Spirituality

I have been thinking a lot about spirituality and the interconnectedness of every living creature.  One of the things that I have been thinking about is "why me? why this?" especially in relation to my career and what I do everyday.  I was talking to a colleague about how so many times I am in awe and completely humbled by how the people under my care or so willing to open up and let me into the most intimate moments in their lives.  People share their worries and fears, their greatest hopes and the wonderful lives they've shared together.  I become a thread in their life tapestry, and am the guide through their last moments on Earth.  It is absolutely incredible that I am allowed into these spaces with these people who I am a complete stranger to.

And, they trust me to the point where some want to confer with me on incredibly huge decisions for their loved ones before they make the choice.  This was especially poignant for me in a recent encounter where I had really only spoken with the family on 2 occasions for less than 10 minutes each, yet when they were asked by another team to make a big decision for their loved one, their first thought was to ask for my guidance.  They trusted me enough, even in those few moments we had talked previously, to request my recommendation.  They had faith that I would help them reach the best possible decision for their loved one.

So many times I want to look at the people I am talking with and say, "do you realize that I have only been doing this on my own for 9 months?".  Yet, that falls into the category of proclaiming my step or shelf or board exam scores.  In that moment, they don't care.  They don't care that sometimes I still feel like I am a baby, that I am just learning how to walk and talk.  They don't care about my insecurities.  They care that I show up, I am there for them, I care about them and their family members, and that I am honest and kind.  As the saying goes, most of all kind.  

Many times over the last two years I have wondered if this is really what I am supposed to be doing, if I really have the intestinal fortitude to be a doctor.  And then I have days like today.  Days where I truly feel like I am where I am supposed to be, caring for the people I am supposed to care for.  I was set on the path of these people's lives for a reason, and they were set into mine.  We are each adding a thread to each other's life tapestry.  Because of that, our tapestries are connected and more beautiful for it.  Even if I am meeting that family at their darkest moment, I am the safe haven where they can drop their guard and let me be the strong one for a moment.  I am the one who listened.

Many times I wonder about what would have happened if I had ended up somewhere else other than where I am today.  While I can imagine I would still be successful and know the people I care for would be equally well cared for by someone else, it would have been different.  I am still exploring my spirituality.  I do know that I was set on this Earth to be with the people I am with, do the job I am doing, and because of that, I am there for the people who most need me when I am supposed to be there.  Even when those cases stick to my heart permanently, I learn to dance with the limp and use that growth to provide for others.  As harrowing as the cases can sometimes be, I still cannot imagine doing anything other than what I am doing today.  I have one life to live, and know I am living it with using my gifts for the purpose they were given to me.  I am forever thankful for this opportunity.

Check-In

The last six months of work have been a roller coaster.  I have had periods of feeling like I'm really making a difference and periods where I feel like an impostor.  I have been told on several occasions to just get over my impostor syndrome, that everyone feels this way, and there's no reason why I need to feel this way.  I have felt like few of my own family even understand the emotional strain of what I do, and there is family who really doesn't understand what I do.  I feel like I am immature, that I can't stand up and fight when I need to, I'm too much of a people-pleaser, and I can't get out of my own head enough to help others.

Then there are times where I really feel like I helped a patient, even if it was only to hear them out.  I have sat by people, cried for people, listened to people vent.  I have been the person others turn to for support, and celebrate the small victories with.  I have helped streamline communication between the patients and teams.  I have come up with ideas for education.  I have built a new curriculum for narrative medicine.  I have taught residents about what I do.  I have turned to the people I work with to help me.  I have learned that I am not always a lone wolf.  I have stood up for myself when I need to.  I have been a team player.

Today, I feel like I have not done any of the things in the second paragraph, and have fallen into the first.  I feel like I made communication worse rather than better, even though I had only met the patient once, and never met the other family.  I have taken the fall for miscommunication I didn't realize existed.  I feel like I haven't been as professional as I need to be.  I have acted immaturely and been scolded for it.  I feel like I'm not really ready to teach fellows since I'm only six months out from fellowship.  I don't feel like I know what I'm doing.  I can't seem to make anyone feel better, and seem to only make people feel worse.  While part of me knows this is a gross over-exaggeration from the events of today, I beat up on myself for feeling like I've messed up.  While most people would have looked at what I did and call me normal, I hold myself to unattainable standards.  I need to cut myself some slack.

I had been so calm and had just enough confidence to be able to carry on without falling apart at every negative encounter.  Today was one negative encounter after another.  There was no stopping.  I got caught in the rip current of negativity, forgot to swim with it, and was swept out into the ocean to drown... or be eaten by sharks.

I feel like the moment I start to feel like I am settling in, finding my groove, on good standing with the rest of my team, the sand shifts and I realize there wasn't actually solid ground underneath me.  Sometimes I wish that I had a lower stakes job, that I wasn't as driven to go into a career that required other to depend on me as part of their healthcare team.  I wish I believed that I was really cut out for this.  I wish that one day of constantly feeling like a disappointment didn't knock me down to zero so quickly.  I wish my self-esteem reserve was deeper and more full.  Instead, I crumble the moment I feel like I've done wrong by a patient or their family or have let them down.  Even if I am not the direct reason for the letdown.  Even if I am not the one fully at fault.  Even if I'm working against a disease that is robbing a person of their essence.  Somehow I am supposed to take away from their oppression, not add to it.  I feel like I added to people's issues, not took some of the pressure away today.

I beat myself up over every little thing.  Every word I say.  Every recommendation I give.  I feel like a failure when I think I did things wrong.  I feel like I am the only person who ever flubs up an encounter.  I don't know the right words to say.  I don't have anything to provide to alleviate the physical pain.  I don't even know how to sit in the emotional or existential pain anymore.  I feel like I have nothing to offer, and anything I do offer is wrong.  Completely and utterly wrong.

Maybe tomorrow will be a better day and I can pick up the pieces so the patients don't see my lack of self-esteem...

New Year's Resolutions

Last year, I set what seemed like a simple resolution.  I would do one thing for my own self-care everyday.  While I did a great job posting my self-care up until mid-March, for the most part, I was able to stick with it.  Some days were less active forms of self-care, and others missed the mark entirely.  However, I am proud of myself for taking the time to focus on my personal growth and emotional stability.  I still have a long ways to go, especially with being a people pleaser and focusing more on how others view me than my own internal moral compass.

This year, I am continuing last year's resolution and adding on.  This year, self-care will be a more active self-care.  I will continue going to pure barre regularly because I love the physical activity and knowing that my body is stronger because of it.  I am also going to do a 6-week course in "Healing through Mindful Movement" which is a 6-week yoga counseling workshop on how "mindful movement can help your body heal your mind".  I enjoy yoga and am always looking for novel ways to help keep me physically, emotionally, and psychologically balanced.  Along that same vein, I need to start doing mindful meditations again with the Calm app.  Finally, my goal is to focus on some of my hobbies: sewing, knitting, crocheting, painting, writing.  I want to have time to do each of these in order to find ways to expand the more creative side of my brain.  I find it helps me think better on my feet.

One of the additions is now continued development of my career.  I have several lectures I am giving this year that need to be developed.  I am applying for a curriculum development scholarship.  I need to build prompts for the narrative medicine curriculum for next year.  It's amazing how little time there is in a day for all these things.  Some will carry over into time at home.  However, I strive to keep the first resolution above at the forefront outside of the hospital.

Even higher than the previous resolutions falls the one to find ways to focus on continuing to improve my relationship with my husband.  Sometimes, this focus can be simple.  Through the Gottman Institute, we have twice weekly marriage minutes to discuss, we have stress-relieving conversations we can have over dinner, we have card decks that we can work through to deepen our understanding of each other.  I want to be more intentional in the energy that I put into the relationship.  My sweet husband has done such a wonderful job of keeping us both buoyed.  I could not imagine having a better life partner.  I want to make sure I devote ample time to showing him my love.  An added bonus is the fact that it will only improve our relationship.

Finally, one of the words that I want to meditate on a little more this year is 'expectations'.  Expectations I set for myself, what I expect of others, work expectations, patient expectations, and so on.  I want to be more thoughtful about which expectations and which are harmful.

I am excited for 2019.  Let's see what the year holds.