You guys, It's 630am and I got up BEFORE this and the thing is it was GLADLY. Because today, TODAY I do not have to work. My work phone is off. My work laptop is shut down. I can finally breathe.
This week has been brutal. Up every night until the wee hours charting, reliving days that were wrought with sadness and a multitude of tasks. But the most frustrating part of all of this is that in the last four days I allowed absolutely NO time for self care. Skipping breakfast, lunches, not exercising, eating crap as I drove in the car from patient to patient house. My granola bar and diet coke filled body is not pleased with me right now, nor am I. I do not feel good when I don't allow time to care for myself, and I can say quite sincerely that if this job were ALWAYS like that, then I would be looking for a new job this instant. But it's not. I still love it (well the working part, NOT the charting part).
My 45 year old that I referred to earlier this week? She died literally while I was holding her hand. I will NEVER not think that is an amazing honor. I felt relief when she died. The suffering was over. The grief that loomed over that house could now come into true form. She was really gone.
Then I moved on to my 48 year old patient. He's new to me. The cancer is new to him. It moved SO quickly that in the course of a little over a month he went from working, being normal, healthy, to full of cancer, a diagnosis of 2 weeks to live, a multitude of really painful and uncomfortable symptoms to contend with. He and his wife are so great; I just want to go in there and make this NOT hard for them. And I think I do a good job of that, at least of providing some understanding of what is going on. Knowledge is power. And pain control is pain control and THAT, among many other symptom management issues, is something I can help with.
But grief? Well grief comes in many ways, in many different moments. As this lovely young man was telling me his story I found myself getting tears in my eyes. I mean, not dripping, but glistening and he stopped me right there and said, "don't". He can't handle seeing other people grieve his losses. It undoes him.
The harder aspect of this job is that these really intense experiences are happening, and riddled throughout them are so many tasks that are involved in the case management of, for me, 12 home patients. You are always busy. There is never someone that I shouldn't be calling. I have 14 things in my head at one time. I tell people, "look, I talk out loud". Because I do, and some people must think I'm nuts, but I have to sometimes. I'm trying to sift through the gigantic load of responsibility that sits on my shoulders. I'm trying to forget that load as I sit with a patient and give them my undivided attention.
I realized, not long ago, as I was sitting with someone WITH that undivided attention, that THOSE moments are the entire reason why I do the job I do. I feel so much connection in those interactions. I feel privileged to be there at this very real and intense time. And I get a feeling of losing myself in the listening. REALLY hearing what this person is telling me. It's almost always a story of grief and loss and amazement that they have gotten as sick as they have. I can look at someone during these interactions and TRULY CARE. Truly want to do the best job that I can for them. Show them that I feel compassion and love for them. Because I do. When my patient died yesterday and I held herhand I said "I love you, Susan" (not her real name, hippa) and I really meant it. I love her. I love all of my patients, EVEN the ones that are less loveable when I'm not giving them my undivided attention. It is my belief that in the game of death, a game we must all play, that it is an even playing ground. No one is better than the other. No one more deserving of attention. Well (honestly), except maybe the young ones. The young ones always get more attention. Maybe because it's so NOT fair, or maybe because I see myself in them, but they are the ones that make my job the most heart wrenching. They are the ones with lives that are being short changed.
I came home the other day, tears brimming to the surface, stepped into the door, saw my husband and LOST IT. Cried and cried and cried. Cried like a little baby. Laid on my bed sobbing, my head in the pillow, thinking about each patient and character one by one, letting myself feel the grief of each person. Each person that I was doing my best for yet also being pulled in a million directions at once. Feeling their loss, their suffering. It was the most CATHARTIC cry I've ever had. I got up from that cry, eyes puffy, and hugged my family. I was ready to feel normal again and did much better with that well of emotions outside of my body and laying in a pool of tears on my pillow.
Today it's Saturday and I'm going on a nice, long 10 mile run with my friend Sarah. I'm going to try to forget my patients and my job and focus on myself. On my own body. On the life that is coursing through it.
I know that someday, when I die, I can rest knowing there were so many people that I helped with so much sincerity and love. I live most of my days in service to others, and though this can be filled with challenges, it is what I have been called to do.
But now? I run!