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Where Did My Joy Go…and How Do I Get It Back?

Looking over the edge of burnout, Dr. Betsy Manor had to ask herself, “What changed?” Did she make the wrong career choice? Does she care about people less? Is healthcare changing too much? In this article published in the fall 2017 edition of Today's Christian Doctor, Dr. Manor shares how she overcame burnout to find joy again in healthcare.

by Betsy Manor, MD

I recall the overflowing enthusiasm I had for healthcare during Christmas break of my first year of medical school. I recall the moment during my fourth year when I knew family medicine was a perfect fit for me. Neither of those realizations came quickly for me, but they arrived with such peace they were unmistakably the hand of God. I was excited to ultimately practice and teach in a residency program in an urban underserved community that desperately needed compassion and respect, and I knew it was exactly where He wanted me.

Now in my ninth year of practice, the joy I once had seems like a distant memory. I have traded enthusiasm for fatigue. I began questioning the fairness of my workload compared to my colleagues, feeling bothered by patient requests and wondering how many more external pressures were going to dictate patient care. I became extremely discouraged about the threats to our right of conscience and even the overall moral decline in our society.

Looking over the edge of burnout, I had to ask myself, “What changed?” Did I make the wrong career choice? Am I at the wrong job? Do I lack proper training or support? Do I care about people less? Is healthcare changing too much for my liking? Do I work too much? Although these are legitimate concerns, I really couldn’t find that answering “yes” to any of those questions satisfied the deepest unrest I was feeling.

That’s when I realized the journey back to joy needed to start with a hard look at myself. I had spent the last four years trying to tackle the daily rigor with my own strength.

Due to an unexpected departure of a colleague when I was only a few years out of residency, I assumed a new leadership role as medical director that came with a steep learning curve and a heavy workload. I kept investing more and more of my time and energy to power through personnel changes, electronic health record transitions and healthcare restructuring, while ultimately hoping I could make things better. But rather than feeling as though I was making things better, I just became more tired and more discouraged. I was stretched too thin and not doing anything as well as I would have liked. I did not even realize for most of that time that I was more concerned with my own ambitions and accomplishments than with revealing God’s glory to others. As it says in Philippians 2:3, “Do nothing out of selfish ambition or vain conceit….”

I cannot really say what changed one day, other than that the Holy Spirit petitioned my heart’s cry for help before I even knew what to pray for—and God answered through the words of a friend. A casual conversation with a friend in ministry was a pivotal point in my journey back to joy. She explained that she and her husband regularly have to ask themselves what God has gifted them to do rather than what others want them to do or what they think they should do. At that moment, I knew I needed to focus on my gifts of caring for patients and teaching residents. But that realization didn’t come with regret or anger for time lost, as I would have expected; instead, it came with a sense of peace and hope. Scripture says, “Now to him who is able to do immeasurably more than all we ask or imagine, according to his power that is at work within us” (Ephesians 3:20). And as God often does, He paved the way for me to return to those roles in ways I could not have asked for or imagined.

“Restore to me the joy of your salvation and grant me a willing spirit, to sustain me.”
—Psalm 51:12

So I had an honest conversation with my boss, a fellow believer and someone who knows my gifting and passions dating back to our time in residency together. Although I have always known her to be supportive and thoughtful, in this instance she truly understood my needs with a depth I hadn’t expected. Her promise to work on transitioning me out of my administrative position over the coming six months was something I was so grateful for. Little did I know that within a few weeks and several conversations, she discovered that one of my colleagues was already interested in the role and was prepared to start immediately. Only the hand of God can orchestrate the perfect timing of such situations.

As I saw this remarkable situation unfolding, I knew I did not want to spend one more day toiling without the strength and guidance of the Lord. It seemed empty and unfulfilling, like Solomon wrote in Psalm 127:1-2, “Unless the Lord builds the house, its builders labor in vain. Unless the Lord watches over the city, the watchmen stand guard in vain.” Unfortunately, I didn’t know how I was going to slow my pace down or really make time to be present for people. I began praying I would have just the right amount of time for each patient without feeling hurried or harried. And wouldn’t you know that’s exactly what has happened? Patients who usually took more time had other obligations to get to, while patients who were more reserved began opening up more. The Lord opened doors for conversation and prayer with patients like I have never had before, even with some patients I have known for many years. Walking alongside patients in their times of need has become a pleasure and a privilege again.

I know this is not the end of my journey. Healthcare is changing. Society is changing. I do work too much. My burnout was not resolved instantaneously, but I now have a hope that comes from fixing my eyes on Christ again. I have a long way to go in really understanding how to trust Him and give up the control I have grown so accustomed to, but I am working on that each day.

If you are standing on the edge of burnout like I was, I encourage you start taking steps to overcome burnout and find your joy in healthcare again. Here are a few things I have learned along the way that may help you in your journey.

  1. What you surround yourself with influences you, whether you realize it or not. I was spending so much time in the trenches of keeping up with change that I did not have time to be grateful for the good things that already existed. I was spending so much time wondering what the world was coming to, rather than spending time praying for the world and recognizing God is ultimately in control. We can really know His character and promises by seeing His faithfulness play out in our lives.
  2. In a culture driven by accomplishments and success, we have to be extra diligent in our efforts to focus on God. From productivity to quality measures, it seems there is an ever-increasing focus on numerical evidence of what we do. While feeding the 5,000 in Mark 6:30-43 was a miracle of numbers, I don’t think Jesus would consider that a greater accomplishment than healing one man’s blindness as in Mark 8:22-26. Only when we seek out God’s will do we start using His accounting system of success.
  3. It is arrogant to think that you alone can accomplish a task. Are we more capable than Jesus Himself? Jesus demonstrated two very important things during His time on earth: first, He sought the will of His Father always; and secondly, He had disciples (and ultimately the early church) who extended His reach further than He could have as one man. We should emulate these same vertical and horizontal relationships as we are His representation in today’s broken world.
  4. We need rest. I enjoy being busy and contributing to things. I have gone months without heeding His command in Deuteronomy 5:12-15 to observe a day of rest each week, but that only ended up with me being more tired and less productive. More importantly, I lose out on the rejuvenation that stems from a pace allowing me to focus on Him. It is for our benefit that God gave us time and structure, because He understands what we need.
  5. Doing good does not necessarily mean you are within God’s will for you and your life. Even though my intentions of improving our clinical practice were good, I lost sight of why and how to do that. Had I sought the daily direction of the Lord, my experience and success might have been quite different.
  6. What is complete joy? According to John 15:1-17, complete joy comes from three things: loving each other, keeping Jesus’ commands and remaining in Christ to bear much fruit for the Father’s glory. I absolutely believe those things give me the greatest purpose and fulfillment, but I so often trade them for lesser things. How would our lives look if we kept this in mind each day as we serve Him?

“Therefore, whoever humbles himself like this child is the greatest in the kingdom of heaven.” 
—Matthew 18:4

I am far from having all the answers for a more God-honoring, fulfilling life and career. My expertise in burnout comes from my sins, life’s lumps and God’s grace. As a result, I no longer look at joy the same way. Joy is not a feeling of happiness; it is a daily commitment. According to Psalm 51:12, joy stems from understanding our worth in Christ and what we receive through His salvation. Joy starts with having the humility of a child that Jesus talks about in Matthew 18:4. Joy continues through an obedient life and trials that lead to perseverance according to James 1:2-3. As it turns out, I could have had true joy all along had I properly decided to put my focus on God and not my circumstances or myself. I pray that He gives me the wisdom and endurance to do better each day forward.


ABOUT THE AUTHOR

Betsy Manor, MD, has been a Christian since she was a young girl. She grew up in Madison, Wisconsin, where she attended the University of Wisconsin for undergraduate education. She moved to Milwaukee, Wisconsin to attend medical school at the Medical College of Wisconsin. She then completed residency at Columbia-St. Mary’s Family Medicine Residency in 2008 and has remained there as an assistant professor since then. They predominantly serve the inner city community in Milwaukee.


This Feature Story Appears in:

Fall 2017 Edition of Today’s Christian Doctor