It's late, I can't think of a snappy title

Today was a post-call day. I worked the last 2 nights on L&D and today had no big responsibilities. The kids had a 2 hour delay (sooo cold!) so when I came home they were still asleep. I walked Bear and then watched some TV until they were ready for school. Because of the cold, I offered to take them to the bus stop but then we decided just to drive to school. I got a lot of lounging and some netflix in and a little nap. Post call days are a little tough bc I don’t want to sleep all day because then I won’t sleep at night! Even so, I’m sitting up in bed at 10:30 as bright eyed as if it were AM instead of PM. Thankful I can use melatonin to make myself sleep!

Tonight the kids & I watched a movie & had dinner & microwave popcorn on the couch. They were both very snuggly as seems to be the case when we’ve been parted for a while. Now I’m going to color and watch a little more of Season 2 of Travelers on Netflix and wait for the melatonin to kick in. Got an extra on the nightstand just in case!

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You know that old joke about making your headache go away by dropping a brick on your foot? Or the one about hitting yourself over the head over and over again just to see how good it feels when you finally stop?

That kinda sums up how I feel tonight! My son’s soccer practice was cancelled tonight (it is raining cats & dogs and the field is flooded). It was an amazing gift not to have to run around tonight and be out late (soccer goes until 9). It’s just a little too far to come home and I need something to do that doesn’t cost money 3 times a week. Even a cup of tea adds up to an untenable amount with that frequency. Yesterday I laid down in the back seat of my car and dozed while he was at practice. I never even left the parking lot! Earlier in the week I discovered that Whole Foods has free wi-fi and I sat and watched TV there. It felt really good to lay down on my bed and not HAVE to get up!

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I have a patient who nearly died and frankly isn’t out of the woods yet. She’s someone I know relatively well, seen her a few times in clinic and inpatient. She got sick really fast and all the teams who have worked with her (she’s been handed around a few times as the acuity of her situation increases), all of our heads are spinning. We are reflecting on what we did, what we could have done, what was happening in the past before we knew why she was getting symptoms that didn’t seem to fit. For all the many MANY medical inaccuracies of the TV show House, MD, sometimes finding one cause that explains the many symptoms is really what you need when treating a really sick patient. Honestly when you have a patient with many different symptoms, they are usually are caused by a bouquet of chronic diseases or complications but for this case, once we identified the root, it explained all the problems. Now that she is not under my team’s care, I’m still following her case, she was my patient before this admission and I feel very connected to her. I’m very worried about her. And I will never forget these symptoms and how quickly she became gravely ill, right after we thought she was responding to treatment.

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On the heels of telling you that I am very worried about and distracted by a very sick patient, I will note as well that I cannot muster the distress to cry about her hospital course, which would be an entirely appropriate reaction. I have a lot of reasons to cry and a lot of skill at boxing it away. I’m working on a moderate amount of unpacking of my emotions, trying not to keep myself totally walled off from an emotional process but also not allowing myself to be mired down by my many stressors. I know there are tears in my heart somewhere for my patient. I just can’t find them with all the boxes.

I consider it a win that I managed to find space to cry over my divorce earlier this week. And that I have also managed NOT to fall apart as my kids are distracted and distracting with their end of the semester projects and finals preparations. Their projects become my problem as well - I had to buy a printer, they need my computer and my room to type & work. It’s a razor’s edge, this balance!

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Deleted my dating apps from my phone today. Actually felt really good about it. I’ll get there, but I’m not there now. It feels better not to try.

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I’m really enjoying a level of comfort, familiarity and mastery at work right now. I mean it is a tiny amount of stuff, but still it is a portion of my eventual scope of practice. I’m familiar with the places we get information when we don’t know what to do, I’m starting to get comfortable with some simple, more frequent complications, like post op pain, postpartum bleeding, fetal heart tracings that look worrisome and most of the standard full term complaints & queries that bring people into triage/outpatient L&D. It is really easy for me to panic and feel inadequate when I see the 2nd years growing into their own comfort level with the content that they are mastering. Watching them precept births, manage complicated, sick patients that I’m not yet responsible for and so forth. I work really hard just to feel proud of them and remind myself of one of our programs mantras, “It’s a 4 year program.” Yeah, I’m not there yet. But I’m not supposed to be. There will be more learning curves and there will be more times when I feel overwhelmed but this isn’t one of them and I’m really grateful for that! 

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In 3 and a half weeks it will be my 20th wedding anniversary. Last year was awful. The year before that was rocky. The one before that I was pretty sick but the marriage was in ok shape. But the rest of them were normal, happy anniversaries. My marriage had a lot of excellent years. Dreams shared and achieved, milestones observed, laughter, travel, love, friendship, children, homes, cars, pets, careers, extended family, friends. I’m feeling a huge sense of loss for those beautiful years.

There’s a part of my mind that still blames me for the dissolution of my marriage. It says that I gave up, that I didn’t try hard enough or wait long enough for the great times to come back around. I don't think so, but maybe. But I don’t think people work that way. We don’t go backwards. We might be able to find our way forward to a new place that’s great, but we can’t go back.

Missing those beautiful years has me fantasizing, engaging in a bargaining phase of grieving. Thinking about making overtures of reconciliation - what I would say, how I would approach it, how it might go from there. Fortunately, I have been meditating for some time and have become quite skilled at just watching these thoughts, appreciating them as they bubble up and watching them as they float through my mind. I’m able to connect the dots and acknowledge that reconciliation is *probably* not what I really want, that I’m processing loss and missing a thing that is gone and wishing it could be here again.