Burned-out doctors feel 'emotional sucker punch' as more patients present with incurable cancers

Exhausted. Helpless. Feeling like a failure. Some palliative care doctors and nurses say they're burned out because more patients face incurable cancers. To cope, they're supporting each other through COVID-19's latest wave in Canada. 

This week, a Leger survey for the Conference Board of Canada suggested 97 per cent of 200 doctors and nurses who provide direct patient care in hospitals reported fatigue and burnout have increased in their workplace. Most cited inadequate staffing levels resulting in stress from not being able to offer optimal care. 

And those offering comfort care tell CBC they're seeing more patients who are terminal at their first appointment than they did before the pandemic. Cancer specialists are in a prime position to observe the effects on patients, their families and each other.

For Dr. Gerald Batist, a medical oncologist and director of the Segal Centre Centre at Montreal's Jewish General Hospital, the pandemic is the first time he's seen burnout up close, in a colleague.

"We're all clinicians. We should recognize what burnout means, right?" he said in conversation with Dr. Brian Goldman, host of CBC Radio's White Coat, Black Art.

Batist's team didn't immediately recognize the burnout, which can be serious and may include emotional, physical and mental exhaustion and feeling hopeless and resentful, along with headaches and backaches. 

Batist leads the cancer centre and says he felt stuck between physicians who were frustrated that their colleague wasn't picking up shifts, and the colleague going through rehabilitation feeling hostility. 

"We're not used to dealing with our colleagues, our professional colleagues as ... patients."

Once the problem was recognized, the team's solution-finding kicked in to help the person recover, he said. 

Batist said colleagues who at one point were sniping at each other are now all determined to support one another, asking how one another is doing in a stairwell and commiserating in their shared experiences. 

As an oncologist, Batist sees the "tsunami" of advanced cancers that are less curable than if they'd been diagnosed at an earlier stage. He said it's happening because: 

"It's very hard to see people in increased numbers facing the end of their lives ... sooner than they and we would have hoped."

He recently saw a woman in the emergency department who was diagnosed with rectal cancer that had spread dangerously. She walked into the hospital for pain and recalled her leg had rapidly weakened over three weeks.

Batist said her cancer was treated. But irreversible damage happened because of the delay in coming to hospital. "That's really hard to swallow, of course, for the family and the patient, but certainly also for the doctors trying to make life better for our patients."