Over this last week, several of my patients were truly in a state of suffering. One patient suddenly lost his sister to suicide the day before his appointment, and was racked with overwhelming shock, anger, and guilt. Another reflected on the death of his girlfriend several years ago, a loss that took his breath away, as he shared her story with me. Yet another patient of mine struggles with paranoid delusions, and is convinced that people in the community are trying to harm her. She is paralyzed with fear and wonders why others would want to hurt her.
Hour after hour, I am struck by the courage that my patients bring forth, somehow. I am amazed that they have the strength and insight to seek help. After all, it is so easy to isolate when we struggle. There is still so much shame and stigma surrounding mental illness. It is infinitely more difficult to acknowledge our need for help, seek out a therapist or psychiatrist, and somehow find the willingness to share the most private, intimate details of our stories.
I realize in moments like these that I am fortunate to have the career that I do. I am humbled by the trust my patients place in me, to be the keeper of their secrets. I often don’t have solutions to the complex problems that my patients present to me, and many times, no solution even exists. I am not sure there is a greater helplessness as a physician, to be impotent to solve what ails your patients.
What I can do is listen for as long as my patients need to speak. I ask questions that allow us to sort through the mud together. I challenge them if its needed. I prescribe medication if warranted. I am there, always.
Best of all, I walk alongside them as their lives evolve, being present for all of it. Going to college. Starting the first job. Getting married. Passing the exam. Having children. Losing loved ones. Getting ill. Getting well. Confronting a difficult boss. Traveling. Managing families. Relapsing. Getting sober. I serve as a witness, as lives play out in front of me, and in my head in between session.
I believe there are things about this process–how a psychiatrist and patient find one other–that are beyond my understanding. I hope I possess the skills to help the particular patients who land at my door. But certainly, with each patient I meet, I learn something important, something necessary, that allows me to grow as a person and as a physician. There is only one way I can feel in response, and that is grateful.
It is not always good and it is not always easy, this work, but it is always meaningful. What more could I ask of my career? Sometimes, I step back and marvel at how patients surprise me, how people change in all sorts of unexpected ways, and wonder about my own role in facilitating that change. What I remember then is what my own therapist once said…he reminded me of Freud’s words, that psychiatry, therapy, is essentially a “cure through love.”
So today, and in the week ahead, I invite you to join me in reflecting on the work that you do. In what small and big ways do you find meaning in your work? Is there a place for love in what you do?
With gratitude, Monisha