anxiety

at the risk of sounding too soft

Robyn, , , 2 Comments

In afternoon clinics I can find and pull medical records in our paper-based system; when required, I can check weights and test urine samples. I measure blood pressure and blood sugar; I write prescriptions. I am quick and efficient, even if I don’t always follow protocol. I think this is easier than asking other people to do their jobs.

Black girl childhood is a very specific and nuanced experience. The particular damage done to black girls often comes from our mothers who perpetuate patriarchal standards of respectability and people-pleasing. This is the legacy of girlhood, passed from womb to womb like the secrets of our bodily cycles. What starts as admonishments to keep the girlchild safe (don’t fight, dress modestly) twists to become the base on which our worth is judged. Good girl/Bad gyal. Prude/Slut.

By the time I hit puberty I had absorbed a constitution of rules about good behaviour and decided that being “good” meant being liked by other people. If I was not liked by other people, that meant I was “bad”. And a sure-fire way to be disliked was to get involved in conflict. As a child observing conflict at home, at school and in my community it was clear that nobody liked the angry person who made noise and upset other people. I developed a panic reaction to conflict and tension of any kind, and to this day whenever I perceive conflict my stomach clenches, my breath hitches, and I become acutely aware of my heartbeat. I became sensitive to the barest hint of discord and in anticipation of that physical reaction I avoid, avoid, avoid.

So at work when someone raises their voice, or grumbles under their breath or takes an inordinately long break time and cannot be found, I hesitate the next time I need to ask that person to do their job. My anxiety doesn’t care that it’s the job they’re being paid to do; my anxiety’s only concern is protecting me from a potentially stressful situation. This ingrained response has kept me alive and safe so far, but the work I do is so much bigger than my anxiety.

So I keep trying to grow beyond my survival mechanisms to a version of myself who can be brave. I find solidarity in the realm of social justice where there are plenty of loud angry women doing their best to dismantle systems that oppress and harm entire groups of people. But mostly I hold on to this lifeboat of questions.

Why is it important for me to stand my ground? Who suffers if I stay silent How will things change if I don’t What kind of example am I setting? So what if they don’t like me?

I don’t get it right all the time, and most of my progress comes in the tiniest of steps. But I’m here to take up space in this fight. And no matter how imperfectly I try I will continue to take up space and work toward the future I want to believe in: a future where little girls don’t get boxed into respectability. A future where women aren’t afraid of their voices.

A future where all of us are brave, and vulnerable and radically compassionate with the world, and with ourselves.

Visions (but not like, the high kind)

Robyn, , , , , , , , , 1 Comment

Lately I’ve been feeling really stressed out at work. Proper stress: headaches, stomach aches, feeling like I was about to explode from internal pressure. I was freaking out about my work responsibilities which seemed to loom ever larger in my paranoid imagination, but in reality were only so intimidating because I was setting the bar so very high for myself.

I started listening to this podcast a few months ago. And while it’s a kick-ass repository of career advice and entertaining conversations on how to be awesome at your job, it was also setting me up for failure. Every new technique I learnt, I wanted to start doing immediately. I judged my own growth against concepts and ideas from more experienced professionals and found myself painfully lacking. I threw myself into a fit, trying to ‘catch up’ and ‘do it all’. My control freak tendencies came out full force.

And week after week, my job resisted all attempts at micromanaging. Shockingly, people are impossible to control. I know this is breaking news to you guys, so maybe take a second to get used to this epiphany. Patients do whatever the hell they want, responsibilities and priorities shift all the time, colleagues do not share your work ethic, etc etc.

Mercifully, the culmination of all this stress was a breakthrough and not a breakdown. Driving home on the verge of tears for the fifth Monday in a row I let my thoughts swirl around the car interior like angry wasps. Then among the wasps, wisps of remembered conversations and podcasts snippets coalesced to remind me of a word I had forgotten in my desperate scramble to control.

Vision.

I didn’t have any. Or I had too much. I didn’t know, because in the middle of all this over-thinking and I had never actually stopped to think about what I wanted to make happen. I was furiously building a boat on dry land without ever having dreamed of the sea.

So I started dreaming, and I started writing things down. I wrote quickly, more concerned with getting the ideas out of my head before they exploded my head. I edited after, because I have standards.

And incredibly I felt lighter. The stress had shifted from an angry hornet’s nest to a more manageable ball of barbed wire. I knew what I was aiming for now, what the end result should look like, and I had something I could show to other people and ask for help so I’d feel less alone. It was incredible.

In his seminal work, Stephen Covey talks about how important it is for a leader to have vision. He makes the analogy of a group of people in a forest working to clear a path, with managers directing the machete-wielders to chop down the right set of trees. But the leader is the one who climbs up, looks around and yells, ‘Wrong forest!’

And honestly, I understood that when I was reading it. Yes, obviously vision is important. 2+2=4. Duh. But I didn’t really get it until I had finished mapping my own visions and realized, with great humility, that this was the most important part of the job all along.

Spring Equinox at the Rasta Village

Robyn, , , , , , 6 Comments

Barefoot, bamboo pipe and box food – this was the scene at the Indigenous Rasta Village on the outskirts of Montego Bay last Sunday. It was a space for communion, reasoning and celebration.

The Rasta Village is accessible by one of two routes – you can drive through Porto Bello to the Montego River Gardens then cross a river to get to the venue. Or you can drive through Fairfield, down a narrow winding dirt track until you reach the last house at the end of the lane. Behind the house is the village.

IMG-20170324-WA0024

Welcoming is the first word that comes to mind when you step into the circular space that housed the festival. Everyone nods and smiles openly when they greet you, with an enthusiastic clasping of hands in what feels like a physical manifestation of namaste.

The full programme included yoga, drumming sessions and an open mic segment. There were performances by Mentor, Nomaddz and Rasta Village Live. Around the central camp were stalls displaying natural oils and soaps. Two huge jars of cannabis stems rested atop a table under the main gazebo. The smell of cook food and ganja perfumed the air.

IMG-20170324-WA0026

As I sat cross-legged on a borrowed bamboo mat I drank my sip and looked around at the motley collection that had gathered. There were a lot of Rastas, certainly, but also several bald heads (I know, you don’ haffi dread fi be Rasta), more than a few mature upper middle class people, and quite a lot of people my age or a little older.

The vibe of the gathering had put me in a mood for reflection (or maybe it was the contact high) and I was intrigued by the thought that all these people from different backgrounds had come here with the same purpose: to revive, renew, replenish and reaffirm. That everyone would be affected by the experience in different ways, and would take away different things from the event that touched them uniquely, if it touched them at all.

20170319_165434
Nomaddz and Rasta Village Live

I leaned into the Rastafarian faith a little more that day. A lot appealed to me: the ideas of personal divinity, the belief in livity, the impressive respect for life in all its forms and yes, the ital food did taste good too.

But I also couldn’t stop my usual anxious over-thinking. I was convinced that there was a right way and a wrong way to be Jamaican and I was definitely doing it the wrong way. every “Blessings” or “Blessed love” I received in greeting I returned a nervous “Good afternoon”. I couldn’t help it – when I’m anxious my Patois stalls. I felt like a fake, because I have locs but I know very little about Rasta culture beyond what I read in school. Only the warm smiles from everyone (and I mean literally everyone) kept me from running away with my head bowed in shame.

How Agent Sasco song go, “no fashion dread nuffi come a talk bout Selassie”?

But over and over my mind kept returning to the deep seated contentment that shone from the faces of the Rastas I interacted with. They had invited us into their sanctum santorum and were so willing to share their music and ideas and food with us – a little bit of their culture free of charge. Maybe it was the weed or maybe it was the kind of peace that springs from a deep personal connection with faith, but however they achieved it I wanted some of that contentment for myself.

I left the Village feeling inspired and uplifted, on a healthier mental and physical plane. The sip and ital food had warmed my belly and the conscious lyrics of Mentor and Nomaddz had warmed my heart.

Then I promptly went and had KFC for dinner. It’s a work in progress.

You are (meant to be) here.

Robyn, , 4 Comments

I am often overwhelmed by day to day decision-making. Simple choices like what to have for breakfast, or which route to drive home, or what outfit to wear build themselves up in my mind, until somehow they have acquired more space than they should. Suddenly my decision to stop at the supermarket after work has the same weight as deciding to pursue postgraduate education.

Often, too, it feels like all my decisions are the wrong ones. When I follow my instincts, when I don’t follow my instincts – no matter how I try to weigh the pros and cons I still end up feeling like I let the right choice slip away.

Last week I was running late to pick my partner up from work. As usual my series of choices led me down the wrong path: tardiness. But as I crested the hill, I caught a glimpse of the sunset on the horizon. The brilliantly scarlet star was seconds away from sinking out of view, and I got to watch those seconds.

Almost instantly I felt a wave of calm and certainty. All the choices I had made that day – wrong, right or indifferent – had led me to this exact moment, and I couldn’t have timed it better if I tried. It suddenly didn’t matter that I was late – lateness happens. All that mattered was that I was exactly where I was supposed to be.

 

Conquering Duty Anxiety

Robyn, , , 4 Comments

I really don’t like being on call at the hospital.

Yes, someone has to do it. Yes, we get paid overtime to do it. Yes, this is how we gain experience as doctors. But all of those logical structured reasons fade away when I’m startled awake at 1am by a nurse calling about the patient in cubicle 5 who won’t stop bleeding.

When I was on pediatric medicine I would have a lot of anxiety to deal with on duty. It’s terrifying to be the first responder to a critical situation when you’re not 100% sure you can handle the case. To make matters worse, I was dealing with babies. Delicate (yet somehow also borderline indestructible) little human beings. In the beginning I would have regular panic attacks and palpitations, but as time went on I got more comfortable handling the common emergencies. I became more confident in my abilities, and could usually rest assured that if there was anything I really couldn’t handle, I could call my senior.

The most pervasive part of duty anxiety for me, though, the one that crops up on every rotation regardless of my self-confidence is the uncertainty about being called. You can never tell whether a night will be calm or hectic, whether you will be called ten times in one hour or once for the whole night. And that kind of unpredictability is anathema to me.

As humans we like to think that we have control over our universe. As interns we have all kinds of superstitions for keeping emergency duties light. Knock on wood to keep the bad karma away; when you notice that a night is being particularly uneventful, you can’t say so out loud or you’ll jinx it.  We do these things to try and hold on to the idea that we can dictate how a night will progress just by monitoring our actions.

But letting go of duty anxiety means letting go of the crazy notion that what we do or think will somehow impact the chances of a patient taking a turn for the worse. Or will somehow keep a hundred people from turning up in the emergency department in the middle of night.

It won’t.

The night will unfold as it was always going to unfold, whether or not you stay up having the world’s most intense staring match with your phone, whether or not you knock on all the wood. Whether or not you try to grab a few hours of sleep or comment on how quiet the wards are being. All the superstitions are doing is tricking you into thinking you have some measure of control, so that you think it’s your fault when the emergency duty turns into a madhouse. “I have 3 emergency surgeries because I didn’t knock on wood this morning”.  It sounds completely illogical, because it is. But that’s usually the nature of anxiety.

I have found that the best way to conquer my duty anxiety is to relinquish this idea of control. To let the night progress as it will, without trying to force it into whatever hopes or expectations I might be harboring. When I do that, when I go about my tasks and breaktimes free from the thought that what I’m doing will make or break the night, I find that I’m a lot less anxious and a lot less tired too.

Getting Okay with Being Happy

Robyn, , 3 Comments

There are two tragedies in life. One is not getting what one wants and the other is getting it.
-Oscar Wilde

Does anyone else find that they are most miserable when they finally get what they want? I’m not talking about the feeling of almost-but-not-quite-satisfaction when you have nothing else to wish for (and come on, we’re human beings. There will always be something else to wish for). I mean the other feeling. The feeling that there’s something wrong with you being happy.

Am I crazy? Yes. Am I alone in my craziness? I really hope not.

My life has been coming together in a way that is entirely surprising and entirely unfamiliar to me. So far everything is on track (I am knocking on ALL the wood, universe): my career, my personal life, my finances. And I’m a little bit (okay, a lot) baffled by how coordinated it all seems. Granted, on the inside I’m still a wibbling mess trying to pass off as an adult. But on the outside and in the big picture things look kinda sorta maybe okay.

And that freaks me the hell out. Instead of enjoying the good times while they’re here I am anxiously waiting for the other shoe to drop. For the storm after the calm. When will this all be dragged away from me, I wonder frantically. How long can happiness be mine??

As if there’s something inherently wrong with me being happy. As if the universe in some way needs to balance out this time of contentment with an equally horrible tragedy. When in reality no one is taking stock of the good times to balance them out with bad, and for God’s sake what is so wrong with being happy?

Freud blames my parents. I blame the messed up way my mind works sometimes, tricking me into thinking that I’m only doing well if I’m suffering. Why do our brains lie to us? Is there some magic way to stop the lies, or at least ignore them?

Maybe the only answer is the daily reminder to be gentle with myself, and appreciate each moment as it happens. Which is a good enough answer for me.

The Final Countdown

Robyn, , , , , 3 Comments

It’s raining today, a very grey world. And damp. Even though it’s bleak, shy patches of colour peek out. Purple flowers in my front yard. Pink and yellow flowers in the yard around the corner that I picked by L’s request yesterday. She’s been pressing them for two days under all four phone books in the house in preparation for a Fancy Manicure. Against my will, I will also be getting a Fancy Manicure.

There’s so much anxiety in the air, I can hardly make words. It’s like reaching the bottom of the slide at Margaritaville where you’re going so fast you can’t even take the deep breath you need for the plunge into salt water.

Breathe.

I don’t know what to tell you. My thoughts are scattered and dwindling, like the days until MBBS, like potholes on Kingston roads, like Riverton smoke some weeks ago.

There is news: local news, national news, international news. Heads of State visiting, vendor shacks being demolished, students massacred in Kenya. And there is life. Trips to Sovereign, fancy dress parties, clerkship exams and MBBS. I’m always struggling with how to reconcile external events with my internal life. How to hold on to emotional impact and evoke social and political feeling while still trying to find the perfect shoes. I digress, but I really wish I could find the perfect shoes.

It seems life is all about balancing nuances. I love nuances, but I’m terrible at eliciting them or acknowledging them or even realizing them most of the time. And even though the world is a million shades of grey today, and I like that, I spend most of my time imagining things as black or white, this or that, me or you.

Maybe because my life has boiled down to right and wrong answers. Even the calendar has been corrupted. For me May means sink or swim, June means pass or fail and July? July means life or death. Mine, and the patients’.

Back to the House of God: some short reflections

Robyn, , , , , , , 4 Comments

1.

Final exams loom, a distressingly diminishing number of days away. Calendars are the enemy now and every sunset inspires a mixture of awe and resentment. Days and weeks and months are finite, fickle creatures.

2.

I reread Samuel Shem’s cynical exposé on medical training in North America because I needed to remind myself what I was working toward in the weeks after exams. House of God isn’t a particularly encouraging novel, but throughout the story hope rises like the Wing of Zock: unstoppable and overpowering.

3.

In this season of fasting (not Lent) I will have to give up so many of my vices: novels, writing, the internet, sleep. Oh, sleep, I will miss you. A fourth year student asked me what I would do come June 3 when the last of my exams are over.

“I’d run naked,” she suggested. Oblivious to our incredulity, she continued. “As I walk out of the exam, I’d be unhooking my bra, pulling down the straps.” She trailed off in slow-motion speech, lost in a fantastical daydream.

I intend to sleep the sleep of the guilt-free. It’s been so long since I had guilt-free sleep, I’m probably going to get an ulcer. Just one time I would like to put my head on a pillow and not have the voice in my head (which sounds uncannily like one of my friends) demand that I cease this nonsense and get on with studying.

4.

This morning while waiting on the bus that shuttles us to the hospital, I stared across the expanse of sea and horizon, thinking.

I feel like I’m being wound-up, I wrote in my journal, like an old-fashioned wrist watch. Will I fall apart when the time comes, or spring smoothly into action like some well-oiled gears?

Do any of us know how we will perform when we need to? I think everyone feels some tension at this point, regardless of ambition. Even those of us who are certain of passing (there are always some) are still anxious about graduating with honours or distinctions.

There’s so much at stake, so much at risk. I calm myself by remembering that this too shall pass.

*

P. S.

Thursdays have sort of turned into book sharing time, so I’m sorry if this wasn’t what you expected. But! If you read this far, know that I have been reading way more fiction than I should, and if you want a recommendation Neil Gaiman’s Trigger Warning is absolute soul-disturbing perfection and you should go read it now (Also, he and Amanda are pregnant so yay).

It’s so rare that I recommend a newly published book – am I doing it right?