How Do You Feel? One Doctor's Search for Humanity in Medicine
By Jessi Gold, MD, MS
Simon Element; hardcover, 288 pages; $28.99
Psychiatrist Jessi Gold, MD, MS, is the Chief Wellness Officer of the University of Tennessee System and an associate professor in the Department of Psychiatry at the University of Tennesee Health Science Center. In her clinical practice, she sees health care workers, trainees, and young adults in college. Dr. Gold is a dedicated mental health advocate whose writing has appeared in the New York Times, The Atlantic, InStyle, Slate, and Self.
In this engrossing, poignant memoir, How Do You Feel? One Doctor's Search for Humanity in Medicine, Dr. Gold and four of her patients deal with the unspoken mental and physical costs of caring for others.
Dr. Gold was used to being constantly busy, but when she hits the point of being mentally overwhelmed, it led to an unthinkable error during a session with a patient. This sets her on a path to reevaluate everything that the medical system has taught her.
While Dr. Gold reassesses her own complex relationship to the health-care industry, she begins to examine it through the eyes of some of her healthcare worker patients, a resident with OCD who's in their thirties, a pregnant nurse who suffers from PTSD, an aspiring medical student who has crippling test anxiety, and an experienced emergency room physician who feels completely overwhelmed.
They discuss burnout, perfectionism, empathy, and the emotional burden of working in health care, leading Dr. Gold to realize she is not alone in struggling to maintain her humanity, which is ironic because she chose it because of its humanity.
Dr. Gold does an excellent job of balancing research expertise with unforgettable stories and raw emotion, and it demonstrated the capacity that humans have for connecting, learning, and growing. It is a personal story that has many universal themes, centered around the idea that, as we care for others, we have to remember to care for ourselves.
In this excerpt, Dr. Gold writes of the moment that she knew something had to change: "EVERYTHING WAS FINE, until it wasn't. At least that's what I kept telling myself during the weeks, then the months, of pushing through and pushing down and flat out ignoring. It's fine. I'm fine. I can still do my job as a psychiatrist. I haven't made a mistake. People need me.
Except one day, something changed. Call it reaching a breaking point, or hitting rock bottom, but something happened that made me realize I wasn't fine and that I hadn't been for a long time.
I had trouble getting myself out of bed that morning, and after my shower, I barely managed to find a T-shirt and a clean pair of sweatpants to put on. I'm lucky that with the Zoom screen, I could get away with throwing on my work-issued fleece, which had the words 'Department of Psychiatry' and my hospital's logo on it. I hoped it made me look semi-professional, but I was also completely aware that staying in pajamas all day is probably not a great sign. If I were my own patient, I'd be concerned.
At the computer, I remember glancing at my schedule and already feeling overwhelmed. It wasn't just the more than thirty patients I had scheduled that week; it was also the three lectures I said I would give across the hospital system and the article I had agreed to write for a magazine. Stop, you're fine, I told myself. I had been telling myself that a lot lately. Then, without another thought, I slipped into doctor mode and clicked open my first patient visit of the day.
On the computer screen was a sandy-haired college student named James, who looked younger than the age listed in his medical record. After saying hi and getting a hi in return, I noted that James was scheduled for an hour rather than the thirty minutes allotted for patients who have seen me before. So, I launched into my usual new-patient spiel, since I didn't recognize his name or face. I often see ten or more patients a day, including one or two new patients. Because of that, I rarely have time to look deeply into the chart of my next patient for specifics on their psychiatric history or the reason they've made an appointment with me. Typically, during the day, I'm running on semi-autopilot: next patient, one hour, go! I glance at their name, open a new note, and start talking.
'It's so nice to meet you!' I said. 'I'm Dr. Gold. What brings you to see me today?'
I paused and waited for James to answer, but then the pause stretched out longer, and longer still. I watched as his expression changed from apathetic to angry, and suddenly I snapped to attention. I began to wonder if maybe James didn't feel comfortable talking to me, or even being here, which wouldn't be a new experience for me as a psychiatrist. Still, I waited, refraining from saying anything. I didn't want to make assumptions when I was meeting someone for the first time.
Finally, James shifted uncomfortably and replied, 'Ummm...I know you, Dr. Gold. We met three weeks ago.'
I felt my stomach drop... I tried but failed to fight my feelings of embarrassment and anxiety, or to keep my deep discomfort from showing. It's a lot harder to maintain a poker face when you're emotionally overwhelmed and exhausted. And I was more tired than I'd ever been before.
I remember immediately dressing myself down internally. I'm horrible, I can't believe I could do that to someone. He hates me and I don't blame him because I hate me, too. Even on the best of days, my negative self-talk can come out loud and clear.
Besides being angry at myself, I felt for my patient. My empathy was on overdrive, my mind imagining what it must feel like to be forgotten by a doctor who, only weeks earlier, had asked you to reveal your deepest, darkest secrets. I'm terrified that in one thoughtless, mistaken sentence, I had just ruptured our nascent therapeutic relationship. Who would blame him for not wanting to see me again?"
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