As anyone in health care knows, work has been difficult this past almost-two years. There are layers of dysfunction and disconnect. Despite our collective fatigue and overwhelm, however, we show up and do our best. We apologize for the system, the lapses in care, the way that everything feels complicated. This emotional work is heavy. Sometimes I have the image of myself, like Atlas supporting the globe, hunched forwards with my patients piled on my back. I am carrying them to higher ground.
Month: November 2021
According to Oprah Winfrey, it’s when we feel least thankful that we are most in need of what gratitude can give us: perspective. The neurologist Oliver Sacks expressed a similar idea; his reflections on what it means to live a worthwhile life were published posthumously in a book titled Gratitude. Diagnosed with a terminal illness, Sacks wrote that his predominant feeling was one of gratitude, expressing appreciation both for what he had been given in life and what he had been able to give in return.
I wasn’t looking for a new dog. I had recently lost my best friend of over sixteen years, a beloved terrier mix. My sister had dragged me into the shelter so that she could get a new cat. So, while she looked at cats, I decided to pet all the dogs, lingering a little longer with the ones that looked the most sad.
The shelter staff began to follow me like I was a shoplifter. “Can we help you find a dog?” “What kind of dog would you like?” “Would you like to meet that dog?” Desperation tinged their inquiries.
My husband George got to know Ruthie while he was sitting with his mom during her final days in an assisted-living facility. Ruthie, a hospice worker, was a middle-aged woman who had reentered the workforce after raising her kids. As a nursing-assistant trainee, she was learning on the job, with George’s mom, unconscious and steadily declining, as one of her first patients.
Soon after meeting Ruthie, George was struck by her lack of self-confidence.
Late one evening, in Open Heart Recovery, my seventy-five-year-old patient’s temperature shot up from 98 to 103. I gave her Tylenol suppositories, double-checked the blood she was getting and called her surgeon. Dr. Vance instructed me to repeat the Tylenol, add intravenous steroids, then quickly hung up the phone. He needed some sleep after performing cardiac bypass surgery all day and on-call.
Mrs. Smith’s elevated temperature both worried and puzzled me. She might be having an allergic reaction or malignant hyperthermia.
I was on the 36th hour of a 48-hour ambulance shift. We had been up all night and had remained busy all day. I was starving, so I ran into a deli for a quick fix. The kid behind the counter told me they were closed. I paused, jaw dropping in disbelief.
“Just kidding, boss,” he cackled.
Being over ninety years old, I have a long list of things to be grateful for. I’m especially grateful for all the lessons I learned over the years that helped me become a better practitioner.
Much of this was acquired fortuitously. The era in which I began my practice. Having four dedicated children who taught me to be fully present by never hesitating to tell me when I wasn’t.
A tug of war lives within me, and my physical body and soul are struggling mightily. Gratitude pulls one end of the rope, and burnout yanks the other. I feel immensely grateful that I can meaningfully contribute to people’s care during the pandemic. I’ve triaged, tested, talked with and tended to countless patients since COVID-19 began. I am blessed with wonderful family, friends and community plus a job with deep purpose and meaning. Each workday I feel enriched by those around me.
A small wooden figure watches over my office. Four inches tall, hand-carved, neatly painted wood—an angel figurine with golden hair, majestic wings and a simple pure-white gown. Throughout my day seeing patients as an internal medicine and pediatrics resident, this angel watches over me—a constant reminder.
Two years ago, as a fourth-year medical student, I was on my internal medicine “acting internship” on the general internal medicine floor. This service was known for great teaching and complex cases—and notorious for emotionally heavy experiences.
Editor’s Note: As New Voices’ first editor, I am thrilled to launch Pulse’s newest feature with this story by Livja Koka, depicting, among other things, the difficult choices that parents make in hopes of giving their children a better future. This story, we hope, is only the first of many accounts by writers whose voices and experiences have often gone unseen and unheard. If you have such a story to tell, we hope you’ll consider submitting it to New Voices. — Olapeju Simoyan
Every family has things they do not discuss. The emotions are too real, the pain is too raw, the guilt is too intense, the denial is still too young to be interrupted. In my family, we have little problem discussing most things, except for the events of one dark day.
The date was March 19, 1997. The place, Tirana, Albania. I was barely six, so my memory of the day feels like a dream that fades in and out and has no finite beginning or ending.