I finally have a full, real, beautiful day off!!!! It’s been a looonnggg stretch these last few weeks. I had one day off in the last three weeks, and even on that day, I had to come into the hospital to round on patients. Working12+ hour days, 7 days a week in a mentally, emotionally demanding job, starts to take its toll—it’s like being in residency again. I have less reserve…for anything. I feel my reserve of kindness and grace and love start dwindling away, and I start to become short with people. I barely give anything extra. I keep my eyes downcast so I don’t have to make eye contact with anyone, so I don’t have to say hello, or listen to small talk, or hear about their medical problem. I don’t greet people with more than a quick “hello” and I don’t make myself available…to anyone. Normally I don’t mind doing any of these things. Often I enjoy them, and they make the day brighter and help refill the general reserve of goodness in the world. And usually the blessings are mutual.
But not these last few days. I’m just hanging on till my next day off when I can rejuvenate and refill this reserve so that it can flow out again. I also make more errors, and I have made a few medical mistakes out of sheer tiredness and not being clear-headed. I wish I was better than this. I wish that I could just keep on giving even without enough sleep. I wish I was still kind and thoughtful and smart and joyful. But all of this dwindles. Small things make my cry.
Funny story: I even cried in front of the president of the hospital this week when my car (technically not “my” car, because I am borrowing from Norton Sound Health Corporation) disappeared. As it turns out, a maintenance guy took my car to use it for our awesome patient driver service here, and then he realized it needed some work so he took it to the mechanic…without telling me. So on my 15-minute lunch break I went to look for it, and it was gone. I had a mini panic-attack, then went to the office to ask about it, where it felt like people were being less than helpful (this is the effect that fatigue has). Then the president was walking by and they asked her, and she said she didn’t know and I just broke down crying. I sobbed about how we spend 12 hours a day taking care of patients and we don’t really take care of ourselves, and then when I had 15 minutes for a lunch break, I couldn’t even go, because the hospital took my car. I realize this was petty, but I am human after all… Anyway, they kindly offered me alternatives, but I had to get back to work.
The good part: later that day, I went down to the port to pick up my new vehicle that just arrived on the barge (purchased and shipped by an amazing human being)! I still didn’t have a proper title, license plates or insurance, but that’s another story…
My new car!!! Fresh off the boat… an Alaska car now.
Uggh… I snapped at a few nurses when I didn’t think things were getting done as needed. I also snapped at the behavioral health clinician after I had done all the behavioral health work for a few psych patients, and he hadn’t come up with a plan. So I told him the plan, and more or less told him to do his job. Uggghhh… I hate it when I am unkind. Even when things are frustrating or not working out well, and you are tired and exasperated, it never, ever pays to be unkind. Unkindness makes you unapproachable. I want to be approachable. My favorite people in life are always welcoming and approachable.
Life has a funny way of restoring things. There were a few days when I was trying to get to the DMV to get a proper title and registration for my vehicle, and of course these days were the days when patients came late, had multiple complicated problems, and needed way more than a 15 or 30-minute appointment could accommodate. But each time when I went in already frustrated, stretched thin, determined to just quickly meet their basic need and get them out, everything changed.
Somehow they opened up to let me see their deepest needs, their stories, the reason why they have these needs, and all of a sudden the DMV didn’t seem that important, anyway. I started writing up these stories, and what I’ve learned, which I will post eventually.
Particularly yesterday I had an amazing visit with an elderly woman from Gambell, who blessed me so much. She had 15 or 20 medications she wanted me to address for her 8+ medical problems, and she had odd pills in her pill box that we couldn’t identify, and was just recovering from breast cancer and felt like her mastectomy scar was so ugly, part of me was trying to figure out how I could rush through this appointment, since I was already behind and trying to get out early (to go to the DMV again). Then she told me the most amazing thing:
She said, “I can tell your parents raised you right. I don’t know you at all, but I can tell that you care so much about your community and people around you, and that must be from the way your parents raised you. I thank you for taking such good care of me.” All of my haste and impatience and stress dissolved in that instant.
*This* is why I am doing this.
She reminded me.
I smiled and told her that my parents raised me in a little village in the middle of nowhere, and that my mom did basically the same thing as what the health aids do in the villages here in Alaska. And that they lived their lives to love and serve…and yes, they were amazing people who instilled these values into their kids. And that is why I came here. She said, “Oh really? That is wonderful!” She gave me a big hug. And thanked me.
I thanked her for her encouragement, and I told her I needed to hear just that today.
I later saw her in the hallway and we exchanged another big smile and hug. Another RN (one who I was a little bit snappy with earlier) told me how much she appreciates me and sees me starting to get burnt out and encouraged me. And others gave me sweet thoughtful offerings of encouragement.
Kind treats from the secretary. My breakfast and lunch to keep me going.
Encouragement from the least expected places…the DMV!?!
Then I actually made it to the DMV, which incidentally is only open a few hours a week!!!!! (Shocking after the way the day seemed like it was going). Finally, 2.5 hours later, I got to the counter and actually, finally got my proper vehicle title and license plates! Then the DMV woman looked at my name and asked, “Are you Dr. Theobald?!” I shyly said yes—I really don’t like to be recognized as a doctor in public, because that’s when people in the DMV start showing their rashes and telling you their medical history. (most of the time I don’t mind it, really). But then she said, “I heard you are such a good doctor. A lot of people have been recommending you as a doctor.” Really?! I felt surprised, and deeply humbled, especially for the way I’ve been feeling this week. My heart softened again, and I felt my reserve fill up a little more.
I got my license plates…now I can drive this car (legally)!
Fresh thoughts…after 12 hours of sleep
Today, after waking up at 1pm and feeling refreshed, I was thinking more about it. My amazing parents work at least as hard as I do, in their blue collar jobs, for a lot less pay. I am so incredibly proud of them and honored to have them as my parents. Because I do get paid extra for the extra weekends that I work. My mom just broke her hip, and I would love to be able to go down and visit her and help take care of her. If I could get time off, I just might. But more importantly, I get a chance to give back to my family who gave me so much. There are so many rewards of this job, and sometimes I lose sight of them, when I am become so exhausted. It is true that we need sleep, we need time to rejuvenate and be filled up again, and to take care of ourselves—and the above events sparked some conversations with the President, the Vice President and fellow doctors of ways to improve the system! But at the end of the day, I am here to serve and take care of people, and I am so lucky and so blessed to get to do what I do. And I don’t want to lose sight of that, even when the days are long.
My TB patient showed me some eggs that were gathered and brought to him. The spotted egg is a seagull egg, and the blue egg is from a different bird… I totally forget what he said. He is leaving for treatment and he encouraged me to keep loving and serving and told me to not get burnt out.
Midnight sun–the view from my bedroom window at 12:00 midnight. Glowing midnight blossoms and rusted tin roofs. Summer nights in Nome.
My Friday night entertainment. Love Nome kids!
Moose right outside the ER!
Sometimes the night was beautiful, sometimes the sky was so far away. Sometimes it seemed to stoop so close, you could touch it but your heart would break.
Sometimes the morning came too soon, sometimes the day would be so hot. There was so much work left to do, but there was so much you’d already done.