Locum work certainly presents notable difficulties, particularly for anesthesiologists. The fleeting nature of locum tenens roles frequently results in disrupted settings, where hostility may develop between permanent clinicians facing long-term staffing challenges and the temporary locums occupying vacancies while receiving higher compensation. In the field of anesthesia, cultivating a robust relationship with the environment, which includes recognizing cultural subtleties, scheduling frameworks, and expectations regarding colleagues, surgeons, nurses, and administrators, is vital for ensuring consistent and superior patient care. Nevertheless, locums, often met with skepticism, may find it hard to integrate into the distinct cultures of each placement, which can be significantly more challenging for those grappling with self-doubt or feelings of isolation.

My experiences with locums reignited my interest in mental health, influenced by interactions with diverse individuals in transitional settings, whether travelers or those temporarily sharing the same space. I observed resilience and honor but also faced the tragic loss of three colleagues, two of whom were friends, and realized their deaths could have been avoided. We operate in isolated environments, weighed down by experiences that render us more alike than different. Many contend that their undermining thoughts and emotions are singular, exacerbated by the quest for excellence that neglects human flaws. This can lead to destructive self-blame when confronted with perceived shortcomings. The actual conditions of our medical profession necessitate the acceptance of human imperfection, which, if ignored, can result in overthinking, avoidance of conflict, and fear of causing harm to patients without facilitating emotional processing of critical challenges.

In a keynote presentation on physician wellness, I addressed the principles of positive psychology, underlining their limitations in tackling the core issues discussed across various studies. I delineated these concerns, their widespread effects, and shared insights from a psychotherapist acquainted with changing work environments. Peer support is emerging as a potent concept, fostering connections within the challenging framework that physicians navigate. By assisting vulnerable patients, we risk inflicting harm, reminding us that none of us are perfect. Acknowledging this reality as a lifelong journey involves diverse levels of awareness. Peer support, which counters feelings of isolation and self-doubt, encourages shared experiences and emotional ties, essential in preventing despair and suicide, as seen in the elevated rates of burnout, depression, anxiety, and completed suicide among medical practitioners.

While peer support mitigates isolation, it may not always be enough. The environments we inhabit are high-pressure, solitary, and at times repressive, impacting perceptions both internal and external. Commonly experienced situations, once disclosed, can validate emotions and assist in reframing negative internal dialogues. However, recognizing the need for professional assistance is crucial for those grappling with despair and self-doubt. Even in the absence of explicit medical diagnoses, these experiences mirror human reality in a high-stakes domain, necessitating attention from professionals dedicated to uncovering underlying issues and empowering change, beyond the scope of peer support.

The heartbreaking loss of my friend, misconstrued by the media as a purposeful overdose, concealed her years of commitment to patient care. Despite such misinterpretations, understanding her actual struggles highlights the necessity for support systems that recognize the human elements beneath professional exteriors, offering care and guidance beyond mere peer validation.