Navigating survival zone

Last month, we explored the unconscious stress responses that medical professionals experience in high-pressure environments, sparked by a recent case at a local hospital. This month, we take a deeper look at these automatic reactions and their long-term impact on doctors' well-being.

Picture this: It’s 3 a.m. The emergency unit hums with an eerie quiet, interrupted only by the relentless beeping of monitors. The LED lights flicker inconsistently, casting shadows over exhausted medical staff. The generators are running low — again. The air is thick with the sterile scent of antiseptic and the lingering bitterness of stale coffee.

The stock cupboard is nearly empty. Essential supplies are scarce. You’re triaging a long queue of patients, each set of eyes pleading for answers. Labour ward is calling — again. A voice from medical urgently requests you to certify deceased patients. You can’t remember the last time you ate or even took a moment to breathe.

This is not an isolated experience. It’s the daily reality of countless doctors, a cycle that takes its toll.

Recognising our stress responses

This relentless environment forces many doctors into what is called “survival zone.” It’s a state of emotional detachment, where you function purely on autopilot — mind over matter, body in standby mode. In this space, you keep moving, reacting, and adapting. But at what cost?

In medical culture, burnout and PTSD are often seen as afflictions that patients experience — not doctors. But that assumption couldn’t be further from the truth. Every shift spent in the survival zone deepens the invisible wounds. The body’s trauma responses — fight, flight, or freeze — become habitual, shaping unconscious patterns of behaviour. Over time, these ingrained responses dictate how we navigate not only our work but our entire lives.

The hard truths of trauma

Trauma responses are natural survival mechanisms, but they were never meant to be permanent states. Living in this heightened state of alertness is akin to driving a car with the handbrake engaged. You move forward, but at an unsustainable cost — draining your mental, emotional, and physical reserves faster than they can be replenished.

Sound familiar? Many doctors either push forward, ignoring the warning signs, or withdraw, engaging just enough to get through the day. The result? A profession filled with dedicated yet depleted individuals, struggling to maintain their well-being.

Connecting to what matters

Imagine stepping out from the protective numbness of survival mode into full awareness. What would it feel like to truly experience the present moment? To be not just in the room but fully engaged in it?

There’s a saying: “To connect with the real world, you have to disconnect from your defenses.” This shift may feel daunting at first. Vulnerability can be uncomfortable. But what if it’s the key to healing? What if slowing down is not a sign of weakness but a vital step toward sustainability and resilience?

Too often, doctors operate under the belief that there’s no time to pause. But the real question is: Can you afford not to? Burnout doesn’t happen overnight — it accumulates with each moment of self-neglect.

The body speaks

Take my colleague Sarah. A powerhouse in the emergency department, always in control, always delivering. Until one day, mid-shift, she froze. Her body refused to move. The stress she had ignored for months had finally caught up with her.

Sleepless nights, irritability, chronic exhaustion — she had dismissed all the signs. But her body kept score. When she finally sought support, she realised that slowing down wasn’t a failure. It was the only way to rebuild herself.

Turning pain into a supportive daily practice

What signals is your body sending you? Are you paying attention, or have they become background noise in your busy life? The headaches, the muscle tension, the persistent fatigue  — what if these are invitations to pause, rather than obstacles to push through?

Let’s get practical. Take a breath — right now. In through the nose, out through the mouth. Feel your feet on the ground.

Simple, right? Yet, how often do we engage with something as fundamental as breathing? Conscious breathing isn’t just a wellness cliché — it’s a direct line to nervous system regulation. Each intentional breath fosters presence, reduces stress, and reconnects you to yourself.

Next time you’re waiting for the kettle to boil or walking between wards, take five deep breaths. Feel your body. Ground yourself in the moment. This small act is not about self-indulgence — it’s about survival on your terms.

So, what will you choose today? Will you continue to power through, burning out in the process? Or will you take a step toward something different — toward presence, awareness, and balance? The choice is yours.

The world doesn’t need more machines. It needs more humans.

Written by Dr. Lienka Botha