Going to the hospital can be an extraordinarily stressful experience—especially for doctors. Physician Pranay Sinha explores the psychological and spiritual burnout practicing medicine can cause and how doctors can withstand it in his absorbing memoir In the Space Between Moments: Finding Joy and Meaning in Medicine.

Sinha, a fellow in infectious diseases at Boston University School of Medicine, took time after a hospital shift to discuss his own struggles with burnout during his residency at Yale New Haven Hospital in Connecticut. Those struggles included occasional thoughts of suicide.

“Not that I was prepared to kill myself,” he recalls, “but I was absolutely dragged down. No matter how good your training in medical school, you’re not prepared for what hits you as an intern. When you first do a heparin drip, for example, and realize that if you do it incorrectly the patient could bleed to death, it’s terrifying. I always had a smile on my face; I was always cheery, always wearing bright bow ties. Nobody knew that I was ripping myself inside.” 

Sinha coped, in part, by writing about his struggles. A 2014 New York Times op-ed titled “Why Do Doctors Commit Suicide?” which he wrote during his residency, hit a nerve with medical professionals facing similar issues. That led to In the Space Between Moments, a brief collection of pieces about how he dealt with long hours, tough cases, dying patients, and unwitting errors by focusing on daily realities of healing and humanity. “This book tries to change the stale conversation about burnout,” Sinha says. “I see it as a vaccine—ideally taken in medical school.” 

He opens the book with the story of a young intern coming to him, almost in tears. “She told me, ‘I don’t think I helped anyone today,’ ” he remembers. “So I translated what she had done from the medicalese.” Here’s how he puts it in the book’s introduction: 

“Look,” I said, ‘You gave this young woman the right antibiotics for her kidney infection, and she feels better now.” I started flipping through the notes of all her patients one by one. “You sent this man back home to his wife and kids who missed him. You reassured this boy’s parents that he’s going to be fine. You spared this terminally ill lady confusion and suffering by helping her understand that her time is coming.”

“Hearing that in plain English, she cried—but they were tears of joy,” Sinha says.

Recognizing and appreciating those small, oft-overlooked triumphs is the key to a fulfilling medical practice, he notes. “Medicine is an extraordinary profession. You see some horrible things but also incredible moments of kindness. These moments of joy whiz past us because medicine is so hectic. I learned to celebrate them.”

In the Space Between Moments manages to find luminous redemption even in the darkest episodes. One is the case of Raymond, a man dying of untreatable infections. (Sinha changed patients’ names and identifying details to preserve confidentiality.) Raymond endured a harrowing ordeal, Sinha says, but “what also sticks in my mind is that the intern was so kind. She prayed with him as he died, and his last words were, ‘Our Father [who art] in Heaven.’ ”

The book also finds wry humor in challenging patients like Harry, a sweet and personable man with cognitive impairments who was confined to the hospital by court order until social services agencies could assemble a support system to deal with his eccentricities, which included a reluctance to wear pants and a habit of relieving himself in public. “I love Harry,” Sinha chuckles. “You cope with a lot of patients like that, and you see the funny side of it. You can either be extremely sad about it, or you can laugh along and be kind and gentle and do the best you can.”

One of the most upsetting incidents he writes about involved a patient named Michael, a veteran who developed serious chest pains after Sinha adjusted the dosage of his blood-pressure meds to alleviate his lightheadedness. Missteps are inevitable in medical practice, but instead of trying to deflect responsibility as some doctors would, Sinha owned up to it.

“I felt that if doctors take credit for all the good we do, we should also take the blame when our best intentions go awry,” he explains. So he apologized to Michael for what had happened. “Being able to tell him that—and then being forgiven—was a huge plus. If I had said it wasn’t my fault, that would have led to worse feelings of shame and guilt.” 

Kirkus Reviews praises In the Space Between Moments for its “just-right details, dialogue, and characterization” and for the author’s “cognizan[ce] of how comedy and tragedy alternate, or even overlap, in emergency situations.” Sinha’s writing is honest and raw in its depiction of medical dilemmas, but his prose can be tenderly lyrical at the same time. For example, when writing about Ted, a man unwilling to accept that his battle with cancer had become hopeless, Sinha admits that “In such situations, I feel trapped and guilty,” then turns to face his patient’s agony.

I strained to read Ted’s lips as he mouthed his response. Sunrays streamed through the window and the bright light glanced off his face. His face seemed puffy, but his eyes were not droopy today; they were fixed firmly on me. I only understood him on the third repetition: “I am scared of dying.”

Sinha is planning to write his next book on tuberculosis in India, where he grew up before coming to the United States for college and where he will soon be doing research. It will be another deep dive into the injuries that medicine inflicts on the soul—this time, the patient’s.

“There’s a lot of stigma associated with TB,” he says. “Patients are considered suspects, and we keep an eye on them to make sure they take their medications. I’m going to tell patients’ stories and ask what health care providers can do to better engage them and not make them feel like contaminated human beings.” 

Investigating that intersection between disease and social disadvantage is hard work, but Sinha thinks he has burnout beat. In addition to the insights he developed writing In the Space Between Moments, he says during a telephone interview, “I have a very supportive family, a huge friend network and a very loving wife. Here’s my wife kissing me for saying that!” And so he savors one more moment of joy at the end of a long day. 

Will Green is a writer in New York.