“Isn’t it hard?” my daughter asked.  “To always be the one doing that?  Doesn’t it affect you?”   Her question may perhaps be a simple one but I felt it, and knew it to be, a much deeper query.  Especially after this past weekend.  We had been discussing my day so far, having just arrived home.  Talking about how I so often feel like the ‘bad news bear’.  How when I finally get the hospital staff to meet to do some advanced care planning its often as our team has been called in so very late in the ‘proverbial day’ and we are having to change tack from chasing acute care results to discussing comfort care and trying to get a child home rather than die in the hospital.

Today my midday case conference with the ward doctors and my team was to discuss the way forward for a little three-month-old baby that had been recently transferred to their ward from the neonatal unit.  Somehow having slipped there through our net of care.  This little girl has been in the hospital since birth.  Her parents have yet to experience being able to take her home.  They may never get that.  Her mother has yet to spend any protracted amount of time away from her or from the hospital at that, or in the company of her partner and three year old son, since the night three months ago she went into early labour. Born with an abnormal brain.  Born without the cry of life, fitting, and destined never to be able to feed, or respond to her mother’s touch, or grow appropriately.  And more and more the little head is looking odd as the body grows, but not the brain.  So our team got involved.   Embarked on the discussion of prognosis, care plans, and talking with the family.  Spending time with the mother.  Hearing how she had only recently told her own parents the baby was not doing well.  How she had hoped against all hope but was starting to see the signs were not good.  Especially after the ‘bad news bear’ arrived and started her ever so gentle, ever so insistent dialogue, of starting to look at the reality of the life her baby girl has.  Starting to really broach the difficult issues at hand.  The ‘bad news bear’ indeed!

Well that be as it may.  It is my work.  My service.  What gives meaning to my every day.  Being good at being the ‘bad news bear’.  But my daughter’s query was prompted by a deeper question.  A concern for my own self-care. And how it affects the family if I slip up on it.  Like all health care workers I need debrief time.  Self-care strategies.  Not only the meetings I offer to the other docs in this field, as the one we had just this morning.  Not only to the medical staff I debrief on the wards, the nurses, my own team, my friends, and colleagues.  But self-care for me.  My daughter’s question was very pertinent today. I had spectacularly lost my cool this past weekend and behaved in a way no parent is proud of.  And while there may be many explanations, including pure unadulterated mindlessness,  an underlying factor is a constant demand to be present for others.  To deliver bad news so very often and be present for the resulting distress it brings.  So my own self-care gets called into question.  Especially when my equilibrium is so blatantly off kilter. Especially when my daughter has more words of wisdom than I do.  Or is that always the case with our children?  Our teachers constantly!

So what do you do for your own self-care?  I have no real helpful answers for you here.  Just questions of myself!  All the usual apply.  What little that I do perhaps know is this and is common knowledge but may need reminding on occasion:  Surround yourself with supportive friends and family.  I try to choose with greater discernment who and what I say yes to these days.  Have time with a friend who ‘gets’ you. Thanks K for that today! Journal. Meditate. It does help.  Trust me.  And if not me, trust the volumes of research that is being published about the positive effects of meditation.  I always know when I’m seriously off balance that my meditation hours/ minutes must be getting too low.  So those Zafus and Zabutans I’ve newly ordered are coming just at the right time.   Eat well.  Mindfully.  Only food you enjoy, but not too much of that either.  If you pay more attention to the experience of eating as you eat you may be surprised that you do enjoy the healthy food. Exercise.  Sleep.  Enough.  In a darkened room.  Do enough of whatever it is you love to do!  And nourish the part of you that needs nourishing.   Make sure that Love is a big part of all of this.  An absolute essential for us as human beings.  I see it with the kids on the ward.  And my own kids.   They just want love and attention.  As do I.  And lots of it!  Why do we forget that so often as adults and make do with less?  Ensure you are caring for the most important person in your life enough.  YOU!  Without that you can’t care well enough for all the others in your life.

Attached below is my poem for today.

By Mary Oliver.

Remember.

You do not have to be good.

You only have to let the soft animal of your body love what it loves

Tell me about your despair, and I will tell you mine.

Whoever you are, no matter how lonely, the world offers itself to your imagination

Calling to you.

Announcing your place in the family of things.

Remember to nourish yourself this day with some love.

But don’t be fooled.

Perhaps tomorrow we will all spectacularly fail again.

As we do if we are human.

And pick ourselves up again.

Beg forgiveness.

And begin anew.

Forgive me if I’ve rambled today.

And thank you if you read this far.

Wild Geese by Mary Oliver

You do not have to be good.
You do not have to walk on your knees
for a hundred miles through the desert, repenting.
You only have to let the soft animal of your body
love what it loves.
Tell me about your despair, yours, and I will tell you mine.
Meanwhile the world goes on.
Meanwhile the sun and the clear pebbles of the rain
are moving across the landscapes,
over the prairies and the deep trees,
the mountains and the rivers.
Meanwhile the wild geese, high in the clean blue air,
are heading home again.
Whoever you are, no matter how lonely,
the world offers itself to your imagination,
calls to you like the wild geese, harsh and exciting —
over and over announcing your place
in the family of things.