Good Morning Anita,

I am back at the same hospital and location that I was the day before I made my decision.  It was the day my father called me in the middle of a work day and thought it was the appropriate time to lecture me for one hour on life insurance, and the fact that most children live close to their parents, and parents forgive them.

Yesterday when I was there in the middle of the day, this occured to me – out of nowhere.  It seemed ludicrous!  Here I was in the middle of an intense emergency case, a patient’s life truly in my hands, no exaggeration.  And just one week ago, in a situation that was not so different, I made time for that nonsense!

How accepting, open-minded, and beaten down I am to think that something like this is worthy of making time for, and sending attention to in the middle of a day like that.  In fact, how beaten down I am to think it is worthy at all – period.

This is not to say this is just about my job, versus other people.  But, in fact, yesterday I did realize that if anyone can say – I truly can not focus on your nonsense right now because someone’s life is in my hands – it would be me!  I never have said this.  I do not believe it is necessary to say this out loud.  But what is important is to know it in my head.

To know the importance of my job, to know that given that, I am ALLOWED, and JUSTIFIED in not diverting my attention and focus elsewhere to things that are not as important, be it that they are inconsequential, frivolous, are plain just not important at that moment.  Some of those things may be something I want to direct attention to later in the day (by choice) – so of those things may be something I want to direct my attention to: never.

I see this now, as a delineation. An example: I am in the middle of an acute situation with a patient.  A friend or someone sends me a text about a boy problem.  This is not nonsensical, just not relevant for me at that moment, so I choose to respond when  I have the time and mental space to do so.

On the other hand, I get a text about something such as: “I walked in and he said that to me, can you believe that.  Gosh he is so annoying.” I read this and realize it is part venting/part gossip on someone’s end.  So I say the latter to myself, this is something I don’t want to direct attention to at all.  Not later, just not at all.  And that is okay!  In this situation I can communicate with this person at a later time about something else, but I do not need to engage in this sort of topic.

This is also new to me Anita. I always felt it was rude to not engage in something the other person brought up, no matter what it was.  I never employed boundaries and the ability to have choice in wanting to exert my attention to a topic (topics such as gossip, negativity, self inflated behavior).  It can be simple, I can simply just not contribute to it!

This may be harder in person, versus text messaging.  Yet, once again, with practice of boundaries in controlled settings, I can get used to what “feels good” and what feels like “reverting back and not good.”

Dear Anita,

Long delay since I have last spoke to you.  I am doing well, much busier with work which is good. It has been nice to come to work and focus on work, patient care, interactions.  It feels like how things should be.

I have since last speaking to you talked to a few friends.  My one friend called me the other day and wanted to know what happened.

To my surprise, my narrative of the whole (acute) situation flowed so easily, like a story book.  It wasn’t fake, it wasn’t insincere, it was just easy.  I spoke of the most recent events, explained the last conversation I had in some detail, then the after math of extreme amount of phone calls, blocking their numbers, changing my phone number – to where I am now.

Myfriend noted that I sounded happier and empowered.  When people have told me that in the past (for whatever reason)  I usually said sure yeah, but not really feeling it or believing it.  This time, however, I noticed it too.  I took a moment and thought wow! yes, you are right.  I do feel empowered.  I do feel better.  In fact, I have been so busy “living” that I have not even noticed. (to me a sign that I am moving forward and living versus being stuck as before such as when I was speaking to you on that vacation a month back).

Of course I know I do not have to explain my whole story to everyone.  With this friend I did want to  explain some parts, and it was much more seamless than I ever imagined.  In a way I felt disconnected from it all, but not in a numb way, more as though I am reading a chapter of my story, and I flip a few pages back to read her what she has missed over the last 2 weeks.

What I am focusing on now is something I have mentioned to you before,  containing anxiety.  I understand that when a person has trouble with anxiety, it is not in a neat little box.  There isn’t a box for family anxiety, and a separate one for school anxiety, and a separate one for work anxiety, etc.  More often than not, the “boxes” all tip over and flow onto each other.

I notice this, and I have been having some anxiety with our upcoming changes in jobs and possible move.  I do notice too however that a lot of this is “normal” anxiety, and I can differentiate it from what may be out of proportion.  I see that almost anyone would have jitters about moving across the country, finding a new career, etc.  I also notice a lot of it is based on not the actual events that will happen, but my “ideas” of the move.  things such as:

1) I have always wanted to move to X place, well when we get there what if it isn’t as great as I imagined.

2) what if we regret moving, perhaps the grass isn’t always greener on the other side?

3) perhaps I am glorifying how things will be in X place, and not realizing that there will be their own share of problems there.  What if that makes me feel like I didn’t appreciate things HERE when I had them.

I notice all this, and I notice a lot of this is “normal” (for lack of a better term).  I also notice that I am able to filter out these thoughts, versus feeling just plain anxious such as years ago.  I know this is a step, because I can target my thinking and certain thoughts versus just an overall feeling of distress.

I know when I read the above 3 things, I can hear my friend saying them to me.  I would respond and say: all of these are normal thoughts and feelings, when you move you will find some things are better, and some are worse.  but if you are so inclined to move (you and your husband) are making the decision based on a variety of factors that appeal to you.  have faith and confidence in your decision.  you are reasonable and realistic enough to know the reality of the difficulties that come with transition, and you are approaching the decision with a fine understanding of that.

and so I will (or shall) tell myself the above…!

Dear Anita,

I used to love the quote: “in the midst of chaos, keep stillness within you.”

I loved it because I admired it, and could not relate to it.

Nowadays  I can’t say I relate to it completely, but I do notice glimpses of it.

This brings me to your point:

Containing the anxiety is about slowing down. At least, in your brain, slow down. Do what you do, at work, but keep your brain slow, calm, alert but calm. Your medical practice of doing just that is helpful as training to do the same thing outside of work.

I love this last line.  I sometimes find it hard to use the tactics I do at work, when I come home.  This isn’t even because of home issues, it is even by myself.  It is as though at work I have a more dedicated discipline in my mind, and am more “strict” in the sense of – keep calm slow down.  When I get home, often things can become “looser” and with that the anxiety can creep in.  I find this ironic actually because in a stereotypical sense you may expect someone to be more tense at work, and less at home.

I also find that because my work is intense and very busy, and I don’t allow myself to get inundated with anxieties while I  am there.  However, perhaps the gates open when I leave this environment.  Some of this is inevitable, and also healthy (need to keep gates open).

However, I like the point you make: do what I do at work, keep my brain slow and calm.  Alert but calm.  It will be more of a deliberate practice to do this out side the work setting, as I will have to enforce it in a scenario I usually don’t.  It will also be more deliberate in social settings such as future dinners, or interactions with others.

But like I have said all month, it will all be practice.  Today when I head home, I hope to keep this in mind. I can employ similar tactics of calmness.  Just because I am no longer at work, doesn’t mean my body and brain have to be bombarded by all the anxieties floating around.  I can go bit by bit.

Dear Anita,

“The more you define those dangers, the more aware of them, in a calm way”

What are some recommendations on how I can define these dangers, at home

Sure Anita, I am interested in your “guess as to what they may be.”

Hello,

This all sounds very reasonable.  I like how you wrote “pursing and accommodating every potential friend.” When it is written in this way it outlines the (almost) absurdity of that “job.” It outlines how out of proportional of normal that is, how intangible, and how lofty of a “fake goal” that is.  The visual that comes to find is: someone going on a walk and kicking every rock they come across, and then being asked when they returned if they enjoyed their walk.  Well how could they enjoy the journey, they made it their job to accommodate an action every step along the way.

Or being at a fair and being told they have to shake hands with every person their age.  Then going home and being asked: did you enjoy the fair? It would be like, what fair? I was doing my “job” of pursuing every potential friend.

Seeing this from the outside looks to me as absurd and delusional.  And yes it is! I am glad to see it this way, and I hope I can bring myself back to this feeling and visual when in the future I do give myself pressure for having that “job.” I am sure you can remind me too!

I was taught my whole life that life is a series of doing, feeling, and acting.  I realize it is not always about action.  Life is also sitting back and observing, enjoying, and just being.  As we all know, just being is the hardest part!

Hello Anita,

How are you? What are some new lessons you have learned recently? I would love to get some insight on where you are.

I see how much daily effort it takes to make the “right” choice.  To not let our minds go down the rabbit hole.  I also see that with practice this is not as deliberate, and becomes more natural.  I am fortunate to see this over the last month.