I originally thought writing would be therapeutic, but lately my chest tightens up with anxiety when I start typing.

I don't usually check the comments posted, and I saw a staggering amount.  A lot of support.  A lot of people with something to say.  A lot of people who want to help me.  I'm a complete stranger, but people from everywhere just appeared with something positive to share.  Some encouragement.

There are so many comments I am going through and I will get to you all.

All the comments are very positive.  What makes me anxious reading them and a little stressed is that so many others said "This is me.  I went through exactly that."  Many comments said things along the lines of being ready to give up, how ready so many people were to quit medicine, how so many people were hurt by their medical training.  

I remember so many people just staring me down and saying awful things to me, and they were all doctors.  There were so many times I felt like a dog who just stood there with ears folding down.  I don't get it.  I'm not a bad person, I'm not a bad doctor.  Why does everyone have to be cruel?  Because they want to?  Because they can?  It hurts people like us because we have such a big heart when we're young and we have so much energy and hope and desire to help and heal, and we just get torn down.  We build back up from that foundation and we try to make the next structure stronger, and many of us do.  Many of us can't and many of us quit, many take time off to reflect, and many take another course of action.  Then I get frustrated because I hear all this talk from older physicians about how tough they are and how they were much tougher than everyone ever.  It's unbelievable.  You have to lose part of yourself to just somehow believe you're so tough and always have been and always will be.

When I was in college I heard from a friend that they had known a doctor who had become addicted to alcohol and lost his job.  It sounded impossible, like a complete anomaly.  But years later I see how stressful medicine is and I see the toll it takes on people.  I've seen people prescribe opioids inappropriately, I've seen made-up documentation, I've seen doctors get divorced, I've actually met people who had or currently have addictions.  I saw substance abuse as a college student, and I saw it as a medical student.

I just want to thank everyone from the bottom of my heart.  I wish you were all people I worked with.  I wish you could all replace the people who make me want to give up and just drop all my equipment with a metallic clatter and walk out of there.

I'm using a few vacation days this week to just get a grip back on my life.

In residency, its easy not to clean your house because you're so tired and have other things to take care of.  When something bad happens, there's no time to clean up your life or get organized and regain your composure.

Once I didn't go to a funeral because I could feel how much tension it caused with everyone's schedule.  We were already down some members for various reasons.  I ended up finishing work at my assigned time, getting flowers from the grocery store, and looking up the cemetery address.

Maybe I can talk to some of you from here on out.  Maybe you'll walk alongside me on this journey.  Maybe you'll feel sad when you remember something you went through yourself.  Maybe we'll talk a little about it if you feel comfortable enough.  I almost want to say I'm sorry that there's hardly anyone who works with me who offers to listen or even just really cares.  Maybe people are afraid to care or get involved or they have their own anxieties and are balancing so much on their own.

I'm sad and frustrated with the world sometimes.  It's a really unfair place to so many people and I don't just mean in medicine.  It makes me sad that us people in medicine really have to shout and scream to be heard and to be helped, because there's so much noise and activity.  You can't fall behind, there's no time to.  There's no time to feel and think and you can't fall out of step, you have to keep marching while people are sick and dying and everyone is stressed and there's delays and pagers going off and phones ringing and shift changes.

At least I know I have friends.  They're strangers, but friends.  And so much more support than I've ever had in my life.  And I want to throw that in the face of everyone who hurt me and made me feel like I was an insult to them.  I won't ever forget those people who hurt me, but I'll never speak to them again.  I'm going to build something new and something better with people who believe in me.