I have a confession to make.
Imagine the two physician work spaces in my ED:
In the first, I sit at a computer surrounded by 16 (mostly occupied) other computers in an area that has half walls to separate it from the patient care areas. As I hear a presentation from a learner, invariably, someone else is also presenting, at least one person is dictating in a normal or loud voice, another is talking on the phone, other people are having conversations, the music or tv is on, a care tech hands me an EKG, my phone rings, a patient asks how to get to the bathroom, the alarm that indicates a psychiatric patient is out of the restricted area goes off, a commotion happens down by the psych rooms (probably related to the above alarm), and an overhead page goes out asking for help or announcing a rapid response or code blue.
In the second area, I sit with up to 3 learners (and maybe a scribe) at any one time, but I’m at a desk essentially in the middle of a patient care area. The patient across from me likes to come out of his room and get on the phone to call for a ride every five minutes. The research room has multiple conversations going on. The EMS radio is going off and a paramedic is talking about a patient coming in. The alarm for the tube system goes off around the corner. A nurse or a care tech brings me another EKG for review while I’m listening to a presentation as my phone rings again.
Confession #1: I have just described to you two versions of my own personal hell.
By now, you either “know” me or you have guessed at the truth: I’m an emergency medicine physician. And yet, I work daily in what I just told you is my own personal hell.
Confession #2 (that explains confession #1): I am an introvert. Though every time I write or say that, I feel like it should be “Hi, I’m Christine S. and I’m an introvert” like the folks at all the various anonymous recovery groups do.
Some of you out there reading this are currently nodding your heads because you too feel like you should stand up and confess this. Shout it from the mountain top. And you have probably told someone and received the same responses I have, responses ranging from disbelief to amazement to outright denial. You can’t be an introvert because:
- You’re not shy.
- You like people.
- You talk to everyone.
- You’re involved.
- You’re engaged.
- You’re social.
- You’re so happy and bubbly.
- You’re not quiet.
- You’re an EM doc.
But, the few people I work with who really know me understand that I’m telling the honest to god truth and if I could stand up in front of everyone and get them to understand it, it would be a huge weight off me.
Our society isn’t very supportive of introverts. If you’re not one, you probably won’t get it. If you are, I’m writing your story. I have felt like there is something wrong with me for ages, only occasionally finding someone who “got me”.
- Wanting to be included but finding large groups hard. Add on top that, small talk doesn’t make sense to me.
- Wanting to go out with my colleagues after a shift but being so exhausted that facing another minute of human interaction isn’t an option.
- Having to explain my thinking in group projects and discussions.
- Getting super frustrated with all the loud music that people want to play in the work station.
- People looking at me funny when my significant other wants to go out with his guy friends and I’m okay with that because I need the time to myself.
When I say society isn’t supportive of introverts, the reasons why I can’t be an introvert is the stereotype. Not every introvert is a shy, ungainly anti-social person who mumbles when they talk and lives in their mom’s basement playing video games and never going out. (Okay, so maybe the last half is a bit of an exaggeration of the introvert stereotype). Either way, these stereotypes are often wrong. For example:
– Shyness: I can make friends anywhere. I just ask a question and let them talk. I mean I do this every day for my job. Outside of work it depends on if I want to listen to someone.
– Liking people: That’s debatable. I like certain people, but people as a whole exhaust me and drive me crazy.
– Talking to people: I’ve learned how, but it took some time, and there are times when I still shake in my boots
– Social/engaged: Notice who I’m social with and what I choose to be engaged in. I pick the things that work for me.
What makes someone an introvert depends a little on which of the many definitions out there that you use. According to Jung, introverts are drawn to the inner world of thoughts and feelings. More recently, there have been a number of definitions, but what makes me an introvert:
- I gain energy/recharge being alone, while spending time with and even just around other people, especially strangers, drains me.
- I don’t do well with a lot of outside stimulation and focus better when there is just one thing around (hence why the ED is my own personal hell and why I don’t do well in open “collaborative” work spaces)
- I think things out slowly, deliberately and completely before I speak or show my work to others, working best on my own rather than in groups.
- I can concentrate really well and easily focus on one thing for hours.
- I express myself better in writing than in conversation
- Superficial conversations and interactions don’t make sense to me. I prefer deep discussions, trying to find meaning in what I do, to small talk.
- I listen really, really well.
- I am what is considered “highly sensitive” – in other words, I’m the person that tears up at the silliest sentimental commercial or sweet story
Not every introvert is a pure introvert and there are certain “introvert” traits I don’t have. You can see how I don’t necessarily fit in with some of society’s expectations of successful people. But there is nothing wrong with me. I didn’t really get this until I figured out I was an introvert and learned more about being one. And there’s nothing wrong with you, if you’re one of the third to half of the population that identify with what I’ve written.
So how do I work in my own personal hell on a daily basis?
I know myself.
I know I’m an introvert (I took the Myers-Briggs test and was so far on the introversion side of the scale that there is no question about it).
I know my core personal values, what is important to me and the way I live my life. These line up with my job and what I do every day. This combination allows me to be a pseudo- or situational extrovert – acting as an extrovert in situations where it is important to be an extrovert to succeed.
I have learned to do certain things in an extrovert style, like thinking aloud so I can help my learners understand how I got to my conclusion.
I know when I need a break – when I can accept that offer to go out for drinks after shift and when I need to say no.
I know what makes my “mask” slip. For me, if I don’t eat, I get “hangry” and have trouble focusing especially with all the noises and interruptions. So I always have food around. I also pay attention to the times when I start to feel overwhelmed or stressed and take a minute for myself to take a few breaths and recenter myself.
Don’t get me wrong. There are certain days when going to work in my own personal hell is really, really hard. I used to be a bit of a grump on these days. Then I heard Liz Crowe talk about how the department really takes on the mood of its leaders, i.e. the physicians. So I started putting on a smile and finding something positive to say as I walked into the department and greeted people. Now, it’s just habit and my mood actually gets better when I walk in, in response to the smile and happy thoughts.
So I am an introvert living and working in an extrovert world. I use my inner extrovert sparingly to help me succeed in an extroverted field in a world that rewards extroverts. But at the same time I use some introvert skills to succeed as a well. Channeling both parts and recognizing who I am is how I work on a daily basis in my own personal hell.
For anyone who reads this and wants to know more about introversion, I highly suggest Susan Cain’s book Quiet.