hurling smiles and judgment

(sobering – plumb)

this lyric seemed just about perfect for one of the topics in today’s post…kind of two of them depending on how you look at it…not gonna say anymore about that…

This is going to be a huge mish-mash of random thoughts, because there are a lot of half-written blog posts in my brain and I couldn’t choose which one to fully write…

Sometimes hope looks like one bottle of soap shared between the shower, bathroom sink, and kitchen sink. It is incredibly inconvenient, but I have finally admitted to myself that the chances of going back to work at my former  place of employment is highly unlikely and have been rejected from the other jobs in the area that seem at least somewhat relevant to my skill set and interests. And I am holding on to hope that it won’t be long before someone is so excited that I am available that they offer to hire me rather than just talk to me…if I could get a job without having to interview verbally I would be thrilled…especially because the person who was thrilled in August to be my mentor cancelled our meeting in September and hasn’t answered my emails since. Speaking of going back to work…I am also realizing that although my shirt says see a red flag say something, that is a lot easier said than done. It is a lot easier to see the red flags when you are more removed from the situation…and when you do see them it is hard to say something if you don’t have a safe venue to share that finding.

But I think I am still keeping the amount of hope realistic. Today I decided on a list of places I am interested in applying for residencies next year if I end up in a position to do so. I honestly don’t know what my ideal plan is right now. Most of me says the goal is get a job somewhere before it becomes a possibility to apply this year, work for a while and figure it out later, another part of me has this master plan depending upon what position I get and the timeline of exactly how long I will stay and when residency application will occur…and a third part of me says you can’t go into a job planning when you are going to leave…it worked for me once, but who is to say it will work for me again. It also is hard because none of these plans align at all with the plans I had in my head a year ago regarding what my path would look like. And I really don’t want to move a million more times, but at the same time, I don’t know if I really want to end up in some of these positions forever…and I’d be lying if I didn’t admit that I am terrified of missing the red flags or ignoring red flags and ending up in another scary situation…what if I run and instead of finding something better I just find a different unwelcome challenge? But at the same time, I can’t do nothing and any job with an income is probably a better option long term than doing nothing and eventually running out of savings. Moving is not fun and is incredibly expensive, but it is possible.

Sometimes you have spent so long surviving that you get really good at it but forget how to live when you no longer need to survive. I don’t remember where this quote came from, but it is incredibly true.

Recently I was doing a CE about suicide prevention. One of the things brought up was the risk level of pharmacists for suicide. As I knew, this is a topic that has not really been studied, so is not fully known. What I did not know is that pharmacists are seven times less likely to seek help than physicians, because pharmacists are good at caring for their patients but tend to have a lot of stigma towards themselves and their colleagues. This is relevant because physicians are known to have a higher than average suicide rate which is suspected to be in part because physicians are not good at seeking help because it is hard to willingly admit that you need to be on the other side of care…but it is known that people who seek help are less likely to successfully complete a suicide. So I thought about this. I am okay-ish at help-seeking. Because of my history I do avoid some of what might seem like the more obvious avenues until I really feel like I might need them because I want to protect myself from things that in the past have led to further hurt, but I find other ways to get my needs met…but I have definitely experienced this year the stigma coming from other people aimed at me.

So…a few weeks ago which by the time I decide to post this might be months or more ago, ‘cause it could be days months or never when I finally post this and I don’t want to keep re-writing the timeframe…I heard somewhere…IDK whether it was a counselor on youtube, someone on the TTFA podcast, or somewhere else, but I heard that healing from significant trauma or grief starts at 18 to 24 months. Not finishes. Not makes significant progress. Starts. Yikes. Yep, I made it to that point only recently…and to be honest, the incredibly slow “progress” I was experiencing *did* incredibly speed up about that time. I mean, there were definitely some slow downs secondary to other stressors outside of the grief experience (aka some things going on at work), but the going from zero sleep to 4-6 hours of sleep took two years. Over the past couple months aside from the past couple weeks, that has increased to 6-7 hours a lot of nights…and I totally do still really miss my dad and wish I could talk with him and be with him, but it doesn’t hurt as much. And people sometimes talk about transitional objects…and I never really thought of my necklace that way because I planned to wear it all day every day forever…and over maybe the past month or so I once in a while do not put it on first thing in the morning or even if I’m running late might leave my apartment without it and while I still wear it a lot, not wearing it would have been a huge issue just a few months ago…for that matter, there were times I was super struggling with my OCD and EVERYTHING was getting wiped down pretty close to daily including my glasses, skin, nametag, pen, the inside of the pencap, sometimes even taking apart the pen to clean the inside but the necklace despite not being willing to wipe it down in case the words faded away was still worn.

And realizing that timing kinda makes me angry. There was someone who not just insinuated but said to my face that this person thought that the loss of my dad made me not a good residency candidate and perhaps I shouldn’t move forward with the residency process. I chose to chalk that up to not understanding the grief process, not understanding that life can’t be put on hold indefinitely, and not understanding that residency is important to me and my dad would not want to get in the way of my dreams…and this person also obviously had no way of knowing that a little under two years prior to that I’d been having the same thoughts as I was trying to work towards PGY-1 applications but was also not sure where I was going in life anymore because your girl who was so passionate about critical care and emergency response was now avoiding responding to emergencies and really struggling with end of life. Obviously I got through that and not only that, the passion returned and I absolutely loved my nicu and picu rotations and my opportunities to respond to pediatric emergencies. And honestly, the fact that someone was telling me that in regards to PGY-2 when I’d successfully completed year one was also probably something I should have considered a little more deeply, but anyway, it is frustrating that without even seeing my abilities or taking the time to understand or even ask how or if this might impact my work I was being discounted for something that happened two years ago. Had I been asked I would have been happy to share how it had impacted me in the past and how I anticipated it may impact me in the future. I would have been happy to share things in the past year that I had learned about my grief and how I was using that to ensure I was doing everything I could to keep my grief from impacting my work. Until that was brought up as a mark against me in September, I felt like it was an incredibly important part of my story for people around me to know. Not only is it part of my identity, but I thought I needed people to know in advance that while the support of routine and normalcy around me is helpful for me that I might struggle on a few particular days and therefore may need unexpected time off, but would prefer not to plan that time off in advance in order to allow me to have that normalcy if I was doing well enough to function appropriately in my role. Now if I had it to do again I don’t know if the answer would have been to plan in advance to somehow find an excuse to have those days off without explaining why and therefore lose out on any possibility of normalcy or if I should have planned on a no notice call out if I wasn’t doing well enough to come in. I feel like the respectful thing is to do what I did and give the advance notice that I might need a day or two off rather than doing a last minute call out when I can’t do it that morning, but I mean, as it turns out I didn’t need time off, and clearly being honest was used against me. But it is never wrong to do the right thing. I guess it is kind of the no good deed goes unpunished kind of thing…

In reflecting further, it is incredible the difference in the response of this person versus the response I got a little over a year prior to that…

The response before was you are strong, you can do this. It was a question of is there anything I can do to help you. It was an email with probably 7-10 options for support that for the most part were  very practical and had considered what might be helpful for me specifically. I copied that list onto a post-it note in my notebook to cross off as I accessed them, and a lot of them I was able to do right away, but the list stayed hidden in my notebook for most of the rest of my year. That is so different than the response this year that I shouldn’t even be doing a residency. Whereas last year my staffing got modified in the spring when I acknowledged that it would help me, this year I hadn’t even asked yet for any modifications to the program to assist in my healing, and yet the fact that I had this loss was used as evidence that I wasn’t residency material and wasn’t safe for patient care. I was so careful each morning to make sure that I could safely and effectively fulfill my responsibilities. I will be the first to acknowledge that there was at least one day last year I really shouldn’t have been at work. I got through the day, and I wasn’t unsafe, but I also didn’t deserve a full day of pay for the level of work I was able to complete. This year there wasn’t a day that my grief reached that level. Every day I came to work ready to do my best regardless of what got thrown at me. I worked really hard to try to get work done in the breakroom or wherever else I was supposed to work. I was consistently on time or early. And it isn’t like anyone would have known anything was going on in my life if I hadn’t been open and honest about it. I wasn’t wearing my heart on my sleeve. I don’t think you should have to hide how you are feeling except for in patient care areas, but that is how I generally operate, because it is what has kept me safe in the past…honestly, I hide it and I try to distract away from my pain because a lot of times things feel like too much. The only way I know how to survive is to try to numb everything so that I only have to process the pieces that fall out of the over-stuffed box. It might not be the ideal way to deal with things based on psychology textbooks, but it is what has gotten me through life so far and that probably isn’t going to change any time soon.

And I’m feeling like I probably already said way more than I should have on that topic…and I’m trying to figure out if I go ahead and post it anyway or if I edit out those paragraphs…I could probably write five or six blog posts worth of material just on that one topic…and it is hard because this was supposed to be the completion of my dreams, and instead it became a nightmare that I didn’t feel safe telling anyone about…and still talk about mostly in very vague terms because honestly I am still afraid.

So…something else that made me feel angry recently but on a very different level was a guy on a street corner. In my experience, people with portable microphones say a lot of ignorant and stupid things on street corners. I don’t know what it is about owning a portable microphone that makes people’s brains incapable of using logic, but anyway, this particular guy’s soapbox was something along the lines of everyone, I need your attention. You have a choice right now to do the right thing. You can either choose Jesus and walk up to this trash can to throw away your mask, or you can live in sin and your dirtiness will send you to hell if you follow the mask and vaccine mandates of your employers. There are so many problems with this message that I don’t even know where to start…I mean, probably a big one is that God makes it very clear that we are to follow the rules of those in authority over us…and that you absolutely can both choose Jesus AND get vaccinated according to the CDC immunization schedules and wear a mask when those in charge request that you do so…hashtag not saying just saying…

Also, I need to edit (or just delete) my half-finished Christmas letter…Among other things, I may have written myself into starting a position today that I haven’t even interviewed for…for that matter, the way in which I wrote it, I don’t really know if I was actually writing myself into a position that I applied for that definitely exists, or if my original intent was a job that isn’t currently available…so there’s that…

the pressure of approval is a heavy weight to bear but so is living with regret

(Uncool – Leanna Crawford)

 

Okay, so this has been on my mind for a little while…and a lot of it I have probably already said before…but…

 

Infectious disease was a thing pre-COVID-19 and will continue to be a thing once media attention leaves this particular disease…

 

Y’all probably are somewhat aware of my opinion, so you know I am obviously not advocating to suggest media and politicians were right to choose one health issue to focus on at the exclusion and detriment of others…but…if we’re gonna pick a health issue to focus on for 2021, I’m getting my nomination in early. I nominate suicide.

 

Just like this year, we can have statistics that are updated with extreme regularity for a couple months before it gets old and frequency decreases. We can track age, geographic location, careers that may carry higher risk, medical factors potentially carrying higher risk, social factors potentially carrying higher risk. These risk categories can be changed and modified regularly. Hey, maybe we can even ostracize people who do end up struggling with this particular problem until we are absolutely sure they are healed or dead and then make them our heroes…

 

And politicians can make inconvenient rules that are supposed to make people feel like they are being safe while mostly just inconveniencing nearly everyone and definitely hurting certain segments of the population while fueling division among people who don’t agree on what the rules should really be. Like we can mandate the number of people you must be around at certain times and the maximum amount of space between people…

 

…okay, while I say this tongue in cheek, I am still very serious that after the devastation in this area that social distancing and closures have brought, mental health needs attention. Humans are social beings. God specifically says that it is not good for man (aka people, not just males) to be alone. Separating us, particularly doing so during an already stressful season (aka during a pandemic) is damaging. Some people have the resilience that they are still doing okay, but when I was working at my previous job it was very obvious that there was a major influx of people pushed over the brink. What was typically maybe one person a week boarding in the ED for mental health related safety concerns for a few days became multiple people daily. What was typically a handful of CIWA (drug overuse and/or withdrawal) patients a week became a handful of them every day. Before you think that I was just hypersensitive to this issue and noticed it more because of how difficult I knew isolation was for me, the number of people I was aware of outside of my professional live dying of suicide also increased, so clearly it wasn’t just my overactive imagination.

 

Also, this is hardly even tangentially related, but someone in a video I was watching today said “we are all just one mistake away from doing something really stupid” and that really struck a chord with me to help me give myself more grace for the times I feel like the worst person in the world for a mistake that I made.

Your heart may be restless

(Plain – Zoegirl)

 

Today there is just a lot on my mind.

 

Yesterday I found out that the person who was the pastor of the church I went to at school when I was in school died. Last night the information didn’t come out and say suicide or directly give any cause of death, but I just knew from what was said that suicide was most likely what happened.

 

My mom had called and I mentioned it and she shot that idea down.

 

Then today the narrative changed.

 

The information has now been updated to admit that the death was suicide. (Hashtag I was right, but being right doesn’t really bring joy in these circumstances).

 

My heart is heavy. Honestly, I care deeply about him, but I wasn’t really feeling direct grief but more like secondary grief. My heart really hurt for the people who were intimately involved in his life. His wife and children who because of the current political climate may not be able to have a traditional funeral even if that was what they wanted and have the double burden of both the loss and wondering if there was anything they could have done differently. I hurt for the friend of his who was there when it happened. I can’t imagine seeing someone you care about having just committed this act and be unable to take it back…and the guilt that you couldn’t stop it from happening. (Okay fine, Nora McInerny would want me to admit that yes, I could imagine it, and have imagined it…I just don’t want to imagine it because it hurts). I hurt for the pastor himself who felt so desperate that this seemed the only solution. That immense pain is so hard to carry and it breaks me that it crushed him to the point of death.

 

And I feel angry. I read the comments on one of the posts and while many were supportive, there were also people expressing that he must not have been a real Christian if he killed himself. Y’all, it is really important that you understand that pain does not discriminate based on your religion. God promises to be with us, but doesn’t promise to take the pain away. Obviously, I am not saying that God wanted him to kill himself, but what I am saying is that you can be a strong Christian yet still feel so much pain that you see no way out but death. That pain doesn’t negate the faith in your heart.

 

Speaking of pain though, someday I will learn to read labels before putting things in my body. On Friday I found out someone had brought in treats the day before. I saw some Crystal Light and that sounded awesome both because I love juice mixes and because wearing a mask all day at work can make it hard to remember to get enough fluids in my body so making it fun is helpful. I noticed that the packaging looked weird, but figured it had just been long enough since I’d used a Crystal Light packet that they had just changed their packaging…nope…it wasn’t until after I’d drank the entire thing that I actually read the packet and realized the reason it looked different was because it was Crystal Light WITH CAFFEINE…oops…so I took some ibuprofen and calcium and hoped for the best since I was already on Zyrtec, but still more than 24 hours later am feeling some residual effect. I sometimes wish I had an anaphylactic allergy so that I would actually have to check every label every time. As annoying as it would be to have to read every label, it would mostly keep me feeling good (and if I was anaphylactic I would obviously never give in to my desire to cheat and have something because it looks so good that I can’t resist). So yeah, my lesson learned is probably still not read labels before putting things in your mouth. My lesson is always have ibuprofen and calcium with you to minimize the effect as much as possible.

 

Because my mind is spinning in a million directions I am going to change gears and talk about how I love finding ways to make my apartment more liveable by figuring out creative storage solutions…but…it would be super helpful if I could remember where I put things. Last night I slept on the toddler bed because my big girl bed sheets were still wet. This morning I was working on cleaning up my apartment and decided I wanted a different pillowcase on my pillow than the one I took off to wash. But the only one I could find was toddler sized and the pillow on my actual bed is not toddler sized. An hour later I finally found the stack of full sized pillow cases. What are the chances I’ll still remember where they are the next time I want to change it up?

 

More thoughts about sleep…last week* I was exhausted from lack of sleep and mentally exhausted but physically had So.Much.Energy. So I jumped on the trampoline until physically I was ready to stop. Good idea, right? Wrong. I was no longer physically wired, but instead my mind was wired and I was ready to have some fun rather than ready to fall asleep. Fail.

 

So a few nights ago I was mostly ready for bed but my brain and body felt dysregulated like I really needed to be in motion enough to settle down my brain…but lately I’ve been wearing a real t-shirt but wearing pajamas on the bottom so I can’t really just go walk the halls (especially since then my pajamas couldn’t be worn to bed because of being worn outside of my apartment) and so that pretty much left the trampoline, but I didn’t want to be wired again…so I set a timer for a minute to crawl over the coffee table, jump on the trampoline and then crawl back over the table before it went off and that was a huge success. My brain felt better, but ready to sleep instead of feeling wired. I don’t really understand how sometimes jumping is calming and sometimes it is activating, but I was definitely thankful that it worked that time. I am also thankful that the past few nights I’ve been getting more sleep. I still am not getting a full night, but getting 4 hours is so much more liveable than the mere minutes I have gotten on other nights. I have faith that I will get my sleep back someday. I am eagerly awaiting that day when I am not exhausted all day every day. It is really hard getting up in the morning when I’m still tired then going to bed at night knowing I am going to eventually have to get up again…

 

*last week being defined as sometime in the past month that is not today but all the days have been running into each other so it might not actually be within the seven days the calendar considers a week…

 

…and then in between writing and posting this I did Saturday church and I have half a mind to re-title this “And my Soul is at Peace” (A Son of God – Journey Collective)…a lot of what we talked about was that it is normal and okay to have big feelings, in fact, expressing our feelings is what God wants because he created us to experience emotion and so to hold it in we are keeping ourselves from experiencing parts of God’s creation and also it is like holding a ball underwater because it will eventually spew out in a less godly way if we don’t use it as intended. I’d never heard things explained that way before…but it made a lot of sense and it gave me an intuition that God was orchestrating this stuff even if it feels like it really doesn’t make sense. I just want to scream Why? But I have to trust that God will be there through it.

Everybody dies but not everyone lives

(Cross the Line – Superchick)

 

This post was originally going to be titled “It’s a Balancing Act: Gotta be Strong” (Acrobat – Plumb). Spotify played me that song like three times while I was in the shower this morning (sometimes shuffle play is great and sometimes I wish I’d put it on play in order…). It’s hard to be strong. Especially in the season we are in.

 

Y’all, something has to change.

 

It seems like pretty much every week I hear about another suicide…and I know for every one of them I hear about there are many many more that I didn’t hear about. Some are in the medical community and others outside of the medical community, but the common thread as I see it is that the restrictions on life right now have not only increased stress levels, but have also taken away people’s outlets for stress relief. Most people are separated from their friends and the rest of their community, and some people have even been separated from their families, so people’s opportunities to vent and share their thoughts or even just feel the power of “with” and get the proven physical and mental health benefits of physical touch have been severely limited. With everything closed any semblance of a normal routine is gone. For some people going to the gym is their stress relief – and that has been not a choice for a lot of people. Add on top of that the uncertainty about when/if we will ever get to go back to normal life, the uncertainty of pay cuts or job loss, the uncertainty about how the people we care about are doing and whether they will continue to be okay…and no kidding people just want out.

 

The stories I’ve heard are heartbreaking. The man who was so afraid he and his wife were going to get Covid19 and die that he shot his wife and himself to prevent what he felt was an inevitable and worse death. The doctor who killed herself because she felt like she couldn’t help her patients enough. The child who killed himself 4 days before his birthday because he couldn’t handle the isolation anymore.

 

Very early on I saw an enormous increase in ED visits and hospital admissions for suicidality and other mental health issues. Lately we’ve been going through thiamine, IV multivitamin, folate, Ativan, and gabapentin like it’s water because of the surge in alcohol related admissions. You want to keep ICU beds and other resources available for Covid19 patients? Well guess who uses far more staff time and effort and also probably still needs a ventilator and significant amounts sedation than a general respiratory distress/pneumonia patient: alcohol intoxication/withdrawal patients. My theory is that as this dumb isolation drags on people are turning to alcohol to try to numb the pain…and obviously then when they either over-do it or run out they end up visiting us at the hospital.

 

The goal of social distancing is to delay the peak. Good social distancing doesn’t really hashtag flatten the curve like the social media trend wants you to believe – what it really does is move that same peak you would have had anyway somewhere else. I’ve even heard our government leaders admit this. We need them to wake up and see that we are as ready as we are ever going to be. We are going to lose more people to suicide than to Covid19 if we don’t open the world back up and let people live their lives. LET PEOPLE PURSUE HAPPINESS. It is right there in the constitution (I think…history has never been my strong point). We are all going to die someday, and no matter whether we stay home for the rest of our lives to minimize the chance we get sick from Covid19 or we go out and live our lives, we can’t change that. Everybody dies but not everyone lives. We can’t change the fact that someday we will die, but our government can change whether they will let us live our lives.

 

Also, related although it definitely doesn’t quite flow right here…I was reading an article last night about trauma and suicide, and as I read, I really felt like the author hit the nail on the head. We learn through observation and sometimes personal experience how to deal with impending trauma. We lock our heart and try to lose the key so we can make decisions and get through the day…but what we don’t usually get to see is the process of resolution of the trauma, because that side is abstract. It doesn’t have any true measurable markers of progress. It is often a more private experience that keeps us from vicarious learning…so we stumble through feeling like the only one – and that feeling is even more prominent right now while we are literally isolated from everyone so it is difficult to access any form of support and even if there is someone out there who has felt something similar we can’t get close enough to really find out so we’re trapped in our own experience. Alone. Anyway, coming back from my commentary to the thoughts of the article, we often get through difficult things by staying busy. As the pressure to do something decreases the pressure to feel something increases, so while we might be seeing an uptick in suicides right now, we are likely to see an even bigger surge once the “Covid crisis” seems like less of a problem…so I would argue that even if it were possible to make covid19 go away completely by staying home for a long long time, that would be an unwise option. I think it is very important that we get people settled back into places where they can feel supported BEFORE it starts to feel like covid19 is over.

 

Kthxbai…thanks for listening to my soap box rant about politics…

When the sacred is torn from your life and you survive

(Held – Natalie Grant)

So I am fairly certain I already have multiple posts with this same title…but right now that title is the only one that feels right to me, so I’m just going to go with it for now and I’ll change it later if something else feels good later…

So yeah. When I am trying to be more open and honest than just answering that I am okay or fine I tend to answer that I am surviving. It is true. I am still here. (Also a lyric I have used at least once or twice as a title)…The thing is, while it sounds almost positive, there are definitely times I am not sure it is really positive that I am surviving.

The first time I can ever remember thinking about being dead was as a result of Certain Someone in school. Early in the school year that I worked solely with her, I described it as leaning against the fence separating life and death and not really being overly concerned about whether the fence could hold my weight.

Then fast forward a few years and I didn’t match. Certain Someone’s words came pouring back in. I was not good enough. I would never be good enough. No one would ever want me. I felt hopeless and helpless and prayed every day for God to take me home. I gave God a very generous deadline. He had until July 1st (2017) to figure it out. I woke up very much alive that morning and was not thrilled about it. I wouldn’t consider it actively suicidal because I had no interest in killing myself (nor the energy to do so) and had no plans. I just wanted God to take me away from the pain of this life…but I woke up alive and I was angry. Now I was just going to have to continue to live, because I would mess things up for people if I died and couldn’t start my new job and I was in a year-long lease…and so now I was stuck.

I at least kind of sort of got over it. I mean, right now work is my lifeline. At work I can mostly just pretend life is still normal. For eight hours five ties a week I can just be another employee doing her time. I’m exhausted because I am still only averaging maybe 3 hours of sleep at night and everything still takes a lot more effort than it should, but it is good for me to be at work.

But then I have to come home. At home the reality is back that my dad is dead. If I constantly play spider solitaire and listen to music or whatever I can numb out enough to feel almost okay, but the minute the game is over so is the numbness…and I am very aware of the pile of things that needs to get done.

At first after my dad died it was weird because I was in a very deep dark place but didn’t want to die to escape it…weird because the research says once a person has experienced thoughts about death ending his/her pain those thoughts never fully go away although they may become less conscious. I actively did not want to die at that point.

Now though. Well…I kind of don’t want to say it because people get judge-y.

It’s just that everyone wants me to be happy and they tell me how they want to see me smile…and sometimes I just can’t be that person for them. It hurts too much. And today someone used “we” to describe that they basically thought I wasn’t healing fast enough for their liking and I don’t know if there really are a group of people talking about how I’m not doing this good enough or if it is really just her, but it is frustrating because I don’t want to hurt anymore either and if I knew how to make it stop I would have done that a long time ago.

Today two months ago I saw my dad conscious for the last time. Sunday night I had worked the overnight and Monday morning I’d gone home and cleaned a little and packed up and drove to my parents’ house. It was still my parents’ house then. Now it is just my parent’s house. Hashtag grammar. Tuesday I was helping with three Night to Unite/National Night Out celebrations. Early Wednesday morning I drove back to my city to work, so Tuesday was the last time I saw my dad, because Friday he was in the accident. Thursday night I tried to call him but he didn’t answer. Friday morning at 10:23 I found out about the accident and I would never be able to be with my daddy conscious again.

But then there was an out. Someone yesterday said in our camp recap that one of their campers talked about attempting suicide in order to be with someone they knew who had done that. There was my answer. I already feel like I am failing and it would be better for everyone else if I just didn’t exist.

And it wouldn’t really be that expensive because I have approximately a year of salary saved in my bank account for emergencies and for if and/or when I ever get a residency…so that would more than cover the cost of dying. (I didn’t realize how insanely expensive dying is until my dad died. It seems cruel how much every step of the process costs. And beyond the actual checks to places like the funeral home and the death certificate people etc, there is the zillion car trips back and forth places and stuff)…and it doesn’t seem like anyone at work would care. They made it pretty clear I am replaceable when I called in for the Monday my dad died because I had been not just awake but actively trying to be alert pretty much all night so was in no shape to take care of patients and also had meetings and appointments to go to all day. I only wanted Monday off and then Wednesday and Thursday for the visitation and funeral since I didn’t know yet what time those things were going to be but we had days picked out. But I was checking my email and they were giving away my shifts from Monday through Saturday. I was angry. I emailed them and was like what the h**k do you think you are doing giving away MY shifts?! (Much more politely obviously). With a little back and forth I got my shifts back…and then Tuesday morning came and I got a call from one of the managers at work that I didn’t need to come in and I was like didn’t we talk about this yesterday?! And made it clear I intended to show up. So yeah. I don’t think they even want me at work anymore even though everyone is all like we are so glad you are here because you are such a helpful worker…like if you really thought I was all that and a bag of chips you wouldn’t be trying to get rid of me.

So yeah, the only real hold up is that now I would feel guilty about the people who put effort into me that is basically wasted if I just give up now…plus the whole I haven’t got a clue how I would kill myself…and also I am pretty sure God says that isn’t my job. It doesn’t feel like God is that good at his job though and I do everyone else’s job sometimes anyway though, so maybe I just need to take it into my own hands. I don’t know how else the pain will ever end. I was happy that I am finally gaining weight again as of this week, but the happiness was quickly overshadowed by a but you still aren’t doing an awesome job eating and you can’t live on cookies and skittles and boxes of sour patch pumpkins forever. I do a good job eating at work…but breakfast is pretty hit or miss and whichever meal I don’t eat at work is maybe a 50:50 chance of having much semblance of nutrition if I am responsible for making it happen…I mean, eating is good and important, but nutrition can’t be neglected forever. My hair isn’t falling out as much as it was at first when until recently I was losing more hair in one shower than I usually did in a week, but I am still shedding at a greater rate than normal…and I don’t know much about hair, but I am guessing that nutrition might help…although I am not sure because I have a “liquid beauty” vitamin that I’ve been trying so maybe it is just the stress and not the nutrition causing the problem…IDK. That is not something anyone really cared to teach in pharmacy school.

Totally changing gears, but yesterday I went to camp. As a small group facilitator, which is a fancy way of saying camp counselor. I don’t know what to say about it. There were pumpkin powder sugar donut holes that were really good. One of the other leaders in my group mentioned sleep and upon finding out that I hadn’t gotten much lectured me on how after loss I really need to take care of myself. It made me feel frustrated because it isn’t like I don’t want to sleep. I do. I desperately want to just sleep. If I am asleep then I won’t be facing the pain of the world…but I can’t. I am trying so hard to take care of myself. I am working so hard on getting food in my mouth and all the other things that are necessities in life. It felt like that enormous amount of effort was being turned into nothingness. What started as and could have been a supportive interaction made me feel unseen and minimized. Then in the icebreaker the question I was supposed to answer was how many people are in my family and I don’t want to answer that question. I don’t want there to be a missing piece in my puzzle. Then in group someone else talked about the page I was supposed to teach and so then I had to teach a different page and it was scary. And then only a couple kids were willing to share their worksheets. The two who shared both had lost someone they didn’t really know and one of the other counselors tried sharing about losing his cousin to get them to talk and they didn’t and the other counselor who is a teacher tried also to get them to share and they didn’t so I didn’t feel like after that it was appropriate for me to share a recent and lot more personal loss with a group of 9-11 year olds who had lost someone they barely or didn’t know a long time ago. A lot of campers had been moved around since training so I don’t have the paperwork to know whether I had any campers who had a more personal loss. I do know all the kids in my group had been to camp before which means that their loss was at least over a year ago. It was hard being in a group where the kids were saying that telling people how you are feeling is really good but feeling like I couldn’t share how I was feeling.

At the closing ceremony one of the other leaders in my group who I was standing by realized how hard a time I was having. She was really sweet putting her arm around me for a little while and offering to let me line up with the campers if I wanted to (but she doesn’t know how terrifying it was for me just to be up in front of the room kind of hiding behind everyone, so I definitely had no interest in lining up with the campers). Part of it was having to think about my dad’s death and part of it was how exhausted I was because the closing ceremony was at about 5pm after leaving around 7am to get to camp, but I couldn’t make it through the ceremony without crying a little. And that was scary and frustrating. I want to be in control and I don’t want a bunch of strangers to see me crying, especially when we are supposed to be having fun and I am supposed to be teaching kids to cope and the only kid who had cried was a 6-year-old crying because her older brother stole her toy from her…

I mean, learning archery and djembe was fun, and they had really good snacks (fruit snacks, goldfish) and there was lemonade at lunch. I think I want to go back if I can, but it would be better for me if I got a group of kids who had losses more like mine and who could take it seriously. Not that being a camp counselor is about me, because it isn’t, it is about the kids’ experiences, but I could be more present for my campers if I weren’t fighting to model having a good time at camp.

So yeah, there are a lot of things that really need to be done that I am struggling to do because when I am alone I am only really making it when I am constantly playing spider solitaire and listening to music and probably in motion and doing those things doesn’t exactly lend itself well to getting the things done that need to be done.

My mom is like your dad would want you to get a residency this year so work really hard so you don’t disappoint him and it is frustrating because I am doing my best just to survive and I don’t know how I am ever going to get through the residency thing at all…much less do well enough to actually get a residency…especially when the chances have decreased significantly for a variety of reasons…like continuing to get older and not being able to go to midyear and stuff…

I just feel like I can’t do this. And I don’t know how to give up. I don’t feel resilient.

There is no fight left on the inside

(JJ Heller – No Fight Left)

I really should find a way to express myself more respectfully. The way I expressed myself earlier this week wasn’t the most respectful. Just because I am hurting doesn’t make it okay to potentially hurt other people.

Someday I will probably really believe again that God cares, but right now I can’t. I just can’t.

My manager put a word to part of how I am feeling right now. Anger.

I managed to shower and get dressed and make it to church on time and at least try to pretend to smile and stuff. I wanted to be by myself so I could walk out if I was struggling, but someone couldn’t understand the whole look preoccupied thing meant leave me alone and asked to sit by me, so I wasn’t going to be a bad Christian and say no. And so I was stuck…’cause you can’t exactly walk out when someone is sitting by you.

I left and I should have eaten lunch but I looked at the fridge and the ball of anger and frustration and hurt in my needed to escape and I didn’t want to eat anything and I couldn’t force another unwanted meal into my mouth. So I decided to ride my bike. I pulled off my skirt and pulled my jeans over my shorts and took off the outer tank top leaving just the inner tank top behind. I put on white gloves (dumbest idea ever considering everything in the garage is covered in a layer of black dirt) and went to my bike. The tires definitely needed some air, but I needed to escape before the tears did. So I rode it that way as hard and fast as I could…

For about 0.75 miles until about 16 hours or so since my last food or water intake plus being out of shape plus all the other exhaustions caught up with me and I had to stop and sit down. I was empty…like the song, “there is no fight left on the inside, but maybe that’s where I supposed to be; I’ve given up trying, I’m giving it all away.” I’m not sure if that song is about suicide, but it kinda sounds that way. I was going to give Dan Allender a chance, but I guess that book got returned on my Hoopla app so I had to settle for the book I did have, Fear Has a Name. The part that it randomly opened to was the guy deciding that the only possibility was suicide. Oh, also those 0.75 miles brought me to be sitting on the ledge on the sidewalk of a bridge…I thought about what it would be like to be brave enough to not worry about everyone else and just end it. Then I started feeling like even more of a failure because I am not even brave enough to kill myself…

So then I decided it was time to go home. I started walking until I was ready to ride again and made my slow way home, kicking the snow in anger and when I ran out of energy for that, just letting my feet hit the snow as I slowly rolled past.

I hadn’t checked my mailbox since Tuesday so I did that. It was empty and defeated just like my heart.

I tried really hard to eat. It took all the energy in me to pour some fruit in a bowl and put it in my mouth a piece at a time hoping eventually I’d get tired of it being there and eat it rather than spitting it back out into the bowl…and that brings me to now. I’ve eaten some fruit and some cookie. Not exactly a complete lunch, but I don’t have the energy to keep trying right now so maybe later. At this point breakfast is a lost cause and I don’t really care. To this point I’ve been able to keep my weight stable and as long as that stays the case, nutrition and normal eating can take a back seat for all I’m concerned. “I’m giving up trying.”

Do your best but still have fun

(Doing it Right – Thomas the Tank Engine)

Have you ever been reading a book and felt like it was eerily similar to your own life? That happened to me this morning with an audiobook. There are a few minor differences, but really a lot of the book (so far anyway) is incredibly similar to a lot of what I went through in college. I’m maybe an hour or two in and I feel with the main character the feeling I am so familiar with of needing to look okay while my soul screams that everything is not okay.

When I looked up the book an Amazon this afternoon because I couldn’t wait until I got to the end of the book to find out what happened and obvi couldn’t exactly listen to an audiobook at work anyway, I learned that the book is a dystopia. I know what that word means, yay English class, you were good for something…oh wait, that’s a word I learned in history…so yay history…anyway, in this dystopia, students are not allowed to show negative emotions. If they do, they are taken away. When they are taken away, their life is essentially taken away. If they come back, they are really not the same person anymore. They may go back to living with their parents, but will have to go to an alternative school and the only contact they are allowed with people outside of that school and their families is short supervised periods of time. They will have no remembrance of anyone they knew before or of their life before, and they are discouraged from really making close friends with anyone.

The students look forward to turning 18 when they can no longer be taken away against their wills, but until then, they can’t show any negative emotion because if anyone sees and tells on them they will be taken away. They can’t even grieve for losses of best friends or siblings or anything (whether to death or to being taken away) because that would get them taken away. They live in fear of being the next person taken away.

Sometimes therapy is required, but it is more about trying to get the kids to break so they can have a reason to send them away or getting the kids to rat someone else out so that person will be taken away. The pretense is that it is to help them deal with everything, but the reality is that it isn’t at all about helping them but about trying to control them.

So yeah. I hurt so much for those kids, because I have been there. I want to say I can’t imagine how hard that is, but the reality is, I know exactly how hard it is. When a kid gave up and killed himself to escape and another kid was upset in private because he only had 3 months left until he turned 18, I wanted to be like, 3 months isn’t that long to try to keep holding on, but I knew that when you are where they are, 3 months might as well be an eternity. It sure felt that way to me. Every day felt like an eternity at times.

So yeah, my second year of college there was a “counselor” hired who used her skills to hurt people rather than heal people. I get that hurting people hurt people and so I should love everyone and at first I didn’t realize how bad she really was and I thought I could just keep loving her until she healed enough to help me…and really at that point in my life I didn’t have a lot of other options and I was kind of stubborn so once I got an idea into my head of how things were gonna go then that’s how they were gonna go…so I didn’t really take very seriously the people who at first tried to save me from her. And eventually I was deep enough in that people stopped trying to save me. Side note, please, if you know someone is in trouble, at least try to reach a hand out even if you don’t know if they’ll reach out and grab it. Anyway, long story short, the abuse was gradually exposed, but I was the only one at the time who was willing to admit that something was wrong…and even I was still for a long time still very stuck in protecting her and therefore really only giving very vague information.

My school has always cared a lot more about appearances than about its students, unfortunately. I don’t know if it was really because of that or if part of it was because they couldn’t get the information they needed from me, but obvi it isn’t good for publicity for people to find out that a counselor is emotionally abusing students. The result: she got princess status where she could do no wrong, and I was threatened with loss of my place in school if I didn’t comply with their crazy rules. Sure, loss of a place in school seems like a lot less of a loss than losing practically your entire identity like the kids in the book were faced with, but when all you have ever wanted to do since early elementary school was pediatric pharmacy, losing your place in pharmacy is loss of a life long dream, especially when at that point I had taken very few classes that weren’t just repeats of high school and on top of that, pharmacy school credits aren’t really transferrable anywhere else so I’d be starting over wherever I went…starting over most likely at beginning a bachelors degree level rather than completing a masters or doctoral program right away, so whether I went back into pharmacy or took a path change, this would have been significant…so I couldn’t afford to find out whether the threats were real or idle. Considering my name was tied pretty well to their school they’d have to do it gracefully if they were going to kick me out or they’d have more bad publicity, but anyway, I really didn’t want to find out what they’d do. I lived in fear of being sent away just like the kids in the book.

I wasn’t allowed to talk about what happened and I wasn’t allowed to talk about the rules. So yeah, this ginormous thing is going on in my life and I am not allowed to talk about it. And I can’t say that I can’t talk about it. And I am too honest to be okay with saying that I don’t want to talk about it when in reality if I could talk about it, it would have been the only thing I talked about for a long time while I processed all the pain I was feeling. So I always had to pretend everything was awesome. If you cry or even just look sad, someone is likely to ask questions. Questions are dangerous. There is only so much this crazy honest girl is willing to let people think is just academic stress…luckily for minor slips people are pretty willing to right off a vague statement as being about academic stress so that I didn’t have to lie and didn’t have to get in trouble. But there was always the insane pressure to be okay all the time so no one would find out.

And the abuse hadn’t ended. I was trying to avoid as much as I could, but I’d go to my car to drop off school stuff and trade it out for Cru stuff or whatever and suddenly guess who also needed to be in the parking garage at that exact same time? I’d be outside hanging out with a friend and guess who else wanted to hang out on the patio? I’d be sitting in the nearly empty cafeteria and guess who picked the table right next to mine to sit down? And guess who claimed that I was stalking her despite my doing everything in my power to stay away from her? One of the organizations I led was putting on an event about stalking. Guess who promised my advocate she wouldn’t attend and then switched places with the speaker so that she would speak instead…and not only that but moved her stuff to the desk next to mine after I picked my seat and sat down. So yeah, I couldn’t just avoid the whole issue because no matter how much I tried to avoid she was seemingly always there. And she was always looking for anything she could try to get me in trouble for so if she saw me then I definitely had to have the everything is awesome mask perfectly in place. No room for slipping. This was a woman who tried to get me in trouble because I mentioned on my blog that I disliked a particular type of music that she liked. And besides, I sure didn’t want to give her the satisfaction of seeing my get worked up by her antics.

So yeah, I definitely get having to hide negative feelings while the reasons to feel negatively just keep adding up. I get how that just amplifies the internal pain. But when your life is on the line you will do whatever it takes to survive. And I totally don’t fault that kid for killing himself to escape. The one place on campus I felt safe and protected was taken away from me – that space was for her only despite the fact that she could easily do her entire job never entering that space whereas I was using a lot of workarounds…a lot of people turned things in for me for reasons I didn’t really explain and I will admit that once or twice I might have gotten stuck and folded my paper and threw it praying it got close enough to its target to be considered turned in. The quiet group study space – not available to me. The prayer room – not available to me. The de-stress room – not available to me. At first it was maybe in a few weeks. Then maybe next semester then next year…it felt like an eternity. If I were brave enough to escape with suicide I would have, but I am too conscientious for that. I know that it is wrong and I know it would cause problems like my apartment being on a lease that couldn’t be broken early that would make it a burden for other people and I couldn’t do that to anyone…and plus a few students from my class had already died and some of them had been handled really poorly by the school and so not knowing what they would do with my death I definitely didn’t want to potentially put my remaining classmates in a potential bad place. That wouldn’t be fair to the people I left behind.

And counseling was forced for me, too. I really did try to go into it with an open mind and recognize that in every profession there are people who are good and others who are not and that there was the potential for this to maybe not be fully positive but at least not be super negative…but you have to realize that counseling is what got me into this mess. I could have been at least mostly oblivious to what was going on and therefore not gotten into this mess if I hadn’t tried out counseling. I mean I still would have seen some of the problems that happened outside of that context, but it would have been easier to write those things off if it hadn’t been for all the other things happening. I still pray that it was worse for me because my selective mutism made it easier to control how much was being shared…the very few words I used made anything I tried to share hard to interpret and she taught me to be ashamed in order to discourage my use of my very few words…I think the summer after third year she realized she had to get rid of me because in finding my words and being around people who cared about me all summer where she had a lot less control over me she realized her secret could be compromised…and therefore the explosion where she turned me in to the behavior team thinking it would get rid of me. Thank God that despite her sitting on that committee there were enough other people who knew me well enough to know that she was making it up. She might have been able to force my friends to choose between her or me and a lot of them chose her, but she couldn’t completely get rid of me.

Anyway, I wish forced counseling on no one. First of all, people think you are crazy when you need two psychiatrists and another non-psychiatrist mental health “professional” in a very short period of time…like seriously, you do know that there is usually a multi-month waiting list for non-emergency new psychiatry patients. So I guess you can imagine that the ones that have a random opening you can get into in the matter of weeks rather than months are maybe not the ones you want to be seeing. The first one charged an exorbitant fee that seriously should be illegal and diagnosed me within about five minutes of meeting me on the basis of my blog title. He never once looked at my intake paperwork while I was there. He refused to believe that I wasn’t a special needs kid in K-12. I wasn’t. I was an honors kid. I was terrified of saying the wrong thing, because at this point I hadn’t been a talker very long yet and my future kind of depended on this crap, but I managed to question his diagnosis of autism. His reasoning: I was wearing shorts and a t-shirt rather than being dressed up. Umm, seriously dude? It’s over 80 degrees outside. I sure have no intention of wearing long pants in that weather! And there is an entire waiting room of people dressed similarly to me out there and it wasn’t like they were trashy shorts and t-shirts that had seen better days – these were dressy casual shorts and a fairly new and well-fitting t-shirt…and where the h**k in the DSM does it ever say anything about wearing shorts to an appointment being diagnostic of autism?!?! So I kind of gave up and just made my way through the rest of the appointment. Ugh…it couldn’t be done soon enough. I felt so angry and alone after that appointment.

The next psychiatrist wasn’t much better. This one was immediately before church so I was very intentional about picking a nice church outfit just in case this idiot took a page from the first guy’s book. This guy new in the making of the appointment that the only reason I was there was to get a note written that I’d shown up. He spent almost the entire session talking to himself about whether or not he was going to write said note. I said very few words not because of social anxiety but because I could barely get a word in edgewise. Then I was thanking God I had brought cash in an amount very close to the agreed upon price despite my mom telling me it wasn’t a good idea to carry large amounts of cash around, because this bonehead then tried to ask for more than was previously agreed upon for session plus note written. I obvi couldn’t offer more than I had and made it very clear I wasn’t coming back with a check or more money so it was this or nothing, take it or leave it and he had to accept only what I had and nothing more. Lol, maybe what I have learned is that I need a patient advocate if I ever go to another psychiatrist…then there was the next counselor. She promised she would write in the letter that future sessions should be at most monthly…but then she called and changed her mind that she was going to recommend weekly or every other week because that’s what her training said was best…like seriously chica? We had an agreement, and also, I am a real person, not a test question where you are supposed to keep erasing your answer until you remember what the textbook said. I never got to confront her about that, because shortly after her note was received, I found out my abuser and her friends were intercepting the faxed noted about me. My abuser decided she didn’t want me to see that psychologist anymore. The reason she gave was that it was too close to her house. LOL. I was angry. I had worked so hard to find a counselor and now I was going to have to do it all over again with an even shorter list of potential candidates and an even shorter timeline. If you plotted all the counselors within a reasonable driving distance of my apartment on a map and then drew a circle around my abusers house of radius the distance to the counselor I had seen, you would find that a significant number of the counselors in the area worked inside your circle or right along the border of that circle.

I finally found another counselor and she really wasn’t bad, I just really had more important things to be doing (like studying) than driving to a counseling appointment and then attending said appointment and had lost most of my trust for any counselor I didn’t know personally. She really was cautious with my privacy and was very kind, but at that point it was too late to try to win me over to wanting to be in counseling, especially when it was kind of expensive…and she still had to report back to my school…so yeah, I understand how frustrating being required to be in counseling is and I get the feeling of being watched.

So yeah, clearly my story isn’t a perfect mirror reflection of the situation described in the book, but it sure was eerily similar. Somehow, hearing that it is hard from someone else’s mouth is really validating. And it also reminds me that all the things I couldn’t express then have mostly just remained bottled up since then. I mean, I couldn’t say anything until graduation, and at that point I was frantically trying to get a job while also trying to get food and water into my body and hoping to get some sleep. You can’t exactly walk into an interview and talk about the abuse you suffered over the past five years. And same with once you get the new job and have to pretend to like it…so yeah. I don’t know when I’ll ever really be able to process everything I’ve been through outside of my computer screen, so I guess I’ll have to make the most of this computer screen…but it is time to go to bed so I’m going to have to say goodbye to the screen for now…lol…I’ve been trying to hurry through this post so I’d have time for other stuff this evening, but even trying to keep it short, I just have so much to say, because the words have been trapped for so long that it feels so good to get to let even just a few of the words come out through my fingers.

I’m Everywhere You Need Me To Be

(The Last Night – Skillet)

So I figured anyone who follows my blog is probably sick of hearing about residency and applications and interviews and stuff…and I’m tired of thinking about it. I just want it all to disappear. Even positive change seems overwhelming at times and there is the very real possibility of not getting interviews and/or facing more failure to match…but that is the last I am going to write about it in this post. I do need to try to prepare for interviews and stuff, but I also need to remember that I am more than the interview process. I still have a life here in the meantime. So since we probs all need a break, I wrote about something else today.

 

In the past I have read that doctors have a high suicide rate and haven’t been able to find much about pharmacists. What I have found in the past is that pharmacists tend to have higher levels of stress than doctors, which I have conjectured would also lead to higher levels of suicide. I have never really thought further than that or questioned what I read, but today that changed a little.

 

Today I was reading a Pharmacists’ Letter CE about suicide, and one of the sections was about risk factors. I have to admit that most of the time when I read something like that I kind of skim because there isn’t usually going to be anything there I don’t already know, but this time, something caught my eye and caused me to slow down and more carefully read the whole thing (except the part that went into excruciating detail about how many questions are on each suicide questionnaire, because ain’t no one got time for that…well, okay, plenty of people have time for that, but as a pharmacist, I am not one of those people). The study that the CE article cited about which occupational groups are at risk took place in New Zealand, so take this with a grain of salt, because I do not know enough about New Zealand to assess for myself how much external validity this study has for the US. The CE writer anyway thought it was relevant, so there’s that…Anyway, female pharmacists were one of the groups with heightened mortality rates. Okay, not too surprised yet…until I got to the next sentence. Doctors are not at high risk. I was also surprised that males in armed forces are at lower than average risk.

 

So yeah. I guess my conjecture was right about pharmacists being at high risk for suicide. I would be interested in finding out more about that – is it a particular type of pharmacist (community, ambulatory, ED, ICU)? At a particular point in their career or life (graduation, first pregnancy, completion of residency, some number of years post-becoming certified)? Sparked by some sort of career-related event (difficult patient death, rejection, failed exam, major error)? I know there are things we probably can’t change like the fact that pharmacy is a field in which 99% isn’t good enough for example, but I wonder if there are modifiable factors in the world of pharmacy that could turn this around. The fact that it was females but not males in pharmacy that ranked at high risk seems telling to me that hidden somewhere is more to the story. I want to know what that factor is and how we can change it, because every death is one too many.

 

Although every death is a real person lost forever, a person who was someone’s friend, family member, etc, these self-inflicted deaths seem to paint a much more cruel picture. I mean, a lot of deaths are self-inflicted to some extent which is why working in healthcare, especially with adults, can be so frustrating at times, but the intentionality of the suicide death sets it apart. There is a very clear cause and effect that anyone can see…and yet the choice is made.

 

I wonder if doctor suicides receive so much attention without being statistically more common because of the doctor heal thyself adage making it seem like more of a stark contrast and maybe even failure of the profession when a doctor dies in an act of suicide. Perhaps it isn’t more common, but more shocking…and potentially more relatable, because doctors get to personally know a large portion of their community, whereas people in other professions likely have a smaller sphere of influence…IDK…this is totally just me thinking things through.

 

I am just one person in a rural community. I can’t change the world by myself. I feel like in some ways it is true that I am not enough…alone I am not able to do anything to really make any difference in these statistics…but that doesn’t mean nothing can ever be done and it doesn’t mean that I can’t have any impact at all. Just like each death is a person, so is each life. If I (and you and everyone) keeps an eye out for the broken and hurting people who might be around us maybe we can unknowingly save enough people to change the statistics…because we all do it differently, but we can make a difference for that one person and all those one person plus one person plus one person can add up to a real impact…just food for thought…

 

…this feels personal to me. I know people who have committed successful suicides (not just through my position as a healthcare professional, but as a real live human person in the world). I know people who have tried or thought about trying. I know people who know people. And there have been times in my life I was not actively suicidal, but longed to be not alive…I am not stupid. I know that very easily my story could have been different. The line between not wanting to be alive and wanting to do something to make that a reality and then the line between that and actually doing it – I want to describe those lines as super totally wide and safe, but I know the reality is that they are thin. As much as I want to describe it as a seven foot high concrete wall that is difficult but not impossible to surmount, I know it is probably a lot more like the barrier on I-75 in Florida this week that was physically present, but for all practical purposes, absent, described as so weak even a motorcycle at safe speeds would not have been slowed much. Just like those children were killed as innocent bystanders as other people’s vehicles careened out of control past the two barriers, it would have been easy for my life to cross those lines. I have God to thank for not answering my desperate constant prayer to take me home. Life is still hard sometimes, but I did not take my life. Neither did God, but honestly His will is more important than mine and if I bring more glory to him alive than getting out of the way then I will live. And I don’t know what great things God might have in store for me later in life.

 

And it is a common problem. I do see it from the other side as a health care professional as well. I try not to go into the charts of the patients on our BH (behavioral health) unit unless absolutely necessary (because HIPAA and especially with that unit because my mental health records were essentially made public in college by Certain Someone and that felt intrusive even though I would have happily given more detail than was in my records to anyone who asked), so I don’t know the amount of suicidal ideation/attempts in BH, but I do know that in our ED (again, in a SMALL community hospital) it is exceedingly rare that we don’t have at least one patient at all times with suicide as their reason for visit, and there are times I check the track board and there are a lot more than one patient here for suicidal ideation/attempts.

 

So yeah, I have no idea where I was going with that, but I guess morale of the story, remember that everyone you encounter has a story and if you listen and care you might save a life without even ever knowing the impact you had. What can you do with what you have?

 

And yeah it is bedtime so that’s all for now 🙂

 

This thing is gonna bend and shake you

(This thing is not gonna break you – Christa Wells)

 

It is still so hard. Today (Thursday) I was holding back tears at work. Saturday is the one year anniversary of the first match day when I didn’t match. It hurts so much. I pray for God to take me home, but he keeps saying no and I feel frustrated and overwhelmed and trapped. The pharmacy match day is Tuesday. The student sitting next to me kept talking about the awesome residency she plans to match with. She asked me where I did residency. I know she meant to make conversation, but it was another wound in my hurting heart. The physician match day is tomorrow. There are lots of information out about celebrating that. I don’t want to celebrate match day. I am grieving match day. It hurts too much. When can I go home to heaven? Why does this have to be so hard?

 

I want to believe the lyrics of this song that this thing is not gonna break me, but I feel so broken and I feel like I’ll never be able to put the pieces back together. It is too hard. I just want to not hurt anymore.

 

I know I am doing so much better than I was – still eating, at least able to hold back tears…but it is still so hard. It still is so intensely painful. And sleep is kind of hit or miss, but I’m at least getting some sleep some nights. But I am so exhausted of just surviving. I want more. It hurts too much. I just want this to end. How long do I have to keep going through this? Why won’t God take it away? I want a way out. Where is my white flag? Why can’t I just quit? I’ve wiped the tears from my face too many times. Does this ever end? Can my fractured heart ever be healed?

 

I’ve been looking up suicide rates following match day. I haven’t found any statistics. What I have found is that medical student suicides are most often quickly swept under the rug and hidden or disguised – labeled as accidental overdose when it was clearly intentional for example, or natural causes or unknown cause of death when wrists were slit or it was a self-hanging or whatever. I have also found that not only is the attempt rate higher in physicians or medical students, but the success rate is also very very significantly higher. I have found nothing on pharmacy students. I do know, however, that stress and anxiety rates are higher in medical students than in the general population and that stress and anxiety rates tend to be higher in pharmacy students than in medical students, although mental health is MUCH less studied in pharmacy students than it is in medical students…so I guess I wouldn’t be surprised if there is also a hidden phenomenon in pharmacy students. So maybe I should be proud I’ve made it a year almost without killing myself. But I don’t want to be proud. I want to be dead and I want to be happy. I’m sorry about not tying this up in a pretty package with a bow, but I’m just so tired of pretending I’m okay every day when I’m struggling so much. I just want to good enough. Maybe then I could express myself well enough that people wouldn’t invalidate my pain. It is probably my fault that people don’t get it, because I’m not good enough at anything, not good enough at using my words, not good enough at explaining what happened. Maybe she was right that I’ll never be wanted. It hurts to know I’ll never be good enough ever. Why did I bother trying so hard for so long just to be left here so aware of my worthlessness? Maybe it would have been better to get a job at Caribou or something or McDonalds or something. I might not have been competent at “would you like fries with that” at the time of high school graduation, but I could have learned. I would have learned, because I am determined and stubborn.

 

Looking for someone to save your life

(Worth it – Francesca Battistelli)

 

Music is an important part of my life. It is how I best encounter God. It is how I like to experience my world. It used to be omnipresent in my world. I realized recently that through this period of grief, music has not been so consistent. Sometimes it was my lifeline, but other times it was absent, the empty soundtrack mirroring the emptiness in my life. But anyway, on Tuesday I was walking home, trying to hold back tears, and singing to myself…”So whatcha gonna do when the bottom falls out and you’re left with nothing but your fears and your doubts to hold to? Who’s gonna hold you?” The lyrics showcasing the desperation and pain and immense loneliness and worthlessness I felt. “And where you gonna run when it’s all on the line and you’re looking for someone to” and then I stopped. I couldn’t explain it. I just inexplicably couldn’t keep going. The tears came as I frantically tried to keep anyone else out on the streets from seeing my wet cheeks. I turned the corner and partially hidden by the privacy of a building I took a deep breath and weakly finished the sentence “to save your life. Save your life.” Those words so hard to say when the last thing I wanted was my life. I wanted so badly to die. But now I am doing better. Now I can move on and start to actually believe the second half of the song. “Love can hear you. Love can heal you if you let it inside. Oh remember now, love’s not easy. But it’s worth it.”

 

So yeah, I thought considering my last post I better hurry up and get something more positive up before anyone got too worried about me. I’m sorry. I do not usually edit my posts anymore now that I am free and don’t need to hide, but that also means I don’t have the opportunity to read my words and wonder if anyone will be legitimately worried about me. I am still trying to heal the hole of grief, and sometimes it is hard. I know my goal was for this year to be better, and crying uncontrollably doesn’t sound like better, but I have to give myself grace. Being able to give myself grace is better than before. And really, I am learning to climb out of the pit I keep being pushed into. I was pushed hard and the wind was knocked out of me, but I didn’t stay down too long. On Thursday, my manager came to apologize to me about the situation (okay, not the whole thing obviously, but the tiny piece he knew – that the PALS class I was excited about was happening without me). He wasn’t going to change it, and wasn’t going to bend the policy about training only being allowed on paid time, but somehow just being brave enough to acknowledge to my face that he understood my frustration was enough to start building the bridge. Like I have always said, there is a lot of power in “with,” and I think that is why that helped. Although I will say that initially breaking the news to me via email was also good, because I don’t really want my manager to see me cry. Vain, maybe, but whatever. Anyway, I might have come home Friday and had skittles and cookies for dinner before going to church, but I had so much fun at the game night that I actually did eat reasonably well and didn’t want to leave…I was up WAY past bedtime and was practically asleep standing up by the end of the night, but I really enjoyed it, and this morning I was feeling so much better.

 

I know that it is not “good” to be fighting life so hard when grief storm hits. I know it is not exactly “normal” to spend significant amounts of time deeply yearning death. I am working on it my own way, at my own pace. I also know that there are some things I am just not ready for, and trying to process with a counselor is still something that is too similar to the abuse for me to be ready to seriously consider it as an option. There is more healing to be done before I am willing to try again.

 

So on that note, back to what I actually originally sat down to write…

 

I know I can’t expect life to be perfect or anything, and sure, I rarely do compulsions anymore, but I do occasionally have more than an appropriate amount of germ anxiety. Yes, I know people do get sick, and the world goes on, but OCD doesn’t make sense. I am so much more free of it than I used to be, but when I am scared I don’t want “better,” I want no fear. Zero. Nada. Zilch. It (the OCD) probably did get worse than it had to because of what else was going on a few years ago, but I am a fighter. Compared to where I was mid to late third year, I basically haven’t had a single problem since the summer after third year…it’s just that I want recovery to mean 100% of the time having zero fear, but that isn’t realistic, because every single person has at least a little fear once in a while. Having some non-disabling fear occasionally and even having disabling fear once in a long while is normal…which is hard to understand when you have spent time in the very black and white world of OCD. Either it is clean or it is not, and either you are afraid or you are not…no in betweensies. So realistically, I probably am totally normal or pretty close, but my perspective tells me it is pieces of OCD back because I had fear…

 

I read an article maybe a month ago about how hard contamination OCD is in the winter and talked about how people with OCD tend to have a radar for signs of sickness and how that can be like a game of dominos. I definitely have a radar for signs of potential sickness and it sets off a theoretical chain of dominos and I end up with a feeling of impending doom. It is terrifying. For me it has always been linked to social difficulties. If you get sick you have to either communicate that you are sick or somehow manage to hide it, which is probably not completely possible (particularly around anyone like me with a very sensitive radar) and is also super disrespectful of other people to not quarantine yourself if you are germy. Communicating it is scary and also means that you have to decide when to come back.

 

I hate winter. I hate germs. I hate norovirus. So far I feel healthy, but my world doesn’t feel stable, and working in healthcare can definitely impact how safe I feel. Plus, the compulsions I had/have with OCD were not just washing, but also “researching” (in quotes, because primarily through social media). So I am acutely aware that a person remains contagious for weeks following the end of symptoms and traditional hand sanitizer is not effective against it, and even cleaning supplies that *can* kill it are often not effective because they are used wrong. For example, I’m not sure if Clorox wipes are effective against noro even if used appropriately, but the way a lot of people use them they might as well be using wet paper towel to clean. Cleaning wipes require a minimum wet contact time to be effective. If the surface doesn’t stay wet long enough you haven’t cleaned the surface and if you *cringe* wipe the surface dry immediately after using the wipe then you have just become a master of the placebo effect if you believe you actually did any cleaning. Frozen noro can remain infectious forever. Room temp noro can remain infectious on surfaces for significant periods of time as well. Very possibly months or more. The number of viral particles required to cause illness is in the single digits. Compare this to the millions to billions of aerosolized particles following a single vomiting or diarrhea episode, not to mention the amount in the vomit or feces themselves, and clearly it is no surprise why infection doesn’t tend to happen in just ones or twos.

 

So yeah, winter can be a really hard season for me as a former OCD-er. I go on a rollercoaster ride from almost certain I am doomed to promising myself that I am safe and back again. Knowing way too much from my former hours of research makes it easy to be fearful. I know how easy noro spreads, so not only do I react to the people in my actual life that get sick (umm, yeah, I have determined my parents entire house is contaminated and am not sure I ever want to go back…kinda a problem), but I also react to the Olympics outbreak in Korea and the outbreak at a college in Wisconsin. I see the dominos. Even if someone doesn’t get sick, suppose somehow an American tourist’s backpack picks up a few viral particles from being near someone who was near someone sick (and realistically there would be a lot closer contact than that). That backpack gets put onto a plane with zillions of other people where the germs are transferred to another person’s purse. That person goes to work and their purse is hung on a hook touching lots of other people’s bags and coats and the germs transfer to the inside of someone else’s coat. That person’s coat comes home. The next day they put their coat on over their pajamas to go to the mailbox. The germs transfer to the pajamas. The pajamas are worn to bed the next night and the germs are transferred either to hands or sheets and then to the mouth. By that next night the person is sick and there are zillions of virus particles everywhere and they are tracked all over the city and people are very mobile, city to city, state to state, country to country.

 

That little scenario I wrote out takes out a lot of potential steps in the process, and drastically simplifies from the zillions of vectors to a single chain, but I hope that it helps understand how easily I can fall victim to fear. It took a lot of words to write that scenario out, but it took less than a second from reading about the Olympics to feeling a sense of lack of safety…and anger. The Olympic committee put out a bunch of hand sanitizer in response. Unless in Korea hand sanitizer is actually pure bleach rather than something like the ethyl alcohol we generally use in America, it will not help prevent spread. In fact, it probably decreases safety, because it makes people feel safe even though they really aren’t. When people feel safe they are a lot less careful which greatly increases the potential for spread of sickness. I want to say that is not okay.

 

But I am proud of myself. So far I have thought about whether I should keep eating and drinking, but have continued to decide that yes I should. Even with all the other things going on making life hard, or maybe because of all the other things going on, I have not come to a panic level of fear. I might be exclusively wearing pajamas in or near bed – not even clean casual clothes, but I am able to go through life seemingly normally at least from the outside, and that is important to me.

 

Although I will admit that I do have a desire to know everything there is to know about what is going on with noro at the Olympics…but that is probably also related to my input strength – trying to collect and categorize all the information available. It really is a bummer that news sources don’t seem interested in reporting full stories. From my perspective they give just enough info to whet my interest and then end the article and cease follow up coverage. It is kinda frustrating when you are someone like me who desires to know the entire story. It’s the same way with a lot of news – like with a school shooting I want to know how people are doing after it’s over. How are things different? What new frustrations are they facing? …ad nauseum…if I had my way we really wouldn’t need much news, because we’d still be getting news updates on the school shooting that happened in December 2012…inquiring minds want to know…

 

Lol…what do you want to know? I would love to do a Q & A post…although realistically I don’t have anywhere near enough viewers for that to ever happen…