Brain Strain

In primary care medicine, we see a lot of chronic stress injuries. People who type all day come in with carpal tunnel. People who sit all day come in with back pain. People who run marathons come in with stress fractures. But sometimes we forget that not all chronic stresses are physical.

The prevalence of burnout in medicine has always been high, and since COVID arrived, it’s been much worse. Though it manifests in several different ways, its roots are always the same: chronic, unrelenting emotional and mental stress. And like with any chronic stress injury, the only real solution is to remove the source of the chronic stress.

This seems obvious, and yet the solutions we come up with for burnout seem to ignore the actual causes of the problem. If someone has a stress fracture, you don’t tell them to run “smarter not harder”--you stop them from running until it heals. If someone gets low back pain from sitting all day, you don’t give them a gift certificate for a massage-- you get them a better chair with some lumbar support, and regular breaks so they can stand up and stretch. 

The sources of chronic emotional stress vary, so it can take a little digging to figure out which ones are causing the injury. It’s clear, though, that a meditation moment, or a pizza party, or even a raise probably aren’t going to stop the damage at the source.