It’s been a bit of time since I’ve written anything, and I was recently reminded that I had this site via a friendly renew email (insert hand on face emoji). The urge to write about some recent life hurdles and joys came back to me. So, here I am.
What a year. COVID, recurrent scares and post viral syndrome sequelae, decreased socialization, family illness and way too much screen time later… here we are. I’m not sure where to begin, but I’ll try. Writing has been so therapeutic in the past, and it felt like a good time to let it out.
I’ve since found other ways to release my frustration, stress and even, anger. Christiana graciously covers 5 behavioral health sessions for physicians – something I never thought twice about. I began speaking with Carol, who has taught me an entirely different approach to anger management and brought to light the previously unrecognizable trauma I have experienced in my life.
It’s hard to step back and recognize the impact of trauma in our lives. I would never think of myself as traumatized or acknowledge the impact that this has on my temperament and interactions with the people I love.
To be blunt, it starts with death. When you become a doctor, you are thrown into a community of people that react to death as a part of a job. It’s part of the training. People become cases. Deaths are labeled expirations. Being paged to a patient’s bedside in the middle of the night to pronounce their death becomes a nuisance. ‘Ugh. I’m knee deep in admissions and nursing pages at 2AM. Now I have to go up to the 7th floor to fill out paperwork and call family.’ Usually its an elderly patient and the death was somewhat expected.
“Hi. This is Dr. —. Are you sitting down? I’m so sorry to tell you this, but your mom/dad/sister/brother/daughter/son passed away this evening/morning/afternoon. I’m so very sorry for your loss.”
Reactions are mixed. Some have been waiting for the call and have prepared themselves. Some are relived – “Well, he/she is in a better place now. Thank you for caring for him/her.” Some sob.
Then, there are the unexpected deaths. These include the patients that rapidly decline and expire. These are more traumatic, naturally. I recall a handful in my career, and I will never forget them. “You did everything you could,” my colleagues have told me before walking away to continue their work day/night.
My first unexpected death was in the cardiac ICU as a fresh second year resident. It was a Saturday morning and I was in charge. This gentleman in his early 50s tanked in front of me while awaiting urgent cardiac bypass surgery. All was well until I hear his nurse screaming, “Dr. —, I need you in RM 4 immediately.” Within seconds, I saw him stop oxygenating and perfusing his organs in front of my eyes. Nurses panicked around me yelling for commands. I checked his pulse and screamed code blue to activate the team. I ran the code with an army of nurses, doctors, chaplains in the room grabbing drugs, IVs, rotating compressions while I yelled out next steps. It was wild. I had done chest compressions as an intern many times, but this was different.
The patient expired. After 45 minutes with the attending intensivist then at bedside, he finally turned to me and said – “I think you should call it.” 45 minutes felt like 10 seconds. I called it and as quickly as the army of people assembled to try to revive this man, they disappeared. The room was empty.
I will never forget what happened next. We stepped out of the room and the attending looked at me and plainly said, “I think we should recap the events.”
“OK.” I replied. I was in a bit of shock.
“I think that went very well.” He followed. He went on to explain that I did everything per ACLS protocol and tried everything I could. He then left to go see other patients. One of the nurses, God bless him, turned to me to ask if I was OK.
“Yes. I’m OK. I just need a minute.” I went to the break room. I let out a few tears and quickly shoved all and any emotion back inside so I could go back out to the floor and finish taking care of the rest of my patients. That was it. I was not expected to cry and take some time. I was expected to continue working. This is part of the job after all. We are doctors.
I’ve had some other similar experiences throughout the years. COVID has brought about new experiences in itself, although one is enough to recap for now.
That brings me to self love. How has I never realized that experiences such as these may affect me over time? This therapist, Carol, has helped me realize this. She helped me recognize that I am only human. As much as I would like to turn these things off, I can’t. I need to talk about it. I need to release it. These experiences stay with me. I need to find outlets for this so that it doesn’t build up and come out unexpectedly and without control.
I have learned that this is part of self love. It may feel like this is limited to grooming and feeling well rested, but much of self love includes making sure you are internally attentive.
It’s easier when you are young and single. Perhaps you have not experienced as much trauma yet. Perhaps you can also dedicate more time to things like fitness, fun and rest. Making a haircut appointment or scheduling a night out, pre-COVID of course, takes just a phone call. There is no need to worry about who will watch the kids or how tired you’ll be in the morning because you’re in your 20s and wake up feeling good no matter what.
Self love takes more effort now. It takes scheduling and planning. It takes thought. Ironically, it means being selfish.
For me, we bought a Peloton bicycle this Summer which was quickly followed by the treadmill, as I love to run. These classes are taught by instructors that continuously shout self love mantras and remind you the importance of “me time.” It feels like physical and mental wellness in one.
I’ve also found that my work schedule surprises me with random call days or days off where our kids are already scheduled to be at day care. I look ahead for these days and plan things for myself. Alternatively, I utilize the fact that my husband is home on Thursday mornings, and I can fit something in early morning while he tends to our kids
So here I am today. I have a mountain list of things to do and a day to myself. I chose to begin by writing and taking some time for reflection. It can feel selfish. It can feel like I should be digging into our tower of laundry or writing a work email I have delayed. I am choosing not to let it. I need this time.
I always remind myself of the visual instructions your receive before taking off on a flight. The flight attendant predictably walks up and down the isle stimulating emergency protocol. Its striking when they emphasize the importance of mom or dad putting on an oxygen mask before placing it on their child, but it makes sense. How can you possibly appropriately care for someone when you are not oxygenating yourself? Maybe you can help at first, but eventually, you will succumb to the lack of oxygen.
Self love is our oxygen. I have to be OK and cared for before I can expect to be in the best shape to care for my beautiful family. Selfish might be the first thought that comes to mind, but really – it’s vital. After all – life is short. Traumatic experiences have taught me that. You have to love yourself to be able to enjoy every morsel.
Breath sounds and bubbles 