I’m not sure where to begin but I know I have to start somewhere. The cliches of burnout and the “broken healer” play in my head. I have this restlessness born out of an addictive, ADD and people pleaser nature to do more, be more, be better and heal more. And yet my reactivity reminds me that something is amiss, lost, broken and perhaps even forgotten.
Healing has been corrupted by production, coding, quotas, endless tasks and paperwork for a growing population with endless needs. Trust once afforded to us as care givers is now lost and forgotten and we are viewed as political and corruptible and science is at best misunderstood and at worse rejected as invasive and poisonous. Social media is ripe with corrupt conspiracy theories and infects all of us with subtle toxic misinformation and, like a frog in a pot with the water slowly being turned up, before we know it, we are half boiled/half dead. As our social media addiction metastasizes into all aspects of our lives, we as caregivers/healers are not immune and are often infected and weakened. Where is our human connection?
“Awareness is the first step in healing.”
– Dr. Dean Ornish
Sleepless anxious nights have infected my time off. As I lie awake in bed I am rattled by the guilt of not “doing” and I worry that my absence creates an undue burden on my colleagues who are suffering from the same affliction. These are symptoms of my current contagion and like a fever that worsens at night I startle awake entangled by drenched sheets. Plagued by a rapidly beating heart trying to catch up with my racing mind I’m embattled by doubts, possible mis steps, lost opportunities and failures. Every illness inflicting my patients feels like a personal failure and every death ravages my soul. These thoughts are like rigors threatening to tear me apart.
With great effort I begin to pull myself back from the delirium induced stress stupor and reflect on those patients who have touched me with their resiliency and courage. I think about a family struggling with a parent’s progressive dementia who can find humor and compassion in the foibles of an adult now returning to cognitive infancy. I am reminded of a retired librarian who named her chemo port “Hamilton” because whenever she goes in for her infusion, she listens to the sound track over and over again for strength, inspiration and healing. I reflect upon the 19-year-old transgender college student who completed a year of hormone affirming therapy and is excited about embarking on a new journey as their authentic self. I remember the parents of an adult child with Down’s Syndrome who tenderly hold their child’s hand as the medical assistant administers a shot. I also call to mind the parents who lost their oldest son in a tragic car crash who can rediscover joy again, as well as the parent of a child who died by suicide who is beginning to let go of the shame and self-blame. I remember the gift of poetry written by the wife of my patient who succumbed to alcohol addiction which helped in her own addiction recovery. I can also hear the strain of the mother of 3 young children who has the courage to share her postpartum depression and is reaching out for help. I bear witness to the pain of a 16-year-old athlete whose injury takes them out for the season and is now ravaged by despair and is brave enough to share his suicidal ideation, and I am reminded of the courage of the 3-year-old boy who proudly announces after his recent shot that “I only cried a little!” Each one of these patients visits my thoughts and helps to reconnect me to myself.
As healers we are given the title of medical “providers” and our work is broken down into business measurements of RVUs and ICD-10 codes. What we do and how we care for our patients is, in part, described as a production system and yet our work ultimately isn’t about production. I am not naïve; we need to understand these basic principles to do what we are called to do and we have diligently applied ourselves to learning the business of medicine. Now it is time for our business people to learn and embrace the language of healing. We need to share with them that my 99215 code is because I have spent an hour with a suicidal teenager and her family trying desperately to find a hospitable bed, that it is about having to disclose to a patient and her husband that the abdominal pain she has experienced over the last several months is the result of metastatic cancer. That 99215 reflects bearing witness to the ravings of a patient who went off of his antipsychotic medication and is experiencing progressive paranoid and delusional thoughts. All of us can think of multiple examples of the incredible hurting and illness that inflicts our patients and our society and it is important that these experiences are not dissociated from the codes that provide reimbursement. I want to extend an open invitation to our administrators, coding experts, tech support, custodial staff and all those who help support the business of medicine to reconnect them with the opportunities they provide us to care for our patients and connect their work with the healing of our world.
Our medical system is critically ill and its contagion spreads to all who encounter it. What can we do to slowly heal our profession and in so doing, our society? “It has been said that time heals all wounds. The truth is that time does not heal anything. It merely passes. It is what we do during the passing of time that helps or hinders the healing process.” Jay Marshall. What I plan to do is recommit to the heart of healing. It begins with reflection, gratitude and an invitation to reconnect with the holy aspects of our profession.
I came across several quotes about healing which resonated with me and I want to share them with you:
“Healing may not be so much about getting better, as about letting go of everything that isn’t you-all of the expectations, all of the beliefs and becoming who you are.” – Rachel Naomi Remin
“Don’t turn away. Keep your gaze at the bandaged place. That’s where the light enters you.” – Rumi