A Start

The walk to the social work office led me down a long hallway lined with medical assistants and physicians coming in and out of exam rooms. A bustling hive of activity that I normally thrived on. Typically, I would greet several people with a smile and quick exchange of words even when I was walking at a fast clip. Not today. My peripheral vision was fading, and my usual smiling face was ashen.

Uncharacteristically, I kept my head down as I walked down the hallway. The tears were already welling up and I didn’t want the medical assistants or physicians to see me like this.

Approaching the social work office, I knew that the tears would flow even more freely as soon as I told her what was happening. No choice, I thought. You can’t go on like this.

She was sitting at her desk working on the computer and turned toward me upon hearing my knock with a smile on her face. Once she saw my expression, her smile evaporated. She recognized that the doctor in front of her had transformed into a patient. And there was work to do.

Closing the door behind me and with tears streaming down my face, I quickly blubbered out, “My husband has cancer…spread to the lymph nodes…50-50 chance of living five years. Our girls are so young. I don’t know what to do.”

My head felt full, and ears were ringing. Although I could still hear, it was becoming more and more difficult. My fingers and toes were tingling. And I was losing the feeling of my hands and legs. They were connected to my body but felt almost like they were floating away from me.  

She helped me sit down, and the tears began flowing freely. This was the first time that I had said these words out loud, and I hadn’t anticipated the effect they would have on me.

My professional career as an obstetrician-gynecologist had been spent helping people deliver healthy babies, but also dealing with abnormal growths of the ovaries and uterus, infertility, miscarriage, domestic violence, breast cancer, homelessness, suicide, and divorce. There almost wasn’t a clinic day when one of my patients wasn’t crying, legitimately about a nightmarish situation that I could hardly comprehend.

With calm and reassurance, I would craft a plan for my patient to help her address the medical and emotional fallout of the problem. Being a rock for my patients was a part of the job that I loved the most. Now, I was the one falling apart.

I tried to focus on inanimate objects in the room to regain my composure. First, a plant. Then, the arm of her chair. Then, a desk lamp. Anything to keep from looking into her compassionate eyes. I had to stop crying. In fifteen minutes, my afternoon clinic was starting, and it was packed. My patients were counting on me, and I had a job to do.

“This is terrible”, she said. “I am so sorry. There are no words for something like this.” Her eyes radiated kindness and sympathy. I could also see the professional in her, who was thinking of ways to help.

Nodding my head while she continued offering words of support, I felt my throat thickening. I couldn’t speak.

“Let’s make a plan”, she said. “First, I want you to make an appointment to see your primary care physician. I can send you a list of grief therapists that I can help you and guide conversations with your children.”

The topic of how to tell our children was something that neither my husband nor I could face. Our daughters were 10 and 12 years old and enjoyed school, Girl Scouts, and playing volleyball. The house was full of their mischief and laughter. They were transitioning from girls to pre-teens and enjoying their childhood.

To have a coherent conversation with our daughters right now about my husband’s grim diagnosis was unthinkable. He and I were still in shock and could hardly grasp what was happening, much less explain it to anyone else.

“I think I need a grief therapist, especially to help us tell the girls,” I said somewhat surprised that I found my voice.

“I will send you the list of grief therapists tomorrow. And you are making an appointment with your primary care physician. I also want you to think about taking time off to take care of yourself and your family,” she said.

“I know that I need to, but it is hard,” I said.

Work-life balance was something that physicians in my era struggled with. There were always more patients to see that needed you. Becoming a physician was a calling and one that came with serious responsibility. Taking time off to process grief or loss was seen as a weakness, or at least my training ingrained this perspective in me. Heck, it used to be the standard for ob-gyn residents to take only 4 weeks off to recover and bond with their newborn after childbirth.

It was a masochistic psychology that had been ingrained in us from the beginning of medical school. Practicing medicine was a tremendous honor. With that honor came a great responsibility and need for self-sacrifice. Perhaps the new generation of physicians had a better grasp of taking care of their own mental health than those in my age group. I hoped so.

My voice failed me again and I didn’t tell her one of my worst fears. How could I continue practicing medicine like this? If my husband had limited time on this Earth, did I want to spend it helping other people? I felt sick.

“I will reach out to you with the names of those therapists. Please take care of yourself and your family. I am so sorry that this is happening to you. Let me know if there is something more that I can do,” she said.

Nodding, I got up to leave and gave her a half-smile to thank her. Relief washed over me. I had started the process of getting professional help for myself, which required a great deal of effort for my grief-stricken brain. If I had let my brain be solely in charge, I would be sitting in a dark room day in and day out. Telling someone was a big win for today.

The afternoon clinic was starting, and I needed to get back to my desk. With the bravest face that I could summon, I turned to walk back down the long hallway wiping my tears before anyone could see.