‘Twas the day after Christmas and all was not well. In a string of unfortunate events that would make Lemony Snicket jealous, my father had come down with the flu, the presents were indefinitely delayed and I found myself – an internal medicine intern – losing the battle to maintain my consciousness in the team workroom. The holiday season, usually my favorite part of the year, was definitely on my naughty list. At least there was New Year’s to look forward to, or so I thought.
It is funny to me how moments I consider mundane stay crisp and vivid in my memory, while important ones arrive already out of focus. One example of these “blurred memories” occurred after I got home from work later that day. I do not remember where I was or what I was doing when I heard my aunt’s voice on speaker phone saying my grandfather was in the ICU. I could have been making a sandwich, or floating in space or swimming in the ocean. In retrospect, the ocean makes the most sense, because what I do remember is that suddenly everything became muted. I heard faint echoes of facts: he had collapsed; he was unconscious; his prognosis was poor.
Suddenly, I was the expert in the room. Without time to process or even comprehend what had happened, I was asked to pass judgment. “Was his doctor making the right choices? What antibiotics should he be on? What would I do?”
What would I do? I would ask my attending physician. As I did not have access to them in my house at 7PM, I utilized the only other resource at hand: Dr. Google. I had been a doctor for five whole months. Imposter syndrome did not even scratch the surface of my feelings of inadequacy. I researched, rationalized and prayed. A multi-pronged approach. We all listened as my grandfather’s state worsened, then stabilized, then improved and then entered the vicious self-sustaining cycle all over again.
And all throughout these happenings, life – like every scholar, fiction writer and random human has said – went on. Something happened between the time I fell asleep and woke up, something akin to dark magic. I realized that compartmentalization was not just a fairytale they taught us in school, but rather a logic-defying fact. I was able to see my patients, laugh at my co-residents’ jokes, smile at the nursing staff and then go home. Home. Where knowledge and reality fell on me like a crippling second skin.
However, sometimes a chink would show in my carefully placed armor. Like when a “Code Blue” was called, and during the process of stabilization, hand-off and transfer, my mind would wander to thoughts of my grandfather. Wondering if he looked this way in his hospital room all the way across the world. Then I would remember that I was in the hospital and who I was supposed to be while here and I would fall back into my armor.
This routine of what felt like play-acting in a Greek tragedy went on for a few weeks that felt like years and then came another call. He was gone. And suddenly all those hypotheticals, all those days spent holding it together, all those chants of “all will be well,” well, all those turned out to be bitter nothings.
Useless, just like I felt.
He was gone and I did not save him.
Nothing would change that fact, which periodically invaded my mind throughout the day. I was more irritable at home, finding it easier to keep to myself than to interact with my family. Work was not much better. I tried to mirror the cool demeanors of the doctors I saw on TV, who were somehow able to bottle their feelings while solving the most perplexing of cases. Needless to say, I failed miserably. It was not grief that was the overwhelming emotion battling to take over; it was emptiness. Numbing, fathomless nothing. And it was so tempting to let it win.
I was trudging through one such day when I met a patient I will refer to as “Sadie.” I was speaking about some issue that seemed minor to me in the context of her larger, looming health problems, when she made a statement that caused me to freeze. She stated very seriously that her sister had gotten hurt in some sport in school and that it was her fault. I was perplexed, and needing to know how this was true, I asked her.
“Because I wasn’t there”, she answered matter-of-factly. I stared at her for what I guessed was an uncomfortable amount of time judging by the look on her face, then took a deep breath. I suddenly had the strange sensation that I was looking in a mirror. No, we did not look alike, but there was a resemblance. The words she said had caused something to move in my rusty mind. The seeming lack of logic in her statement was quickly replaced by recognition. All my feelings about my grandfather were encapsulated in that simple sentence, “Because I wasn’t there”. Because I had not saved him. Because I was not enough. But those were not facts. They were myths that were slowly loosening their hold.
I looked at Sadie and softly asked, “And if you had been there?” She stared back and then slowly answered, “I don’t know. Maybe nothing would have changed.” After she said that, it seemed like she relaxed just a tiny bit. I mused that maybe she had never said that out loud before. We learn about this topic called transference and countertransference, where emotions can muddle patient-clinician relationships. I knew that my personal feelings were there, but they were not clouding my judgment. Rather, they were allowing me to clearly see what Sadie and I both needed: some grace.
Losing my grandfather did not happen in one day. It happened slowly, over time. Sometimes it feels like he is still here, and I feel a pang of sadness when I realize he is not. But with that time came healing and an understanding that no one expects or wants me to be their savior. My role, which I am increasingly grateful for, is to keep caring and to use what I know to keep trying. Being physicians, with all that entails, does not alter the fact that we are human beings with emotional and physical limitations. I learned that giving and receiving grace can have as much of an impact as all the medical advice or knowledge can.
I will always miss my grandfather and the way he called me “Sonny”. However, I know this Christmas, though still painful, will hurt a little bit less than the last one. And a little less is more than enough.
Image Credit: “Christmas Tree Fruit” (CC BY-NC 2.0) by Sergé
Resident Physician Contributing Writer
UT Health Houston
Shveta Abraham is a third year resident in the General Psychiatry Department at UT Health Houston. She went to the University of Houston where she majored in Biology and minored in Medicine and Society and Psychology. Shveta has always been interested in helping fight against the stigma related to mental health through education. One form she has always valued is writing. Through writing various forms, she strives to both express herself and the values and beliefs she holds dear. In her free time not spent writing, she likes to sing karaoke, bake and watch an enormous number of movies.