Query
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Anxiety.

![Figure1](http://www.cmaj.ca/https://www.cmaj.ca/content/cmaj/175/3/320/F1.medium.gif)

[Figure1](http://www.cmaj.ca/content/175/3/320/F1)

Figure. Photo by: Fred Sebastian 

It's been plaguing me recently, yet I can't really attribute it to anything new. Nothing has changed in my life — I continue to work hard, perhaps too hard, but that's not new. My marriage is sputtering, faltering, perhaps even dead, but it has been so for some time. I don't understand, and I can't seem to do anything about it.

Oddly, it starts with a feeling of freedom. As long as I'm not on call for the weekend, I feel free at the end of the day on Friday, as if I'm leaving work a free man. Time at home quickly cures me of that, as there is always one more argument as part of the larger campaign. Perhaps the anxiety begins there. I worry I'll be alone, that I'll live out the rest of my life alone. I worry that I deserve to be alone.

Then I begin to fear Monday. I fear what will happen. I wonder if a patient will arrive who's really ill and I won't know what to do, that I'll freeze or panic or babble or lose control.

Yet Monday morning, when I actually do get to the office and start to work, the anxiety fades. Then the evening comes and I worry about the same thing all over again. Tuesdays I work at a local office in the morning and then I drive to a nearby community for the afternoon. I worry that I won't finish my morning patients on time to make it to the other place, and then when I'm there I worry that I won't finish my afternoon patients in time to pick up my wife and daughter to drive them home. I end up rushing through both clinics. On Wednesdays, I work a walk-in clinic where I can see up to forty patients in three-and-a-half hours and I constantly worry about what will come in the door. On Thursdays I work an evening clinic where, except for a nurse, I'm all alone, and again I worry about what might happen. And did I mention the days I'm on call?

Yet compared to my colleagues, this schedule isn't unusual. Why am I anxious — am I the only doctor who feels this way? Is there something wrong with me?

I try to think about what I'd tell one of my patients if they presented with the same symptoms and history. I'd probably advise them to reduce their hours if possible, to change what they could about how they worked, to make themselves feel more comfortable, to seek counselling, to make a decision about what they wanted to do about their marriage.

Yet I don't want to ask for help. I don't want to see anyone, it's tantamount to defeat for me. I don't want to reduce my hours. I love the job despite this overwhelming anxiety. Above all, I don't want to change and I desperately want to avoid taking medication. All the arguments my patients give me every day. I should know better.

But I just know that I feel the same, and I feel stuck. I know I dread going into work every day, with only a brief release when I walk out of the office on a Friday afternoon.

When I am between work and home.

— *Dr. Ursus*