Carrie Hempel-Sanderoff, DO
For many physicians, the psychological messaging of our years of training emphasized the need for distance, walls, and armor. In order to be “professional,” we must be able to stand in the face of unfathomable pain, suffering, and trauma on a daily basis, unaffected and stoic. The system itself demands the absence of our individual needs, our emotions, and our authentic selves in the roles we play. I dutifully internalized this as gospel, and for years, I felt shame, inadequacy, and unworthiness at the intensity of my own emotions and experiences. I did what many physicians do to cope. I worked harder, numbed my feelings, and chastised myself for my “weakness” using the same voices as my preceptors 20 years ago. I was in pain that I couldn’t understand because I’d built so many walls inside of myself in order to fit the image of a “good doctor.” Why did I feel so bad if I was doing everything I had been taught?
But here’s the truth. Our patients die, sometimes horribly and painfully. Families grieve, scream, yell, and engulf us with their unmet needs. It’s messy. Pandemics happen. Unfairness and injustice happen. Electronic medical records and stifling bureaucracy happen. Our patients can be mistrustful of us and, even worse, vulnerable to lies and misinformation that fuel antagonism rather than partnership. We have to live and work through our own personal pain and tragedies. We have to keep showing up, exhausted, grieving, heartbroken, and depleted. And we do it, denying ourselves, because for some reason, we have been taught that our own reality, our own pain, is not welcome in the House of God.
Is it any surprise that at some point, for many of us, the dam finally breaks? As human beings, our mortal capacity is finite through no fault or weakness of our own. We call it burnout, but for me, it was the cumulative unacknowledged pain and trauma that I believed I didn’t have a right to feel that consumed me. I burned up from the inside. And I eventually broke. It was terrifying. I could feel myself fighting it and losing ground quickly. Instead, one day, I got up from the floor, where I often found myself on my knees, crying and praying. I breathed in and surrendered to it. I didn’t know what would happen next, but I knew that this version of me and this doctor I built was crumbling. I needed to decide what was next, and only I could take those steps. I had to be willing to put it all down and save my own life.
What happened next is truly a miracle. The moment I gave myself love, acceptance, and compassion was the moment I began to heal. The moment I chose to really see myself, my whole being responded. Was it painful and terrifying? Absolutely. Did I have to ask for help? Yes, and it was one of the hardest things I ever did. Did it happen overnight? No way. Prescriptions of tremendous patience, love, and support were needed. The rigors of training, fellowships, and years of practicing medicine taught me to turn away from my pain. I was not trained to give myself care and compassion. It took months and years of remembering and reconnecting. I had to be taught how to see and care for myself as the unique, highly sensitive, intuitive, free spirit that I am.
Imagine my surprise and relief that, armed with a more complete understanding of myself, I rediscovered and embraced my unique mind and all of my strange and beautiful quirks. I found a much clearer path back to the work I truly love. Medicine is soul work, and we are meant to show up whole, using all of our gifts, able to hold space and see ourselves in every soul we care for, not to shame ourselves for it. Instead, we can awaken our empathy and compassion. We can recognize the chaos outside of ourselves without the impulse to fix it. We can learn to see that our patients don’t need us to be all-knowing, all-powerful, and unyielding. They need us to be present with them in their worst moments, to acknowledge their pain, and to not feel it alone. We can’t offer it to them until we offer it to ourselves. They can’t heal unless we heal.
I wish to share this painful and beautiful lesson. You can release your fear of being a failure or a burden. If you are in pain, feeling empty and lost from yourself as a physician, it’s not your fault. You were trained this way. We can unlearn this and go find ourselves. And we can keep going, come back stronger, and show up completely.
I love this Leonard Cohen line. I repeat it to myself daily:
Ring the bells that still can ring / Forget your perfect offering / There is a crack, a crack in everything / That’s how the light gets in.
Cohen L. “Anthem.” The Future. Columbia Records, 1992.
Go and find your light. You know exactly what to do.
Carrie Hempel-Sanderoff, DO, is a hospice physician in Baltimore, MD. Her passion is helping patients experience comfort and quality of life at any stage of illness.
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