“Every day you ask us how we are, but today I want to ask you: how are you?”

Those words from a patient stayed with me.

Doctors ask questions every day. How are you? Where does it hurt? How long have you had these symptoms? Do you have a fever? Are you taking any medication?

We are used to the doctor being the one who asks, listens, assesses and helps.

But who asks the doctor:

“How are you?”

A few days later, a colleague asked me another question:

“If a patient came to you with the symptoms you have, would you put them on sick leave?”

I fell silent.

Perhaps that silence was answer enough.

But it was also the beginning of a much more uncomfortable question:

Why do I not apply to myself what I would advise a patient to do without a second thought?

Why would I tell a patient to rest, not to ignore their symptoms, not to come to work while ill and to seek help, while I feel guilty when I am the one who is sick?

Why is a doctor expected to know when a patient needs rest, yet finds it so difficult to recognize the moment when they need rest themselves?

And it was precisely there, unexpectedly, that I began thinking about a book I had read long ago.

George Orwell’s Animal Farm.

From Ideals to Reality

At the beginning of Orwell’s story, there is an idea.

An idea of a fairer world. Of equality. Of a life in which no one will be exploited and in which the fruits of work will belong to those who do the work.

The animals believe in that idea. They believe that change will bring a better life.

And then something begins to change.

Not suddenly.

Not through one great decision.

It changes little by little.

Some rules no longer apply equally to everyone. Some become privileged. Some begin to work more, others less. Language begins to justify what would once have been unacceptable. Those who are most loyal to the system become its most useful workers.

And perhaps that is precisely what makes Orwell’s story so universal.

The greatest danger is not always that the rules are openly broken.

Sometimes it is more dangerous when we become so accustomed to them that we no longer notice that they have changed.

Medicine as a Calling

When a young person enters medical school, they are usually not thinking about the system.

They are thinking about a person.

About the patient they will one day help.

About knowledge.

About diagnosis.

About the moment they will put on a white coat for the first time.

About the feeling of doing something important.

Almost no young person beginning medical school fully understands what they are actually entering.

That cannot be learned from a textbook.

You cannot learn what the first death of a patient will feel like.

You cannot experience in advance the weight of a decision on which someone’s life may depend.

A classroom cannot fully explain what it is like to work after a sleepless night, when you are exhausted and there are still many patients waiting for you.

Nor can you learn how not to take home with you the story of the person you saw that day.

All of that comes later.

When the white coat stops being a symbol of a future profession and becomes part of everyday life.

That is also when the difference begins to emerge between the medicine we imagined and the medicine in which we actually work.

Are We Becoming Boxer?

In Animal Farm, there is a horse named Boxer.

He is strong, hardworking, loyal and always willing to work more.

His phrases become symbols of his relationship with the system: “I will work harder” and “Napoleon is always right.”

Boxer does not ask many questions.

When things become difficult, he does not question the system.

He questions himself.

Maybe I can do more.

Maybe I have not worked hard enough.

Maybe I just need to endure a little longer.

That is his tragedy, but it is also one of Orwell’s most important messages: diligence, loyalty and willingness to sacrifice can be exploited precisely because the individual does not question them. Through Boxer, we see a worker whose loyalty and self-sacrifice are used in the interests of those who hold greater power.

And it is here that one of the most painful parallels with medicine appears.

How often does an exhausted doctor avoid saying:

“The system is overloaded.”

And instead say:

“I just need to hold on a little longer.”

How often do we fail to think that the problem might lie in the amount of work, the organization or the working conditions, and instead conclude that we are simply “not strong enough”?

How often do we say:

I will get through this day.

This shift.

This duty.

This one more patient.

Tomorrow I will rest.

And then tomorrow comes.

And we say the same thing again.

At that point, it is no longer only a question of work ethic.

It becomes a question of where responsibility ends and self-destruction begins.

When Helping Becomes a Burden

One of the paradoxes of the medical profession is that doctors are trained to recognize symptoms of illness in others while often neglecting their own.

A patient who is in pain seeks help.

A doctor who is exhausted often keeps working.

Why?

Perhaps because they are used to being the person who helps, rather than the person who needs help.

Perhaps because they are afraid of being perceived as weak.

Perhaps because they believe they “have to endure”.

Or perhaps because medicine has celebrated endurance for so long that we have forgotten that endurance is not the same thing as health.

The World Health Organization identifies time pressure, long working hours, shift work, lack of support and moral injury among significant psychosocial risks faced by healthcare workers. Prolonged workplace stress can be associated with burnout, chronic fatigue, absence from work and increased staff turnover, as well as consequences for the quality of healthcare.

That is why my colleague’s question affected me so deeply:

“If a patient came to you with the symptoms you have, would you put them on sick leave?”

I fell silent.

And that silence told me more than I wanted to hear.

I would probably tell the patient exactly what I had not allowed myself to do.

To rest.

To get treatment.

That they do not have to be at work while they are sick.

That their health does not become less important simply because they are responsible for other people.

And then I asked myself:

Why would I not do the same for myself?

Why do I feel guilty when I am sick?

When did we, as doctors, begin to believe that our absence from work is a greater problem than our health?

Perhaps this is precisely the moment when we have to ask whether we have become what Orwell’s Boxer never knew how to be: critical of the system to which we are so loyal.

Medicine speaks a great deal about professional responsibility. But responsibility toward a patient must also include responsibility toward oneself.

A doctor who does not take care of themselves will find it difficult, in the long term, to provide the best possible care to others.

A doctor does not stop being human when they put on a white coat.

Young Doctors Between Ideals and Reality

It is especially important to talk about the mental health of young doctors.

Years of education prepare a young person to know what they should do.

Experience only later teaches them how to live with what they had to do.

Many young doctors only begin to understand, once they truly enter the healthcare system, how great the difference is between the image of medicine they had as students and the reality they face when they begin working.

The first encounter with serious illness, the death of a patient or one’s own mistake can leave a deep mark.

Young doctors learn how to save a life, but they must also learn how to preserve their own peace of mind.

That is why professional support alone is not enough.

They also need an environment in which it is acceptable to say:

“I am struggling.”

That is not a sign of weakness.

It is a sign that we are human.

Who Cares for Those Who Care for Us?

There is no simple answer to this question.

Doctors should take care of themselves, but responsibility cannot rest on the individual alone. Healthcare institutions, managers, colleagues and the healthcare system as a whole all have a role in creating a working environment in which mental health is taken seriously.

The World Health Organization emphasizes that protecting the mental health of healthcare workers also requires organizational changes: appropriate workloads, safe and adequate staffing levels, regular breaks, support from managers and better working conditions.

We need to develop a culture in which talking about stress, burnout, anxiety, depression and emotional exhaustion is not taboo.

Accessible psychological support, better working conditions, more realistic workloads and enough time for rest are needed.

Because telling healthcare workers to “take care of themselves” means very little if the system does not simultaneously give them the possibility to actually do so.

WHO specifically stresses that workers’ mental health is not merely an individual matter and that employers and organizations have a responsibility to prevent risks, support employees and create a safe and healthy working environment.

Perhaps that is why the question one patient asked us matters so much:

“Every day you ask us how we are, but today I want to ask you: how are you?”

That one sentence contains something medicine should always be: a relationship between two human beings.

The Human Face of Medicine

Medicine is not only a science.

It is a relationship between people.

A patient does not arrive with symptoms alone. They come with fear, hope, questions and trust.

But a doctor does not arrive with knowledge alone either.

They come with their own life.

Their own problems.

Their own exhaustion.

Their own fears.

Their own sleepless nights.

With a family they may have left at home that day.

With their own pain.

That is why the true face of medicine is not simply the white coat.

The true face of medicine is the person inside the white coat.

Perhaps that is why the words of one patient matter so much:

“Every day you ask us how we are, but today I want to ask you: how are you?”

For a moment, she stopped being only a patient.

She became a person who saw the person standing in front of her.

The doctor.

The human being.

What If the Problem Is Not How Much We Can Endure?

Perhaps it is time to stop asking how much longer we can endure.

Perhaps we should ask:

Why do we have to endure so much?

That is an important difference.

Because when we constantly teach an individual to become stronger, we may fail to notice that the system itself is becoming harder to bear.

When we tell a doctor to organize their time better, we may fail to notice that the workload itself has become unsustainable.

When we tell them to “think of the patients”, we may forget that a doctor can also be someone’s patient, someone’s parent, child, partner or friend.

And a human being.

Orwell’s Animal Farm is not merely a story about animals on a farm. It is an allegory about power, changing ideals, manipulation, obedience and the way a system can transform until those who are most loyal to it become some of those it exploits the most.

Perhaps that is why Boxer matters to medicine too.

Not because we should stop working hard.

But because we need to learn that a hardworking person has the right to say:

“I cannot do this anymore.”

And that this should not be the end of their professional story.

It should be the beginning of caring for them.

The White Coat Must Not Hide the Person

In the end, perhaps everything comes back to two questions.

One was asked by my colleague:

“If a patient came to you with the symptoms you have, would you put them on sick leave?”

The other by a patient:

“Every day you ask us how we are, but today I want to ask you: how are you?”

Two questions that made me fall silent.

But also made me think.

About medicine.

About young doctors entering the profession who do not yet know how much will be asked of them.

About colleagues who give more than they have every day.

About patients who trust us.

About a system that must be humane enough to protect the people who keep it running.

And about Orwell’s Boxer, who reminds us that not every sacrifice is noble simply because it is a sacrifice.

The white coat should be a symbol of knowledge, expertise and trust.

But it should never become a uniform behind which we hide our own exhaustion, illness and fear.

Because a doctor is not a machine for treating people.

A doctor is a human being who treats other human beings.

And if we want medicine with a human face, perhaps the first step is simple:

To start asking one another how we are.

And when someone asks us:

“How are you?”

not to answer automatically:

“I’m fine.”

But, at least sometimes, to stop.

And tell the truth.

Because those who care for others also have the right to have someone care for them.