James Burger

How many times have you recently responded to the question “how are you?” with “busy”? I catch myself doing various permutations of the above,

Busy, but good

Good, plodding along

Head’s still above the water

We seem to have a culture that superficially rewards busy-ness. People always comment to me about how I’m so busy and difficult to pin down for plans – but it almost seems complimentary when it’s put forward, like this must mean that I’m doing well.

I have always had a strong sense of obligation to hold true to my commitments – it’s a trait I find valuable and I’m proud of the fact that I don’t let people down. As with many traits which we value in ourselves, we may often take this to extremes. The downside of this trait is that I often spread myself too thin and worry about disappointing others. I am lucky, though, to have a great support network who try work around my time constraints. Despite living together, my girlfriend basically has to schedule me in for date nights to make sure that we can get to spend real time with each other away from work and studies.

At the moment, I am feeling a little overwhelmed. Not overly, but in just a littleover my head. Not through a lack of a plan or an inability to get through everything in front of me, but because I feel like I have lost my autonomy in my actions. My time is no longer my own – and that affects all aspects of my life.

This feeling of loss of autonomy seems to be pervasive among many aspects of medicine, from medical schools where students must fit the mould and schedules, to among junior doctors where there is much uncertainty in their placements, frequent calls, and variable supervision, to registrar programmes with all the exams, research, and clinical duties, as well as in academia, where we recently had the death of one of the pillars of UCT medical school, Prof Bongani Mayosi. With his death, we lost someone who so many looked up to, but who likely felt the weight of all our collective expectations to remain strong in difficult times and that he could not let anyone down. Many speak of how he was one of the few carrying to torch for students in the rather hostile world of medicine.

Feeling trapped is an especially dangerous position, which is often suggested as a precipitant for successful persons who die by suicide. With Prof Mayosi, some reports suggest he tried to resign twice from the position but was dissuaded. In medicine, there is incredible pressure to push through the tough times because “happiness is around the corner”… “if I only just get through my exams”, or “if I just get through this call”. Unfortunately, this delayed gratification may never come, as there is always something else that pushes it back. There may be fleeting excitement that accompanies accomplishing the goal, although by the time we near it, the goalposts have often shifted to some new goal, some next step in the journey to being content.

We still need to be able to celebrate that win in the moment and understand that we have accomplished something in the current game before we move those goalposts. Having reasonable expectations may be beneficial in managing our plans and disappointments, although I think we sometimes put too much emphasis on these expectations. If I put in enough work, I’ll get there eventually. With that line of thought then that becomes the expectation after all of the hard work. I am working on allowing myself the ability to celebrate these victories, even if they are ‘expected’.

It boils down to being present in our current life, not just waiting for the next step, the next project, the next place to shift our focus in our journey. I also catch myself also asking those around me, “what are your plans?”, which automatically deemphasises the present in favour of this loftier future satisfaction. We are so indoctrinated to believe that we need to constantly be moving towards this end point that we lose sight of all the joy that is around us in the little moments.

I am slowly learning that I need to allow myself to not be busy, to stop and be present in this phase of my life, and celebrate the minutia of my day and the underrated victories.


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