I've been away. Like Alice, I fell down the rabbit hole. I took an intermission. From my blogging. From my schooling. From many things....experiencing both my own health issues, and those of the people I hold nearest to my heart.
It has been a crazy adventure....but I'm back. And I learned a few things along the way.
Some of them were educational. Pharmacology. Physical examination techniques. Better listening skills. Others were more personal, most importantly that
I am human.
Surprise! Insert eye-roll here if you wish :) For what its worth, I've learned that all the scientific, medical, and research training in the world, will never prepare you for the words "terminal" and "cancer", in your own life or the life of a precious loved one.
And thus, though I would like it not to be so, like anyone else in such a situation, my strengths and weaknesses were laid bare to me. I learned what things I need to work on. In these I have seen progress, but there are always new things to learn and become better at. I learned what things I am naturally good at and what I most enjoy. Of course, I learned lots of things in between too. Life can be a brutal teacher, but it can also be the best teacher. It is one thing to give a diagnosis and prognosis, and it is something entirely different to experience it on the other side of the table. My interaction with patients has changed through this new lens of experience.
I think many physicians would like for all doctors, including themselves, to be these perfect examples of successful humanity, gliding with ease from family struggle to physician-patient relationship, to diagnostic abilities, to continuous learning, and more...but if we are to be truly empathetic listeners, we must be able to reach inside ourselves and remind ourselves that the information that we hand out so freely can be very, very difficult for people to receive. This must be done, even with our clinical face on, to remind ourselves that our patients are human too: they have strengths and weaknesses and stories of their own. And our words, however unintended, however necessary in the giving of information, the telling of the truth, and the describing of options, can cause pain.
"Months. Poor prognosis. Presented in the late stages of the disease."
Nothing prepares you for how to go about life when you are told that there is so little time left.
Where is the road map that tells you and your family how to navigate this process? There isn't one anf this can be immensely terrifying. I locked myself behind a glass wall of clinicalisms, facts and caretaking. This is the way I cope. I put everything aside until the necessary work has been done and I have time to sort through my emotions. For me, it was easier to keep busy, and there was a lot to keep busy with, rather than feeling what was happening. It wasn't until much later, when I had time to myself, that I allowed myself to feel. And that was hard. Feeling is hard. Loving is hard. Disease and mortality and suffering are hard. There's no two ways about it people, this is no easy thing!
It feelt like being robbed. Robbed of time: the milestones: graduation from high-school, grad-school, medical school. The birthdays. The family events: Christmases, Easters, Thanksgivings and other holidays. Robbed of joy in the ordinary, regular days, with their laughter, jokes, tiffs, eye-rolls, the incredible highs and lows and their tears and late-night-phone-calls...the joys of surprises and successes, future plans and dreams, and everything else that is tied up in the experience of beautiful, freely given love.
What do you do when there is less than a year to spend with one of the most precious people in your life?
I don't have an answer for you. Because the reality is:
Nothing will prepare you to face that. I learned that all you can do is try to t do the best with what you are given, and more importantly, to be present and enjoy each moment that you do have with those you love. You're in the now: Carpe Diem! Live life to whatever "fullest" looks like to you, in whatever capacity, physical, emotional, intellectual....whatever! And live this "fullest" life with those you love. Even when its inconvenient. Even when it interrupts your plans. Even when it takes those plans and throws them out like a non-recyclable (its a long list in this city folks!)
There really is no better time to do things, say what you need to, travel to places you want to go, visit people you want to see, and just be.
Facing our own mortality, or feeling robbed of time with those we love, is really the pits man. I hate crying messy, snotty, blotchy-face tears over the people and things I love: my family, friends, pets and others in my life.
Some people might find my career choice odd in light of this. Our culture is fascinated with the Dr. House's, the Sherlock Holmes' and other such "geniuses", who care about little other than their problem-solving abilities...that is, until their layers are peeled away and their core exposed....
But I am not like that. And I am proud to be different from these idolizations.
I LOVE being involved and caring and LOVING people in their most difficult moments...their trials, their fears, their truths.
You know what one of the craziest parts of all of this is? What I've noticed about myself over the past couple of years, the last two in particular, is that I actively seek those moments out. And having gone through this experience, I want all the more to be a comforting presence to others. I want to support others through their difficult moments, days, weeks and years. I want to make a space where people are comfortable to express their hopes and fears in a safe, judgement-free environment. I want people to feel free to share, free to think and hope and make decisions, with the knowledge that I am doing my best for them, my 100%. I want to do this because I want to be the best doctor I can be, to form long-lasting, important relationships with patients.
I've learned the importance of being present.
I want patients to not just feel, but to truly know that they are heard.
I want patients to walk away from each meeting with a peaceful, knowledgeable glow in their minds and in their hearts, that gives them what they are seeking for in the medical world.
I want patients to feel comfortable to share their inmost being, so that we can work together to find solutions to the things they are facing.
I want to be the Family Physician that make people feel like my mother's family physician did and still does. She's been through everything with Mom: pregnancies, allergies, life in general, teenage-kids, middle-age, cancer, chemo, palliative treatment, sepsis, many, many surgeries, the ICU, and now....that beautiful, painfully-sought, hope-giving, complicated words: potential remission.
My mom's family doctor came in to remove her chemo drug bottle when I couldn't - the doctor didn't allude to, discuss or even or mention this, but she was coming in on her day off, solely for this chemo drug bottle removal, being the woman who had been there for my mother's five cesareans, other health concerns (and those of her five children!) along the way, and eventually, her cancer and treatment and surgeries too.
There is something for me, about the human person, the true essence of difficult experiences: the true joy, true pain (the two almost oft thought of opposites are so often united in one memory), true love and the eternal, supra-earthly call of the bond of blood and family that one has by genetics, adoption or by pure loving acceptance, that makes my heart clench to the core with intense love, pain, beauty and hope. It is something that calls to the essence of who I am, and fulfills my deepest self - the "me" that was made to love others, no matter what state they're in, and if they're having a difficult time (navigating through the surprises of life isn't easy by any means), to love them as fellow human beings and do my absolute best to care for their well-being all the more, each day, giving of myself and learning more and more about medicine and humanity in the process.
I love caring for others.
Nurturing those that need nurturing. Loving those that need love. Listening to those that don't want advice or any other sort of words, but the being-there-ness that a physician can give to their patient. Medicine contains such joys, sorrows, beauty, love....Few things will top seeing the expression of a woman looking at her baby for the first time. If that doesn't make you fall in love with medicine a hundred times over, I really don't know what does.
I've learned all over again, something I already knew: that women are incredible. Their strength is SO mighty, SO courageous, SO self-sacrificial. Mamas, around the world, with their born, unborn, stillborn, miscarried and otherwise babes, have an essence of understanding, an experience that has embraced them into the sisterhood of motherhood, one which contains such frightful deeps and such incredible highs so as to not be able to be captured with words...
Only.....my complete and utter admiration.
This past Thanksgiving weekend I found myself looking around me and thinking....I have so much to be thankful for. Though I would not wish it on anyone, I am thankful for this journey. Thankful for all it will do for my future patients. Thankful for more time with my Mama. Thankful for life and joy and family and friends and laughter and education and hope.
So, dear readers, I wish you a Happy Belated Thanksgiving. May you find all that you are looking for, hope even when life chokes your throat with its difficulties and anger and decisions and sadness and everything else. May you experience hope when you are overjoyed and brought-to-tears-happy and excited and in wonder of the beauty of everything that life is and can or could be. May you find peace and joy along the way, and those people you want to share it with, and family, be it blood or love or both that ties you together.
Happy Urban Homesteading, whether that be in a physical homestead, the homestead of your heart, or both.