The Pager

I have heard he is a Muslim man, but we never spoke about his faith. Muhammad is his middle name. I was captivated by his beauty. The most gentle voice. The purest eyes. He was a joy to work for. He was a patient teacher with our patients and with me. We had one particularly difficult patient. All of the attending physicians previously leading the service had spent as little time in her room as possible. She had been back and forth between the main hospital and the fourth floor long-term care facility for close to a year. She was frequently emotional and became offended easily with our attempts to care for her. Every day brought a fresh complaint. Other staff had softly muttered before entering her room, “Get in, get out” or simply passed her by during rounds altogether, saying “I’ll see her alone later.” He and I spent twenty minutes in her room every day at least, and once forty-five when she became particularly distressed. He was on his knees at her bedside for most of that time, holding her left hand with both of his. He did mutter softly before entering her room. “We must be as patient as Jesus Christ,” he had said, and then again as he caught my eyes and used them as a portal to my soul–“As patient as Jesus Christ.” He inspired the best in me, and he saw only the best in me, even when I failed him despite all my efforts to please him with my work as his resident. I was just so weak.

Hello, friends. Hello, readers who call yourselves friends but tear me apart (I just re-read the comment threads under my more recent posts–ouch). I have missed you all. I haven’t written in close to 21 months. The last time I wrote, I was not yet a mother of three, not yet a physician, not yet a disappointment to my parents. Much has changed in my absence. My third daughter was born healthy after a rather precipitous delivery in February 2016. Soon after her birth, I “matched” to my first choice residency program, where I am now a second-year resident in a three-year program. I’m thriving at work, and it is a privilege to be commanded with the duty of telling my patients’ stories as accurately and completely as possible. I am learning to marry the fear of making a mistake with the confidence that I have earned this position and am good at what I do. Both are necessary. I have learned much, and I have much to learn.

Both of these truths were solidified when I started my second year in our most difficult rotation, called “1909.” That’s the extension of the medical ICU phone, carried by the ICU upper-level resident, who happened to be me in July. For those of you who don’t know, July is the month when new doctors start their residency training, and the month when current residents advance to a new year with new responsibilities. In other words, stay out of the hospital in July. My nights went extraordinarily well, but they tested the limits of my knowledge and stamina. I’ve never been more proud of my work. I’ve also never utilized internet searches to the extent that I did during the nights of those two weeks. I know how to treat hypernatremia with carefully calculated fluid administration, and I know how to treat volume overload with cautious removal of fluid through diuresis. But wait–the two of them together in the same patient? That can be complicated at 3 am. Somehow, I left every morning exhilarated by the strong work I had done, and I was even complimented at the end of my weeks by the day-time attending physicians who noticed my carefully planned work-up, my well-justified orders, and my thorough documentation.

We rotated on an internal medicine day-time consult service in the week between our two weeks of ICU nights. When I started that service, I was almost half-way through a three-week stretch without a day off. After working nights, I struggled with night-time insomnia for that interim week of days. For some reason, the only time my body gave into sleep was when I was driving home from work every day. How convenient. I met him on Wednesday of that week, and he recognized my fatigue. “Do you want to round later in the morning?” he would ask in response to yawns he noticed from behind the arm of my white coat. I declined his offer, not wanting to delay patient care and hoping that my body would snap out of this soon. It did not, and he noticed my gradual decline. Blood-shot eyes with dark circles. Opting for the elevator when I always take the stairs. Coffee with lunch instead of water. Tears in my eyes when my pager went off with the tenth consult of the day.

We were rounding late one afternoon when my body defied my will over it, and I fell asleep during a patient presentation outside of a hospital room. I caught myself after what must have been only moments and tried to recover gracefully, but there was no elegant return from that. He had noticed, and I found myself apologizing profusely and fighting back tears, imagining what he would write on my evaluation for the rotation. It seemed like the height of unprofessionalism, to be so unengaged with rounds that I could fall asleep while discussing my own patient. His response shocked me. “When do you have a day off?” he asked. I told him that it would be after my next week of nights in the ICU–that I was in a three-week stretch without time off. His next words have been imprinted on my heart forever. “Roll your pager into mine. Go home, and don’t come back tomorrow. I will see all of your patients and all of the new consults.”

Roll your pager into mine.

I was on nights again the next week, but my day of rest had been healing, and I was ready. Again I worked carefully and wholeheartedly and was recognized for excellence. This second week was in the ICU at our VA hospital, and the hours were longer. The 15-hour work shifts and 1-hour of commute time (to and from combined) required that I sleep immediately upon arrival home and awaken as late as possible before getting ready for work. That afforded no time at all for my children, and I suggested that my husband and daughters visit my parents for the weekend. My sister and her children were planning to be there as well. It was Saturday night when I got the text from my sister. “Remind your husband to not engage dad when it comes to global warming,” it said, with the eye-roll emoji. My heart rate heightened. I could sense where this conversation was going, and I wasn’t there to reign it in. As more text messages unfolded, it was confirmed that an attack had been launched by my parents against my husband, and I wasn’t there to defend him. They blamed him for making me “liberal.” They accused him of pulling me onto “the bandwagon” that held the gay-loving tree-huggers. They told him they were disappointed that I had strayed from my upbringing as a result of our marriage. My dad had given an abusive and high-volume harangue, and I couldn’t let him have the final word.

My husband came home the next day and told me in his words how the conversation had gone, and I was devastated. I collapsed into his chest, and my daughters saw me cry for the first time. I eventually locked myself in my bathroom and called my mom. “It wasn’t him,” I said. “My beliefs are my own.” She had asked how I could worry about global warming or condone homosexuality when a literal interpretation of the Bible shows us that the former is not necessary and the latter is not acceptable in the eyes of God. “I don’t have a literal interpretation of the Bible,” I confessed. I’m not sure what she said after that. Her sobs overcame her words, and they were unrecognizable. The only one I recognized was “disappointed.” I told her that I loved her and that I wished she and Dad could be proud of me and accept me and agree to disagree. And then I had to leave for work.

In the days that have followed, I have had too many text messages from my dad to count. It’s an assault, bathed in dispensational “truth” and providing all the reasons why his faith is the only legitimate faith. I told him after the first series of texts that I loved him, but didn’t have the time to read them or respond, and that any free time I did have would be spent with my husband and daughters. Still he sends them. I finally had to put my thread with him on “do not disturb” mode because of the anxiety I had every time my phone vibrated in my white coat pocket. I am the mission failure, and the engineers are disappointed in their product and frantically seeking a solution. And they don’t even know a fraction of my journey or anything of what I have written about here. This severe reaction comes because I believe the scientific consensus on climate change. Because I believe there was a big bang. Because I don’t believe in a global flood. Because I believe that a loving God would not condemn someone for loving who they want to love. What if they knew I had denied his existence–or worse–cursed his name and affirmed over and over my hatred of him? Launching deadly attacks from cannons called Disappointment, through a fog called Dogmatism, into enemy territory–My Broken Heart. My husband and children the collateral damage. My own defenses swept away by a poorly timed storm called Exhaustion. We used to be allies. I was already fragile. Now I’m shattered. No will to fight. Barely a will to live. My phone alerting me like a pager in the night in an intensive care unit or on a busy consult service, except this time I have no answers. You’re living a lie. You’re a disappointment. No daughter of mine…

Roll your pager into mine.

Roll your pager into mine.

Those eyes that had compassion on me in my weakness. That voice that gently called my attention back to him when fatigue overtook me. Those words. Those precious, precious words that keep coming back to me now that my weakness has turned to brokenness.

Come to me, all who are weary and heavy laden, and I will give you rest. Take my yoke upon you and learn from me, for I am gentle and lowly in heart, and you will find rest for your souls. For my yoke is easy, and my burden is light.

Cast your burden on the Lord, and he will sustain you; he will never permit the righteous to be moved.

Roll your pager into mine. The modern day medical field version of Matthew 11 and Psalm 55. I saw Jesus in a Muslim man. The man who spent most of his time among the least of these. The man who found me in my weakness and spoke grace to me when I failed him. He bore my burdens that day, and his words have remained with me and been my only hope as I have fallen under the weight of the burdens that followed. He has no idea that being near him was the closest I’ve felt to God in many years. He left me with this serenity, this assurance that I do not walk alone.

Friends, I’m here, after nearly two years of absence, to ask you for that same assurance. I need you to bear my burdens with me, to shield me from these attacks, to remind me of who I am and what I’m fighting for, to carry me to higher ground. I am at the end of myself.

May I roll my pager into yours?

-J

 

 

Image credit: By Dme motorola.jpg: Starwhooperderivative work: VT98Fan – This file was derived fromDme motorola.jpg:, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=32400448