Vision of Hope

I have a favorite poem.

Salutation of the Dawn, attributed to Kalidasa. It's a poem from a Classical Sanskrit poet and dramatist who could capture the emotion of life with words far more precisely and succinctly than I dare try. It's been in my head that last few days and I can't help but think yet again of it's power to me on a day like today.

It's been one of those days. Residency can be hard. I have it relatively easy in my program. But that doesn't make the hard days any less demanding, draining, and gut-wrenching. From being misinformed from the beginning about a patient, to spending multiple more hours in the ER than usual stabilizing someone who is not doing well, to watching the family grieve someone who was well less than 24 hours before a conversation about end-of-life care. To go from a room with the above scenario to getting feedback for being slow on rounds makes me want to cry.

Deep breaths.

Look to this day, for it is life, the very life of life.

To be honest, this family reminded me of my own. The spouse had a kindness that reminded me of my father and the daughter had the same shock I know I must have had in a very similar situation. I haven't had that yet- the flashback to personal loss- until today. There was something in their sweetness, their innocence that brought it out. Something in the love that was so clear. I will never be able to express what growing up in my family was like- there are not enough words. Love was so clearly expressed. In the end, I am so thankful for that, because like this family - there was no regret, only love and fear of loss. Fear of a future without a beloved family member. I know what tragedy comes for him. Going home alone. Planning a future alone. The absolute and soul killing loss of having the future you did have planned pulled out from under you. It is a wound that never heals. He shook my hand and hugged me. He thanked me for all that I did. All that I did. What I did.

Deep breaths. Let it pass.

In it's brief course lie all the verities and realities of your existence.

At the same time, I look around what I now consider my workplace and see how my work intersects with people's lives in the most severe and abnormal of ways. I see people on their worst days. I break the worst news. People live in parallel to the hospital, glimpsing it occasionally as they pass by to other life events, until they need it... and when they enter it's doors they come in contact with us. It feels like the strangest frontline for raging a war on health. There's always little cases - stable people you know will be in and out and on with their lives. But then there's the people who will never go home again. Case management for placement. Hospice. And then today. The people who don't make it out of the ICU. 

I find the interaction of our realities the most interesting. The hospital can be dehumanizing for us. Sleep deprivation, personal frustration with our own inabilities, frustration with patients who won't take care of themselves or who are working the system, emotional turmoil of patients whose lives will be forever changed because of a simple hospital visit. Despite all of this, there is a daily dose of empathy and compassion from listening to patients stories or fighting insurance for them, of interacting with the family and hearing the burnout, the sheer overwhelming nature of their family members health on their and their family's lives. You get to know hundreds of people in deep and meaningful ways in such a short amount of time. And if they're lucky (and not your clinic patient), you will never see them again.

The bliss of growth, the glory of action, the splendor of achievement.

And in the midst of all of that is the personal growth. Even on the rough days, you can see yourself grow. As a doctor, there are so many aspects that continuously develop. From competency to confidence, compassion and efficiency. To say we work hard is an understatement. To see myself objectively work that hard, that quickly is comforting from a development assessment side. It's strange to have such diverging abilities to assess yourself- an emotional, empathetic nature and a cold, objective nature. Despite the oddity, they work together to make me a better physician.

For yesterday is but a dream, and tomorrow is only a vision.

It's surreal to be home, bathing the dogs, laughing and cooking dinner on a post-call night with my family and be getting text messages about a family I care about and their impending loss. How to separate that to be able to function in life? It happens naturally. I think of them. I draw them up in my memory, I surround them in whatever loving energy and vibes I have in me, and I say goodbye. I am surrounded by amazing people who I know I can count on to support the family, to make good decisions. By people who tell me, as I'm walking out on one of the hardest days, that they learn from me every time they work with me (thank you. thank you in a million ways with a million words, thank you). The people I work with make the schedule worth it. The family and friends I come home to make the ups and downs a passing event. They allow it to not be a part of my soul that effects by ability to function. It's self-preservation, true. But how much easier to know that you're actually just well supported by the people around you. What more could I ask for?

Deep breaths. 

But today, well lived, makes every yesterday a dream of happiness, and every tomorrow a vision of hope.

Every day is a new start. A new patient, family, situation. A new chance to learn. A new chance to get better. A new day to clear my vision. It allows me to take on that family that exuded love and whose hearts broke today without fear and with the ability to help, in whatever way I can. Find beauty in the way the world interacts, in the way lives intertwine. Find joy and peace in the tragedy and comedy of life. See love in the heartache of loss.

Deep breaths.