Lessons from burning out - Rishad Usmani
In this episode, I share my deeply personal story of experiencing burnout in the summer of 2022. I open up about the journey that led me to that moment, exploring the impact of my childhood in India, my relentless pursuit of success and validation through work, and the challenges I faced along the way in my medical career. Discover how I am now striving for a more balanced life, navigating the pressures of being a high achiever, and the lessons I've learned about the importance of rest and mindfulness.
- (0:00) The Burnout Moment: The specific shift in urgent care in the summer of 2022 when I realized I was experiencing burnout.
- (0:31) Where It Started: How my childhood in India shaped my early ideas of success (status, power, money).
- (1:35) My Rocky Medical Path: The challenges and uncertainties I faced while pursuing medicine, including failing exams and dealing with residency rejections.
- (2:27) Chasing Success (and Validation): Achieving financial milestones after residency and how I used excessive work to validate my insecurity and feel "enough."
- (3:16) Seeking Status: Taking on multiple roles and committees, including my experience on the front lines of the COVID-19 pandemic.
- (4:29) Still Unfulfilled: The realization that despite achieving financial success and status, I wasn't feeling fulfilled, which led me to explore starting a startup.
- (5:04) Juggling Everything: My attempt to balance entrepreneurial ambitions with full-time clinical work and major personal life changes (my wife's pregnancy, having a baby, moving).
- (5:41) Hitting My Limit: Working 100+ hours a week with a newborn and how the resulting guilt and missed family moments paradoxically drove me to work even more.
- (6:08) The Ongoing Struggle: How the need for constant production and validation (mostly internal) still influences me today.
- (6:46) My Need for Validation: Using things like putting out a blog post every day for my startup to get instant feedback and feel valuable.
- (7:06) Questioning the Hustle: Reflecting on the startup world's emphasis on constant, fast work versus the potential benefits of slowing down.
- (7:35) After Burnout: My initial difficulty in changing my work patterns even after the burnout incident.
- (8:12) The Drive to Improve: The internal pressure to always be doing something new and seeking worthiness through continuous progress.
- (8:36) Society's Role: How the emphasis on constant growth in many areas of life might contribute to the burnout epidemic.
- (9:03) Finding Balance Now: My current efforts to balance reduced clinical work (22 hours/week) with my entrepreneurial ventures (angel group, exploring a fund) and creative outlets.
- (9:42) Joy and Escape: How activities like podcasting (connecting with people and sharing ideas) and painting (finding a state of flow and escape) are crucial for my well-being.
- (10:47) My Main Takeaway: The most important lesson I learned: it's okay to not constantly chase things, to slow down, be present, and rest.
- (11:23) Learning from Mindfulness: Mentioning my Vipassana meditation experience and wishing I had incorporated long-term planning and health considerations earlier.
- (12:11) Staying Vigilant: Acknowledging that I'm still susceptible to old patterns but am on a better path.
- (12:44) Internal Drive: Clarifying that the need for constant production is largely about internal validation, not just external praise.
- (13:01) My Closing Message: A final thought for high achievers: rest is essential for your physical and mental health before you can do your best work.
1
00:00:00,000 --> 00:00:07,200
It was the summer of 2022. I was working a shift in urgent care and as I was going to pick up my
2
00:00:07,200 --> 00:00:12,320
next patient's chart I realized that my heart is beating fast and I feel a little bit dizzy and a
3
00:00:12,320 --> 00:00:18,400
little bit lightheaded. I checked my pulse quickly and it seems to be racing. I asked the nurse for
4
00:00:18,400 --> 00:00:25,440
a pulse oximeter and when I put it on my finger it reads 135 beats per minute. That was the day I
5
00:00:25,440 --> 00:00:31,760
realized that I was burnt out. To understand how I got there I think we need a little bit of background
6
00:00:31,760 --> 00:00:39,120
on myself and my childhood. I grew up in India in a middle-class family and we lived in an apartment
7
00:00:39,120 --> 00:00:44,000
right across from the slums where there were kids going to the bathroom on the streets.
8
00:00:44,960 --> 00:00:50,640
We did okay according to standards in India at that time but compared to the standard living
9
00:00:50,640 --> 00:00:57,840
in Canada and the rest of the world we would be categorized as a low socioeconomic status.
10
00:00:59,360 --> 00:01:09,280
Growing up there a success for me looked like somewhat status, power and money. I never thought
11
00:01:09,280 --> 00:01:17,760
I would be able to afford a house or drive cars such as BMWs and Mercedes and I've always chased that
12
00:01:17,760 --> 00:01:25,280
growing up to an extent even though I'm not sure if I ever recognized it or even if I fully accepted
13
00:01:26,640 --> 00:01:35,680
as I talk to you guys today. My path to graduating from residency was at times uncertain. I failed
14
00:01:35,680 --> 00:01:42,560
my one of my screening exams called the USMLE Step 2CS after I graduated from med school in the
15
00:01:42,560 --> 00:01:47,280
Caribbean and it took me three years to finally get a spot in family medicine at the University of
16
00:01:47,280 --> 00:01:54,400
British Columbia and even then I was rejected the first time and I emailed them asking them to
17
00:01:54,400 --> 00:02:02,000
reconsider me for an interview and thankfully they did and now I am a practicing family physician
18
00:02:03,520 --> 00:02:10,080
and I do a few other things I'll get into towards the end of this video. Even after I got into
19
00:02:10,080 --> 00:02:20,320
residency at one of the best schools in Canada I was in remediation during residency and then I
20
00:02:20,320 --> 00:02:27,360
also failed my board exam for family medicine after I graduated. Once I graduated residency I
21
00:02:27,360 --> 00:02:35,920
finally had the opportunity to make an amount of money I never thought I would be able to make in my
22
00:02:35,920 --> 00:02:43,040
lifetime so anywhere from a few hundred thousand dollars up to a million dollars a year if I worked
23
00:02:43,040 --> 00:02:50,640
in the right settings and if I worked hard enough. So I started working as much as I could not realizing
24
00:02:50,640 --> 00:02:58,880
that this was my way of validating myself and dealing with my insecurity of not being enough.
25
00:02:58,880 --> 00:03:06,880
I worked and I worked and I worked to fulfill this desire I had to feel like I was contributing
26
00:03:06,880 --> 00:03:15,680
to the world and to myself and I was worthy of the success I had achieved up to at that point.
27
00:03:16,880 --> 00:03:24,880
I remember I got a job offer at one of the Harvard hospitals in Boston as a hospital medicine physician
28
00:03:24,880 --> 00:03:36,320
and I finally felt that I had made it. Growing up in India Harvard has this almost spiritual
29
00:03:36,320 --> 00:03:42,240
religious connotation where you have achieved success if you've made it to Harvard to an extent.
30
00:03:43,520 --> 00:03:50,560
That didn't end up working out because of licensing issues between the US and Canada
31
00:03:50,560 --> 00:03:58,560
and I moved to Vancouver to work as a full-time hospitalist at that point. I kept chasing status
32
00:03:58,560 --> 00:04:07,040
to an extent. I joined some committees. I was on the COVID advisory committee and I was the hospital
33
00:04:07,040 --> 00:04:13,680
health officer and I was taking care of one of the very first COVID patients at that point.
34
00:04:13,680 --> 00:04:22,160
I was getting paid fairly well as well about $1,600 a day and again I never thought I'd
35
00:04:22,160 --> 00:04:29,680
been in a position to make that much money. As I kept working I started realizing that I'm still
36
00:04:29,680 --> 00:04:39,200
not feeling fulfilled and I'm not sure if this was still insecurity or just the need to do something
37
00:04:39,200 --> 00:04:50,000
different every day or something more. Again, money was still a factor here for me. I thought
38
00:04:50,000 --> 00:04:57,120
about improving inefficiencies in medicine and also making money at the same time and
39
00:04:58,880 --> 00:05:04,320
I landed at doing a startup. As I launched my startup I continued working full-time.
40
00:05:04,320 --> 00:05:14,720
My wife became pregnant and we had a baby to move provinces to be closer to family.
41
00:05:16,800 --> 00:05:23,360
This all ended up with the summer of 2022 where I was working full-time on my startup
42
00:05:23,360 --> 00:05:30,960
in addition to a full-time hospitalist gig and urgent care and rehab hospital at times.
43
00:05:30,960 --> 00:05:41,440
I was working about $100 a week I'd say with a newborn home although I was not helping much
44
00:05:41,440 --> 00:05:52,720
at home. I was missing events and birthdays for my family which made me feel worse and drove me
45
00:05:52,720 --> 00:06:00,720
to work more so I can make more money and provide them more things to fulfill this desire or this
46
00:06:00,720 --> 00:06:08,880
guilt I had almost that I wasn't doing enough. This insecurity still drives me to an extent
47
00:06:09,920 --> 00:06:16,720
although I worked on it quite a bit and as I said here today I'm working about 22 hours in clinical
48
00:06:16,720 --> 00:06:25,200
medicine a week and I'm working on my entrepreneurial and creative endeavors and I have a lot more
49
00:06:25,200 --> 00:06:32,960
balance but I still feel this need to work a lot and get instant validation. I do this with my
50
00:06:32,960 --> 00:06:38,960
startup where I was putting out a blog a day and the part of the reason I was doing that is because
51
00:06:39,520 --> 00:06:46,640
I wanted instant feedback. I wanted the world to tell me what I was doing is valuable and for
52
00:06:46,640 --> 00:06:57,760
people to tell me that what I'm doing is important is helping them constantly and my wife has been
53
00:06:57,760 --> 00:07:04,080
telling me this for I'd say the past 10 years that that's arguably the wrong way to do things
54
00:07:06,080 --> 00:07:15,440
which is interesting because in the starter world you're told to just work a lot interoperately fast
55
00:07:15,440 --> 00:07:24,000
and just constantly be working but you know I do think there's something to say about taking your
56
00:07:24,000 --> 00:07:32,160
time and taking it slow or how Adam Grant calls it moderate procrastination in his book.
57
00:07:35,680 --> 00:07:44,400
So you know after my burnout what I did in the summer of 2022 is I went home and I laid in bed
58
00:07:44,400 --> 00:07:54,240
for a week and I thought about you know how did I get to where I am. I got up after a week and then
59
00:07:54,240 --> 00:08:04,720
kept doing the same thing for another I would say another year or two years and I still fall
60
00:08:04,720 --> 00:08:12,080
victim to this mentality that I have to keep producing. I have to keep doing something different,
61
00:08:12,080 --> 00:08:20,400
something new, I have to keep seeking validation to be worthy and I'm not really sure to be worthy
62
00:08:20,400 --> 00:08:30,800
of what but it's just as drive to constantly improve on myself and I think the world in a
63
00:08:30,800 --> 00:08:36,800
lot of ways rewards this mindset that you have to keep growing you have to keep improving
64
00:08:36,800 --> 00:08:46,480
and whether it be at work and relationships with money with your physical health and I do wonder
65
00:08:47,440 --> 00:08:58,000
if it's responsible for the burnout epidemic and if there's a way to live life and build things
66
00:08:58,960 --> 00:09:03,440
and grow startups even in a more mindful in a more balanced way.
67
00:09:03,440 --> 00:09:12,400
This is what I'm trying to do with my balance and with my work so as I said I'm 22 hours clinical.
68
00:09:14,080 --> 00:09:23,200
I am playing around with launching a venture fund. I have an angel group of about 600 physicians
69
00:09:23,200 --> 00:09:28,480
that I manage although it doesn't take too much of my time at this point. I have a podcast
70
00:09:28,480 --> 00:09:33,120
which I have not been consistent with and a newsletter that I have not been consistent with
71
00:09:33,120 --> 00:09:42,880
although the podcast is what gives me quite a most of my joy if I were to categorize into what
72
00:09:42,880 --> 00:09:48,880
brings to the most joy at work. I would say it would be this podcast because I like talking
73
00:09:48,880 --> 00:09:56,480
to people and I like sharing my ideas as well. I have not painted in about a year and I used to
74
00:09:56,480 --> 00:10:07,680
paint quite a bit and it's one of my creative outlets in which I feel like I can get lost
75
00:10:08,720 --> 00:10:15,760
into the art of what I'm doing and not worry about anything if I'm being frank with you guys.
76
00:10:17,760 --> 00:10:22,720
When I'm painting I feel like the only thing that exists is me in the canvas and the paint
77
00:10:22,720 --> 00:10:32,000
and I'm not thinking about the world and to be completely honest my family or my kids or my
78
00:10:32,000 --> 00:10:41,040
wife or anyone and I think having something that gives me that sense and maybe some will call it
79
00:10:41,040 --> 00:10:47,280
escape is important and I am trying to incorporate more of that in my life as well.
80
00:10:47,280 --> 00:10:57,840
So the reason for this video was to share my burnout story, what I learned from it,
81
00:10:57,840 --> 00:11:05,680
although I'm not sure if I've done that successfully. But the big takeaway I would say is that
82
00:11:07,440 --> 00:11:15,520
it's okay to not constantly chase things and not constantly grow. It's okay to just slow down
83
00:11:15,520 --> 00:11:23,280
sometimes and just be present and be mindful. And it's funny I say this because I did take a
84
00:11:23,280 --> 00:11:32,720
vipassana which is a silent meditation in which you meditate for about 10 to 12 hours a day and
85
00:11:32,720 --> 00:11:40,800
you don't talk to anyone and you're not allowed to exercise and you're essentially in the state of
86
00:11:40,800 --> 00:11:52,640
complete silence. And I wish that as I was doing my startup and ramping up my work and taking a lot
87
00:11:52,640 --> 00:12:00,480
of overnight shifts and call shifts and having these hundred hour weeks I took time to plan my life
88
00:12:00,480 --> 00:12:11,520
a little bit more and plan for a little bit longer than say the next month and thought about my
89
00:12:11,520 --> 00:12:20,080
longevity and my health while I did that. The past two months I've worked out almost every day
90
00:12:21,120 --> 00:12:28,400
and I'm on a much better path now although I'm still susceptible to falling victim to my
91
00:12:28,400 --> 00:12:37,840
insecurities and my mentality of constantly doing something and constantly improving and progress
92
00:12:37,840 --> 00:12:44,640
and and and requiring these short feedback loops for the work I'm doing. And this isn't
93
00:12:44,640 --> 00:12:50,480
necessarily external validation I'm seeking. This is internal validation largely where I don't
94
00:12:50,480 --> 00:13:01,600
feel like I'm doing enough if I'm not constantly producing. So to end this short podcast I will
95
00:13:01,600 --> 00:13:13,040
say it's okay to just rest and this is mostly what resonates with people who are high achievers
96
00:13:13,040 --> 00:13:21,840
who constantly overwork themselves for money or for power or for status or because they're running
97
00:13:21,840 --> 00:13:27,760
away from something or running towards something. I think sometimes you should rest and you need
98
00:13:27,760 --> 00:13:43,760
and you need to take care of your physical and your mental body before you can do the work you need to do.
