This Was Not the Break I Needed

There is a particular kind of misery that comes from having something good handed to you at exactly the moment you needed something else.

Years ago I took a stretch of leave because I wasn't sleeping and I had stopped feeling safe taking care of patients. A few days into it, my youngest child's preschool had a fire in the kitchen. Nobody was hurt, and I was grateful for that. The building closed for ten business days, which took most of the rest I had taken that leave to get.

The thought I could not shake was simple. This was not the break I needed.

And immediately behind it, louder: what is wrong with you. You love this kid. You already don't get enough time with her. Plenty of people don't get leave at all.

I want to be precise about where the suffering actually came from, because I had it wrong for years. It wasn't the fire. It was the ten days I spent litigating whether I was permitted to be disappointed.

If you work in medicine, you know this shape even if you've never named it. The golden weekend that arrives with norovirus attached. The two weeks off that turn into caregiving because someone at home needs surgery. The trip that evaporates because your partner tests positive for COVID the day before. We work stretches that no reasonable person would design, we are not good at resting, we hoard our time off, and then when something takes it, we treat our own reaction as a defect.

Here is the process I use now instead, in this order. The order is the part that matters.

Name what you feel. Out loud, and badly is fine. Sad. Furious. Resentful. Flattened. Then look for the second one, because there is almost always a second one sitting on top: guilt, shame, or the slick version, which is rationalizing. I should be grateful it wasn't worse. Other people have it harder. If you catch yourself building a case for why you shouldn't feel what you feel, that's the second layer, and it's the one doing the damage.

Normalize it. Say to yourself what you would say instantly to a friend: it makes complete sense that I feel this way, because I was counting on that and I didn't get it. This is the practice Kristin Neff, PhD, calls common humanity, and it sits alongside the shame resilience work of Brené Brown, PhD, LMSW. You already know how to do this. You do it for your patients, your kids, your friends, your parents. The skill isn't missing. It's just never been pointed at you.

Allow it. Give it somewhere to go. Cry in the car. Scream into a pillow. Call someone and open with I don't need you to fix this, I just need to say out loud that I'm furious. Bring it to a coach or a therapist. Feelings that get named, normalized, and felt tend to move through fairly quickly. Feelings that get shoved down and judged are the ones that stay for months.

Then problem solve, and not one minute sooner. My own coach gave me the question I now keep in my pocket, and she prefaces it exactly like this: you don't have to do anything, but how could it be possible? How could it be possible that I still get some rest this week? How could it be possible that we still have some fun, even stuck at home? That question opens doors that this is ruined keeps bolted shut. Sometimes the answer is a different bucket of leave. Sometimes it's another caregiver for a few hours. Sometimes it's asking for unpaid time, or a trip credit, or something enjoyable you would never have thought of if the original plan had worked.

You will be more creative about all of it once you are no longer spending your energy on whether your feelings are permitted.

Your time, your rest, and your fun are precious resources. Losing them is a real loss, and having feelings about a real loss does not make you ungrateful, or a bad parent, or weak. It makes you a person who needed something.

New episodes of Ending Physician Overwhelm go up every Tuesday. My website has just been completely rebuilt, and you can find everything, including how to work with me, at www.healthierforgood.com. I'd also love to hear from you directly at [email protected].