Family work. When I started pediatric medicine, I listened to my mentors and peers, and I was first shocked at the pervasively pejorative social gaming that stagnates the practice of medicine. This was twenty years ago. Some people play the game, others do not, and the martyrs don’t get invited off unit much. Fun police. Politically correct. Sanctimonious. Whew. Exhausting.
But healthcare providers are people. Fallible, vicariously traumatized humans. Our inability to admit it does not make it less true. Our inability to shuck the need to look witty, strong, or socially adept to our colleagues, over compassionate, does not make it ok.
I can’t do it. It makes my stomach hurt. Even when it’s spot on. Whisper martyr, I dare you.
First, there is no judgment cast without judgment internalized. When we look out, with a lens of judgment, we are absolutely judging ourselves–in our spare time, in our sleepless nights, in the mirror, and in our every single move. Packed a lunch today? Bought a lunch? What–you took a lunch? Lace it up. Judge away. Already did.
Back to our families. When we judge parents, they crawl up into their heads, if they’re able to, where we can’t get to them. And then, what’s the point? Apply this to your individual adult clients, too. What, your patient was too whiny, and came to you for help? Maybe it’s the fact that you have to figure out how to pathologize that, and up-charge it too, but really you just want to send them to a therapist to learn how to live a more balanced life.
Lonely. Sad. Less resourceful than you, and you can’t look in the mirror without feeling the weight of your soul’s every imperfection.
That’s hard to look in the eye, right?
Cue the self-preservation response: If you can’t get past your judgment of me, how the hell are you going to presume to help my family? You can’t. Necessarily, now they tick off justifications, defenses, or launch improvement strikes against themselves, and/or you, and the family is buried in a landslide of shame. Or they just stop coming. No work now, only retrieval. Removing the rubble. Mexico, my heart is with you.
How the hell do you bill for that?
And how do we parent in the face of so much consternation? Pious constructs–the concept of a good parent? If I can’t do it, and you show me in our first appointment, that you believe I can’t do it, then where does that leave us?
Man, it’s hard. I watched a disabled woman scream at her baby with leukemia once, because she’d thrown up the breast milk. It smelled so bad in that room, every day, that I had to hold my breath and still seem relaxed and smile, because dignity is important. You help her clean up. You bathe the baby. You offer comfort. It’s what nurses do…sometimes. Let your imagination run wild with this. It can go a lot of different ways.
The judgment does not matter. You’re welcome to keep it. I feel it, too. It’s like leaves blowing down the street. Can’t get through a fall day without walking with some.
I try to set it back down after it bounces off the floor and hits me in the face. We were imprinted long ago, and we’re really good at keeping it alive. When some lands on you, take a minute, and see if its yours. You can put it down, too.
These are our white, and increasingly red flags. If you see me holding some, sneaking it into my pocket for the just right morbidly wrong joke on a hard day, call me out, would you? And ask me how it serves me, and what I told myself in the mirror that day.
Lastly, how does it serve your practice, and especially the children of our clients?
Think of this as a hug. Nothing more.