Being a patient has taught me patience, with myself, with those I care about, and with those I care for as physician.
I recently shared Mary Oliver’s beautiful poem “The Journey ,” to begin a talk I was giving about my experience with depression. Something about “…a wild night, / and the road full of fallen / branches and stones” captures the stormy and rubble-ridden path through the dark forest of depression in a way prose never can.
As with any journey, there are lessons to be learned along the way, whether one wants to learn them or not. They are the gifts born of the effort. Being a patient has taught me patience, with myself, with those I care about, and with those I care for as physician. Some of the lessons I’ve learned from this humbling experience are:
Never Worry Alone
Each June, I welcome new interns into my residency program. I know that the words they hear in the first hour of their orientation are likely to be the most sticky, to set the stage not only for their training, but perhaps their careers. Early experiences are like that; they shape us. So, along with a gift of small Guatemalan worry dolls, I impart a message I hope stays with them: “Never Worry Alone.”
Yet, in the slide into depression and the depths of its darkness, I worried alone. I did everything alone. Loneliness is the most visceral memory I have of a time where many memories are fuzzy and confusing. Fighting my way back, it turns out, I couldn’t do alone. I needed a guide, a psychiatrist who treated me with compassion and patience, and a village, my loved ones who bore witness to my suffering.
I learned, finally, the message I had been teaching for so many years. I work hard now to not worry alone. I engage in therapy; I seek out company when I’m having a terrible day. For my own patients, whether they be new parents or teenagers with depression, I remind them also to never worry alone. It is a simple sentiment – but one that is actually quite hard to do.
Vulnerability is a Gift
I am a fan of Brene’ Brown’s work which brought a new description to an inner truth for me. I value vulnerability because it is what allows us to be authentic and humble, two qualities I value greatly. When I was most unwell, my psychiatrist told me that sometimes those used to being on the giving end of the equation find it hardest to be on the receiving end. He told me it would take time to get used to being the one needing help.
At that moment, I didn’t value being vulnerable one bit. Now, however, I see the chance to be vulnerable – to share my story, to grow from the challenge of being the patient when I was trained to be the doctor – as an amazing gift. It isn’t a “vulnerability” to be vulnerable, it is a chance to be strong. I hope it allows others be strong by realizing the value of struggle and imperfection.
As much as I appreciate the opportunity to share my story, I am particularly mindful of the fact that illness takes away a great deal of agency from patients. For me, I choose to honor my illness as part of the fabric of who I am as a way of meaning making. That is my choice, however, and it is important we not expect patients to glorify their own experiences as valuable. Suffering is suffering and I would not have chosen it, even if I can see meaning in it now.
Joy is Hiding Everywhere
I think there can be a misperception that depressed people don’t smile, don’t laugh, don’t enjoy anything. If that were true, I don’t think depression would be as hidden an illness as it is. You can smile, you can laugh, you can even enjoy something, but it is superficial and fleeting. Depression robs its victims of joy, that powerful, deep feeling of delight so often connected to ideas of spirituality.
Finding joy is also protective, as Moskowitz et al recently showed and was summarized on NPR. With my depression is in remission, I seek out joy, small and large. And you know what? Joy is everywhere, you just need to look for it, indulge in its beauty, and engage in gratitude for it. Joy in the spring blossoms. Joy in the achievements of your children. Joy in the opportunity to care for patients. Joy in the gift of a handmade paper crown from a patient.
Some journeys have a clear destination, but as with Mary Oliver’s protagonist, I think the journey through depression is a longer road, a journey one can expect to continue, hopefully “determined to save / the only life you could save,” while collecting lessons along the way.