Compassion fatigue

I worked hard for my title “Doctor of Physical Therapy”. It’s objectively not as difficult as pursuing a Medical Degree (MD) or becoming a Doctor of Osteopathy (DO). I know this because I slept 8 hours a night every night during my doctoral education.

Despite its depth, the scope of physiotherapy is narrower. There’s no on-call nature of our work, we’re not a branch of emergency medicine (though still very essential). I can confidently say, as I near 5 years of postgraduate work, that getting the degree didn’t feel nearly as challenging as being the provider.

I got into this work because I struggle incredibly with my own body. I wanted to close the gap I felt as a patient by becoming the provider.

Physical therapy intrigued me in its subject matter. The physics of the body. The “why” behind all the movement that precipitates our interactions with the world around us. The “why” behind my own knee pain. Movement experts.

To know that we already knew so many of the answers to my mind’s wondering was a delight. Education is really the process of getting “caught up” on history so you can jump in and be part of the future’s revelations.

But the revelation part requires getting your hands dirty and amassing the experiential knowledge that comes with time and volume of patients. I thought once I had the information, working would be the easy part and I’d make a seamless transition from student to provider.

In 2022, I started to realize despite liking the work and loving the content, I’d get home feeling completely empty. I pushed myself too far. In March of that year, I broke my wrist and took no more than 2 weeks off. In November of that year, I suffered a horrific knee injury and didn’t take a single hour off. I just showed up to work with crutches.

Bend until you break, huh? I was breaking, physically and mentally under the stress I placed on myself. I am my own boss after all. I considered closing ROOTS down last Christmas. But why? I objectively enjoyed it. And what else would I do if I did close it?

I went back to my therapist and learned that I was burning out. When she asked me what I was truly feeling at work and I surprised myself with my answers. The summary of the sentiments culminated in compassion fatigue. I found it hard to empathize with patients, to view their pain as valid. If I evaluated someone with a resolvable injury, I felt jealous and spiteful. I shoved those emotions in some shelf of my brain. But those were the things emerging in intense end-of-day sadness as I crawled into my bed and attempted to reset for the next day.

In 2024, I reduced my patient caseload by 30% down to 18-20 hours/week and I hold tight to that boundary. I wish I could do more and maintain my own mental/physical health as well as the quality of the sessions but I know that I can’t.

I wish I could tell you that everything wrapped up in a tight little bow and I feel amazing both mentally and physically (I don’t). I feel better than last year but I wrestle with my knee injury every single day, almost 2 years later. On bad days, I still struggle to show up authentically for my patients.

But I know that even on my worst days, I can help people improve theirs. That’s what keeps me going (alongside my therapist and incredible support from my partner and best friends).

For my patients, know that I’m only human. Know that I bring my best every day and some days my best isn’t what I want it to be. Know I appreciate it when you ask me how I am. Know I still cherish being part of your healing.

For anyone who works in service of any kind, know that it’s not shameful to experience compassion fatigue. Know that you can still be great at what you do and not love the small voice in the back of your mind. Know that there are tools and spaces to help you move through that experience.