Published April 3, 2023
‘Thou must be like a promontory of the sea,” the Roman emperor Marcus Aurelius wrote in “Meditations,” “against which, though the waves beat continually, yet it both itself stands and about it are those swelling waves stilled and quieted.” Though he intended these words to describe the practitioner of Stoicism, they also define the ideal disposition of a doctor. As the chaos of the hospital reigns, the physician tunes it out and focuses on helping the patient. Alas, this paradigm seems more at home in a bygone era than in our current medical system. Burnout now consumes American physicians, who are overworked, nonautonomous and adrift without help.
Such is the crisis facing physicians, according to the psychiatrist Wendy Dean and the hand surgeon Simon Talbot, co-founders of Moral Injury of Healthcare, a nonprofit focusing on distress in the healthcare workforce. In their new book, “If I Betray These Words: Moral Injury in Medicine and Why It’s So Hard for Clinicians to Put Patients First,” they state that today’s physicians are “seeing more patients, in less time, with fewer support staff,” and are “required to use technology that interfere[s] with rather than facilitate[s] care.” As a result, our healers feel exhausted, cynical, alienated and ineffective. However, the authors argue, “burnout” is a misnomer—it suggests that physicians lack resiliency. They claim physicians suffer from “moral injury” instead. This places the blame on the system, not the physicians.
Aaron Rothstein, M.D., is an EPPC fellow in the Bioethics and American Democracy Program and an attending neurovascular physician and neuroepidemiologist. He completed his neurovascular fellowship at the University of Pennsylvania and his residency in neurology at the NYU School of Medicine. He received a B.A. in History from Yale University and his M.D. from the Wake Forest School of Medicine.