Burnout and Beyond with Jessi Gold, MD
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What is Dr. Jessi Gold’s background and why does she focus on caring for caregivers?
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You're listening to The Nocturnist Conversations. I'm Emily Silverman. In the last few years, mental health has become a big part of the public conversation. But what happens when the clinicians who are caring for others are struggling themselves? Today's guest, Dr. Jesse Gold, is an associate professor of psychiatry and the chief wellness officer at the University of Tennessee. She specializes in mental health care for health care workers, and in addition to her work in outpatient psychiatry, has become a trusted voice in the media on issues like burnout and mental health in the clinician workforce. Jessie's new book, How Do You Feel? One Doctor's Search for Humanity in Medicine, takes a deep dive into these topics, weaving in Jesse's personal story alongside the stories of four composite patient characters and broader insights into the emotional toll that healthcare takes on clinicians.
In my conversation with Jesse, we discussed the difference between burnout, moral injury, depression, and PTSD, how mental health stigma continues to affect healthcare workers, the fear that clinicians feel when filling out their licensing paperwork, not knowing if they'll be penalized for seeking care for mental health, and the great work that's been done to reform that licensing process. We also dive into Jessie's exploration of telemedicine and her new role reshaping wellness at the University of Tennessee. But before we dive in, first take a listen to Jessie reading from her book, How Do You Feel?
When I see Luke on my screen, I offhandedly ask, how are you? I regret it immediately. For one, it's an overused question and not typically meant to evoke actual vulnerability. Most of us, when someone asks us this, don't have the time or energy for giving a real answer. Society is generally okay with that. We've decided it's polite, even acceptable, to answer on autopilot, but it isn't to me. To help Luke as a psychiatrist, I need the real answer. Predictably, he responds, I'm fine. Fine is often a joke among mental health practitioners because it usually means the person, like me so many times, is anything but fine. We've even given it an acronym, feelings I'm not expressing. Luke then pauses briefly and asks, how about you?
This is the other issue with the how are you question. It begs to be reciprocated, but that's far removed from the purpose of our session. And in this kind of situation, we psychiatrists aren't supposed to talk about ourselves. Still, I noticed something about the quality of Luke's voice, something I've noticed in a lot of my patients lately. I can tell he's genuinely curious about my well-being, that he wants to know the truth. He won't be satisfied with the answer they teach us to give when we are in training, which is basically to ask why someone is asking about us in the first place, turning the question back on them. I feel myself desperately wanting to tell Luke the truth while ensuring him I'm safe and coping so he knows I can take good care of him.
Psychologically speaking, I suspect this is the core reason for his question. I'm living through a pandemic too, and he's worried about my ability to help him. How am I? I think, trying to come up with an appropriate answer. The truth is that I'm busy and tired, but I don't yet know what deeper emotions those feelings are masking. I don't tell him that though, because I worry he wouldn't trust a psychiatrist who can't figure out her own feelings. All that comes out of my mouth is, I'm hanging in. I get that, he nods, and we have a moment when we look at each other through the screens with what feels like mutual respect for our different roles in healthcare at this moment in time and how hard it's been.
Something tells me he feels satisfied with my response, even though it wasn't long or heavy.
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Chapters
7 chapters
1
What is Dr. Jessi Gold’s background and why does she focus on caring for caregivers?
0:00–10:04
2
How does the personal reading from *How Do You Feel?* set the tone for the conversation?
10:04–20:27
3
What did Dr. Gold discover about pre‑medical culture and why do students drop out?
20:27–29:30
4
How has the COVID‑19 pandemic reshaped clinician burnout, moral injury, and workforce sustainability?
29:30–36:59
5
What is the difference between burnout, moral injury, depression, and PTSD for clinicians?
36:59–42:39
6
How are licensing questions being reformed to protect clinicians seeking mental‑health care?
42:39–49:48
7
How has telemedicine changed psychiatric care for health‑care workers and what are its limits?
49:48–55:34