Staying put, for a change

Being on the Consultation-Liaison service feels like everything is in constant flux: a patient list that is different every morning, walking all over the hospital, encountering different clinical questions, and seeing patients with different attendings. Over the course of a day I put on hats ranging from psychopharmacology non-expert (who is nonetheless trying to offer some semblance of expertise or authority), to therapist (for the patient) to therapist (for the patient’s family member) to therapist (for the primary team), to amateur ethicist, to legal hold writer, to student, to teacher, to note-writer, to team manager.  At any given moment, I’m probably trying to wear more than one of these hats.  None is comfortable yet.  One thing that is unchanging is the constant reminder that inherent to residency, and to being a physician, means never getting completely comfortable.  I read once that if I stop feeling all fear or uncertainty, then I need to change something about my job.  Right now there’s plenty of both.

This past week I was on vacation, i.e., staycation.  It started off with several days of sleeping poorly and feeling generally anxious and grumpy, which made me feel upset about being anxious and grumpy, which made me additionally upset about how I wasn’t enjoying my vacation the way I wanted to and the precious days were just ticking by, poorly spent.  Then I felt even worse that I was feeling bad at all, when so much of the state is literally on fire and so many people have lost their homes, are afraid of losing their homes, have lost loved ones or are afraid of losing loved ones due to COVID or structural racism or both, and/or don’t even have the option of taking time off because of financial insecurity.  In short: I have so, so much to be grateful for, so who am I to complain?

When I’m at work, certain core elements of that work have remained relatively unchanged from pre-pandemic, and that too is a blessing.  I’ve been consistently working in inpatient settings since February, and so I’ve acclimated to the masks, face-shields, and Zoom teaching sessions.  When I have time off, it’s much harder for me to ignore how disrupted our world has become (first by a pandemic, and now by fires and air pollution), that this is our new reality, and that we cannot predict a return to “normalcy.”

What ultimately unfolded this past week was that I let myself mope, to some extent.  I watched “Indian Matchmaking” and the latest season of “Selling Sunset,” ate some pastries, and drank some wine.  I also had regular meals with protein and vegetables; talked with my therapist, who helped me put words to the negative emotions I was feeling; and talked with one of the chief residents, who helped me come up with different ways to approach some of the challenges I have been encountering in my current clinical rotation.  I did some online exercise classes, and even went on an outside jog with friends.  I chatted in person with some of my residency classmates, and felt slightly (but tangibly!) less weighed-down afterward. My husband and I went to Ocean Beach and found some intact sand dollars, watched a seagull battle with a crab (the seagull won), and stared in horror at the apocalyptic ridge of smoke stretching from the North Bay to the horizon.

I finished Isabel Wilkerson’s “The Warmth of Other Sons” (in a word, awe-inspiring) and Frances Cha’s “If I Had Your Face,” and started and finished Molly Wizenberg’s “The Fixed Stars.” I started Jonathan Metzl’s “The Protest Psychosis” and Kara Cooney’s “When Women Ruled the World: Six Queens of Egypt,” and started listening to the audiobook of Isabel Wilkerson’s “Caste.”  Last night Andrew and I finally watched “Parasite,” during which I alternately laughed and squirmed, and nearly cried at the end.

Tomorrow morning I head back to work. I’m trying to keep in mind that it is simply impossible to be confident and excellent in everything that I do, that being resilient does not mean being emotionally impervious or without anxiety, and that a certain degree of emotional permeability allows for empathy. Accepting uncertainty and constant change has never been a strong suit of mine, but it’s an area of ongoing growth.

Other update: A little while ago I was honored to work with the expert storytellers heading up Stories Behind The Mask, which is a fantastic project focused on highlighting perspectives from healthcare workers on the fight against COVID-19 and racism. My video is here:

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