First class tickets

"Are you sure you're ready to go back to work?! Its only been three days since your bone marrow biopsy and diagnosis!"

I was asked this question multiple times last weekend and even over this past week by many concerned family members, colleagues, friends and onlookers expressing their own disbelief that I would be back at clinic, as I limped around after my biopsy and slept minimal hours day after day. But, I returned to work on my typical side of the desk feeling a great sense of purpose and belonging - this was where I needed and wanted to be. To be honest, I wasn't completely sure if I was ready how could I have truly known?

I've taken layovers on anger/rage and tearful islands, got back on the plane numerous times and I think I received a first class ticket for an all inclusive trip to the resort of denial this week. I like it here, I may stay a while.

Denial in itself is far easier to spend quality time with and has transitioned and assimilated me back into a work environment, enabling me to take on my role as a physician again. At this stage, it is preferable to the many other emotions that have pulled my typically stable emotional framework apart at the seams these past few weeks. It is important for me to express that it doesn't necessarily mean I am not dealing with my diagnosis, nor does it mean I won't face what is ahead or cope below the surface of the smooth current floating around me right now. To me, it means reeling in my emotions to bring me to a place of functionality and presence. Its early days. I know my previous visits to those less than glamorous islands will resurface and I actually look forward to it all. We all have to remember, I knew this was happening to my body weeks ago, while everyone else was in denial. See, you liked that resort while it lasted, didn't you? The sunshine and endless cocktails certainly eased the pain of the sunburn.

I have had this conversation over and over in my head. Why are you holding up so well? Are you truly being honest with yourself? The truth is, I am being honest to my core and I am in control again of one thing - how I react to and deal with what is happening. Otherwise, the universe has the major role to play. I firmly believe there are numerous reasons as to why I am in this position and at some point I will write about it. But lets just say, these reasons are the foundation to who I am and I can continue to surge ahead with all that is on my plate nearing exams and the end of residency as a result.

No question, there have been a lot of tough moments in patient encounters. I think that because I am and have always been so focused in my chair, I feel a new sense of understanding, be it of great importance to the patient or not (in a sense I was so acutely sitting where they are in front of me just a few days ago). I ask questions I never thought to ask before - I want to know more about the psychological understanding they have as to what is going on inside their physical being. If they don't have alternate ideas, I try to work with them to discover what is beneath their complaint and wonder if they are either too afraid to recognize what may be going on, or not informed. I felt like I was on a high at times despite the lack of sleep, with each patient I just wanted to help, to show them I understood that no matter how big or small their complaint, they were important to me. I really care about what brought them in to see me on that very day, but more specifically, when they left our encounter I wanted them to leave feeling listened to and above all, human.

I found myself drawing hilarious diagrams, one of which included explaining what a 'sweep' was to a prenatal patient and how I would perform this in the office as she was close to delivery. I thoughtfully drew her uterus and woman parts (I should have kept this illustration for the records). At one point I looked up and chuckled saying "This looks like a sink with the plumbing coming out of the bottom doesn't it?" She could only smile and likely lied when she stated the picture was a good idea. In essence, I guess I wasn't wrong with the sink and plumbing part..maybe I am on to something.

From going into detail about why I was giving blood tests, to asking patients to summarize our treatment plans, to simply facing each patient and not typing on my computer the entire time, I already knew my practise was changed forever. I know that some of these meticulous points will ease and subside but for now, it makes me feel good and my patients better. I realize everything is all a bit fresh. That is enough to help me sleep at night and perform to my potential.

Ofcourse it wasn't all good, I did struggle with some of my short term memory which is normally spot on and I did possibly over explain or emphasize investigations or differentials to patients which made me less efficient. I was once told I had to be "less efficient with my feelings" while giving bad news to patients, or any news really as feedback from a supervisor (I have to agree). I hope she is reading this because I think I really took her advice to another level! Less efficient with my feelings, got it. Take time to feel, no problem. I'm not going anywhere.

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