Patient as Doctor

I usually do Pilates and have lunch with my friend Susan every Thursday. It’s my day off from work, and I do all my household errands and self-care, along with this special weekly date with Susan. But yesterday, I called her and told her I just couldn’t do it. She asked me what was wrong, and I told her I didn’t know, that I just felt like I wanted to crawl under a rock.
She was worried. It’s not like me to cancel, and certainly not like me to hide under rocks. As a general rule I am pretty high-energy, and I’m fairly social.
“If you’re feeling depressed, it would be better for you to get out of the house. It’s not good to isolate,” she told me. She offered to make me lunch, bring it over, or have me over to her house. She is a really great friend, and she meant all this in earnest.
But it wasn’t depression that was the problem. It wasn’t like I wanted to isolate because I was sad or down. I was just exhausted. Not the kind of exhaustion that comes from too much physical activity, or the kind of exhaustion that comes from not enough sleep. In fact, probably I hadn’t had enough physical activity for the few preceding days, and, while, like most of the U.S. population, I’m always on a little bit of a sleep deficit, I wasn’t significantly sleep-deprived. It was more that I was mentally fried. I needed a day to re-charge, and my instinct was that I should do it alone.
I can’t explain exactly why I was so fried. I’m sure it was a combination of factors. A week earlier, I’d taken an unexpected trip to Toronto for my aunt’s funeral. I only went for a day, which was probably foolish. But it was a Tuesday, and I had to cancel patients. And Wednesday is my busiest patient day, so I felt uncomfortable canceling a second day at the last minute. The funeral was, of course, sad, but my aunt had been sick for a while, and that side of my family has a wide net of family support. I convinced myself that this trip was no big deal and I could get back to a normal schedule the next day. Probably my first mistake. The rest of last week was okay, but this week my Monday thru Wednesday patient hours were packed, long and intense. When I work, I really put myself into it. I came home each evening too tired to exercise or do much else. Not pushing myself to get some physical activity was probably the second big mistake.
By Wednesday afternoon, I was beat, barely able to finish my hours. One of my patients, a nurse, looked at me with a furrowed brow during her appointment and said, “Are you sick?”
“I don’t think so,” I answered.
“You don’t look well. Your color is off,” she told me.
It took this to make me stop and pay attention to myself. I’d been running on empty, and I couldn’t keep going.
I think this happens to many people periodically. We plug along, continuing our tasks no matter how tired, hungry, sad, or in some cases, ill, we are. I know better than this, but sometimes I’ll put off eating, drinking, or going to the bathroom in order to keep moving in the office… until putting it off is no longer an option because my body goes into revolt. Maybe it was okay to do this to myself when I was 25, but at 51, it is simply self-abusive. I would never suggest to a patient that it was okay to do these things, yet I’ll do them myself!
It took my nurse-patient’s comment to snap me out of my denial about my own needs. I may have responsibilities to my patients, but unless there is a dire emergency, I clearly need to attend to my physical and emotional needs, or I’m not going to be much good to anyone else.
Fortunately, I had the opportunity for a mental health day today. Not everyone has this. I’m not going to call it a luxury, because it really isn’t. It was essential to get some extra sleep, some good-quality exercise, hydration and nutrition, and a good amount of quiet time today. But unfortunately, our society does not always allow for these needs to be met. We overvalue ‘productivity’ at the expense of well-being, and all the technology that constantly demands our ‘immediate’ attention makes things even worse.
Many other cultures are better than ours at recognizing the need for breaks, both daily breaks during work hours and vacations for more intensive recharge. If our society is not going to look out for the needs of the individual, we each have to try to do it for ourselves.
In the future, I’m hoping not to reach the point of having a patient tell me I’m wrecked before I notice it myself. Lesson learned…I think.

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~ by drrozkaplan on February 17, 2012.

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