(On the mountain – Christa Wells)
I recently re-discovered Christa Wells’ Frame the Clouds album…I am a little bummed I couldn’t find it on Spotify, but that’s what youtube is for 🙂 . Lol, a little throwback to high school…or college…or whenever it was that I first discovered it via (in)Courage (which no longer has the link to listen to the album for free…).
The grief is still an ever-present companion that makes life a little harder than it should be every day, but God is good. Even when it seems like God kinda forgot about me over here, I have to believe that he is in control, he loves me, and he isn’t making this happen just to make things harder for me. I have to keep believing that he cares and understands. It is hard, but I am strong and I am not going to be defeated. Things are a LOT better than they were though. Progress is slow, but not stagnant. That is an accomplishment to be proud of because especially with the continued big losses. Like that high school Bible study that I almost signed up for as a compromise between me and my best friend, Life Hurts, God Heals. I have to remember that God isn’t up there making me hurt for funsies, but instead he sees it happen and wants to be involved in the business of healing.
There has been a lot of hurt in the past few months, but there has also been a lot of healing. Someone said something recently about pain lasting only for a season…I’m kinda pretty sure that they didn’t mean that once fall hits it won’t hurt anymore, but I will admit that I got my hopes up for a few moments until I figured it out…but while one day to the next you might not identify the progress, it is there. I realized yesterday as I was walking home from work how far I’ve come. In the beginning I was lucky if I got more than a couple hours of sleep at night. Now most nights I am pretty much at baseline. My sleep is a little messed up still, but now it has more to do with the strange hours that I get at work. In the beginning I was doing whatever it took to get SOMETHING in my mouth, which usually meant hoping skating a few minutes balanced out that the calories and fluids in were greater than those out. Now I might still be careful to have three meals every day and that each meal consists of at least the four key components (protein, carb, fruit/vegetable, dessert), but it isn’t usually that hard to do anymore, and I don’t doubt that someday eating will be something that doesn’t really use much thought again like it should be. And I might still cry more days than I don’t, but it still is a lot better than it was in the beginning. It isn’t like I am holding back tears most of the day and almost certainly crying once I am alone. Considering it has only been a little over a week since the last big piece of the career-related loss, I am ready to be proud of that. I know that it all God. I couldn’t have possibly recovered this well without God on my side. I still have a long way to go. It still feels like I’ve been climbing forever and am still at the bottom, but I know that my soul is going to get there one day. Grief is a marathon, not a sprint.
I was working on getting rid of some stuff I don’t need anymore and came across some notes from one of my classes a few years ago. Some of it is definitely junk, like a list of updates we were supposed to sign up for and some things that we were supposed to follow on twitter. I might not have ever actually done it because 1) I don’t really *want* to blend school with my social life and 2) I didn’t then and certainly don’t now need more stuff showing up in my email inbox that I don’t care about and will just delete, and TBH, I don’t go on twitter often enough to ever even see anything useful if it was there…I like the idea of being connected on twitter a lot more than I like actually using it…especially since I prefer to use a lot more than my allotted 140 characters at a time.
Anyway, there was one page that I almost kept. It was the lesson about grief that most of the class either didn’t show up physically or showed up physically but not mentally because it wasn’t going to be on any of the tests…yeah, they probably shouldn’t have told us that in advance…but I did pay attention in case anything important came up, because loss is something to which I am no stranger. As usual on topics like that, it was mainly pretty self-explanatory material, but sometimes it is reminders of the obvious stuff that is important. Lol, so here are a few highlights.
- We can’t really be present in life if we can’t accept death
- There are four human conditions: freedom, isolation, meaninglessness, and death; Meaninglessness and death give life meaning.
- This is one that I don’t really get…but I thought it kinda sounded interesting.
- We are affected by loss because we are social creatures who need love and care and lacking those things our communication becomes feral.
- We are affected by loss because we cultivate relationships and engage in communal living.
- Grief is an experience. Mourning is a process.
- Grief is normal and expected.
- There are four responses to grief
- Feelings: complex emotions can make it difficult because we experience negative but also positive emotions
- Behaviors: withdrawal, isolation, impulsivity, erratic, denial (Yep, I have fought against most of these)
- Cognition: numbness is common
- Physical sensations: fatigue, tears, laughter, muscle cramps
- We go through five stages of grief, recursivity is when we go backwards. (I would add that although this lecturer suggested that it was always linear that I believe it is also possible to skip over certain steps sometimes…)
- Anger only exists because pain exists.
- We attach therefore loss hurts.
So I was going to post this before church, and I can’t explain why I didn’t expect for that it was a God thing…God knew there was going to be another element of loss I was going to need time to process…
So the pre-communion message was about exclusion. And slowly I started to understand another element of the loss. I’ve always been on the outside looking in. In K-12 school it was because I was painfully shy (social anxiety/selective mutism??) and struggled to make friends. I framed my watching of conversations as observing for mimicking later to gain skills, and while that is true, it is also true that I would have loved to have been included. A lot of my friends were the ones who didn’t have any other friends…it meant that a lot of the time once they had the chance to make other friends they didn’t want to be my friends anymore. In college I started making friends. Then I was abused and the abuse itself made me feel like I didn’t deserve friends and no one would want to be friends with me. Then, after the abuse people started taking sides, and the people with whom I was most comfortable were reached by her first and they weren’t very nice to me. Over time they started to be more nice, but it was super hard to go to school every day knowing that “no one” wanted me there. I was already dealing with the pain of the abuse and the stress of the breaking of the relationship to get out. On top of that I was still being tormented by my abuser and the people who had been my friends were being hurtful. The people who were still trying to be my friend just didn’t really get it. No one really understood what was going on. I’d always been someone who was pretty self-sufficient because socially I kind of had to be, and now I was outside of my realm but couldn’t access help. And then the gag order came as I was slowly figuring out how to let people in and I was required to shut everyone out again. At a time in my life when I REALLY needed people I was threatened that my options were either no more school or no more people. I chose no more people because becoming a pediatric critical care pharmacist was super important to me.
And while school is talking about how everyone has so much access to XY and Z, they were telling me I was absolutely not allowed XY and Z. While they were inviting the whole school to an event it was understood that I was not invited. I was always excluded. While they were having discussions about how every student deserves the same rights and respect I was still being left out. I wanted to be involved on campus but when there was a prayer walk I was left behind alone in the stairwell trying to figure out where I could go without getting in trouble for no longer being with the group. When everyone was going to meet in the “special study space” I had to be the awkward group member pretending I didn’t understand the directions and joking that the cafeteria sure is special as a reminder to the organizer that I can’t go anywhere good for groups…I was effectively set apart as different in a negative way in group projects, study groups, student organizations, and anything else I wanted to do. What a way to show that every student is important and valued. It was very clear that some students were valued but I wasn’t one of them. I do understand that there were a few people on campus who were nice and cared about me, but the overwhelming message I got was that it would be easier for everyone if I had just chosen not to come back. It was incredibly hurtful to go from the promise second year that there would always be resources for me whenever I needed them to the decree fourth year that I had no access to any student services and better not create my own support network outside of the school’s system or else. Eventually I had to admit that the “next month” “next semester” “next year” was never going to happen. I just had to hang on until graduation. That’s why I was counting down days until graduation before I even reached spring break fifth year.
More to the point, when I was being abused I was being told I wasn’t good enough, I wasn’t ever going to be enough, no one was going to want me. Getting the residency I wanted was going to prove to myself and to everyone else that I was good enough. It was going to prove that someone did want me. It was the only thing I had ever wanted and I had thrown all of me into doing whatever it took to get there even if meant living in painful silence for three years. Residency was when I was no longer going to be on the outside looking in. I was going to be included. I was finally going to be on the inside.
And then I didn’t get the position I wanted, nor did I get any position. Eleven months of applications and interviewing and I wasn’t wanted by even one position. I had so many friends, many of them on the residency panel at my preferred position and even they didn’t want me. No one wanted me. Like Dan Allender said in The Healing Path,”it is being used by someone who violates our dignity and then is unmoved by our pain.” No one cared about me. At every interview I was told that I was a top candidate…but I guess when someone better came along I was just a nobody that tossed aside like dross. Serious question: I have heard that saying before, but I don’t actually know what dross is…also, I apologize if that is a rude thing to say…sometimes I hear things and imitate what I’ve heard and it isn’t until people are shocked and mad at me that I find out that I am mimicking something that is a bad word. Yeah, I may have learned the B-word was bad by imitating it and being told off for saying it. Anyway, not getting a residency made me think that maybe it wasn’t really abuse but just someone telling me the truth that I wasn’t worth it. I do now have the perspective to know that it was abuse, but I think now that I understand 1) why the abuse was so hurtful and 2) why the failure to match was so hurtful. It all came back to exclusion. Another way to exclude me from the world in which I wanted to live when I so deeply longed to be included.
I am a fighter. Looking back I can recognize how strong I was. I might have been fighting to eat and drink and sleep, but I was still driving all over the country applying and interviewing for more positions in the next few weeks. I was still told how excited they were I applied and how I am such an excellent candidate…and then 5 days short of a month later was left completely unwanted again. And then the Scramble. And then eventually I had to admit that I had been excluded from the world of residency and had to settle for something else. So many positions applied for, most without even so much as a sorry you didn’t get the position.
Exclusion hurts. Isolation hurts. Add that to grief and no kidding it was (is) painful and hard…
Totally unrelated, but I try to avoid medical talk outside of work unless directly asked for my opinion…because I don’t want to be one of those people who is all up in your business. My opinion is that if you want me to know what kind of sick you are and how to fix it you’ll tell me and if not I should keep my mouth shut…(the exception being stomach flu…even though I am not struggling with OCD anymore, I do still tend to have a radar out for the stomach flu…). But here is one situation in which I am going to voice my opinion…so someone I know has been in the ICU because this person punched a window and somehow nearly amputated the arm. They don’t really know if it will ever be functional again, and for that matter even after a few surgeries keeping the arm still isn’t a guarantee, and there are a bunch of rules to follow to give at least a possibility for healing. My opinion is that it was a waste of resources to attempt to keep the arm…we’re talking things like no chocolate, no caffeine, no alcohol, no smoking, etc…umm, this is someone who didn’t have a driver’s license but thought it’s be a good idea to get drnk and go joy ride someone’s car…and then after being released from the hospital went home and was robo-tripping…seems to me that just taking the arm and promoting healing of the rest of the body would have been a better choice, because as it is it seems like they did all that work for an infinitesimally small possibility of it actually leading to saving the limb…I know that we are trained to heal, but sometimes you have to look at the whole patient and family and realize that there is a contradiction between what medical literature would give as the correct answer and what is really best for the patient. Obviously these decisions don’t happen in a vacuum and the patient and family need to be involved in the decision making, but I think sometimes in laying out the options we present it in such a way that people feel kinda forced or obligated to choose a certain option when it might not really be what they wanted…lol, maybe I am way off base or maybe I’ve done too many hospice and end-of-life CE’s, but I think part of empowering patients and families is giving them options without coloring those options through the biases of our own lenses and desires.
And yeah, I know that “patients and families” is really not the vernacular in the adult medical world…I have pretty much grown up in the pediatric realm (and really really want to go back to pediatrics). In pediatrics we know how hard hospitalization is on the whole family, including the siblings and caregivers, and we know the importance of the role the family plays in healing. We care about and have services for the families that are just as important as caring for and serving the patients. In adult medicine it is very clear that, as one of the logos of my employer states, “the needs of the patient come first.” No mention whatsoever of the family. That really bothers me. I haven’t seen research on the family in healing in adults, but based on what I know about pediatrics and adding that to the psychology that I learned in school and the basic skills of observation, I have to believe that family is still important in adult medicine. I know that the patient him or herself gets the final say if he or she is competent to make decisions, and I know that any sharing of medical information even with the family must be okay’ed by the patient, but I also believe the family should be included in the care decisions if the patient agrees and I think the family should be cared for. I’m not sure what resources are provided for families where I currently work, but from what I’ve seen so far, it appears to be precious little. It is a stress on a family when a member is hospitalized. It changes routines, it causes uncertainty and sometimes fear. It takes someone out of their home and leaves behind a hole. In some cases it takes away a source of income, or something else that directly impacts functioning of the household. I don’t think that is something that I can change though…and I should probably stop writing because I don’t really need more reasons to miss my friends at Children’s…
Wednesday is going to be hard. I usually kinda sneak out to avoid goodbye parties…now I’m having two goodbye parties in the span of two months. I’m not saying I don’t appreciate it, because I totally do. I really really love my coworkers, and I love that they show how much I matter to them, but I just don’t like being the center of attention, and I don’t like confronting the goodbye head on. It is really hard to have lost the one last thing that was really important to me. I know God cares, but it is hard to understand why he lets this happen if he really is omnipotent.
Also totally unrelated, but I recently did a CE on depression…I took the screening tests as if it were still March/April/May. On the first one if you score at least 3 points the pharmacist is supposed have you take the second screening. Even now I would hit three points. On the second one if you hit I don’t remember whether it was 7 or 10 points, the pharmacist is supposed to refer you for additional professional help rather than helping you with self-care…I would have scored something like 23 points…I was running short on time so I didn’t do the second screening again to score myself for right now, but I know for sure my score now would be significantly lower, and IDK for sure, but it might not even reach the cutoff for you shouldn’t be figuring this out on your own…that is kinda awesome. K seriously gotta do something useful with my life now…