I want to live!

“I----want----to----die!”

“Mr. Sylvester!” The nurse entered his hospital room with the computer on wheels, “You have got to calm down.” We could see him lying on his hospital bed with the covers discombobulated all around him. “I want to die!” he kept repeating emphatically. I could tell I and the rest of the infections disease consult team had witnessed only a small slice of what likely represented an entire pumpkin pie hospital stay of struggles between Mr. Sylvester and his 12-hour per shift nurses, “I’m not going to kill you,” today’s nurse insisted with astounding patience, “I know you need something for pain,” then she muttered in a less authoritative voice, “I’d put in the order myself if I could. The doctor isn’t calling back.”

“I want to die!” The old veteran kept yelling as we finished talking about possible reasons for bacteria in the blood of my patient in the room next door.

Mr. Sylvester and I could not share more dissimilar desires at the moment, “I want to live!”

Oddly enough, these words flashed upon me while I lay in the corpse pose at yoga tonight. I’d shown up late to class due to parking debacles and I always feel bad walking in late to a class of people trying to find their centers. I let that guilt go as the hour long class progressed. “No judgment,” repeated the instructor soothingly in talking about releasing our bodies as far as each person could go, “Focus on your intention for this time. Maybe it is just to stay with your breath. Maybe it is just to relax and let go of worry for a little while,” she demonstrated breathing rhythmically and audibly into her headset microphone. Inhaallle. Exhallle.

Somewhere between yoga plank and windmill and tree and triangle and happy baby and downward dog and cobra, I finally let go. Relaxing into the moment, I no longer worried about arriving late or crowding my classmate (who after class I discovered had barely contained herself from tickling my feet with a warm smile). I no longer worried about Mr. Sylvester’s desire for death. I let go of the guilt I feel for being sick and having my classmates have to pick up the slack for me. For those moments, I forgave myself. “We forgive ourselves, and each other; we begin again in love,” like we sang in the Jewish New Year song at church a couple months ago.

Today was my first day back at work in almost a week. It felt good to get back. I have had to increase my prednisone dose again due to the headache/knee pain/fatigue lupus flare that started while I worked in the intensive care unit last week. The increased steroids make me hypomanic and hypodepressed. It basically makes me almost hypo-bipolar with the rapidly undulating moods. I do not enjoy it.

I have channeled the hypomanic phase into baking and cleaning and decorating the last few nights. My neighbors love the lemon bars, spiced apricot bars, lemon bread, and hermit cookies that have been pouring out of my kitchen. The Christmas decorations are up and the lights add a nice glow to the place. As I put them up last night, trying not to worry about work today, I thought fondly of my sister-in-law who bought them for me last year. She surprised me by decorating my apartment while I worked 90 hours a week in the CCU over the holidays and had no time to think, let alone buy happy red bows with bells on them. Even with all of that done, I still felt waves of anxiety and despondency and called one of my ex-boyfriends who only threw me into another hypodepressed cycle. Then I decided to see if I could get some people to play board games with me. You see how I began to drive myself nuts. Some people live with that kind of energy all the time. I do not. That is not normal for me and I quickly begin to annoy myself once I’ve finished baking or cleaning or making phone calls.

I even tried taking some sleeping pills to calm myself down once my partner and I had won at Taboo and everyone had left because I had an earlier day the following day. No luck. I stayed up until almost 1 am trying to relax. I think “trying to relax” is a bit of a paradox. Relaxation is inherently lacking in effort. That is the whole point. It’s very Buddhist—just letting go. “Relax into that pose,” says our yoga instructor calmly, “Close your eyes and breathe.”

Finally, last night, I wore myself out and collapsed like a child does after a long day of exploring all of the new and wonderful things his body can do and experience in this big world. That is why toddlers often lose weight, by the way; they get too involved in life to take time to eat. I did not feel nearly as content as those toddlers, however. My mind whirled between anxiety and guilt until it spun itself into a sleep riddled with dreams of chocolate and men.

My tangible anxiety revolved around starting a new rotation the following day. And in the larger sense of going back to work still with the uncertainty that I could do it. My guilt centered around not being good enough to be a doctor and getting sick so much and having other have to fill in for me. When recognized and taken individually, both the anxiety and guilt become manageable and banishable. I know the rotations to come are achievable; I even look forward to the challenge of them, especially when I can remember to not take the feed back personally. My chief and program director ease my guilt by repeatedly and generously assuring me that the program can absorb the time I need to take off work—that the most important things are me and my health. And if this career is what I want to do, they will (and have already with my infinite gratitude) do everything they can to help me. Those thoughts bothered me last night, but the intangible anxiety and guilt really kept me awake. I could not console what I could not touch or name.

Fortunately, I decided after I watched a termite chew away at my windowsill for most of the day a couple days ago, I absolutely do want to be a doctor. I want to finish this training. I want to see my own patients in clinic. I want to learn as much as I can while I’m here and I want to share that knowledge and my gratitude. I want to live!

Even if it means I die. We live perhaps only once. Perhaps more, because sometimes I feel like a very old soul and see that in others. Regardless, this life is precious, be it the only one we have, or one of many. “Do not squander this precious life.” I don’t know when I will die. Maybe these blood clots in my head mean a stroke will come and my time on this earth is more limited than others. Maybe they mean nothing. Maybe they are a reminder to slow down and let the blood flow as it can and create new pathways around those the clots have blocked.

My best friend, Szilvie, spent most of tonight as a patient in the emergency room at the hospital where she works as an obstetrics and gynecology intern. She cries every day for her own tangible and intangible reasons. Now she passes out in the operating room and they do head CT and chest CT and heart monitoring to try to figure out why. I think I know at least one reason why: this training—this medical training—is hard on the soul. I see some doctors in training become hardened and it saddens me. Jason, a budding cardiologist, who used to love to laugh with me, now has wrapped himself in a stiff and dark cloak of responsibility and bitterness. I wish I could tell him he can be glad and responsible at once, but he’s decided to not talk to me anymore because our memories of laughter together make his girlfriend feel threatened.

I cannot change Szilvie’s dizziness, nor Jason’s journey, as much as I sometimes wish I could. Everyone has to find her own peace or his own center. And that source of balance changes, sometimes hourly. I remember when I found peace in the pool, or in the ceramic studio, or in throwing a Christmas party for my auto shop class. Or when centered meant riding my horse through the orchards along the river, or spending long mornings in bed with someone I thought wanted to lay with me forever. Tonight I remember peace while lying in yoga class on my back in the corpse pose knowing that I am working toward something that gives me the skills and the privilege of intimately touching lives. I find peace in it now because I want it despite the sacrifices it requires of me. Mr. Sylvester’s wish will come true. Someday we all die. Until then, I want to live!