Tag Archives: burnout

the light amidst the struggle

One morning this week, I spied a woodpecker perched on a tree outside of the Cancer Center. Such athletic, flighty creatures, it seemed odd that he remained perfectly still, appraising me and the rest of the world around him with his unblinking eye.  Only a few feet away, I stared back and sipped my tea and my bones started rattling deep, deep inside:

I don’t want to go to work!!

Its odd, I almost always walk through the doors of the Cancer Center with a smile on my face, eager to see patients and start my day. But its been a struggle lately.  I’ve been tired, and working so very hard.  The endless stream of emails, prior authorization requests, distraught patients, hospice talks, conflict between staff members, and ever mounting pile of unsigned notes are taking their toll.

Or is it something more internal that caused me to be frozen under cloudy sky, unable to walk through the Cancer Center door?  I haven’t been taking care of myself as well as I could, but its not all been miserable either- I have been eating pretty well, and taking my dear dog for runs in the dark November mornings.

And then there are the anniversaries that quietly haunt me.  The anniversary of the day I napped next to my mother and noticed she was breathing differently.  It was so subtle, it escapes description.  But I knew something was different.  And she smelled different too- not bad, just ever so slightly different. The dying process started with a whisper on November 13th, 2011.

And then on November 14th, I got the call at 6 in the morning that she was hospitalized with a bowel obstruction, and in a matter of minutes I was barreling down the highway again in my Corolla, headed to Phoenix and biting my nails I could make it there in time. Turns out, we had quite a bit more time: almost a month.

Then there was the cascade of events and phone calls and praying and weeping in lobbies that lead her to be sent home on November 15th with hospice care. It felt so right and so wrong and so unbelievable, a dream and a nightmare.

Life had a singular focus: my mother.  There was no room for the stuff that doesn’t matter, like work stresses.  There also wasn’t room for a lot of stuff that does matter.

So, this year I’m doing well.  I smile a lot, and even have started worried about some of the small stuff again.  But this year, on November 14th, I struggled to go to work. I stood outside of the clinic under a grey sky, longing to stay still and sip tea and stare at beautiful birds. I had little to offer to the patients waiting for me, but I gave them what I could.  I needed not to give, but to receive.

It wasn’t an easy day for me. But perhaps the universe understood my plight, because when I came home there were two packages waiting for me: dried corn from my mom’s dear friend, and a book from my dear sister.

I don’t always get what I want, but sometimes I get what I need.

my work

Here I go, breaking my rules again… (the one about not writing about work)

Its been a hard few weeks at the office.  Even though I feel I’m divinely suited for this job (nurse practitioner in oncology), sometimes its overwhelming, and I think maybe life working in urgent care or a weight loss clinic wouldn’t be so bad.  This last month has been full of disease progression, hospice discharges, and death.  People I have grown to love, struggling with pain, dying too young.

My years of working in bone marrow transplant taught me a certain brand of detachment–  how to stay rooted in the present and not be attached to a future for the human beings in front of me.  It was a powerful lesson in letting go; I couldn’t look into the eyes of children with high risk leukemia day after day and worry about what was awaiting them next month or next year– it was unlikely to be a healthy, normal childhood. I had to care for and advocate for my patients, do the very best job possible every day, but turn over the outcomes and what would happen tomorrow to the universe, God, Buddha, Mother Mary, physicians, someone or something else other than myself. Because there are patients that will die despite a favorable prognosis and everyone doing the right thing, and there are patients that will somehow fight their way out of the grip of death and against all odds, survive. You never quite know in this business.

My patients these days are healthier and many of them are cured.  Even the women with aggressive, metastatic disease usually live years rather than months. I see them week after week, month after month, and I grow very fond of them.  We laugh together, we hug, we share photos and stories, I meet their best friends and relatives.  Its hard to say goodbye after such a long relationship.  I thought I was getting better at this but now I’m not so sure.  My loss of my mother has made me more sensitive to what the families are going through. As I work through my own grief I can feel what the surviving loved ones are experiencing.  It hurts.  I also see my mother in some of these patients and feel as helpless as I did to fix things during her illness.  I sit in the exam rooms with my dying patients and look down at my empty, searching hands.

And yet perspective is everything.  I am greeted with success stories every day.  These women plunged down the rabbit hole of cancer treatment and emerged on the other side, bathed in sunlight. As elusive as those rogue cells can be, resorting to every dirty trick in the book, sometimes cancer is completely slaughtered with the arsenal of treatment.  It happens.  An everyday miracle.  A billion cells, a million microscopic explosions in the battlefield of the body.  Victory down to the smallest unit of life.

Even when the war cannot be won, the enemy is usually held at bay for a while.  Mom’s cancer was very drug resistant, but I still think chemo bought her time.  Important time.  If she were here, I think she’d say that the nausea and the hair loss and the fatigue was worth it for her.

So, what I do weighs on me sometimes.  But it matters.  I can’t forget that.