatic arthritis is not responding; when those with polymyalgia rheumatica can’t get below 9 mg of prednisone; and when they somatize and have hyperbolic symptoms that are wildly disproportionate to the degree of arthritis.

For all the vagaries of our chosen profession, I have more than once wondered at my boss’s resilience and admired his ability to let things slide off his back when I constantly find myself at the brink of collapsing under the weight of the world’s expectations of me, including my expectations of myself. (Who’s being hyperbolic now?)

But when I missed those 10 days of work and was so eager to return, I realized the inescapable reality that, to a degree that I had not previously appreciated, my doctorhood defines me.

Doctoring is a privilege. We would not be here if we didn’t possess the gifts of intellect, talent, industry, and altruism. Because we have those qualities, we are in a unique position to belong to such a noble profession, to belong to the ranks of people making other people better, to stand on the shoulders of the giants who came before us, looking at a horizon that they could not have imagined.

If you consume pop culture like I do, you are familiar with the injunction to "find your happiness," as if happiness is a good that can be acquired. I’ve long struggled with this concept. I’ve wondered what, if anything, I was missing. I wondered if I was being disingenuous by not pursuing an appropriately low-paying-but-oh-so-antiestablishment job that was purportedly my passion (writer, musician, artist, organic farmer?).

But I think I’ve finally figured it out. Happiness is not a good, it is a byproduct of a life well-lived: to make a difference in our patients’ lives, to earn the trust of colleagues whom we respect, and to treat people with kindness and generosity. This is a meaningful life from which happiness derives.

Dr. Chan practices rheumatology in Pawtucket, R.I.