Dissociation. It's a funny looking word when you stare at it almost immediately. It's that feeling one gets when they've sacrificed themselves entirely to something or someone not themselves and have little self left for his or herself at the end. It's the feeling I used to get after long days as a third year medical student, caring for patients, trying to figure out what was expected of me and comply with that, living for compassion and living for a grade.
I hadn't had that feeling in residency so much until this last night shift. I woke up, tossing and turning, unable to sleep more than three hours after the last shift in which I was absolutely exhausted. I keep thinking about the last patient we admitted. I keep thinking about the family meetings, his grandchildren sprawled out on the floor crying, running out of the room intermittently, bowing their heads, trying to understand, in an instance, death that they apparently did not see looming.
I was tempted to log into the computer to see if he's still alive. If I keep thinking about him, I'll have to. He may not be. I wish I could close the loop with the family and debrief. I wish I could be there, in spite of my lack of sleep.
I couldn't turn in my bed but for dreaming I was in the hospital. So I just had to sit up. And purposeless tears flowed down my face. I did not start them nor stop them. They came on their own.
I think I'm tired, too. Last night, I started losing my sense of self. I felt isolated, I felt apart, I felt different. I feel alien. I feel like I'm different from everyone else. I feel like no one can relate to me, not my classmates, not anyone in my program, not my SO. I felt alien in the music that I like, my sensibilities, the way I dress, the way I think, the way I am.
I think it's all happening because last night was a rough night, I put too much of myself into that family meeting, that patient encounter, gently touching the man who may be dying and speaking to him softly so he wouldn't feel discouraged as his granddaughter, not understanding the gravity of his illness, told me how his legs had been becoming cold before he was admitted. It was hard and I had to be strong. It was hard when I had to be strong because I'm in this position right now because I was inappropriately weak. I can't be weak now.
I think it's all happening because I'm also in transition, a transition that's been long in coming. A transition in my faith, a transition that is not complete but that will be long. I've lost elements of my life that used to give it meaning. My life still has meaning, of course, but in some ways it's so different I barely recognize myself.
I'm in the same in the mirror, and that I'm so the same in the mirror despite how different I sometimes feel inside feels incongruent.
It doesn't make sense that I look the same. I should look different.
I feel like dropping off the face of the earth. Not really. I feel like disappearing for sometime, into myself, away from everyone else, like I used to have the luxury to, to listen to the music that I like that no one else cares for, to dance my samba in peace. I feel like taking long walks alone, reflecting alone, being by myself. I feel like being present only in a professional sense.
And now the tears are purposeful.
Sometime in the course of last night, I completed a turn of dissociation.
I can't be someone I'm not, and I can't play like every way that I've changed since I've started this residency isn't a big deal.