After my graduation from medical school, I took two weeks off before starting my obstetrics and gynecology residency. In hindsight, I wished I spent those weeks doing something more memorable than studying and looking at the June call schedule. My training program was a small one, only four residents per year, which meant we took call every other night to every third night, unless someone was on vacation and then we basically lived in the hospital. As residents, we worked punishing hours; I recall driving into work at 3 a.m. and leaving at 8 p.m. the next day. First-year residents were not allowed to sleep at all on call nights, and there was no time for that anyway. We manned the emergency room, the labor and delivery room, and the obstetrics triage clinic in a very busy metropolitan city in Florida. There were emergencies constantly: women with uterine bleeding, fetal distress during delivery, a triplet pregnancy in preterm labor. I recall one heartbreaking case in which a mother to be, 32 weeks pregnant with her first child, presented with concerns as she had not felt her baby move for over 24 hours. We diagnosed a fetal death in utero where the mother was then was required to deliver her deceased baby.

Going into medicine, the expectation is there will be difficult moments with patients, families, and co-workers. The workload is known to be intense, and the amount of information to consume grows daily and requires superhuman efforts to manage. We take out hundreds of thousands of dollars in loans that require 20-30 years to pay off, while earning very low salaries during training. And training can be brutal: sleeplessness, high stress, and life-and-death stakes are constant companions.

I thought it was interesting that my intern year was the year residency programs were required by regulation to implement the “80-hour rule.” This rule meant that residents were limited to only working 80 hours a week. Imagine my surprise when I worked 110 hours or more every week and my training program required me to sign a form stating those 110 hours were really only 80.

Taking all these factors into account, is it any wonder that health care workers are struggling with mental health issues? COVID simply amplified the atmosphere creating a battlefield medicine environment for doctors and nurses, especially those working in ERs,........

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