How to Be Burned Out When Everyone Else Is Getting a Fresh Start

There’s a subject line in my inbox queue that’s something like, “Thank you for helping with intern orientation next week!” And there are two of them. Because, months ago, I volunteered for two things. The weight in my chest stopped me from opening either one of the emails each of the six times I checked my inbox today.  

It's not dread, exactly. It's more like the feeling you get watching someone else's car coast toward a pothole you already know is there. July is coming. The hospital is about to refill itself with people who don't yet know where the bathrooms are, let alone how to call a rapid response, and I am about to spend six weeks answering the same question fourteen times a day. While also caring for patients. Meanwhile, the internet (and, fine, my own blog, a few years ago) is telling everyone it's the "academic New Year." Fresh start. Clean slate. Time to level up.

I want to be honest about something: some years, that framing works for me. I genuinely love the energy of a new group of trainees, the wide-eyed willingness, the chance to watch someone become the doctor they want to be in real time. But some years, "new year" lands like a dare. As in, congratulations, you get to do the hardest version of your job again, and you're supposed to be excited about it.

If you're reading this in late June with your stomach already a little tight, I want you to know that's not a character flaw. It's pattern recognition. You've lived through enough Julys to know what's coming: the slower rounds, the orders that need to be re-explained, the sinking feeling when you realize the senior resident you relied on all year just graduated and took their competence with them. Anticipating a hard season is not the same as failing to be grateful for your job. It is just your nervous system doing its actual job, which is noticing things.

Here's what I'd ask you to do: not after you're already underwater, but now, while you can still see the shore.

Decide your minimum baseline for July before July decides it for you. Not your aspirational, well-researched, evidence-based self-care baseline. Your actual one. What's the floor, the thing you'll keep doing no matter how slow rounds get or how many times you have to explain the difference between Q6hr and QID. Name it now, while you have the bandwidth to think clearly, so you don't have to negotiate with yourself at 4 pm on a Tuesday when you're running on fumes and a granola bar. Notes that are done are better than those that are perfect, and that mentality will get them finished before you have to resort to “pajama time.” Teaching about a single patient during rounds is a perfectly acceptable amount of bedside teaching per day. Early bedtimes that resist the pull of doomscrolling and “one more episode” binge-watching will make the already-difficult mornings much easier. Minimum. Baseline. 

Look honestly at what's actually yours to control. You cannot shorten the learning curve. You cannot make a brand-new intern move at the speed of someone who's done this for three years, and trying to will that into existence with sighs and silent seething will cost you more than the slowness ever will. What is yours: how you teach. What you model when something goes wrong. Whether you let yourself be a person who remembers what it felt like to not know where the bathrooms were.

And please, for the love of everything, put a break on the calendar now. Not in September, when you'll "have more time." Now, while July is still theoretical and your schedule hasn't filled in with the things that always seem to multiply once the new trainees arrive. A long weekend. Four real days. Block it before the system fills the space for you, because it will, given the chance.

I'll resist my own urge for dramatics here, the part of my brain that wants to tell you this July will be unbearable, the worst one yet, a uniquely cursed season. It won't be. It will likely be what most Julys are: harder than June, easier than you fear at 11 pm, and survivable in the way most hard things turn out to be survivable, one slow rounds day at a time.

You don't have to be thrilled about the new academic year to get through it well. You're allowed to brace instead of beam. I'll be over here doing both, watching for the new fellow who reminds me why I love this, and the day in week three when I will absolutely lose it over a ventilator screw-up. Welcome to the new academic year. Bring snacks.