- Moving Through and Moving Forward
On the five hour drive home after my father–in–law, Mike's, initial hospitalization for renal failure resulting in a diagnosis of aggressive multiple myeloma, my head seemed too tight, the radio too loud, and the DJ's too rambunctious. The tension in my head built, hammering, getting more severe over the evening. I slept fitfully that night, my head pounding every time I rolled over. The headache continued into the next day, when I went into work as I was scheduled to teach a clinical reasoning small group. I was horribly irritable, and didn't understand the headache. Mike was suffering with an illness, and medical school and residency trained me to deal with illness, so why was I so tense? I could deal with any patients' [End Page E10] medical problems. Yet Mike was not just any patient to me, a tiny voice inside whispered.
I confirmed with my supervisor that I was back and would cover the small group on clinical reasoning. I naively felt that if I could work, the headache would pass. The first sentence of the case stopped my breath: the chief complaint was a growing lump in the neck. I frantically flipped to the last page, searching for the diagnosis. My grief, packed away for the past week, erupted in chaotic, wracking sobs. I closed my office door so passing students wouldn't see me losing it and tried not to wail too loudly. I sat on the floor in one corner of my office because the walls felt solid to me and I didn't want those in the nursing building who could see into my office to witness my private sorrow. I called my supervisor back and, still crying, said "I just can't do it." I wanted to give him time to find faculty coverage so I called when I was still in tears, thinking that I wouldn't be composed for hours or days or ever. The tears seemed infinite. I pulled myself together as much as I could and made my way to my car, awkwardly accepting kind remarks and dodging faces full of pity. Everything—the air, my body, life, reality—felt too thick, too heavy. I went home, crying the whole way. Slowly, my headache eased and through it, I felt more real than I had since the ordeal began the week before. I understood my crackling irritability and massive headache—I had been suppressing my feelings.
Why wasn't I ok with feeling sadness? I hadn't even realized that I had turned that part of me off for the last week. I had been in crisis mode, doing what needed doing, supporting my husband, filtering the medical–ese being spoken by my peers. Besides, I was just the daughter–in–law. What right did I have to be upset? Mike wasn't my father, though he was a principled influence in my life for two decades. I didn't even realize I was avoiding my sadness or trying to reason around it.
Looking back, I had some serious issues with sadness. I learned to stuff sadness, as needed, to function, especially in residency at the county safety–net hospital. Working 36 hour shifts with very sick patients, emotions became superfluous; work and marriage and then sleep were the priorities. I didn't feel justified in feeling sad. Even though feeling feelings was actually self–care, it felt indulgent, though in retrospect was entirely necessary. I crave reason and order whereas sadness isn't orderly at all. Sadness can't be scheduled and seems to exist on its own terms. Expressing sadness, crying, is replete with messy secretions. It didn't feel acceptable to not work just for feeling sad. What? Was I going to call in sad? Yet, I couldn't work when I was bawling and incoherent. I also didn't want people to know that I was that sad, feeling defenseless and entirely helpless in my sadness at work.
During my father–in–law's many hospitalizations, I acted as the trusted medical interpreter and liaison for the family. The physicians were intelligent, compassionate...