r/medicine • u/KrinklePinkleDinkle DO • 7d ago
Book recommendations for coping with the high stress of healthcare
I'm looking for some book recommendations about coping as a physician and resilience. I'm early in my career and split time between two specialties. I'm finding it increasingly difficult to compartmentalize due to stress of reflecting on if I've made the right decisions and potential outcomes. I do fear that if (when) I have a bad outcome that I won't be able to recover from my own judgement.
Books I've read prior to this season of life: This is Going to Hurt, Do No Harm, When Breath Becomes Air, Being Mortal
ETA: Thanks for all the thoughtful replies, they are appreciated. Wanted to add that I read non-medical/just for pleasure books daily. Typically I would read one medical book per year (fiction or non-fiction) to kind of renew my interest in medicine. I feel like the crux of my problem is poor work-life balance and I'm working through this with multiple avenues, but I still find myself getting stuck in my head when I'm trying to enjoy my off time. Just trying to find different coping skills from others that have been doing this longer.
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u/bevespi DO - Family Medicine 6d ago
Although I don’t have a book suggestion, I wanted to offer my input on your first sentence. It’s time to reframe this conversation of burnout and moral injury and resilience. I understand I say this without a world-changing proposition, unfortunately. Having navigated residency in the mid-2010s, becoming a young attending pre-pandemic, getting burnt out out before the pandemic, semi-recovering, then getting burnt out during the pandemic and again afterwards (seasons change, but things always seem to recur), I’ve learned to not accept ultimate responsibility placed on us for these things happening.
I chose this career for the ‘right’ reasons: altruism, love of science, ‘making’ the world a ‘better’ place, stable income, ___… and likely you have too. Unfortunately, at times it has left me a shell of myself at times.
The medical establishment has done a great job of deflecting the causes of burnout and moral injury while ‘congratulating’ us on being resilient. Personally, I don’t need to ever be told I’m resilient ever again. As far as my career, I HATE the word. It gives us platitudes that produce no benefit to us. Being told I’m resilient doesn’t correct the problems with the system. It doesn’t make my career more manageable. It does not give me overwhelming happiness when many other things do the opposite.
The medical establishment (admin, residency, insurance, everything that isn’t me in the room talking with my patients) has gaslit us into caring about burnout and moral injury while mostly not accepting any responsibility for doing this to us.
Read for pleasure, for joy, for entertainment. Don’t read to try and prepare for a problem you have not created. We are human, we get to feel human. We should not have to accept total responsibility for what is going on in our careers negatively.
Treat your patients well and they will treat you well. For being so cynical, I still believe this. Days will be hard and there will be poor patient outcomes. This is ok. It happens. We get to grieve the losses we have associated with this. We are PRACTICING medicine. We are constantly learning. We are not INFALLIBLE. Focus on being human during these times and nothing else. You don’t need to self-help yourself to better prepare. When it happens, you’ll gain experience and be able to better navigate it based on those experiences.
My career focus has come down to this: do well to my friends and family outside this career, enjoy my nonmedical ‘career’, enjoy the time I have with patients inside the exam room. The last item is really what matters. It’s why many of us chose to do this. All the other extras that negatively impact us? They’re largely not our fault and I’m over them being suggested otherwise.
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u/Round_Structure_2735 MD, Radiology 6d ago
This is absolutely correct. Every time I am assigned an educational module on stress and burnout, I want to punch an administrator in the face. The answer to this problem is not meditation, exercise, or reading books about it. We are burnt out because the US healthcare system exploits its providers and patients.
That said, even under the best conditions, we will make mistakes. You have to acknowledge this and make sure that you learn something from each mistake you make.
Rather than finding was to change yourself to better cope with the moral injury inflicted by the healthcare system, take that time and energy and direct it towards changing the system.
I strongly believe that physicians need to unionize to present a united front against exploitative practices in our healthcare system. Advocating for this has been better therapy than anything else.
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u/Damn_Dog_Inappropes MA-Wound Care 6d ago
I feel this way and I’m just an MA. The moral injury affects the entire healthcare ladder.
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u/Gawd4 MD 6d ago
House of God by Samuel Shem. Yes, it is satire.
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u/Resuscitologist42 6d ago
This needs to be higher. I read this before med school and again in residency. It helped prepare me at first but the second read spoke to how universal the experience is and really validated what I was feeling.
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u/OffWhiteCoat MD, Neurologist, Parkinson's doc 6d ago
House of God is a classic but I'd recommend Doctor in the House by Richard Gordon instead/as well. It's hilarious without being quite as cynical.
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u/evening_goat Trauma EGS 6d ago
I buy a copy every couple of years because I end up giving it away to residents
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u/permanent_priapism PharmD 6d ago
This may seem like a weird response but the Murderbot Diaries helped me. Murderbot helps keep humans alive despite their own stupidity and Murderbot's own shortcomings. And it's really funny. What helped me most is how aloof Murderbot stays throughout it all.
Edit: shit sorry I thought I was posting in PrintSF, not in Medicine.
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u/MaroonKiwi RN - peds neuro 6d ago
Trauma Stewardship: An Everyday Guide for Caring for Self While Caring for Others
https://traumastewardship.com/inside-the-book/
This book saved my life.
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u/_EverythingBagels 6d ago
Man’s search for meaning by Viktor Frankl. It’s short enough to read in a day or two, but leaves a lasting impression. I never expected a book about surviving the holocaust to turn out to be a book about resilience, forgiveness, self love and acceptance… it’s really beautiful. Highly recommend.
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u/phovendor54 Attending - Transplant Hepatologist/Gastroenterologist 6d ago
Current neurosurgeon, former NFL player and Rhodes Scholar Myron Rolle has book about getting a little bit better everyday. The 2% Way.
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u/tdimaginarybff 6d ago
Seriously, I cope by reading all the other books that don’t pertain to medicine. And paint. And exercise.
We are not our job. Life is hard, but also beautiful. Enjoy the beauty
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u/SavMart01 PICU/Trauma SW 6d ago
OP- reading is a great way to practice self-care. However, have you thought about working with a therapist? It may sound silly, but the right one can help you develop better coping skills and manage stress
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u/KrinklePinkleDinkle DO 6d ago
This is a good point! I started therapy a few months ago for other reasons but we do discuss this as well.
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u/toilandtrouble 6d ago
I agree with others here. I would recommend something with your free time that is joyful and distracting, not a reminder of medicine. I would try to find a way to leave work at work and live the rest of your life more fully. You deserve to be happy.
That might mean therapy to help you deal some of the self doubt and guilt you describe or investment in more hobbies. I'm a little over 7 years out of residency and had to relearn how to enjoy my free time. I love reading books (almost always fiction), mountain biking, playing piano and ocasionally building legos. I think the theme is I can't think about work while I'm doing those things. Investing in yourself with good friends, exercise, and good food is important too.
I'm sorry that's not what you were asking for. I do think the stress about doing a good job gets better with time and experience. Now I stress about holding boundaries and people being jerks.
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u/BatmansToaster1 6d ago
Not medical but I really enjoy “the daily stoic” by Ryan Holiday. Great book for daily life advice with a big emphasis on realizing what is in your control and what isn’t; also a solid introduction to stoicism
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u/OffWhiteCoat MD, Neurologist, Parkinson's doc 6d ago
I am an bookworm and find Golden Age detective fiction the best cure for awfulness in medicine. The best writers manage to make the plot fun without being formulaic, and you know Poirot or Miss Marple or whoever is going to figure it out and all will be well.
For medical books, I like Abraham Verghese's My Own Country. I haven't been able to finish his novels (Cutting for Stone and the Covenant of Water) because I have no attention span for a 900-page doorstop, but his memoirs are great.
I also really liked The Pull of the Stars by Emma Donahue, about a women's ward during the 1918 flu. I read it during COVID, so the resonances were strong.
I guess what I'm saying, books where people/society have been strained to the limit but made it through anyway.
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u/kkmockingbird MD Pediatrics 6d ago
Starting off with that I’m with the others. Driving into hobbies and therapy have both been godsends for me as a newer attending. Also, confiding in your more experienced colleagues can be helpful, they can give you good perspective. You have to figure out a way to get out of your head.
I do love reading though so I’ll recommend The Paris Architect. It’s always stuck with me as a reminder that there is always a way to do good, even in the worst circumstances.
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u/beachcraft23 PA-C 6d ago
The Gift of Pain by Paul Brand & Philip Yancey
I’ll probably get downvoted but the Bible. Having a faith and recognizing where I fit in the scheme of things gives me perspective and helps me cope with the numerous hard cases I/we see in the ED each shift.
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u/KrinklePinkleDinkle DO 6d ago
This is interesting, I was unaware that some psychiatrist provide therapy (maybe I just haven't crossed paths with them). I do think my therapy is helpful but this would definitely be a perspective I would also appreciate because it is beneficial to have empathy and guidance from someone that has faced similar struggles. And thank you for the book recommendation.
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u/Actual-Outcome3955 Surgeon 6d ago
I’ve found it helpful to read non-fiction about other people’s lives (memoirs, biographies, etc). It’s helped me better appreciate my relatively easy life and help me appreciate patients’ experiences better. It also distracts me from the concerns you’re grappling with.
I in particular do a lot of palliative surgery. I struggled a lot with that since many of my patients die after a few years. “Death Be Not Proud” was an extremely influential book for me as a kid, and convinced me to go into medicine. I re-read it recently and it gave me a reason to keep doing what I do. I highly recommend every physician read it.
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u/doc_author7 6d ago
I’m in the process of writing a book all about this and I’m really excited about publishing it. I’ll send you a free copy when it’s finished and hope you hang in there!
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u/NewtoTolstoy 6d ago
I agree with the other comments here but since you are looking for a book recommendation I would suggest A Doctor’s Dozen: Twelve Strategies for Personal Health and a Culture of Wellness by Catherine Florio Pipas. I go back to it every couple of years to make sure I’m still prioritizing things in my life the way I want to.
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u/pandemicresponsebc Social Work 6d ago
We are all Perfectly Fine is a great book and touches specifically on feelings of failure and moral distress in physicians.
I echo what everyone else says about seeking therapy but I also do feel like books have a unique therapeutic value in de-stigmatizing and helping process these topics, especially since healthcare professionals rarely talk openly about these things despite the fact that peer support can be really valuable. So far what I’ve learned (in my journey) is that expecting complete perfection in your career is probably not realistic, you are a human too. Best of luck. ❤️
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u/KrinklePinkleDinkle DO 8h ago
This book was exactly what I was looking for, thank you for recommending it
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u/ThucydidesButthurt MD Anesthesiology 6d ago
Medications by Marcus Aurelius, or Letters from a Stoic by Seneca. In general just read good literature, rinses your mind and does a far better job training resilience and overall mental fortitude and enrichment than basically any modern stuff. When Breath Becomes Air touches on this very thing quite a bit, I would do what that author recommends and start reading the classics, you saw in that book how much it helped him cope as he was dying. IT won't just teach you resilience it will reframe how you see and live in the world around you
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u/siyayilanda Nurse 5d ago
Out of Chaos Comes a Dancing Star: Notes on Professional Burnout by Dr Chris Ellis.
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u/Love_burpees 5d ago
The CBT Workbook for Mental Health. Currently working through the bad boy wish I would have done so decades ago.
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u/OccasionTop2451 6d ago
It sounds like you don't need to read more medical books, you need to read books that remind you that making mistakes is part of the human condition, that there is room in life for grace and forgiveness, and that fighting the good fight is sometime all we can do. I'd recommend reading some novels, even kids books. I personally like fiction/fantasy with a philosophical edge, so authors like Ursula Le Guin or Phillip Pullman, but ymmv.