Hole in the soul

A few years ago I was struggling. I was going through a difficult time, feeling depressed, sad, empty, not myself at all. For a time I was miserable, but over a period of months I came to terms with some of the issues I’d been struggling with. And eventually life was better again; not perfect, but so much better.

Sometimes I remember those months, and what I learned from the experience.

Depression steals your energy. I remember feeling like I just wanted to sleep, to escape. Simple chores were overwhelming. The only thing that kept me somewhat normal was work. Work helped me put on the façade, gave me a reason to get up and get moving. Because I didn’t want to bring drama to my work place, I tried to minimize what I was going through, tried to hold myself together so I wouldn’t feel embarrassed with my co-workers.

Depression steals your appetite. At least that was what happened to me. I lost interest in cooking. I was alone a lot during those months, and it was easy to ignore meals when I wasn’t hungry, and too disinterested to cook. I lost 20 pounds in a few months. Best and worst diet experience I’ve ever had, the only “diet” that was effortless. In the past I’d put on pants or a favorite skirt and realized it was time to lose a few pounds. I’ve never before had to look through my closet for something to wear that wouldn’t fall off me.

Depression steals your interests. I would try to read to take my mind off the things that were bothering me. I couldn’t read. I would try to watch TV. I couldn’t stay engaged. I couldn’t settle myself long enough to accomplish much. I was restless and yet exhausted.

Depression steals your rest. I slept a lot when I wasn’t working. But often in the middle of the night I would wake up and my mind would race, going over and over the things that were troubling me. I was sleeping all the time, but not resting. My sleep cycle was broken by stress and worry, and somehow, the more I slept, the less I rested.

Once I was in the grocery store, walking around like a ghost, feeling the physical impact of depression. I felt like there was a hole in the middle of my body where my stomach should have been. In my mind’s eye, I saw myself with a gap between chest and hips…a hole that only allowed for the churning engine of stress that took the place of my belly…and even though I knew there was no hole, I remember thinking that the gaping emptiness seemed so real, I was surprised other shoppers weren’t staring at me, stopping to ask if I was alright. Because I had a hole in my middle. It was a surreal experience, and I wasn’t even on any medication. I was just feeling the drowning grip of sadness.

I walked around the store, filling my cart, looking normal on the outside, feeling lost and empty on the inside, and so aware of the gaping hole. As I walked around, I began to wonder who else was walking through the store with their own holes, invisible to me, but so real to them. Holes in souls.

That question took the focus off myself and allowed me to stand back and recognize that I probably pass people all the time who walk around with holes. I just don’t see what’s in front of my eyes. I try always to be kind, to be thoughtful. But even so, there are days that I’m wrapped up in my world. I pass people on automatic pilot: kind but remote, polite but disinterested, because I’m busy, and on the run, and don’t really look close enough to see the hole that’s devouring the person in front of me.

Living for a time with a hole in myself helped me realize, in a way I hadn’t before, that a lot of people walk around like that. Walking wounded. They put on the face, just like I did. They go through the motions of living, just like I did. Some get help, and some get relief from a change in the situation that’s causing the pain. That’s what happened to me. Circumstances changed, the skies cleared, my smile came back.

It wasn’t without some effort on my part. I did a lot of soul-searching, made some changes that were within my power to make.

It was a humbling experience. When you’ve always been hopeful, mostly happy, mostly sunny side up, it’s hard to recognize a self who’s drowning, who can’t snap out of it. You begin to look at people who struggle with depression and other forms of mental illness through a different lens. You find more compassion, more appreciation for the struggles that are invisible to the eye, but so real to the heart.

When I remember that time, now I can feel grateful. It taught me a lot about myself and helped me find strength I didn’t know I had. I learned the value of “wait and see.” I learned that the phrase “trust the process” isn’t just something you hear in corporate settings. I learned that life will often right itself, if you work with it.

I don’t want to tempt fate by thinking I’m invincible. I’m not, and the truth is, no one is. If there is a next time, I think I’ll manage my hole a little better. I think I’ll know to trust, I’ll find my smile a little faster, a little easier. The reward for weathering the hard times is being better prepared to face whatever comes, and knowing, knowing, that you’ll survive, and thrive, and grow above. Eventually, assuredly.

Once you’ve worked through a hole in your life, you’re never quite the same. You’re scarred, but you’re wiser.

I no longer have an engine of stress running in my stomach, or feel like there’s a hole in my body. But I can empathize with those who do. I don’t talk a lot about this experience…just doesn’t come up in normal conversation. But now and then I see an opportunity to speak up, to share, to encourage, to say, “I’ve been there.” It’s a powerful thing to look back at a challenge and know you’ve overcome. And it’s a powerful encouragement to someone else to hear a first-person story, to know someone else really gets it.

I don’t claim to have it all figured out now. I’m not even sure why I’m sharing this, except that I suddenly wanted to.

I’m not sharing to get sympathy. I’m sharing to give hope.

I started my blog during those months, started it to stake a claim to the positive person I knew was somewhere inside. I was determined to find my way to that self again. And I did. I had help from a few significant people who knew what was going on, and some of the conflict in my life subsided.

After the worst of it was behind me, I noticed I was singing again. I noticed I was interested in food again. I noticed I had a renewed sense of grace, of redemption, found a new sweetness to life that stays with me. I sometimes have small setbacks, and I sometimes feel discouraged. But I’ve never gone to the depths again. I’ve learned the signs to watch for, and the steps toward healing.

I think I’m a better person than I was, in part because of what I went through. It changed me, grew me. And though the details are not important now, I can share this much: to anyone reading this who is lost and despairing, don’t give up hope.

Do something to get yourself moving, literally. Get off the couch, do the smallest thing, and let that lead you to the next thing, and the next. Action inspires hope, and hope is the lifeline to healing. Reach out; there are probably more people than you could guess who understand at least some of what you’re experiencing. And give yourself time. Time can be your ally, and in time, you can look back and see that you’ve come a long way from your lowest point.

You’ll find your smile again. You’ll hear yourself singing again. You’ll sleep through the night again. And you’ll know you’re healed.

 

Wounds

 

Primary Care

Two weeks. For two weeks this month I worked in the local primary care clinic, seeing the daily parade of patients and problems: the good, the bad, the ugly.

The clinic was short-handed with some staff out for spring break, and I was able to help out at the front desk. I went through training last year to be a super-user for the clinic’s electronic record, and it helps me to stay current to go in and work in the live setting when I have opportunity. And it’s good to catch up with staff I used to see on a daily basis when I worked full-time in the admin department. Plus, the clinic is in Ketchikan, so I got to be in my own home while I fulfilled this commitment. So all good.

I’ve blogged about this before. Most of my work in the world of healthcare has been on the administrative side. I came into healthcare through the back door of grant writing and office work. I’ve expanded to policy writing, recruiting, project coordination…all tasks that are familiar and comfortable. But patients…now that’s different.

Patients are the reality check to all the work I do.

I usually work in quiet offices, with much of my day consumed with writing, or researching, or interacting with other staff: problem solving, planning, coordinating efforts, meetings, interviews. All valuable, and part of the mechanism that keeps staff in house and programs operating.

But in that world I’m shielded from the nitty, and the gritty. Two weeks of primary care changes that focus.

The other staff I worked with are great: patient, helpful, appreciative of the support I offer, even when it’s imperfectly delivered. In a busy clinic, you need all hands to juggle clinic hours (the clinic offers extended hours; some days the schedule begins at 7:00 AM, and others it ends at 7:00 PM), patient demands, and keep up with the minute-to-minute of busy days. Navigating the electronic system for patient registration,  scheduling appointments, fielding a million questions a day…ok, maybe a thousand, but it seems like more…well, I’m reminded again: I’m grateful to be healthy; humbled to recognize that my complaints of life are “first world” in nature; and I alternate between admiration of people who are cheerful and upbeat in the face of difficulty, and amazement at patients who abuse the very staff who are trying to help them.

Patients are thoughtful, kind, appreciative, attentive. Some are dainty little old ladies, or stately elderly men, in for blood pressure checks and routine appointments that make them regulars. The staff know them by heart. They’re the ones that give you a sense of purpose and satisfaction.

Others are also known, but not for their good traits. They’re rude, demanding, careless, dysfunctional. They’re the ones with an attitude and a knack for saying the wrong thing. They no-show for appointments, then complain when they can’t be worked in; they “lose” prescriptions; they’re quick to criticize and expect more. You see one of those names on the schedule for the day and you hope you don’t have to encounter them. They make you glad with their absence. And yet, even as you put on the smile and ignore the attitude that’s so inappropriate, you wonder: what happened to this person to turn them into a (take your pick) bitter/manipulative/ungrateful/difficult human being?

Work in a clinic setting, and it’s inevitable: you begin to have better understanding of the issues. The headlines about healthcare and insurance and regulations have a real-life meaning that you see through forms, and requirements, and layers of bureaucracy created to manage patients, and the business of paying for care.

The patients make it real too. Some of them can barely walk. Some of them smell. Some of them are dying, slowly but surely. Some of them are living, but miserably. I see the way the staff work with the needs, the challenges, the drama. I’m impressed that these people make a life of touching, healing, processing, listening, advocating, arranging, soothing. The list could go on, and does: the work is never-ending, and the reward is more of the same.

Sometimes it’s funny. When people become patients, you can expect the unexpected, and just when you think you’ve seen it all, it’s another day, and you’ve haven’t seen anything yet.

Sometimes it’s heartbreaking. Patients die, and every week there are two or three sympathy cards laid out on a back shelf, ready to mail “to the family of…”

I say it often: working in healthcare is not a job for the faint of heart.

The job of professionals is to make hard work look easy, and the team I just worked with does that on a regular basis. They find the grace to rise to the challenge every day.

I never had any aspiration to become a nurse, or a physician, or a hands-on healer of any sort. And I’ll admit I’m more than a little relieved that now I’ll go back to my role as a sometimes-recruiter, sometimes-project coordinator, juggling many balls and enjoying the variety of my world. But I have to acknowledge, a little time in the hot seat, interacting with patients is a good thing. It reminds me that there are people at the heart of the work I do from my safe and sanitized desk.

Back among the living

Last week was a hard one. First there was my travel saga…not to make too much of that…it ended well. But the long trip home set me up for a rough couple of days. I was exhausted from the cross-country flying, and probably picked up a bug in the friendly skies…all the close quarters and shared air. By the time I got back to Ketchikan, all I really wanted to do was crawl in bed and sleep for a week. By the time I’d been there a couple of hours, I was feeling chilled and sick. Not a good homecoming at all.

On Wednesday I tried to get up three times. Finally I forced myself  to be upright long enough to see off our friends who had stayed in the house while we were gone for the holidays. If they hadn’t been retiring and moving out of state, I’m not sure I would have made the effort to rouse myself. But in the circumstances, it seemed right that I crawl out of the covers for a formal goodbye. I kept a safe distance…didn’t want to share a parting gift of germs with them…and as soon as they left, I dragged myself back to bed. I knew I had a few hours yet I could be horizontal. For the moment, it was my life goal: To. Be. Horizontal.

Rob was scheduled to get home that evening, so I set an alarm to make sure I’d wake up in time to pick him up. I revived enough to do that, but didn’t last long after we got home from the airport.

On Thursday I was supposed to go to Metlakatla. My alarm went off at 5:00 AM and I started playing the game. I reset it for 5:30, then 6:00. Then I finally turned it off. I couldn’t have gotten myself out the door if the house was on fire. I’ve rarely felt like every cell in my body was drained, but that was how I felt that morning.

I never sleep in, but after a couple of mid-morning attempts to get up, I gave up. I finally surfaced between noon and 1:00, and we ran a few errands. We had to make it over to Metlakatla Friday morning since Rob was covering call for the clinic over the weekend, and I needed to connect with some staff on Friday. So Thursday afternoon was my chance to pull myself together and get ready to be there for a few days. I managed it, but barely.

By Friday morning I was almost back to normal. And good thing too. I could not have walked out the door a day earlier. Maybe I just needed some time for my body to catch up with all the bouncing around I’d done in the past few weeks.

I mention all of this to say…wow!…what a hard thing it is to be sick. I’m so rarely under the weather that I’m sometimes guilty of forgetting that not everyone is so fortunate. It’s easy to take good health and energy for granted when that’s mostly all you’ve known.

I remember when my dad was going through chemo and radiation treatments. Even when he was not visibly ill, he was fatigued. He rarely had much energy, and he couldn’t eat normally. And of course so many things work as part of a vicious cycle for cancer patients. I would visit and try to encourage him to eat a little more. Or to be interested in something going on, or going for a ride, or anything. There were days that he could participate in life, and days he couldn’t.

It was frustrating, for someone filled with energy, to try to infuse someone else with life, with interest, with desire to do something, to do anything. Last week, lying in bed feeling like the world could disappear and I wouldn’t care, feeling like talking and even listening required more energy than I could muster, I thought about my dad. I remembered some of the times I tried to share my energy through encouragement, through optimism, through my hope for him.

It’s humbling to realize…I didn’t have cancer, or some other debilitating disease. I’m sure I just had a virus, and ibuprofen and some extra sleep were sufficient to get me back on my feet. But for people who have serious illness, or depression, or some life-crippling condition….a little sleep and a few over-the-counter pills are not going to cut it.

Last week was a reminder that I need to appreciate my own good health. But I also need to be understanding and patient with people who are struggling. I would never criticize anyone battling illness. But I’ll confess that it is sometimes frustrating to feel like you’re trying so hard for them. And they just don’t pick up the cues and perk up. It’s disheartening, when you have energy to burn, and you can’t ignite a spark.

Thinking about my dad, I know he understood that I was just trying to help, and that I was so longing for him to feel better, if only I could have done it for him. But I couldn’t grasp how much he was doing, just by sitting in his chair, by being dressed, by eating a little bit, by talking a little bit. I couldn’t grasp how that little effort was taking all the energy he could find, and all he could spare.

Well, I’ve been sick a few times in my life. Not for long, and never very seriously. But in recent years, when I’ve had days that knocked me flat, I’m reminded, again, that I need to be respectful of the boundaries. That I need to understand…when you don’t feel well, no one can feel well for you. No one can hope you into energy and strength and wellness.

I suppose this is on my mind because I was just flattened, and reminded. And because Rob was on call and saw a lot of sick elderly folks. Most of them probably had flu, and will likely recover. I hope so. But my 53-year-old self has bounced back, and recovery will likely be slower for the older ones.

I am pausing to reflect on this now, and to store it away for “some-day,” when I’m on the elderly side of life, or ill…I’ll be the one needing patience then, and kindness, and understanding that just wanting isn’t always enough.

It’s perspective, isn’t it?