One of those days.

It’s one of those days.

It’s one of those days, when you’ve pressed the snooze button on your alarm for what might be the twentieth time. When no amount of cajoling, self-reprimanding and mentally yelling at yourself can get you to muster the energy to put one foot out of bed. It’s one of those days, when the only safe place is the warm cocoon of your doona; where you can curl up in the dark and quiet, and there is nothing to disturb you but the steady thumping of your heartbeat and the soft whooshing of your blood coursing through your veins. When it feels like there is lead in your bones, and in your chest, holding you down, and it is exhausting just to think, just to breathe.

(It is okay to call in and tell them you are taking a day off today. This is not a defeat. This does not mean you are giving in. In an age when it is burn bright and burn fast, what you must remember is that first, you have to last. When the ideal is to strive for machine-like efficiency, you must concede that you are only human.  You need this. You need to recover for the many battles yet ahead. Tomorrow can wait, will wait.)

It’s one of those days, when there is a lump in your throat that won’t go away and a loop somewhere in your head that seems stuck on replay. When you turn up the volume on your headphones to the loudest they can go. When you take the train absentmindedly past your stop and get off and walk the rest of the way back home. When you distract yourself by scrolling mindlessly through social media and stay up late in the morning binge-watching Netflix until four.

(Self-medication is a band-aid solution and numbing or swallowing your emotions does not make them go away. They tend to lie in wait, lurking in the corners of your mind, until they ambush you when you least expect it. When it’s time, let them in. If the tears come, let them fall. You have been carrying these things that are so very heavy for so very long now. It’s okay to put them down for a while.)

It’s one of those days, when you stare into the mirror and practice a smile that doesn’t quite reach your eyes. When you notice every dark circle, every little blemish, everything that feels too large or too small or too asymmetrical and oddly placed. It’s one of those days, when you lie awake at night and suddenly remember every fumble and folly, when you agonise over every word you wish you could take back, every mistake that you have ever made. When you dissect yourself apart, until you can’t tell outside from inside. When you wish you could just resect those silent malignancies of the soul, those parts of yourself that fill you with shame, or loathing, or anger and disgust.

(If only you could remember to try to see yourself the way those around you see you, or moreover, you would treat yourself the way you treat those around you. Nurture; be patient with and forgiving of yourself the way you are for others.  Of course, you are flawed, as are we all. But what is most important is that you are always learning. Your weaknesses and failures make you who you are, and it is in them that you will discover your strength. They are what make you good, truly good.)

It’s one of those days, when you feel a yearning to return home, even though you are home. When you feel utterly alone in a crowded room. When you cannot fight the feeling that others, even those closest to you, do not see you, do not see through you. When you feel the expanse of an ocean between your heart and theirs. It is one of those days, that a small voice whispers in your head that you are insignificant, replaceable, unworthy.

(Despite what you may sometimes think, you are not alone. There are so many who have felt the way you do. There are so many who have loved you, who love you, who will love you. There are so many who you have not even met yet, who will need you here. There are so many connections, whether fleeting or long-lasting, brimming with meaning and potential, waiting to be made. And sometimes it is up to you too to make the first tentative step. There is so much more to gain than there is to lose. You have given so much, and you have so much yet to give. You matter.)

It’s one of those days.

(And these days too, shall pass.)

The Dead Teach the Living

By An Anonymous Author

Embolus feature May

This picture was taken moments after resuscitation. The dried blood on the watch marks the time we took to save the man’s life. Yet, unfortunately, the patient passed away, alone in a room full of strangers he briefly met just forty minutes ago.

The patient arrived by ambulance, with the paramedics pumping on his his chest as we transferred him over to the gurney in the resuscitation room. The paramedics failed to intubate because of a difficult airway. Once the residents managed to intubate him, I was handed the task of ventilating the patient with a bag valve mask. I internally counted the intervals required to help the man breathe, squeezing the bag and watching his chest rise rhythmically as the doctors carried out chest compressions.

With each subsequent breath, however, he became increasingly difficult to bag, as if life was slowly escaping his limp body. And with each squeeze, blood would leak out from the small valve of the mask. Amidst the chaos, I watched as his blood trickled from my fingers down my forearms. It was as if he was falling apart in front of me.

“Time of death, four twenty-five,” declared one of the residents.

The desperate atmosphere of the resuscitation room became suddenly somber. As the residents left, thanking everyone for their help, I overheard a senior nurse asking one of the new nurses whether she’d prepared a body before. Watching the nurses quietly zipping the man into a body bag, I looked at the man’s face one last time. How lonely he was in his last moments without the company of his loved ones.

In clinical anatomy when we dissect cadavers, identify the landmarks, we are told, Mortui Vivos Docent, the dead teach the living. During our clinical years, armed with the anatomic and pre-clinical knowledge, we see the patients we serve pass away and recall what was once said to us, Mortui Vivos Docent, the dead teach the living. But in this case, the dead not only teach us the clinical knowledge, but the human aspect of medicine.

It seems amidst all the time we buried ourselves in books, we have lost the human touch to medicine and forget the humanity of those we serve. With our numbering days we spend in medical school, we realize that time flies so quickly as we look back into our youthful days. Yet, we have a hard time confronting the time in front of us dwindles just as quickly. The deaths of our patients not only teach us the things we could have done differently, but grounds us with the reminder to never abandon our patients and the humanity that embodies them.

And perhaps when we graduate, we will read this oath to re-affirm this promise we once made when we decided to commit our lives in service of others:

“At the time of being admitted as a member of the medical profession:
I solemnly pledge to consecrate my life to the service of humanity;
I will give to my teachers the respect and gratitude that is their due;
I will practise my profession with conscience and dignity;
The health of my patient will be my first consideration;
I will respect the secrets that are confided in me, even after the patient has died;
I will maintain, by all the means in my power, the honour and the noble traditions of the medical profession;
My colleagues will be my sisters and brothers;
I will not permit considerations of age, disease or disability, creed, ethnic origin, gender, nationality, political affiliation, race, sexual orientation, social standing or any other factor to intervene between my duty and my patient;
I will maintain the utmost respect for human life;
I will not use my medical knowledge to violate human rights and civil liberties, even under threat;
I make these promises solemnly, freely and upon my honour.” 


(World Medical Association’s Declaration of Geneva)

 

 


 

First published as an AMSA Embolus Feature

The work-life balance: myth or mantra?

By Megan Herson 

The mantra of achieving emotional, physical and spiritual happiness seems to echo throughout every facet of life. From social media and television, to work and study, it seems to be inculcated into our generation that it is necessary to find a way to equally incorporate social life, family connections, hobbies, physical activity, and spirituality into our lives in order to be happy.

Social influencers have been able to make an entire career out of posting photos about their seemingly perfectly balanced life. It was not until very recently that I realised that the components of achieving a balance in life actually makes quite a long list. How on earth am I able to engage in extra-curricular activities while I try to understand the difference between aortic stenosis and mitral regurgitation whilst simultaneously keeping up appearances at my friend’s social events, and remembering to get my daily dose of veges whilst I rush to gym to stay physically active? Just reading that sentence makes me anxious! The components of keeping a balanced life seem attainable, but cannot all necessarily be maintained at the same time. I am not saying that career, connections, physically health, and spirituality are unimportant, but rather that it is difficult to focus on all aspects equally without collapsing under the pressure. It is okay – even healthy (in my humble and not-yet-medical-professional opinion) – for work and life to be experienced unequally.

Having a perfect balance of work and life, in order to achieve a state of wellbeing, seems a fallacy to me. We are all at different life stages with different priorities. Placing more attention on one aspect of life at a time may actually support wellbeing by attenuating the stress of achieving everything in balance. If you are at a stage of life where focusing on career is more important to you than going to parties, you can focus on that aspect of life for a period of time. If you are in a stage where you need a break from driving career and want to focus on personal growth, it is okay to put more energy into spirituality, social connectedness and emotional wellbeing. Of course, it is always important to have some aspect of all components of wellbeing in play; however, it may not be possible to give a hundred percent of yourself to your career, physical fitness, spirituality and connectedness all at once. Acknowledge that you may not be able to balance every single aspect of what makes life ‘healthy’ equally all the time, yet you’ll still be able to make the best decision for yourself at that particular point in your life. The caveat is to remember to limit the amount of time that maximal attention is spent on one component of life, and to alter the focus depending on what your priority is during that period of time.

 

Here are my top tips for achieving a state of wellbeing from one type-A to another:

Let go of some of that medical-student-perfectionism. Okay, this is quite hypocritical because I find this difficult at the best of times… but perfectionism is unattainable, and you cannot give yourself completely to every aspect of your life at the same time. Focus on what you need at that stage of life. Balance is important, but it is impossible to manage everything that is important to you equally and at once.

Have a few phone-free hours every day. Constantly being on our phones makes us available to people every hour of every day, and makes the world available to us every hour of every day. A sense of urgency is thus created, with the constant need for instant gratification producing a need to rush through life rather than enjoying it slowly.

Be kind to yourself – a concept that is perhaps the most important yet hardest one to accept and accomplish. Acknowledging what you need to be happy – and putting your needs before others – not only identifies what your priorities are in life, making it easier to realise where your focus is needed, but also automatically makes you a happier person.

Finally, be kind to others. You never know what someone else is going through, and one seemingly trivial comment or act may have a disproportionate impact on another person. This has been said before but medicine is hard and it may not be possible to give it everything all the time, whilst juggling so many different things at once. However by supporting ourselves and each-other we can give it our best and enjoy the journey at the same time.