I Thought I Was Getting Better…And Then I Wasn't

There's a particular brand of hubris that lives inside the overachiever's recovery from burnout. You start to feel a little bit human again. The edges soften. Your inbox feels navigable. You think: I've turned a corner.

And then, because you are who you are, you interpret "I've turned a corner" as "back to full capacity, no restrictions, go."

That's what I did.

I wrote a few weeks ago about needing to lower my expectations of myself, to hold myself only to my minimum baseline for a while. About choosing ruthlessly and protecting the handful of things that keep life structurally stable when everything else is too much. And I meant all of it. I still mean it. But somewhere between writing that post and this one, I started to feel marginally better, and I allowed marginally better to become a permission slip.

I let myself get pulled back into the reactive current. I was immediately available again: to messages, to requests, to anyone who needed anything. I found myself writing clinical notes that didn't just document the decision; they preemptively defended it against the next five hypothetical challenges, as if I were already in a courtroom I hadn't been summoned to yet. I fell back into the mode where my opinion isn't an opinion until I've cited three papers, added four caveats, and demonstrated that I've considered every possible thing (as well as its opposite). 

You know the mode. Some of you are in it right now.

The truth is that these patterns didn't come from nowhere. They were slowly trained into us over our years in academic medicine. The immediate availability: that's a survival skill that became a reflex. The over-documentation: that's self-protection that calcified into compulsion. The anticipatory problem-solving: that's competence that curdled into anxiety. None of these things are character flaws. They are adaptations. The problem is that adaptations stop serving us when the context changes, and we're often the last ones to notice.

The other day, a friend/colleague said something offhand about her summer so far: "Usually by this point," she said, "things are pretty calm. But this year is just... everything."

Everything. Yes. I know that word with that emphasis. I've been living in it.

And then I had a few conversations with friends and with clients, and the same thing kept surfacing. The everything of it all. The exhaustion. The sense that there is no floor, just a vast space with a gravitational pull. The inability to locate a moment in the recent past where things felt genuinely fine. These are not people who are new to medicine, hard work, or periods of difficulty. These are people who are experienced and capable and who know how to manage a lot. And they are tired in a way that won't be fixed by sleeping in on Saturday.

I think we might be in a particularly rough stretch, collectively. I don't have data on that. I just have a lot of conversations that sound like variations on the same theme. And I know that burned-out is contagious (I've cited the research on this before, and I stand by it): when the people around us are depleted, we feel it, even when we can't name the source. The atmosphere gets heavier. The work gets heavier. And the return to old patterns, the over-availability, the defensive documentation, the over-explaining, these become load-bearing walls we didn't plan to rebuild.

So here I am. Back to the minimum baseline.

I'm not claiming defeat when I say that. Having to revert to my minimum baseline (again) is not the same thing as failing. It's the thing I reach for when the alternative is using resources I don't currently have. It's the structural floor I create over the vast space with the gravitational pull. It keeps the essential things standing while I figure out what comes next.

What I'm letting go of is the idea that feeling better means I've fixed anything. Feeling better is not the same as being restored. It's a data point, not a conclusion. The overachiever in me will always read “slightly improved” as “ready to re-enter,” and I'm slowly learning not to trust that read.

If any of this is landing for you, if you recognize the current you've been swimming against, or the particular exhaustion of a summer that was supposed to feel calmer and doesn't, I want to hear about it.

I am, as established, in the middle of my own version of this. But because I've started to think that more people are burned out right now than I originally estimated, and I find it helpful to know I'm not alone. I suspect you might too.

Email me back. Tell me what you're going through. I read every message.