That night I was exhausted yet wide awake at the same time…

Arggghhhhhh!  I laid awake the night after my first patient died after surgery.  I was exhausted, but unable to keep my eyes closed or my brain quiet.  I felt cold and sweaty at the same time. I laid on the couch watching inane late-night tv while I did a thorough job of beating up on myself:

Did I cause this death?  What sign did I miss that this was going to happen? Could I have done something better? If only I was a better doctor this wouldn’t have happened. I am such an incompetent doctor.  I obviously should never do surgery again. How could I do surgery ever again.

I eventually fell asleep only to wake up with the exact same thoughts pounding in my head as I headed into the clinic for another day.

GUILT.  The emotion that comes over us as we believe we caused someone harm.  

GUILT.  The emotion that arises when we compromise our values by acting, or not acting, in accordance with our beliefs.  

GUILT.  That horrible feeling we get when we believe we should have done more.  We should be able to work more hours, know everything about everything, and cure every patient we see.  Silly right? Of course, but we all say these things to ourselves!

This emotion, guilt, brought on by our thoughts, is a major reason we experience compassion fatigue and burnout.  We keep layering on the belief that we should know more and be able to do more, day after day, week after week, until we are depleted and not able to see how much good we do in a day and how needed we are.

I like the cognitive theory way of softening and negating this emotion of guilt.  By changing our thoughts about a situation we can soften the feeling of guilt and even avoid it all together.  

When you experience a situation that has you feeling guilty, notice the thoughts you are thinking.  What story are you telling yourself about the situation? Be on the lookout for thoughts that begin with “I should have” or ‘I could have” or those thoughts using words like “always” (such as “I always make mistakes”).  These are the kind of thoughts that lead to the emotion of guilt and keep us from being able to assess a situation honestly, learn from it, and move on.

I encourage you, when you are feeling guilty, to change the story you are telling yourself.  Phrases like “I did my best” and “My team and I did all we could to save her, it just was not to be” are powerful and true statements. Learn from all outcomes, successes as well as failures, and be willing to let yourself off the hook. Notice the thoughts associated with your emotions and create new thoughts to orient yourself in a better feeling direction.

The Lessons One Damn Black Cat Taught Me About Love

This week finds me facing the reality that soon I will have to say goodbye to my dear little Mu, my cat.  He is failing and there are no more treatments that I want to pursue. So it is coming to decision time.

I have many emotions swirling around me over this situation and the predominant emotion changes from hour to hour.  I wanted to explore some of them with you as I know they are not unique to me, but common to all of us who have animals in our lives.

The predominant overarching emotion is FEAR.  

Fear of the future-me not being able to handle the absence.
Fear of the future-me missing the soft fur, the eyes, the purr.
Fear of the pain this loss will create in my heart, my body, my soul.
Fear of judgement of others for how I handled his disease and when I chose to end his life.  

I feel GUILT, as well.

Guilt that I didn’t do everything I “could” have done to keep him here longer.
Guilt that I missed some doses of medications.
Guilt that I waited too long to start treatments.
Guilt that I didn’t do regular monitoring.

I also feel UNWORTHY of his love.  

I know all the things I have done that he can’t possibly know about. That if he did, he would surely not love me.  If he knew the real me, he would not love me the way he does.

I cannot look in his eyes anymore without crying, due to the absolutely crushing weight of emotions that I feel – FEAR. GUILT. UNWORTHINESS.

LOVE.

How can I possibly come home to a house empty of his presence?  How will I fall asleep at night without a good night snuggle with him first?  

How do I admit how much I needed him to listen to my fears and my worries.  He was so strong to listen to all of my emotional dumps on him and not once did he walk away from me in a huff.  Not once did he tell me to get a grip. Not once did he tell me he couldn’t listen to me any more. There were no eye rolls, no huffing, no disengaging.

How do I go through with his euthanasia?  When do I know it is the right time?

If I strip away the fears for just a moment I know it is time now.  I know I am delaying the inevitable hoping that there will be a way of avoiding the emotions I know are coming.

I am delaying because I hope he will just… die in his sleep. Why don’t more of our pets die in their sleep?   

I believe their last gift to us is that they allow us to face all of our fears, with shaking knees and tears, because they know we can handle it and grow.

The only way I know to deal with all of this in a healthy manner is to be brave and wade right into the emotional whirlpool that surrounds death and especially the choice of euthanasia.

I can only feel the depth of loss if I have felt the abundance of love.  

Can I be brave enough to feel the pain in my heart? Really feel it. Allow it to be with me in any way that it needs to be.  Can I find some part of me that realized the pain could not be there if I had not opened myself to the love in the first place?  There could be no pain if there was no love. That is the price of being human.

We love and therefore we grieve.  They are the two endpoints of the pendulum swing.  

Can I allow myself to grieve as much as I allowed myself to love?
Can I grieve harder than I loved, knowing that I also held back some of my love as a protection against this day as well? 

Facing his death, can I admit that I didn’t love him to the fullest because I knew this day would come and I wanted to protect myself.  It didn’t work. Now I hurt for the loss as well as the knowing that I held some love back and now it is too late.

So the only way out I know is to be willing to feel all of these emotions and love myself for them.  They are the indicators that I am human. They are the indicators that I am capable of love and worthy of being loved.  

Some damn black cat came into my life and look what happened.

He loved ME.

He loved the doubts, the insecurities, the lies, the shame, the failures, the me that is messed up and human.  

He loved ME.

He is my teacher, he has confidence in me and I hope to honor his memory with the lessons I learned from him.