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How “self-care” is elusive until there is no choice

Torie S. Sepah, MD
Physician
June 29, 2021
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It took about ten minutes of carefully shifting the controls on the hospital bed, placing pillows in the right spaces to prop me up to an angle that resembles “sitting”—all done delicately so as to not increase the pain level I was already in.  All of this was for a specific purpose; like all post-op patients, it was time to advance my diet; it was time for my first “solid” food.  Clear, but solid.  I hadn’t thought much about the details of this, having been focused mostly on the logistics of physically moving.  At that point, I’d eat/drink anything they wanted so I could go back to laying back on my side, at a 30-degree angle. “Let’s just get this over with” was my only thought when I arrived at my 60-degree “sitting” angle.

Then I saw it—there it was: a bowl of red jello. I chuckled deep enough to feel a sharp pain along the incision line at my lower abdomen.

The nurse asked, “What is funny? Do you not like jello?”

“I like jello. Its nothing. It just takes me back to my days as an intern.”

I didn’t have the strength to explain why I found it so amusing that after all of these years, they still served red jello to hospitalized patients, nauseous post-op ones no less.

Perhaps the most unexpected experience of having a complicated surgery involving my abdomen has been that somehow, in the aftermath, it has felt like the contents of my brain—memories, impressions, perspectives—have been equally swirled around in the process.  Things I had not thought about for decades are all of a sudden front and center in my mind.  For once, maybe in my adult life, I feel more anchored to the past than to a future destination.  None of this is happening in a contrived way; I am not telling myself to “take more time” and “be present.” I have always found such advice to be well-intentioned but like “self-care,” difficult to apply logistically in the demanding profession and life built around it that I was already elbow-deep in. Honestly, when people told me to do such things, to shift my focus onto the “now” or to invest in “self-care,” I was quietly resentful.  My brain problem solves as a scientist—the viability of an intervention needs to be clear, not amorphous.

But then one day, it changed. Not from reading any books or going to a wellness retreat— no, it happened when I looked down at the bowl of red jello.

As I stared at it,  I recalled being a young doctor—an intern, who had made an interesting realization halfway through the year.  Calls reporting hematemesis (vomiting blood) were more common when dinner included red jello.   I remember scratching my head, wondering how the leader in health care utilization management—Kaiser—hadn’t caught on that red jello nights correlated with an uptick in hematemesis work-up orders.  Why not just remove that confounding variable? Serve green jello? Yellow jello?

Yet what I found more surprising about all of this was less so about the grip of red jello on hospital menus and more about my own ability to remember this ironic detail and with a sense of nostalgia.

Usually, when I think back to internship or most of part of medical training, it has almost never been in the context of nostalgia. Rather, I feel relief that it is over. Sometimes, I still feel tinges of anger, not regret, such tiny flames of resentment about the sacrifices I made in my own life to do what I do. That lost decade—the weddings, funerals, birthdays missed. The many Mother’s Day lunches at school missed. The hours I didn’t spend holding my children. Again, there isn’t regret, rather a reminder of what was given up when I think back to my training.

Perhaps at this moment in time, I can appreciate a different perspective given the imposed absence of noise—the cacophony that usually fills my waking hours: phone calls, patient appointments, texts, emails, refills requests, labs to review, scheduling problems to solve, pre-authorization denials to appeal.  There is a void just long enough for my mind to wander, even meander, without a particular direction, no “plan” or goal attached.

And then there is the most obvious yet difficult to acknowledge change—being vulnerable viscerally, not being the doctor but the patient.  Maybe this is at the crux of appreciating my journey, to see the young me who represented a different chapter in my life, not a protagonist in a continuous essay.

In this new chapter, I am the nauseous patient about to ingest some red jello. Chuckle, pain, chuckle.

Torie Sepah is a psychiatrist and can be reached at her self-titled site, Torie Sepah, MD,  and on Twitter @toriesepahmd. She is also founder, Physician to Physician: Healing the Practice of Medicine. 

Image credit: Shutterstock.com

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