How do you do it?

Although "How do you do it?" is a question I get fairly often in my line of work, in the last few weeks I have been asked this question eight or 10 times.

Usually, I answer with a shrug, and a smile that is meant to imply "I just do." Yet, the truth is really more nuanced. I believe that no one promised me a job without hardship. I believe it is OK to cry in clinic, especially at times of loss or difficult transitions. I believe that death is a part of life. I believe that no one promised me that a job in medicine would only involve happy news and cures.

However, even knowing all this, being an oncologist can sometimes wear you down. At a recent gathering, a few of my coworkers and I discussed how to prevent burnout — if possible. One said, "I leave work at work, and home at home." I think that is sometimes a good policy, but difficult to put into practice if you ever work from home. I understand the need to build in some distance and not be 100% on the job. One said he meditates a lot (daily) and the evidence would seem to support that that is useful in building compassion and endurance in difficult situations. I do yoga, and lots of family activities. I write sympathy cards to all my patients' families. I snip out and keep obituaries and flip through them from time to time to remember all the nice people I have worked with. I also can blow off steam talking with my husband, who is also a physician. I think that is enormously helpful — to have someone you can talk to who understands what you do and how medicine works. I find that most non–medical people glaze over a bit when you mention that you had to send a 28–year–old to hospice at work today. Not that they don't want to know, but it is difficult to know what to say or how to help.