A Hard Day At Work + What I’m Learning From It
One day at work, I had 3 consecutive patients tell me that an immediate family member had died within the past month. My 8:00am patient told me her son passed away. My 8:30am patient told me his mom passed away. My 9:00am patient told me her husband passed away. One after the other after the other. By the time 9:30am had rolled around, I was simply heart broken. Unable to concentrate, still processing what I had just heard, and feeling, deeply, the unbelievable grief that engulfed each room.
Of course, as one does in healthcare, you must “put a pin” in the processing, emotional toll, grief, and helplessness of it all, and go about your day caring for the rest of your patients. Now, this is seen on a much larger scale in sectors of medicine that see unbelievable loss, death, and grief on a daily basis (re: the ED where one patient was coded for an hour and then you have to go tell someone they have a UTI and on and on you go. Or the trauma team quite literally only seeing… well… trauma).
You take a deep breath and head into the next room to chat about weight loss and diabetes and back pain. You make small talk about the upcoming holidays, how their grandson’s football game went, and the new dog they just bought. You approach each new room with your sole attention on that patient and his or her problems or concerns. You compartmentalize feelings, just a bit.
In the acute moment, you do not want to bring the grief of the 8:00am into your 1:00pm’s room. Of course not, that is not their burden, it is yours.
But, no matter how hard you might try, you bring it with you into every room.
Into most interactions you have that week, or month, or year.
How can you not?
These moments quietly sow into you. They subtly change you. They become the fabric of who you are as a provider. And yes, who you are as a person too.
Medicine is interesting like that. It has its unique set of difficulties, just as all careers do. However, these difficulties are often heavy, burdensome, emotionally taxing situations that involve real people and real lives coming and going in often traumatic, tragic, too-soon sort of ways. Some of us are there when that tragedy occurs. Others get the “deceased” notification. And still others, manage the diabetes of the wife of the deceased.
Medicine is working at the peak of emotions. The most heightened emotions you can think of, often surround healthcare scares, shocking diagnoses, ambulance calls, the list goes on.
Sometimes, these peaked emotions are so near us, in our face, splattering on our clothes, falling into our arms. Other times, these emotions are so subtle, you almost have no idea you feel it until you get to the end of your week, month, or year, and are feeling so disassociated you don’t even know how you got here.
What I’ve been ruthlessly forcing myself to do, in my short time as a PA so far, is lean into the emotions and the stories. I do my best to only “put a pin” in it for a brief time, before diving back into the feelings of those moments. Because truthfully, it’s these emotions, stories, patients, moments, that are the job. To me, that is what it’s all about.
The subject of medicine is not really science or anatomy or pharmacology; it’s not really bodies or brains or human beings….. It’s the heart and soul and mind that exists in those bodies. It’s people.
Simply being in a room where the air is filled with grief, making eye contact with your third patient of the day who is explaining how they had to take their loved one off of life support- that is what the job is about. Rushing past those moments is quite literally, akin to missing out on your entire career.
If we do not, to some degree, at some time in our training and jobs, process this stuff, it will eat us alive.
Because what I’ve quickly come to find, is that leaning into the hard stuff in medicine equally allows me to make room for extracting the unbelievably incredible moments that are nothing short of magic from that same tragedy.
During my patient’s discussion about taking her husband off of life support, I also am witnessing a strength and vulnerability that I’ve only witnessed, heck, maybe a few times in my life. I’m witnessing a resilience that I hope I never have to learn for myself. I’m quite literally feeling my patient’s steadfast faith.
One of my favorite quotes, sums up these feelings quite well:
“Even now, all possible feelings do not yet exist, there are still those that lie beyond our capacity and our imagination. From time to time, when a piece of music no one has ever written or a painting no one has ever painted, or something else impossible to predict, fathom or yet describe takes place, a new feeling enters the world. And then, for the millionth time in the history of feeling, the heart surges and absorbs the impact.”
The feeling of working in medicine, and seeing what we see, and witnessing new people with new stories is something quite out of our capacity or imagination. It’s hard to fathom, much less articulate in a blog post the newness and “surge” of each feeling in each room as each patient tells me their loss. The stories are so similar, but so different.
What a miracle it is, to absorb that impact.
I pray I can keep my heart absorbing it forever.
Always rooting for you,
Marisa
