On My Mind
Showing you my path so you may see yours more easily
I have been thinking of you lately, how hard. You work on the analytical, mechanical, decisive approach to medicine. How hard you work to get the diagnosis just right so you can prescribe the right cure. I remember how that felt, and I wanted to give you a little taste of how you change over the next 25 years.
Letters to a young Doctor… the first in a series
Hello,
There are so many things that I wish I had known when I started in medicine, things that unfortunately are unknowable until you have spent some time in practice.There are some things that you cannot know until you have walked this path for a while.It is like a pair of shoes you plan to take hiking, you try them on, walk around the store, climb the fake rock to see how they fit going up and down, and make your best guess.The felt good while you walked all over the REI, looking at everything, but when you hit the trail you find they are not quite right.The break is a little too far forward on the foot and so after 20 KM the midfoot is sore, as are your toes.There are so many things like that in the world, they require first-hand experience to understand…..
‘One of the ways that Gil adds value and makes important contributions is…’ That is the assignment, to reflect upon when we are at our best. We were to solicit opinions from our colleagues, family and friends about moments when they had seen us at our best. Asking for positive feedback from people that know you well, why is that so difficult, why is it so frightening? Yet, here is was, that sense of trepidation as I pressed send, that sense of unease, of disquiet. It felt really wrong to ask for positive feedback from people, really wrong.
‘Well, I guess it is time to go back to reality…” Hearing those words, my heart sank, I felt sad. I heard longing, longing for a different life, longing for change, a desire longing to be met. I heard the voice of someone who did not expect the world to be different than it appeared, and I imagined someone who felt a little powerless to make any difference. Within me, there was a voice of rebellion to this statement, a voice that wanted to call out, to shake them out of their expectations, and it is the voice that speaks to me often.
Looking out the window, I can see them working their way across the barren flowerbeds. The bright orange of their breast showing me the hope of spring. Today is the first day I have seen robins in the yard. Moving from place to place with their hopping step, pausing to peck and scratch at the surface. They are so puffy with the feathers fluffed up against the cold wind, as if inflated just a little too much. It is a sign of springtime, and today is the first day I have seen them. It reminds me that I should take time to look, and see what is happening in my world, something I forget to do.
My father cannot tell me how he feels. It is something that does not appear to be part of his make-up. This is not unusual, it is part and parcel of masculinity. I hear it in the office every day, spoken and unspoken. Men who struggle to express their feelings, struggle to even acknowledge they have feelings, feelings long suppressed that are killing them. I see it in unmanageable blood pressure, in stomach problems that defy solutions, lousy sleep, boundaries that are never set, unrealistic expectations, deep profound depression that seems to lurk just at the edges of their lives. These men hold one thing in common, though they do not know it, they cannot speak of their feelings… ever... to anyone.
Fresh snow blankets the world, the wind was absent last evening as it fell, so it come straight down, settling into fluffy piles upon the surfaces. Every branch has become a small shelf allowing the snow to rest for a while, the spruce trees with their small, tight leaves hold the snow so well among the branches, each one piled high with snow, undisturbed. The lower branches are weighted down, touching the drifts that lay below. In this space, there is a silence that is felt, the sounds of the world further away as these heaps of snow slow and muffle the noises of life beyond the pasture edges. It is a silence I have felt before, in other settings, in other places, but it always brings the same sense of peace when it is here.
Lately, I have been seeing a lot of writing from Pamela Wible MD and today I re-read her article about doctor suicides. This time in the Washington Post. As I read through these articles, and reflect upon how medicine has changed during my lifetime, I am struck by the degree to which I have seen the humanity scrubbed out of the system. I think about the times during my career when I thought, ‘you know, it is not worth it anymore to do this, I should just go.’ .....
The sky is so blue when the storm has passed. It is clear in a way that it never seems to be on normal days. When it is cold, deeply cold like it is today, it is as if nothing can be in that air other than the blue. There is a deep beauty to this kind of day, you have to take a moment, slow down, and let it unfurl before your eyes. It is funny, I did not used to look at the world with this set of eyes, and they seem to grown in clarity over the last year, as my vision has slowed down, the clarity with which I see has changed.
“He had great faith in you, and you let him down…” These words landed, heavily, in the middle of my chest. These words brought pain, they were a tool to bring pain, and they did their job well. I cannot know the state of mind within the one who spoke those words, but I imagine they came from a place of great worry, great pain, and great anger. I have spoken words like this myself on occasions, more than I would care to remember at any given moment, and when I have used words like this with others, they were designed to hurt. It is from this place of seeing the pain, that I began to wonder about why anyone would choose to be a physician, and I realized it’s because no one really knows what they’re saying yes to when they pursue this career.
