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Burnout at the Broom Tree

I had no idea what burnout was until it happened to me…twice…on two different continents. Actually, I knew what it was the second time, and I felt like I should have known better and seen it coming.

by Stan Haegert, MD, MPH

I had no idea what burnout was until it happened to me…twice…on two different continents. Actually, I knew what it was the second time, and I felt like I should have known better and seen it coming.

The first time I was serving in a small rural mission hospital near the edge of the Sahara Desert in West Africa, nearing the end of my second four-year term, and at the end of my wits. I was the only physician for around 30,000 people, and although other missionary and national staff supported me, I could not release myself from the feeling that I must always be available to others. I allowed myself very little time for rest or replenishment. The concept of Sabbath was unfamiliar to me. The results were predictable—I became cynical, irritable, withdrawn, physically ill and eventually “despaired even of life” (2 Corinthians 1:8b).

This shouldn’t happen to believers, right? Shouldn’t our dedication and sense of calling prevent burnout? Actually, our dedication and sense of calling can set us up perfectly for burnout.

James tells us, “Elijah was a man just like us” (James 5:17a). Can any of us accuse Elijah of lack of calling or dedication? He faced down 850 false prophets, and he even had the guts to douse his offering with water three times before asking for fire from heaven. Yet, shortly after that victory, his life was threatened and panic seized him. He became the inventor of the ultramarathon, running well over 100 miles into the desert, leaving his servant behind before crawling under a broom tree and begging God to end his life. “I am no better than my ancestors” was his verdict on his life and ministry (1 Kings 19:4). Exhaustion? Check. Depersonalization? Check. Reduced sense of effectiveness? Check. Burnout? Yep. Even though he was “called” and “dedicated.”

 

OUR LIABILITIES

Being a dedicated and called Christian healthcare professional carries with it certain liabilities. As we enter a patient’s room, we see an eternal soul with spiritual needs we long to engage. We have a Great Physician who almost always went beyond physical healing to address the whole person in His encounters during His time on earth. We value relationship and long to connect emotionally with our patients. These longings can lead to frustration as time constraints pressure us to “treat ‘em and street ‘em.”

Positive values become part of our DNA as Christian healthcare professionals. However, these positive values may undergo malignant transformations as the patient numbers and pressures mount. We value truth, which may drive a need to fill all the checkboxes in an electronic health record. We value altruism (putting others’ needs first), which can mutate into a complete denial of mental, emotional and physical limitations, as well as a lack of attention to our own replenishment. We value accountability, but this can turn into constant availability. The drive for excellence (which is attainable) can subtly morph into a drive for perfection (which is unattainable). The false assumption that perfection is somehow attainable tempts us to believe we can control outcomes. So we label poor outcomes as “failures.”

You see the problem, don’t you? Perfection is an attribute reserved for our Lord. Only God possesses all knowledge, is everywhere present, controls all outcomes and has no need for replenishment. We can only pretend to have these qualities, and we can drive ourselves crazy trying to be who we were never intended to be.

If we’re not careful and thoughtful about our lives, the very qualities that make us compassionate, competent Christian healthcare professionals can render us liable to burnout when needs around us multiply.

 

OUR ASSETS

OK, so we have liabilities as Christian healthcare professionals. What do we have in the “assets” column?

Well, we have Jesus…His example, His grace and His presence. Knowing Jesus may not protect you from burnout, but living like He did just might!

 

HIS EXAMPLE

Jesus, God the Son, did not independently use His attributes as God while He was on earth, but subjected them to the will of God the Father (Philippians 2). In His humanity, He limited His omnipresence and became focally present in a body. He was not invincible, and yet He did not succumb to Satan’s temptation to meet His physical needs supernaturally (Mat-thew 4:3-4). Instead, He took time to sleep and eat when He became tired or hungry. He did not run around frantically trying to meet all needs, but He limited His ministry to the confines of His Father’s will and entrusted outcomes to Him.

Jesus often dismissed crowds—people whose needs were not yet met. He most often did so in order to rest and have concentrated time with His Father. And when Jesus ascended to Heaven, there were still lots of sick people around, along with those who had not heard His message. And yet He could say to His Father in John 17:4, “I have brought you glory on earth by completing the work you gave me to do” (emphasis added). If the incarnate Word of God was given only a subset of the world’s needs to meet in His human body while on earth, surely you and I have permission to say “no” to some (perhaps most) of the needs we encounter!

 

HIS GRACE

In the 1960s, British psychiatrist Frank Lake noticed missionaries to India were quickly losing their joy, becoming cynical and burning out. He asked theologian friend Emil Brunner to look at the life of Jesus with him to discover why we do not see this happening to Christ. The result of their deliberations has come to be known as the “Cycle of Grace.”1

The cycle begins with our acceptance by God and our identity rooted in Him. At His baptism, Jesus heard a voice from heaven saying, “This is my Son, whom I love; with him I am well pleased” (Matthew 3:17). At this point, Jesus had not even started His ministry. The basis for His acceptance by God the Father was not performance, but relationship, the communion He enjoyed with the Father and the Spirit from before the creation of the world. In the same way, our acceptance is based on our Lord’s choice and actions, not our own (Ephesians 1:4).

Jesus’ acceptance by the Father sustained Him, and it gave Him the freedom to engage in sustaining activities such as the cultivation of relationships and friendships, prayer, solitude, physical nourishment and Sabbath rest. His life was characterized by a rhythm of input and output, of work and rest, breathing out and breathing in. His significance and fruitfulness in obedient ministry flowed naturally from the nourishing fountain of the Father’s acceptance and sustenance.

What happens if we get this reversed, trying to derive our significance, sustenance and acceptance from our accomplishments? As I was burning out in West Africa (and later in the U.S.) my diminishing ability to meet over-whelming needs, without boundaries or thought of rest, ate away at my sense of significance. “What if I can’t do this job any longer and can’t be known as a heroic missionary physician?” I wondered. Likewise, I didn’t feel I had time to engage in sustaining activities since I had to keep the “machinery” of my ministry going. I was trying to sustain myself on the accolades of those praising me for my performance. Ultimately, I secretly worried that such performance was the basis for maintaining God’s love. What if I turned out to be “no better than my ancestors?”

 

HIS PRESENCE

That’s pretty much where we left Elijah—the “man just like us.” After questioning his significance and begging God to take his life, Elijah curled up under his bush and fell asleep. That’s where Jesus found him. I believe the “angel of the Lord” that got His knees dirty crawling under a shrub to touch His worn-out, despairing prophet was the Incarnate Son of God. The evidence?

1. Attributes of Deity seem to accompany this angel when He is mentioned in the Old Testament.

2. Jesus likes to touch people when He heals them in the gospels. Elijah’s angel chooses a gentle touch rather than standing beside the bush to shout him into wakefulness.

3. Jesus loves to make breakfast for people He wishes to restore ( John 21:9).

Our Great Physician and Wonderful Counselor doesn’t lecture Elijah, but rather He provides sleep and food. He then pre-scribes His presence, which shows up not in the wind, fire and earthquake but in the whispers to which Elijah hadn’t had time to listen. When the time is right, the Lord meets Elijah’s misconceptions with truth and then provides a new task for Elijah that is sized to Elijah’s new “normal.”

I have seen these actions of our Lord in my own recovery from burnout. I have learned to practice a Sabbath in order to remember that I’m human and to remind myself that someone else is in charge of the universe, which doesn’t fall apart when I rest. I am investing in my personal resilience through community, regular exercise and spiritual nourishment. I am learning to challenge lies that strive to pull me the wrong direction around the Cycle of Grace. I have modified my work life to be a better fit for my life stage. Most of all, I am trying to “practice the presence” of my Savior, picturing Him with me in ALL my moments, whether restful or challenging.

 

SPEAKING INTO THE WELLNESS CONVERSATION

CMDA wishes to speak into a gap in the burgeoning national and international conversation about burnout in the healthcare environment. Thus far, that conversation has primarily focused on maximizing workplace efficiencies, cultivating wellness-promoting environments and enhancing personal resilience. CMDA wishes to promote all of these efforts by articulating biblical foundations for them, as well as advocating a full-orbed approach to well-being that includes a recognition of the indispensability of spiritual well-being to resilience.

Recognizing that the values that spring from our Chris-tian heritage can become liabilities unless they are guided by The Holy Spirit, and infused with the example, grace and presence of our Great Physician, CMDA is launching a Center for Well-being. This center intends to help Christian healthcare professionals face the challenges that may lead to burnout, ill health and decreased workplace satisfaction with biblical truth that holistically addresses all aspects of health—physical, mental, emotional and spiritual. We want to be a source of helpful resources, including a well-developed coaching ministry with certified physician-specific coaches. Plus, we will be nurturing relational connections and sponsoring retreats and conferences specifically designed to equip you to serve others with enduring joy.

We encourage and invite YOU to join the conversation…especially if you feel like you’re no better than your ancestors!


BIBLIOGRAPHY

1 Lake, Frank. 1966. “The Dynamic Cycle.” Clinical Theology: A Clinical and Psychiatric Basis to Clinical Pastoral Care, Vol. 1. Great Britain: Darton, Longman and Todd. Quoted by Karen Carr, “Personal Resilience,” in Schaefer, F. and Schaefer, C., eds. (2012). Trauma and Resilience: A Handbook. City un-labeled: Condeo Press. Pg.95ff. See also Hudson, Trevor and Haas, Jerry P. The Cycle of Grace: Living in Sacred Balance, 2012, Nashville: Upper Room Books.


STAN HAEGERT, MD, MPH, lives in Lafayette,
Colorado with his wife Deb. They have two daughters, a son-in-law and two grandsons. Af-
ter Stan’s medical training, the Haegerts served
as medical missionaries in The Gambia, West Africa, over a 13-year period. Stan’s experience of burnout, recovery and return to the mission field has given him a passion to help others learn to care for themselves while serving others. In addition to practicing telemedicine and serving as Associate Director of CMDA’s Center for Well-being, he enjoys frequent opportunities to teach about wellness to healthcare personnel, missionaries and other groups. When not playing guitar, he is usually looking for a good game of chess.

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