An oncologist’s story of burnout

Dr Memory Bvochora-Nsingo explains that her burnout comes from working a job that never truly switches off.

I love my morning coffee. Every morning before work, I walk into the boardroom at Gaborone Private Hospital, sit with my colleagues, and allow the day to begin with laughter. Not polite laughter — real loud laughter. Many days, I’m one of the loudest people in the room. My colleagues often ask, “Ngaka, why are you always so jovial?” The truth is, I’m happy for many reasons.

I have patients who survived. Patients who were once very sick but are now in remission, with clear scans. Some who were carried into hospital, later walked out by themselves. They return smiling, breathing better, bleeding less, eating better, and living longer. These successes bring me genuine joy.

So no, I’m not burnt out because of my patients’ deaths. Of course, losing a patient is painful. Every death leaves a name and a family. But today, I want to talk about the patients who live. That is what many people outside oncology don’t always understand. They imagine the heaviness of this work comes only from death. But that isn’t the full truth.

A lot of my patients live. And sometimes, that is exactly where the burnout begins.

Far from work but still working

Recently, I was sitting in a conference room in Spain. I was learning from colleagues, admiring new advancements, and imagining how we might bring some of those possibilities home. I wasn’t wearing my hospital coat. I was in jeans and a T-shirt, far from the rush between patients and chemotherapy infusions.

Then my phone lit up. “Dumela Ngaka, remember we gave Kabo chemotherapy on Thursday? I’ve admitted her. She has a fever.”

In an instant, Spain disappeared. The conference room, the slides, the conversations — all gone. I was back with my patient, facing the consequences of my treatment decisions. I replied quickly, “What are her white cell counts?” 

“Zero, Ngaka.”

Zero. A number that can silence any room. Her white cells had been 3.5 when I ordered treatment. I had seen the result, weighed the risk, and made the call. Now, while I sat in Spain, my patient was fighting a fever with  no white cells to protect her.

That was painful. The conference continued around me, but I was no longer fully there. Speakers presented, people networked, yet for the rest of the event I carried Kabo with me; texting updates about her temperature, antibiotics, cultures, blood pressure, pulse, and repeat blood tests. Part of me remained at her bedside.

This is burnout

Burnout isn’t always a dramatic collapse. Sometimes it’s sitting in a beautiful country  at a professional conference, dressed casually, yet unable to relax. It’s being physically away from work, but unable to leave the work behind.

The deeper lesson came later. I learned Kabo had felt like she had the flu for three days before coming to hospital. In oncology, flu isn’t always flu. A fever after chemotherapy is never something to watch casually. Weakness, chills, sore throat, diarrhoea, vomiting, or sudden unwellness can become life-threatening when white  cells are low. Infections move fast.

I found myself asking difficult questions: Had I become too familiar with chemotherapy? Had routine made me less careful when explaining danger signs? Had experience made me too comfortable? 

Had I omitted a prescription for protecting white cells?

I asked these questions not because I believe I was careless, but because oncology must never become casual. Cancer treatment can rescue and control disease. It gives patients time, comfort, dignity, and many precious years with their families. But  it demands respect every single time. When it goes wrong, it can be the last thing that happens to the patient.

This experience reminded me that informed consent must never be a mere formality. It’s real protection for the patient. Before every treatment, I now slow down to ensure patients truly understand the purpose, benefits, risks, and especially the warning signs. They must know that calling early is never a disturbance; what feels like flu after chemotherapy can be an emergency. Silence can be dangerous.

My prophylaxis against burnout

This is my daily practice: I begin each morning with real laughter and coffee shared with my colleagues. I carry both caution and hope with me into the department, still smiling, still laughing, grateful that so many patients live, and committed to protecting them as best I can in a job that never truly switches off.

Dr Memory Bvochora-Nsingo is a clinical oncologist with 20 years of experience in radiation oncology and chemotherapy, specialising in the treatment of cancers of the cervix, breast, prostate, head and neck, and many others. She has worked for 16 years in Botswana, achieving significant success in both curative and palliative care, including end-of-life care. Currently, she works at Gaborone Private Hospital and is involved in government work as well.

Header image by Freepik