I just can't say what I want to say, I can't find the right words. I feel so mixed in my life. I can palpably feel the emptiness of my existence, and it hurts. I don't know if this is a fair complaint, but when there's no one else to buffer the bad times, it's hard to recover from the downs, and there's no one to share the ups.
It's hard to grasp the dilemmas of my life. I'm without a rudder.
So, I talk to a lot of the nurses on the floors. I know the names of at least half a dozen nurses in every unit, and probably more than that in the ICU's. I am often the resident that nurses come to, because they know that I listen.
And so, I'm never really surprised when nurses talk to me about their lives, because... well... I listen. And I don't make much of it, until recently. One of the nurses I know, I think she was flirting with me.
I say "think" because honestly, it's been that long since anyone has flirted with me. It's not like I'd know it if I saw it, and really, I don't want to read too much into it. But it certainly seemed like it.
Now, there was all that big talk about taking advantage of opportunities and growing personally and socially, but I completely let it hang. And I realize that it's because I'm chicken shit. And what can I say? I have no defense. It's who I am, and that's all I can say.
I've moved my laptop into the living room so I can watch TV and surf the net at the same time. This should tell you about how boring my life is. My whole life is working at the hospital. I wake up to go to the hospital. I come home and wait to go back to the hospital.
My attendings are mixed in their opinions on my complete and utter lack of a social life. Some think this is grand. I can dedicate all my attention to medicine. Some think this is horrible, that I run the real possibility of losing any semblance of normality.
I can feel it now, this complete emptiness in my life, and it's not so bad. It's not like I'm playing in traffic. It's just that there's nothing that inspires me. I put in my time and I'm good at what I do. I even enjoy it. But that's not the same as having meaning and fulfillment.
There's no meaning in my life. I don't know how you go about fixing that.
After talking to some friends about the process of delivering horrible news, I need to add a few things. When I say horrible, I mean there's no chance for recovery. If there is a chance for recovery, albeit slight, you have to tread a little more carefully.
But there are certain things that must be avoided. Never use the following phrases:
"We'll keep fighting"
"Do you want us to give up?"
ANY sports analogy
Quit, throw in the towel, give up, stop trying, surrender
Never make it a choice between life and death
I say this because it's important to understand that letting someone die peacefully takes a lot of courage. It takes a strong will to say, 'No. S/he wouldn't have wanted this.' Because you're not asking for a family to decide if their loved one should live or die. That's just not fair.
In most cases, you're asking the family to see that the focus of treatment needs to change, that treatment isn't making the patient any better, and so we must redefine what 'better' means. Better can mean cure, but better can also mean at peace or comfortable or right with God or any number of things, and it's important to help a family realize that if we can't make a person medically better, we need to think about these other better's and maybe think more about that.
I'll admit, I get palliative care involved very early in a case where the patient is in my opinion without hope for recovery. And it's important to know that palliative care isn't about giving up. It's quite the opposite. It's a determined and concerted effort to make someone feel better.
When I was little, I would eat my french fries without ketchup. This was because I was too scared to go up to the counter of McDonald's and ask for ketchup. It was easier just to eat the fries. Occasionally, one of my parents would realize this and make me go up to the counter and ask. I'd wait in line (for ketchup!) and then, in this meek little voice, "can i have some ketchup please?"
I was very easily embarrassed as a child, so I'd avoid all kinds of social situations in an effort to avoid assured humiliation. Every now and then, I'd find myself in a terrible spot, and I'd turn some freaky shade of purple. My friends never realized that it was possible for someone to blush that much.
Some of my friends were unbelievably cruel to me when they realized this. They'd shamelessly flirt with me, and watch me flush. it became a contest. Some people might view this as fantastically lucky, to have girls flirting with me, but it was utterly anxiety provoking.
I stopped watching the evening news after the riots in LA from the Rodney King verdict. I saw people hurting other people and sat in front of the TV weeping. It was traumatizing. Since then, I barely watch the news.
It was sometime in high school that I realized that I have a delicate soul. Since then, I've been trying to desensitize myself. I would ask questions, poke and prod, talk to people at the grocery store randomly, I would flirt. I would try to meet new people. I learned to open up and try to connect with the world.
And now I don't blush so easily anymore. I'm not afraid to ask for what I want. I can interact with the rest of the world normally. But I never learned how to defend myself. There are things that we do to defend ourselves from situations. But my solution is always the same: withdrawal. I pull back, pull away, never let anyone in. And it's worked out surprisingly well. But the problem is that it's not really any different from that five year old who was too afraid to ask for ketchup so he ate his fries without any.
