#tw conditioining

[dxmedstudent]

The little cup of emotion.

(TW for discussing grief, miscarriages, paediatric death and the things we see at work) You know how sometimes you’re chilling happily and you just feel like listening to music that’s a different emotion. Perhaps today’s an angry music day, or a sad music day. It usually works well; it’s easier to appeciate sad music when you are, you know, not sad. Today I decided I was sick of mooning love songs and opted for grief playlists to ‘brighten  up’ my life as I read. Weird, but OK. I don’t recommend it. It starts off with songs about missing grandparents (sad, I’ve been there), there’s always Tears In Heaven (as a pediatric doc I can’t deal with the history behind it) and ends up with Ed Sheeran songs about miscarriages. And then you’re back there, in resus, watching them bring in a tiny, lifeless baby, perfectly formed but far too little, far too soon. The entire room grave with the certainty that there is nothing that can be done. You didn’t cry, then; there was nothing you could do. But now, sitting here, you can’t stop the tears rolling down your face because the song doesn’t have to be real for it to be real. Because since you started working this job, no worst-case scenario will ever be only imaginary for you again. This isn’t just about sad songs. It’s about medical dramas and their usually implausible storylines. It’s about stories of any kind involving suffering. So many things remind me of patients I’ve seen, losses I’ve witnessed. I’m OK, and I’m not depressed right now; I enjoy my life, look forward to a good deal many things and don’t have any complaints at present. I’m not kept up awake at night thinking of these events; most of the time life carries on perfectly happily.  I wouldn’t even say that it’s necessarily always traumatic when this happens; it’s always sad, and often upsetting, but sometimes it’s a form of healing. A chance to reflect and grieve over something you couldn’t deal with at the time. There are things I’ve been meaning to write about or reflect about but couldn’t really deal with at the time. Sometimes it’s exactly  what I needed to move on. I didn’t cry watching films when I was younger. I’m a sappy person, yes, but it wasn’t as much of a thing for me. I’d watch a film, and it was a story; sad, yes, but not real. But the further I got ith medicine, the closer things hit to the bone. I witnessed and experienced suffering in ways I hadn’t as a layperson. It’s like you have a cup of emotion.  And normally, it’s not very full, so you can watch a film and reflect that it was sad that someone died, but it’s OK. Except now, when you work in medicine, your cup of emotion is always nearly full. There’s always so much going on at work. People share their stories of pain and loss and suffering and you feel for them. People die. People get diagnosed with incurable illnesses you know will take their lives soon. You share stories with your friends and colleagues; the interesting, the weird, the really happy, and the really really sad. Eveyone is always stressed, and you’re always looking after each other. You get on with things, and you stay strong at work because you have to; that’s what your patints need. So you don’t get to feel things then, and you don’t get to process things then. But it builds up. Later, when things are quiet, and nobody needs you to be strong, it happens. Even if you’re going OK and things are under control, and you really aren’t beating yourself up about it, because what you did was exactly what you were supposed to do. But all it takes is something to remind you, or fill your little cup of emotion to the brim, and that’s it. You’re always that little bit closer to just spilling over. Sometimes it’s because you don’t have the emotional reserve that day. Sometiems it’s because it’s just too much like real tragedy you’ve seen. You know how hard it is for real people, and that make spectating more uncomfortable. When you’ve been real suffering, a parent who’s lost a child, someone receiving a diagnosis that will kill them, it changes you in ways you didn’t realise. You’re not just an observer of the human conditioin, you are very much involved in the best and the worst that life brings. We all deal with things differently. I know for some people, it’s numbness and not thinking about things, trying to forget. For others it’s burnout or depression or other things entirely. Some write as a form of therapy, some chat to friends and family, and some try to distract themselves with fun things. I like talking about medicine, and writing about it, even the sad things. Sometimes, I like to reflect on them, even if it makes me feel sad for a while. Because I’m OK enough to cope with it, and then move on. It’s lucky that’s the case; I can see why our jobs get to so many people, it’s hard. But, I’m OK with sometimes remembering, and I deal with things as best as I can, same as everyone else I know.  We do our best, to be true to our patients as well as ourselves. I can’t change the fact that tragedy happens; no matter how hard we work, it will always be the case. if I remember, then it’s not like they never existed.