Chronic Inbox Inflammation

Trying to stay human in a system that never stops

I’ve been trying to put a name to a feeling I get on my day off.

It’s not full-on anxiety. It’s more of a background discomfort that’s always there. Something unsettled. Like you should be relaxing, but your mind keeps drifting back to the unfinished notes, the unanswered messages, the Epic inbox that you know is waiting for you.

I’ve started calling it Chronic Inbox Inflammation.

It seems to hit hardest in physicians who spend real time with their patients. The ones who actually listen, who stay in the room longer. That time has to show up somewhere, and usually it’s after hours or on your day off—when you thought you might finally take some time to yourself.

That’s the part that’s hard. Most of us docs were used to staying ahead. We tend to be organized and efficient. But the system we work in now doesn’t really allow for that. The inbox fills faster than you can clear it. There’s never a sense of being done.

My brother, also a physician, has talked about the guilt of doing notes at home while your kids are in the next room. That feeling of being physically present, but mentally somewhere else. He’s used the term pajama time to describe that tension. Not the cozy kind, but the version where you're still working in your PJs at 10 p.m., wishing you weren’t.

I’m grateful for the work I get to do, the patients I care for, and the trust people place in me. But gratitude doesn’t cancel out the cost. And when the work starts creeping into the only time you have to recover, it begins to feel like something deeper.

Because the goal was never pajama time with the electronic medical record. It was pajama time with our families. With our kids. With ourselves.

I think the first step back is admitting that time off shouldn’t feel like falling behind.

Dad, doing Epic notes, circa 2012