Paper folded over the crease of the clipboard, we file on into the side-room, the smell of thick phlegm and night-breath hovering in the stuffy bay. A gentleman, middle-aged, thick, strong, dark tufts of hair sticking up greasily behind the steamy mask of the nebuliser. He is pale, yellow, and famished, his calf muscles withered down to a pair of flaking breadsticks. We look up from our clipboards. The consultant breathes a heavy sigh.
Drawn out dissatisfaction and loss in clarity for the long-term goal can be a fundamental first sign of buildup, burnout and breakdown, in both our work and social lives. The feeling that we no longer have that one concrete function or purpose can leave us fragmented from sync and daunted by the fragility of carelessness. It leaves us with little more words to say. And, for those who have always striven to be the best they can be, ambitious, fulfilled, all-rounded, then this can be even harder to come to terms with. As a medical student timidly feeling my way through the precarious system of a struggling NHS, this is just one classical observation I continuously see, each day on placement. Our staff, braving through courteous smiles and desperately juggling the balls between sick and health, health and sick, are, deep down, hanging by by that same burning thread. We scratch our heads, as the gentleman in front of us gazes through the white gaps in the wall behind us, his pond-water grey eyes fixed still. He gasps a silent breath.
Besides my medical student role, my everyday routine has forever been to be spontaneous, or, in other words, not to have a routine at all. A thirst for the adventure undiscovered by anyone else I guess already predisposes me to the predictable disappointment that I won’t always be able to do this – it’s just nature of life, the restraints of time, money, accessibility. All the infrastructures that we have to, as a society, reluctantly accept holds us together. Yet, if we can grasp this, then we have already opened up doors for the many alternative opportunities. And so I ask for the chair beside the gentleman’s bed, to sit down heavily, still clutching onto my clipboard.
For those of you who have followed my various journeys so far will appreciate that I actually simply cannot stay sitting. There has been many a summer where I have spontaneously set out an intricate travel itinerary for an entire continent just days before the hour of departure. I’ve signed up for marathons, half-marathons, swimathons, mud-runs (not ever managing these in the end, sadly. Yet). I’ve written notebooks of poetry from within the bathtub, submitting them half-heartedly to contests and then creating myself more unnecessary work when I realise I then have to attend these contests. Prepare. Present. But at not one point did I stop then, and listen to my body. No surprise then that you soon hurtle past the first ditch on the side-road and blast through the 3 B’s: buildup, burnout and breakdown.
Receiving the diagnosis of a progressive muscle disease, a mitochondrial disorder, in the second year of my medical school training was thus then a complete and utter death sentence, or so it felt. How on earth would I possibly be able to fulfil and satisfy that everyday (spontaneous) routine I had always had, now? Every single doctor had told me thereafter that I should absolutely, most definitely, refrain from any forms of exercise – I needed to stop running my daily 10Ks, I needed to have chairlifts installed and mobility scooters assessed. I needed to reconsider taking my course in a part-time fashion rather than full-time, and I needed to, in essence, wrap up every ounce and inch of extremities to shield me from the natural winter. Oh, and other people. And this was all because even the slightest mistake, physiologically, could send me into a crisis, landing me back in an ICU on ventilatory support, physically and mentally exhausted, and back to square one. I still wasn’t learning my lessons.
But, none of these ‘doctor’s orders’ mentioned “not fulfilling daily wants and needs” in the criteria, the management plan. The first stage of the diagnosis, the acceptance stage, was an eyesore and a feeling of weakness, giving in, but, at this stage, all it truly required was a level of acceptance, an approach of new maturity, to accept that yes, I could still make the most of every day, but in the bubble of that new lifestyle I now needed to adopt. This same approach goes with anyone who undertakes a new lead somewhere else, whether that be out of necessity or out of choice – new job-roles, new family responsibilities, changes in financial situations, during the courses of chemotherapy, relocation overseas. It’s all applicable, and it will forever be applicable so long as the environment around us continues to shift, change and readapt. And that includes us, within it.
So, for anyone currently having to accept a big lifestyle change, adopt a new lifestyle routine, in the face of challenging health, or not, here are a few tips on how to still fulfil your time, whilst you undertake this reluctant shift, based on my own lessons I’ve learnt.
I won’t be inconclusive or scruffy – the first hurdle is tough. Face it. It’s still nauseatingly frustrating when I have to politely decline even the pettiest of social endeavours with friends. When I turn down a trip to Saturday’s Pilates class, or a ‘stroll’ in the park down the bottom of our road, for the tenth time running, I still get fixed the look of question on the faces of even my most understanding, closest friends. Truth is, if I push my body that slightest bit too much, it will inevitably knock me back six – an extra mile’s walk too much could cost me a recovery time of a fortnight. Or even a hospital stay. I’ve now had to abandon my place on the GB Parasnowsport Team, dashing hopes of building up to a future Winter Paralympics, and if I can’t move the next morning, I have to simply accept it’ll be a day in bed, and that to remind myself that I am not lazy, I am not a failure, and I can’t start trying to think up what seems like a better, more justifiable reason for another absence reported on my books.
Pen to Words. Words to Paper
On another kind of book, I have meanwhile rediscovered my love for reading and writing, from beneath the bedcovers. And it’s refreshingly good. Writing these blogs, for instance, has become a refuge for laying down the ride of interchanging emotions this new routine welcomes me with each day. It’s a form of stable communication I can still turn to when I can’t get out to see friends, process and master deadlines on assignments. I have begun reading an article a day, of no specific interest or topic – just another grain to the soil in which I can feed my buzzing interest to stimulate the mind whilst my body is still catching up over times of rest. Making my way through some powerful works of literature, written by fellow healthcare professionals, so heartfelt and shedding pockets of inspiration and emotion, that they take me to a virtual dimension where I can live and breathe the place of work, the hospital wards and clinics, on the days I don’t make it in. Story is powerful and the pen gives it power, hence why I continue to write to ensure I make the most of my new ‘every day’.
On the contrary to before, routine is now very much the essence to staying on track, I have found. This is so that everything else I do in addition to my new routine becomes a bonus. And those bonuses feed a sense of achievement, no matter how small they are, which is so invariably great in those of us who are waded down by additional pressures in our personal life. Without sourcing out too much of the vanity, I shall never leave the house now without looking in the mirror. I look into the mirror and ask myself, “what do I want to achieve today? And what do I want to become?” Your reflection reminds you of who you are and what you want to be, all whilst having respect and pride in everything you continue to do. Serving others, serving yourself. If you can’t answer the questions, and your judgment is clouded, then are you really doing the right thing? Are you really following the right goals, the right dream? Never stop questioning your own motivations because how else are you able to confirm you are in fact fulfilling every part of you?
Looking through the Glass – A Reflection
In the corner of my desk, scattered by a dozen loose papers of study notes and post-its, doodles of the renal system and its arterial supply, sits a glass jar, unused from a few too many cocktail parties from freshers’ year. In the jar I keep tiny slips of paper, each scribbled with a small thing I have achieved on each day of that year. The achievement is in no way big, but they are small drops of triumph, the proof to be proud of every small step I am making, progressing. At the end of the year, this jar will be tipped, and all my paper slips will roll out. It will become the physical record of reminder that I did, regardless of the lost times folded in within each week, month, fulfil each day as much as I somewhat could. Try it. Start stewing the fruits to the jam of your 2019. The sweet taste of the good berries will override the odd bad one, here and there.
Above all, when fulfilling those little expectations, those little berries of hope and triumph, making the most of each day, it is important to be thankful, but also realistic. I’ve had to quit my sporting roles – my athletic self is now a thing of the past, and it was very much a very different life when I was that sportsperson, looking back. But if I tried renewing any of that old lifestyle now, it would completely break me. Running, cycling, skiing, swimming – they are no longer realistic forms of routine now that I require to constantly keep the progression of muscular, metabolic, haematological, respiratory disorders in the balance, at bay. Be healthily ambitious, but don’t ever over-stride, carelessly freedive into the beyond, the unknowing. Because if these unfamiliar depths are unrealistic for where you are now, in body and mental state of mind, then you are only going to plague yourself in failure, disappointment, and we, as humans, who only ever seem to focus on the negatives, the imperfections, rather than the positives, it’ll forever feel like you haven’t fulfilled anything – and the mark of incompleteness, underperformance, stains a lot longer than the short, sweet taste of success, trust me.
Be thankful that you are here
Be thankful for what you can still do and what is yet to achieve in any new light each day brings. It sounds cheesy and it sounds cliche, and most certainly sounds obvious. But I am so overwhelmingly thankful that I can still make the most of many things, continuing to study Medicine being one of them. So many times in these last 2 years where I have very much clinically hit the brink and frozen in a timeframe where seeing into the future and fulfilling any of my past’s ventures were adamantly opaque. Be thankful that you are here, that you are still here to serve a purpose on the bandwagon of life. The pressures and struggles of an ever-growing, discerning society will only linger into more pools of problems – the NHS and our burnt out employees, the cold isolation mental health services are so enormously plunged into, the calculated judgment made at every traffic island and T-section. There is certainly no quick-fix, so why must we dwell on what we haven’t achieved yet, rather than what we have so far done?
I have been thinking about the gentleman I saw on my first respiratory ward-round this Monday just gone. Young, in his 40’s, father of three, husband and friend to many, he is at the very end-stage of a terminal lung cancer diagnosis. Pale, yellow, tufts of thick black hair, and legs like a pair of flaking breadsticks. On each ward round there on, for the remainder of this week, he continued to ask us the same, pressing question. The same question that the doctor simply couldn’t answer: “How long do I have?” The Palliative Team had only been summoned 2 days ago and I can only hope that he has now had this conversation. But why was he so insistent on this precisely accurate, numerical answer? – Because he wanted to ensure he would be making the most of every day forward. Every day that he now has left, ticking. Today, that father of three, husband and friend to many, went home for his final days, weeks, months, who knows. But, in his own way, with the allowance of his abilities and realistic boundaries, he is without doubt making the most of every day, with a very new and refreshed perspective on how he is going to achieve this in fulfilling his life. Let’s all adopt this positive, optimistic attitude. Breathe in. Make the most of it.