I Can’t Do It All
Author: Avital O’Glasser, MD
Keywords: boundaries, self-care, workload
“I don’t know how you do it all.”
It was a recent conversation–several recent conversations, actually.
“I don’t know how you do it all.”
“You must not sleep at night.”
I used to demurely smile, emit a petite giggle, and say, “thank you for that compliment”. I used to continue to secure the reputation that I was able to do it all…indeed, to secure the illusion that I ran on caffeine, could run a 5 minute mile, and had a supra-physiologic ability to subsist on less than 2 hours of sleep a night. “Well, since you mentioned it, I just somehow got it all done.”
At some point in my journey, I realized that I was only hurting myself if I continued to pursue attainment of that external validation. And when I realized that it was humanly impossible to pursue and achieve the “do it all” endpoint, I then realized it was disingenuous to maintain the vanity of that mirage. Was the comment, “I don’t know how you do it all”, a backhanded compliment? Was it wishful thinking? Was it a challenge? Was the pressure to maintain an impossible standard worsening feelings of inadequacy and imposter syndrome in myself and others? It was exhausting–and inauthentic–to continue to put on a happy face and keep up appearances that I was indeed doing it all.
For too long, the culture of medicine has insisted that we are superhuman and that self-care is a sign of weakness. Doing it all is an impossible standard. It’s an unhealthy standard. It’s a dangerous standard. Pre-pandemic–and even after two years of this pandemic–we propagate a culture of working sick days, of not taking our vacation time, of catching up on work on weekends. We propagate a culture that we must devote as much of the 365 days in a year to work-related energy expenditure.
And then let’s talk about the expectation that we possess the time-bending ability to cram far more than 24 hours of energy expenditure into only 24 hours. We add on the mounting daily work loads during our “first shift” and the “second shift” of family and home responsibilities including childcare--and are then further expected to contour the time-space continuum to cram in the “third shift” of diversity and equity work, and the “fourth shift” of ongoing advocacy and volunteerism in response to the COVID-19 pandemic. Then add on all the additional bandwidth requirements we face in 2022. By my calculations, that leaves…4 hours to sleep at night. And even if you truly can run on 4 hours of sleep a night–WHY are we doing this to ourselves?!?!
I can’t do it all. I can’t see patients, and lead a clinic, and serve on multiple COVID-response related committees…and also care for my family, and engage in self-care, and have time for my passions and “fill the cup” activities. If I find myself resorting to being sleep deprived, skipping healthy meals, ordering take-out multiple times a week, not exercising, maxing out shortcuts, and burning the candle on both ends–if I find myself saying “no” to myself too often–then I need to start saying “no” to other things.
I have learned to advocate for extended deadlines, ask for help, delegate, triage, sponsor. I have learned to set out-of-offices and avoid answering emails on nights and weekends. I have learned to just say “no”. I am learning to role model this and respond, “I really DON’T do it all. I set boundaries, I prioritize, and I strive to say ‘yes’ or ‘no’ intentionally and authentically based on needs, responsibilities, impact, passions, and available creative energy”.
I don’t want to do it all.
I don’t want to be known for doing it all.
I can’t do it all.
I shan’t do it all.
I won’t do it all.
About the author: Avital O’Glasser, MD, is a hospitalist at Oregon Health & Science University and the editor of the WIMS blog (Twitter: @aoglasser).
