As an emergency room physician with over 20 years of experience, I’ve faced countless moments of emotional intensity—saving lives, delivering difficult news, and navigating the chaos of a health care system stretched to its limits. Yet, it wasn’t a catastrophic patient case or a bad day at work that led me to my breaking point. It was the slow, relentless erosion of my emotional capacity. I call this state the emotional flatline.
The emotional flatline is not about apathy or indifference; it’s a defense mechanism—a survival strategy in environments where the stakes are always high. For health care professionals, it begins as a protective layer, shielding us from emotional overload. But over time, it becomes a barrier, numbing our ability to connect with patients, colleagues, and even ourselves.
In my TEDx talk, I explored this phenomenon and its impact on the health care workforce. Burnout is well-documented, yet the emotional toll remains underexplored. The emotional flatline is a hidden cost of working in high-stress, high-stakes environments, one that takes a profound toll on our mental health and well-being.
Recognizing the warning signs
The journey toward an emotional flatline is insidious. At first, it looks like resilience—working through exhaustion, pushing past grief, and compartmentalizing pain to focus on the task at hand. But as time goes on, these coping mechanisms lead to disengagement, fatigue, and, ultimately, burnout.
Health care professionals often pride themselves on their ability to “power through,” but this mindset can have dangerous consequences. We start to lose the very empathy and compassion that drew us to medicine in the first place. Patients become cases, and colleagues become obstacles. Even our personal lives suffer as we withdraw from friends and family, unable to summon the energy to connect.
Breaking the cycle
Addressing the emotional flatline requires more than surface-level interventions like mindfulness apps or wellness programs. While these can be helpful, they often fail to address the systemic issues that drive burnout.
The first step is acknowledgment. Health care professionals must recognize when they are operating on an emotional flatline. This isn’t a sign of weakness but a signal that the system has pushed us too far.
The second step is advocacy. Hospitals and health care organizations must prioritize the emotional well-being of their staff. This means creating environments where it’s safe to express vulnerability, implementing manageable workloads, and offering meaningful support for mental health.
Finally, there is resilience, not as a buzzword, but as a practice of intentional renewal. For me, this has meant creating space for rest, reconnecting with loved ones, and redefining what success looks like in my career. It’s also about teaching others—through my books, talks, and workshops—how to navigate this journey.
A call to action
The emotional flatline is not inevitable. By addressing the root causes of burnout, we can revive our humanity as health care professionals. We can rediscover the joy of medicine and the connections that make this work meaningful.
The stakes couldn’t be higher—not just for us, but for the patients and communities we serve. To heal others, we must first heal ourselves. That begins with recognizing the emotional flatline and taking the bold steps needed to bring ourselves back to life.
Pamela Buchanan is a board-certified physician, speaker, and thought leader dedicated to transforming health care and championing mental well-being. With more than 20 years of medical experience, she is a TEDx speaker known for her powerful talk on “Emotional Flatline,” which explores the emotional toll of high-stress professions, particularly in emergency rooms during the pandemic. As the author of The Oxygen Mask Principle and Emotional Flatline, Dr. Buchanan teaches self-care as a revolutionary act for working mothers, health care professionals, and high achievers.
In addition to her work as a physician advocate and ambassador with the Lorna Breen Foundation, her work extends to coaching and consulting, focusing on helping physicians navigate burnout and preventing burnout in medical students and residents. She strives to keep more physicians practicing. Dr. Buchanan’s mission is to help people break free from burnout, prioritize self-care, and live with purpose.
Dr. Buchanan is the founder of Strong Medicine and can be contacted for coaching, workshops, and speaking engagements. She can also be reached on TikTok and Instagram.
