My Black Box Warning for Medical School: Medicine Isn’t for the Faint of Heart

In my book, "The Soul-Sucking, Energy-Draining Life of a Physician: How to Live a Life of Service Without Losing Yourself," I reflect on the profound duality of the career we call medicine. Medicine is a calling—a deeply personal and all-encompassing journey that demands resilience, passion, and an almost unwavering commitment. However, let me issue my own “black box warning” for medical school and the profession as a whole: medicine isn’t for the faint of heart.

When I first wrote about this (if you missed the first part of this discussion, you can read it here), I didn’t realize how timely it would be. Just days after publishing my article, U.S. Surgeon General Dr. Vivek Murthy issued a strong warning about the dangers of another societal addiction—America’s favorite drink: alcohol. Statistics reveal its staggering impact on public health, and while coffee might be a close second for many of us in medicine, the deeper point remains: our society often seeks solace in things that can harm us, even when the warning signs are clear.

Yet, as physicians, we don’t have the luxury of ignoring reality. We don’t get to turn away from suffering, pretend problems don’t exist, or drown our stress in unhealthy coping mechanisms. We carry an even greater responsibility—one that is both noble and overwhelming.

The Burden of Responsibility

Medicine isn’t like most traditional jobs. Being a physician becomes part of your identity—it follows you, whether you’re in the hospital, at the grocery store, or even on vacation. You’re constantly “on call” in one way or another, whether it’s answering a panicked family member’s health question at a dinner party or treating a patient in distress at 35,000 feet on an airplane.

And that’s part of what makes this career so fulfilling. There’s an honor in being entrusted with the health and well-being of others. People come to us at their most vulnerable moments, placing their lives and the lives of their loved ones in our hands. That’s a privilege we don’t take lightly.

But that privilege comes with immense pressure.

• ?The fear of making a mistake can be paralyzing.
• ?The demands of patient care can leave us exhausted.
• ?The emotional toll of witnessing suffering, death, and loss can wear down even the strongest among us.
• ?The administrative burdens, bureaucratic inefficiencies, and endless paperwork can strip away the joy of practicing medicine.

To my fellow physicians and healthcare professionals: I salute you. You’re courageous enough to believe that you can make an impact on your patients, your communities, and beyond. But let’s be honest—this profession will tax you.

The Heart of Medicine: A Profession That Never Rests

Health lies at the heart of every strong nation. Weak nations have historically collapsed under the weight of poor health, poverty, and inadequate infrastructure. Look to the fall of empires like Rome, where public health crises contributed to societal decline. A robust healthcare system, supported by healthy and supported healthcare professionals, is essential to national strength.

In many ways, medicine works tirelessly like the human heart—our metaphorical and literal core. The heart beats continuously, adjusting during periods of stress or exertion, and it deserves moments of rest at a comfortable baseline. So, too, must physicians learn to find balance, to care for themselves as they care for others. Without this, the risks of this career—burnout, mental health struggles, even physical decline—can overshadow its benefits.

But how often do we truly rest?

How often do we prioritize our own health the way we tell our patients to?

It’s a bitter irony that those dedicated to healing others often neglect themselves. This has to change.

Reform and Resilience: The Future of Medicine

This brings me to another critical point: healthcare policy and reform. If we truly value the heart of our nations, we must address the systemic issues plaguing medicine today. A healthcare system that burns out its physicians ultimately jeopardizes the very health it seeks to protect.

Consider these staggering facts:

• Nearly half of physicians report symptoms of burnout.
• Physician suicide rates are twice that of the general population.
• Administrative burdens, excessive documentation, and loss of autonomy are driving record numbers of doctors out of the profession.

We must do better. We need to ensure that the next generation of healthcare professionals isn’t crushed under the same pressures we’ve endured. Medical education must evolve to address the mental health crisis within the profession. Work environments must shift to prioritize physician well-being as much as patient care. And we, as physicians, must continue advocating for systemic changes that allow us to practice medicine the way it was meant to be practiced—with care, compassion, and humanity.

Yes, the risks of this career are great, but so are the rewards. Entering medicine with eyes wide open—with an understanding of its demands and a commitment to its joys—can make the benefits far exceed the risks.

A Salute to the Brave: Keeping the Heart of Healthcare Beating

And yet, despite everything, people still choose medicine. Not because it’s easy. Not because it’s glamorous. But because it’s a calling. There’s something about this work—the rawness, the humanity—that keeps us here, even when the weight of it feels unbearable. We stay for the moments that matter: the connection, the impact, the chance to save a life.

To those who continue to choose this path despite its challenges, thank you. Your courage, dedication, and compassion keep the heart of healthcare beating.

Medicine isn’t for the faint of heart, but with strength, balance, and reform, it can remain the incredible calling that drew us here in the first place.

Let’s ensure that medicine remains a beautiful, life-giving profession for generations to come.

Want to go deeper??

My book, The Soul-Sucking, Energy-Draining Life of a Physician: How to Live a Life of Service Without Losing Yourself, explores these themes in depth. Get your copy here.