You see us at MD offices, on hospital floors, in your home. We can be chatty and kind, intense and focused, sometimes chided for being abrupt like a nurse Ratched. We are moms and sisters and aunts and grandmothers. We seem like nice people. Many are amazed that we can do what we do every day. And we always seem nonplussed by it all. Like we are going off for just another day of work and coming home and getting on with our daily chores and lives.
It looks that way, it does.
But you cannot always tell a book by its cover.
We don't talk much about our days, especially those of us who work with the critically ill and dying. And why would we? Who wants to hear about that? We don't even like to hear about that.
We bury it way down, or at least try to. But occasionally, it comes back up. We feel stressed and sad. Sometimes despair creeps in. Life seems unfair and we are powerless to help. It can all become too much to bear.
A nine year old that dies. A mother with two kids, 44 years old, sent home on hospice to die. A woman who needed emergency heart surgery dead of a simple complication. A man who was cut off on the highway while riding his motorcycle (with a helmet) dead of a head injury, extubated with his 15 year old son standing next to his bed. An ALS patient who cannot breath at 3pm on a beautiful Monday afternoon. A man who came in with a cough, leaving with a death sentence of small cell lung cancer after a routine CAT scan.
I could fill pages with the patients I have seen. And this abbreviated list was compiled in just my prior working week.
I am not complaining or looking for any sympathy. I don't need or deserve it. My patients and their families do however.
I am not an angel, special or a saint. I have been called all, as so many others in the medical field have been called. But we don't see it that way. We try to be helpful, compassionate and competent. We try to make people healthy and well; and when that fails we try to make them comfortable. It is all we can do. Many times, it falls short of the mark. Feels like it is never enough. And many times it isn't.
It would seem as though this is the stuff of nightmares; of what could keep me up at night fretting about the tragedy of life and our own unknown futures. But it isn't. This is not what my nightmares are made of.
So what is it? I will tell you. It is seeing healthy people blindly leading their lives who just don't get it. It is watching people continue to smoke knowing that it will shorten their lives eventually and reduce the quality of it dramatically. It is watching someone not paying enough attention to their kids or being cruel to them under the umbrella of "discipline." It is hearing people talk about the petty nonsense of their lives looking for sympathy and being angry when it doesn't come their way, lamenting that "no one understands me." It is dealing with people who have never seen tragedy in their lives and who are selfish and never lend a hand to anyone else.
I know that sounds a bit angry, and perhaps it is. And perhaps I have been guilty of some of it myself. But the truth is, most of us don't really want to get it. We like protecting ourselves with our day to day lives and our trivial complaints, it is safe there. We hope we never have to deal with tragedy. We hope to be blessed with the mundane.
And that is why we nurses and doctors don't talk about our days. No one wants to hear about the bad we see. If they don't hear it, they don't have to acknowledge that it exists. They don't have to learn from it. They don't have to feel it.
I can certainly understand that. But it is a shame because death has so much to teach us about life.
We don't have to think about death or disease to know about life. We can go through each and every day without giving it a thought until it is presented to us. But what we miss by thinking that way and shielding ourselves is huge.
Honestly, the happiest people I know are those who stop trying to harden themselves to the truths of life. The happiest people I know are those who have softened themselves and let life and love in, with all of it's scary, messy feelings.
Being strong enough to let down your guard and actually love someone without abandon, that is true freedom. And freedom is happiness. But most people don't do this until they face a sure end, when they finally feel they have nothing left to lose. But what they failed to realize, as most of us do, is that they never had anything to lose to begin with. Not really. And by the time most come to this conclusion, it is too late. And they die with much regret, leaving regret in their wake for future generations, the ones they had sought to protect.
Not living life fully, that is my nightmare. It is not the patients I have seen and tried to help. They were my teachers. I am forever in their debt. I don't want their lessons to go unheard. That would be the true tragedy. The scariest nightmare of all.
Do not fear death so much, but rather the inadequate life.
Until you divest yourself of the notion that you are a collection of needs, an empty vessel that someone else must fill up, there will be no safe place to harbor yourself, no safe shore to reach. As long as you think mostly of getting, you will have nothing real to give.
Remembering that I'll be dead soon is the most important tool I've ever encountered to help me make the big choices in life. Because almost everything — all external expectations, all pride, all fear of embarrassment or failure - these things just fall away in the face of death, leaving only what is truly important. Remembering that you are going to die is the best way I know to avoid the trap of thinking you have something to lose. You are already naked. There is no reason not to follow your heart.