My work as a physician often centers around helping mitigate trauma held by my patients. Recently I realized that my work also revolves around helping my patients manage their longing.
People long so deeply, and for so much. They go through countless medical procedures for a chance to become parents. They trial numerous medications and lifestyle changes to lose weight, feel less pain, or sleep through the night. They yearn for relief from the panic and depression that prevents them from leaving the house, working, and making friends. They pray that their cancer will stay in remission amid traumatic memories that resurface with each test and scan. They long to affirm their gender identity – to look in the mirror and see themselves as they feel inside and be fully embraced by their loved ones and society.
My patients jump through countless bureaucratic hoops for approval for housing or disability or programs that can help them access necessities that so many others take for granted. Perhaps the most painful yearning is to reverse the irreversible: to bring a deceased loved one back to life; to restore the memory of a partner with dementia; or, to become one’s younger self to make different decisions to change the trajectory of one’s path.
Longing generates physical symptoms and emotional distress. Some patients make this connection. Others cannot see the “why behind their what.” For me, moving endless prescriptions or referrals that merely ameliorate symptoms around a proverbial chessboard feels unsatisfying and may do patients a disservice. Instead, I prefer to better understand my patients, find threads of connection, and offer these as a new way forward. Then I step back and let my patients choose. We dance, as doctor and patient, trading off who leads. I strive to keep playing the background music.
Meanwhile, what do I do with others’ pent-up longing that I have collected? I need to set it down to create space for my own living and joy. Yet it is an honor to witness people’s wishes and desires, so I do not wish to toss their longings away carelessly. Additionally, seeing patients in 20- or 40-minute increments leaves little room for reflection.
The best I option I have found is to “metabolize” people’s longings. I learn from and honor their experiences, marvel at their strength and perseverance, and finally allow their stories to be carried away by life’s breath, into our collective existence.
Pam Adelstein
Newton, Massachusetts
