A physician who’s always in control

My friends and family used to say that I was born 30 years old.  I get it.  From the time I was young, I was controlled, risk-averse, studious, and polite.  In addition to the fact that I was naturally reserved, I learned over time to do my best not to make anyone uncomfortable.  I frequently refused to stand up for what I wanted, always deferring to the wishes of others. In the process, I learned not to tell the truth.  Not to others who needed to hear it and worst of all, not to myself who needed to hear it most of all.

Add to that, years of college, medical school, and residency, and I became a staid, solid, predictable, disciplined man.  Who was often pressing down the things I wanted to say.  But it was functional.  In education in general, and medicine in particular, we learn that behavior well.  The hospital ward, the OR, the ER, these are places where control in the name of the profession is paramount.

After training, the practice of medicine is highly regulated and closely watched.  We keep our certifications up to date.  We pay our licensing fees and take our board exams. We are always prepared to give an account of where we were and what we were doing; even for a month “off of the radar,” someone will demand an account.   We are watched, and as men and women watched, we guard our words and behaviors in the interest of the job.  And because discipline, indeed stoicism, is what is demanded of us.

Now and then, however, I want to lose control.  I see it in my patients, who come in ambulances saying “I’m freaking out!”  They scream and sweat and writhe; they hyperventilate and curse even those helping them because “I’m under a lot of stress, don’t you get it!”  They run, and they argue, they punch walls and climb out of the back of ambulances. They fling themselves in the floor in a torrent of tears and jump up agitated, anxious, fearful and often, quite honest.  What I mean is, their emotions pour out like water from a fire-hose.

That makes me uncomfortable, or it did.  These days, though, I wonder if they aren’t onto something.  Those people whose pain is always a 10/10, whose lives are wrecks but who continue to laugh and scream through it to the other side.  Those who can’t possibly make it to work because they’re either hung over, or have head colds, or anything but work!

I’m envious that they throw things in the room and yell at the staff.  (I’m not talking about violence, just displays of emotion, mind you.)   I’m fascinated that they sometimes are surrounded by a circle of loving friends in the midst of their crazy.  It touches me because it is not me. I have friends and family who love me enormously.  But I can’t imagine subjecting them to similar displays.  I have no idea what it would be like to “lose it,” to go outside and scream, and argue and run and collapse.  To then be hauled to a hospital to be cleared, treated, calmed and embraced.  Odd.

I wonder if those of us who are, shall we say, “predictable” are the crazy ones.  We who keep powderkegs of emotion packed deep inside; we who sometimes want to light the fuse to see what happens.

The world is full of people with lots of issues. And some of them can only be best described as “crazy.”

But then, maybe, just maybe, we’re the crazy ones.  We, poisoned by education, duty, honor, achievement.  Who knows?

But if you seem me running down the street, screaming, be patient. I did it all one way for so long; I just wanted to mix things up.

I’ll be back to stable by tomorrow, don’t you fear. Then everyone else can continue to decompensate around me.

Edwin Leap is an emergency physician who blogs at edwinleap.com and is the author of the Practice Test and Life in Emergistan

Image credit: Shutterstock.com

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