i’m learning

I learn something new every day. Truly, ever day. Well, perhaps sometimes it is more of a reminder of something I once knew long ago, that has had to be dragged from the calm, deep, recesses of my brain and jolted into action. Usually, the formation of this new synapse is from what I consider a mistake. I’ve asked myself at times why experiential learning is so painful. If you don’t recall something that you read in a textbook, you devise all sorts of sensory ways to improve your recall. This failure, however, did not have immense consequences besides frustration with yourself and perhaps a poor grade on the paper (believe me, I know how painful that can be, but there are few real-world sequelae). But if you don’t know or don’t remember something while in the midst of doing it, the experience is all the more acute, and the memory sears deep.

Perhaps people describe mistakes in different ways? For some, those who are bent on achieving perfection, a mistake is a grand tragedy, its occurrence a blemish upon the smooth contour of a successful day, enveloped in guilt and pockmarked by anxiety. A mistake, in my book, is when I am unsure of a path, choose one, then further deliberate and feel that another would have been better. The deep dilemma here, though, is that no one can exist in the counterfactual. Maybe the patient would have gotten better if I had not intervened in that way. Perhaps I should have been more aggressive. Maybe next time i’ll talk to his family before making decisions. Maybe…

In medicine, once you get to the level of reasonable proficiency with day-to-day decisions, there is often a multitude of answers for each person. I often wonder if there is any way that I will come up with a standardized response to those things that take over my brain for nights at a time after seeing certain patients. There are certain factual things that I learn today, and can apply tomorrow. Then there is all the other stuff that takes finesse and understanding of people and their own beliefs and needs, and which doesn’t have one true answer.

I think that bringing up a child is quite the same. There are so many facts to know, then there are  the recommendations, often catapulted at me, accompanied by the iron-clad reason of “experience.” Every decision has some impact, everything could have been done differently. But different is not necessarily better, and for every action, there will be a vehement response from someone that this is, absolutely, the wrong way to do it. How do we survive this, as parents? Choose a few sources of guidance that we trust, use our own common sense, and, if all else fails, turn to the internet.

So I keep learning. My goal for the next year is to cut down on the guilt and increase my retention of what I learn each time. To try and identify when there may not have been one correct path. To share what I feel are my mistakes and ask for guidance from trusted people. And to keep writing through all of it.

 

returning to me

some days are tough. sometimes, weeks and months meld into a sticky haze with no defined borders. endless tasks pile into dusty to-do lists, with only the “postpone until tomorrow” button worn down. I used to write to express the thoughts that swirled in my brain but that could not truly be expressed in my work, or that sank down in importance when happy events took over. giving time to these thoughts helped them to form into opinions, to embody ill-defined and difficult emotions, to support my quest to be a better doctor, a better researcher, a better person. they were the questions without simple responses, those that needed time and thoughfulness to produce a path through the  brambleweed of “process” to the clarity of enlightenment.

and then, when I began my most difficult job, and the most demanding time in my life, I abruptly stopped writing. this place, these blog posts, have lain dormant for 2 years. I almost put an “almost” in there, but went back and left it at the stark reality. 2 years. Not almost, but truly.

In the same way that I attempt to de-clutter the wordiness of my writing, I hope that my return to writing will help to clear the roadblocks in my mind, to help me focus, and to leave dedicated time to move forward in my work and in my life.

in the past 2 years, i’ve changed cities, institutions and tiers in my career. my little family has grown, and with it, the capacity for immense love, an elevated responsibility and so much more of the unknown to fear, but also to celebrate.  I  have done what I always wanted to do – to attempt to balance a full-time career with a more than full-time family – and have found it to be the most difficult thing that I have ever faced. I have also lost important people, whose essence permeates everything that I do, and whose legacy I wish to carry on in some small part.

I will write differently going forward. Not to the end of sharing a finished piece of work, but in order to help me to both dream a better reality, and to chip away at the small steps that reality dictates are necessary to reach that dream. starting today.