The Work of Staying

When people talk about “guts” in medicine, they often mean the dramatic moments. The resuscitation. The difficult diagnosis. The decision that carries obvious weight.

But the moments that stay with me look different. I think of patients who return after a period of absence. They sit down, hesitant, unsure where to begin, and say something simple: “I didn’t think I would make it here today.”

I think of those who have been living with depression for a long time, who have learned how to speak about it in ways that sound almost routine. Near the end of a visit, there is often a pause, followed by a quiet admission that things have been worse.

I think of the times when showing up is the work.

In psychiatry, there is often no clear turning point. Progress is uneven, sometimes invisible. There are long stretches where nothing appears to change, and yet something is being carried forward.

It takes a different kind of guts to remain in that space. Not the kind that announces itself, but the kind that repeats. Returning to the next appointment. Saying one more true thing. Staying, even when leaving would feel easier.

I have come to understand that guts is not always about doing something extraordinary. Sometimes, it is about continuing.

Devina Maya Wadhwa
Thunder Bay, Ontario