Turning Tables – Treating Physicians

Today, one of the other residents and I had an interesting conversation.

Somehow, the topic of treating physicians came up.  And it is something that terrifies us both.  And not just for the reasons you might think.

I will confess, treating other health care people is always nerve wracking because you worry even more about saying something wrong or stupid because you always wonder if they are secretly judging your skills.

But the bigger thing is that when we see them, they are being faced with a cancer diagnosis.  And for some reason, most physicians and nurses get the bad ones and all the complications.   And that is horrible for anyone.

The issue is, they know too much.  Sometimes, having some uncertainty is a good thing.  But, when you have cared for people with the same thing.  When you understand the odds and get the treatments, it is a whole other level.  You know the worst case scenarios.  All of them. Sometimes the unknown bits of the known are the worst.  Especially when your whole world gets turned upside down.

That is the hard part.  The anxiety, the sadness, the anger and guilt.  The fact that sometimes, the person who knows too much coming in can’t be easily comforted.  That the numbers that scare everyone have too much meaning.

It also forces us to face our own mortality.

We both agreed that given we work in Oncology and given the odds in the world today, we will both one day have cancer.  And we will probably die from it.   Those are simply real odds.  And the “comedy” that is life.

And we know this and accept it.  In fact, we laugh about it in an uncomfortable kind of way.  Sure, I might have a heart attack or an accident, but it is more likely I get dementia or die of cancer… Or both.

Really, it is something I accept.  But, it is still something that is terrifying. And maybe that won’t happen.  Maybe I’ll just die in my sleep in old age.

Either way the reality of seeing people who dedicate their lives to healing others broken, afraid and unwell is terrifying.  They are “one of us” who became “one of them.  It is just too real sometimes.  Too close to home.

I just want to fix the hurt.  I want to prevent the hurt.  I want to be out of a job (kind of).

But I can’t.  So, we do the best we can.  With every person.  Because one day the tables will turn in one way or another.

Genuine Feeling Placement

I sometimes struggle with being genuine with people.

I don’t want people to feel sad or take on my hurt.  I also don’t always know what to say.

This weekend, we were home and I was being asked every seven seconds how work is going, what rotation am I on and then when I say Peds Onc they gasp and tell me how terrible or difficult it must be.  I don’t like to burden other people with my feelings, so I always smile and say things are going well and that I like Peds Onc.

It isn’t like I am lying.  I am doing well on my evaluations, things are going smoothly at work and I LOVE peds and I LOVE oncology, I would even say I LOVE Peds Onc.  But, last week was a bad week and there is only so much life-ruining, hard-hitting stuff one can deal with before a person gets feeling down.

My honest answer this weekend should have been that Peds Onc broke me.  That my week was awful and yet amazing.  But, I think that would freak people out.

I have been having problems verbalizing that.  I just don’t really know where to put what I am feeling, how to process what has happened and then say it in a way that doesn’t make me burst into tears or put off other people.  Plus, to top it all off, I don’t want people to think I am weak or can’t handle it, especially when it is something I think I could do for the rest of my life as a part of my practice.

So, all weekend, I smiled and answered in half-truths and avoided the meat of the issue.  I tried once or twice to verbalize it, but I am not good at that at the best of times.  I am the person that people go to with their problems.  I am not good at being the person that goes to others…  And often when I try to bring up how tough it is, that just gets turned around into a how tough the other person would find it or some other random thing.

It gets frustrating sometimes.

Patrick tries to get it, but he admits that he can’t.  I have other resident friends, but their experience and outlook are obviously different than mine, although they help.

I don’t know where to put what I feel.  I can’t process telling 15 year olds about relapsed cancer and having parents who are at a similar age and stage in life break down crying because their baby is sick.  I in one breath say cancer in kids is very curable and in another realize that that means nothing to the child who isn’t cured.  I am having a hard time trying to figure out what to do with it at the end of the day.  I normally am fine with that kind of stuff.  I accept death as a part of life.  Illness as something we go through.    I have cared for people my own age before… But, the kids scare me more.

I keep imagining what if they were my kids.  I keep worrying about my unborn baby’s potential to develop a neuroblastoma.  How we would cope with months of chemo and surgery and radiation.   It breaks my heart to see any kid sick, but the thought of my own child being sick paralyzes me.  It actually causes me to reconsider having kids (just for a second).

I have a hard time processing because despite how much the bad stuff sucks when people are little and young, I feel guilty that I don’t have this tough a time in the adult world.  At least not always.  I can rationalize the treatment potential.  I can more easily accept that adults die, sometimes young.  Adults seem less helpless, even if sometimes that is untrue.

I have a hard time processing because it is difficult to see God in some of these situations.  I step back now and I see Him everywhere, but sometimes in the moment, even after the moment, I question and that scares me.

I have a hard time processing because I am supposed to be able to deal with this stuff.  And I want to do this in my practice and how can I do that if I get upset every time a kid gets diagnosed?  I know compartmentalizing is not healthy, but there needs to be some degree of this to function appropriately.

I felt as if I was broken.  I felt sad.  And yet, I was loving my job, which made me feel a bit more awful in a sense.

Some of this is because it was a busy week and I was tired.  But, some of it is because I care.  Some might argue I care too much.  I like to think I am human.  But, my human-ness needs to take a breather sometimes.

I don’t know where to put these feelings.

But I am glad I have them.

I am glad I can try to put myself in other people’s shoes… Even if my perception isn’t always accurate.  I am glad that I can bond with a little child over “Toopy et Binou”, that a Grandmother can feel comfortable spilling her guts to me, that most kids do get better and grow up and do things just like me.

I need to take care of myself.  I can’t take it all on myself.  But, it is good that this bothers me.  And that I love it despite that.

So, no, work isn’t a cakewalk, but it is going well.  I am on Peds Heme/Onc and my heart breaks for these kids and families every day, but I still smile more than I frown and I am happy and am enjoying myself even though I sometimes feel sad.

So yes, I was down this weekend.  And yes, I find it frustrating that I can’t always effectively verbalize how I feel, especially to people who are just asking a general question.  Sometimes I just don’t feel like talking about it. And that is okay.  Sometimes, I come home and cry a little and that is okay too (although I probably won’t admit that to your face).  Interestingly, despite all that, I am kind of  happy except that I feel I have to lie about how I feel overall.

The good thing is that this work does make a difference.  Even when the outcome is not what we like to see.  And I love kids and want to see them live as fully as they can for as long as they can.  Because that is what it is really all about.  That is why I want this potentially incorporated in my practice

Everyone feels down sometimes.  Different things eat away at us.  It is interesting how sometimes the very thing that breaks your heart can also be a thing that brings you much joy.

I don’t know where to put these feelings.

I just wish I had a word to honestly explain them.