Sleep

For as long as I can remember, sleep has always been my greatest stress reliever. I know that a lot of people relieve stress with exercise or partying or drinking. On some level, exercise always seemed to add to my stress… primarily because it seemed to always remind me of how out of shape I was. Partying and drinking never really worked for me, because in the quiet moments in between the action, I could physically feel the weight of the stress that I was avoiding.

But sleep… sleep always has taken me to a place where things just seemed to work themselves out… or at the very least… sleep takes the edge off of whatever raw emotions I am dealing with… and when I wake up… I am somehow able to think a lot clearer.

I think a lot of this has to do with the fact that I am such an introvert. I know a lot of people have a hard time accepting that I am introverted, but I really am. I enjoy interacting with people and I enjoy knowing lots of people. But being out and about in public exhausts me… and at the end of the day, I absolutely need time along or with just a few people to recharge myself. When things are stressful… I think the ultimate “alone” time really ends up being sleep.

I’ve also always felt that sleep was when God provided me the most comfort. It sounds silly, but in the way that God talks to us in our dreams… sometimes I feel that in my sleep, God is just there with me… knowing I don’t need to hear Him… I just need to feel comforted by him.

So, I am giving this extended dissertation on my relationship with sleep, because I think that’s what makes my job so tough sometimes. Sleep just doesn’t come easily. It’s a lament that I have made often over the past 6 years or so… often in jest. However, the past few weeks have made this fact especially noteworthy. As I struggled with trying to recover from my patient’s death (see previous blog post), I found that the one thing that has helped me the most was exceptionally hard to attain. And it made it much harder to get myself back to being who I am.

Until… I got sick. Predictably, after everything that has happened the past few weeks, I finally got overwhelmed by one of the many upper respiratory infections I treat 100 times a week. It started last weekend. I started to feel fevers and chills and kind of achey. Then I found myself on call and though my call was mercifully mild, I woke up post-call feeling like I had been hit by a tractor and had no voice. I came home post-call and went to sleep. I did not wake up until the next morning. I then slept through most of that day as well. By Thursday, I was starting to feel significantly better. And I started to try to catch up with my work. That’s when I realized… that sleeping had not only helped me get better from being sick… it had also taken the edge off of a lot of the pain I was feeling. And I also awoke with a lot of clarity.

In the middle of one of these sleep filled days, I somehow woke up to check on lab results that I had ordered on a patient. This patient had had some very odd and troubling symptoms for almost 6 weeks. I originally was very worried that she had a cancer. I checked a ton of stuff initially… which all came back normal. I sent her for studies… all of which confirmed that there were some weird things going on, but none of which gave a definite answer or clue as to what that was. I sent her to some specialists… none of whom really seemed as puzzled or concerned as me. Yet, something nagged me about her. I couldn’t put my diagnostic finger on it, but something was not quite right. So I had ordered another battery of tests… and added a Lyme Test as almost a last minute-why-not-check-this-while-we’re-at-it kind of test. In the middle of my delirious sick state, I somehow remembered that her labs still hadn’t come back yet and I needed to check on them.

When I did… lo and behold… her Lyme test came back positive. I had to read the result multiple times to believe it. It was such an odd presentation of Lyme Disease. She had none of the typical… and all of the atypical symptoms of Lyme Disease. It just was not something that was on my radar as a possible diagnosis. But the most important part of this… is that it was still treatable. So I called her and got her started on treatment right away.

I guess that’s the reality of my job. Medicine is imperfect. I am imperfect. I am going to miss diagnoses. There is no way around it. I could be the smartest doctor in the universe… but it wouldn’t change the fact that there are just some illnesses that simply don’t show themselves in a diagnosable way. Not necessarily rare once in a million illnesses… but even simple, common diagnoses… just because there is a natural variance to things. But in reality… I will probably correctly diagnose a lot more conditions than I will miss.

This all came to me as part of a greater epiphany. I need to get my act together. I think on some level, the fact that I’m a doctor still has been a shock to me. I think about my past and how I got here and it is still hard to believe that I am actually at this point. But it needs to get real for me. I don’t mean in the way I approach my job when I’m at work. I mean in the way I approach my job outside of work. It’s a lot like professional athletes who suddenly realize how much work they need to put into their craft outside of the time they spend on the field or on the court. I realized that the only way I am going to truly do right by my patients is to really put work into my craft. I need to get smarter. I need to get my life in better order. I need to get myself in a better place physically.

This has been a really hard few weeks. I haven't taken an emotional hit like this in a very long time. I’ve gotten a lot of support. I have certainly felt that there were places I could turn. I've had a chance to talk things through more times than I care to count. I've done more soul searching than I ever have before in my life. Finally... I feel that I am coming out of this stretch. But I'm not coming out of it with a sense of relief... I'm coming out of it with a sense of focuse.  I see now the way my life needs to unfold a little more clearly. I see the things that I need to do to take the next step. It took some incredible misery and pain to see all that. But I am excited about the changes I see coming.

And with that… I’m off to sleep.