January More Voices: Grit

Dear Pulse readers,

When I think of grit, I think of someone who perseveres–and sometimes triumphs–in the face of hardship.

When I was nineteen years old I hitchhiked alone across the US and back. Was that grit? Or was it teenage wanderlust and foolhardiness?

Making my way through medical school certainly involved hardship–and I persevered. Was it grit that got me through, or was it a fear of failing?

It did take grit to make it through residency. I can recall many mornings when I trudged to the hospital, feeling anxious and bone-weary, wishing I could be anyone else doing something different–something that didn’t rub my soul raw and leave me so depleted.

In the hospital, it took grit to handle bodily fluids and uncooperative patients, something that nurses and nursing assistants did as a matter of routine, many with matter-of-fact, good-humored energy that I hoped would rub off on me.

And then, as an attending physician, there were patients whose grit I often underestimated because I saw them when they were at their most vulnerable.

I think of Elena, an older woman whom I cared for after a colleague left our practice. Elena took daily opioids for chronic pain. She would come to appointments in tears because the pain had settled in a new area, and the pills just weren’t strong enough. Radiographic studies were unrevealing. Physical therapy never helped, nor did referrals to a pain specialist, or to a social worker for counseling.

We had a recurring conversation, during which Elena begged for higher narcotic doses and I replied that I didn’t think it was a good idea.

I took care of Elena for years. She was my “heartsink” patient. When I saw her name on my schedule a feeling of dread and gloom would come over me.

Chronic illnesses finally caught up with Elena, and she passed away. It was only then, when attending her wake and speaking with family members, that I came to realize what I’d been missing all along: that Elena had real grit.

“She held the family together,” her son-in-law told me. Other family members who came in for appointments in the weeks and months after her death echoed the same refrain: Elena was their matriarch, a linchpin of the family. They missed her deeply.

So while I’d experienced Elena as a needy patient with mysterious pains begging for higher doses of narcotics, her relatives knew her as their family’s pillar of strength.

How much grit did that take on Elena’s part? Far more, I’m sure, than the grit I needed in caring for her.

What I also learned, after her death, was that she liked me and thought I was a good doctor, even though I felt I’d done so little for her. In my eyes, my only “success” was keeping her from getting addicted to higher doses of narcotics–something that, in her eyes, wouldn’t have been a success at all.

January’s More Voices theme is Grit. What’s been your experience with grit–as a patient, health professional or caregiver?

Share your story using the More Voices Submission Form. For more details, visit More Voices FAQs. And have a look at last month’s theme: Birth.

Remember, your story should be 40-400 words. And no poetry, please.

We look forward to hearing from you!

With warm regards,

Paul Gross
Editor