Lisa RubianoThere’s a specific moment when you stop believing it.
You’ve sent the email. Raised your hand in the meeting. Said the thing that needed saying, again. And somewhere in there, you already know nothing is going to change.
This may seem unconventional to say, and may even be a faux pas, but finding yourself hopeless about a situation changing may be the key to getting unstuck.
Feeling hopeless isn’t a great place to be. It’s about one of the lowest feelings there is.
At the same time, feeling hopeless is probably the first step to change, if the hopelessness helps you see reality with a clearer lens. Let me explain.
The Limerence of Medicine
Have you heard of the concept of limerence? It’s defined as an obsessive, addictive need for validation and reciprocation from someone, often fueled by ambiguity.
I think physicians can develop something resembling limerence when it comes to our careers in medicine.
We went into medicine with the desire to help people. To have an impact. We invested our time, our energy, our twenties.
- Large loan burdens
- Comparably low wages during residency, with insane hours
- Teaching that involved shame and humiliation as motivators
- Sacrificed time with loved ones and friends
Our mental health gets impacted, not only by the trauma we see, but by the toxicity within the culture of medicine and our increasingly broken healthcare system.
We’re expected to carry the liability while answering to organizations that need us to remain profitable. Autonomy when something goes wrong. Compliance when they need something from us.
I think somewhere deep down, we’re waiting to be validated. To be reciprocated. Dare I say, loved?
Not the love of a romantic relationship. The basic love of a fellow human. The kind that says the work you do matters. More simply: what you do matters. You matter. We appreciate you. Thank you.
Unfortunately, the way healthcare is these days, there isn’t enough reciprocity.
Instead of “we appreciate you,” more work is added. Instead of a raise, reimbursements are cut.
Instead of support for the secondary trauma we encounter, we have a culture of silence, an expectation that we can and should absorb it all.
As healthcare becomes more like factory work, where each person becomes a cog in the machine, more replaceable, and productivity and profitability become the main goal, the concept of reciprocity can sound absurd.
Losing False Hope
Doctors continue doing what’s asked. Sustaining for as long as they can. Advocating for changes. Doing what we were trained to do, which is what’s right for the patient. We keep hoping things get better.
And nothing does. In fact, the changes made are usually making things worse instead of better. Until one day, the reality of the situation finally sets in. You lose hope that it will change.
There’s an important distinction here. I’m not talking about losing hope in your life, your future, or yourself. I’m talking about losing hope that a situation that has repeatedly shown you what it is, will suddenly become something different.
Maybe what feels like hopelessness in that moment is actually the loss of false hope.
What you were hoping for was a wish. A wish for a broken system to make the practice of medicine better. And that can be clarifying.
This is the crossroads: hopelessness can deepen into despair, or the loss of false hope can return us to our own agency.
Reclaiming Your Power
Because if your hopelessness about a situation finally allows you to believe what you’ve been seeing, about where you work, who you work for, or the system you’re working within, then perhaps that hopelessness has served a purpose.
You’ve stopped waiting for reality to become something other than what it is.
When you stop needing the situation to change before you can move forward, you can finally ask a different question: if this doesn’t change, then what do I want?
That’s where you begin to reclaim your power.
You realize that even when you don’t have the power to fix the enormity of a broken system, you may have more power than you realized to change your relationship to it. You can make a different decision. You have the power to choose.
It can even be a little overwhelming to decide what’s next.
A sabbatical? A boundary? A new job? A different career?
The options are endless, and depend on what you want and need. And that, my friend, is where hope is.
Sometimes we have to lose hope in what isn’t changing before we can rediscover hope in ourselves.
Hope is the flame within you that moves you forward.
If You’re Ready to Ask What’s Next
You don’t have to figure this out alone. If you’re ready to reclaim your own agency, and find your way back to real hope, let’s talk.
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