A recent comment on one of my posts stopped me in my tracks – “Thank you for your positive reflections.”
Whoa
I don’t think I’ve ever been told I’m a positive person. Like EVER.
In fact, when I was a senior resident on my adult ICU rotation, I vividly remember one of my interns telling me I had a black hole where my heart was supposed to be. I think the words used were, “It’s where light goes to die.” It even goes back to 7th grade, when my teacher told me I was sadistic. (s/n: I wasn’t her biggest fan either)
I think if my closest friends were to describe me, they’d tell you I’m cynical. A skeptic. A tell it like it is person.
I prefer the term realist.
In my ideal world, there would be no sugar coating. No good-bad-good feedback sandwich. No more “Let’s only look at the bright side” comments when your world is exploding – that’s NEVER helpful. You know what is? Saying, “Let me help you clean up this mess when the explosion is done. Then we can go after who set the bombs off in the first place.”
We should say what we mean, not tip toe around uncomfortable issues. We all do this dance, however, and for this reason I assume no one ever tells each other what they really think. Except to their doctor or therapist, and even that’s an iffy maybe.
The problem is, people don’t really see this side of me because it’s really well hidden by a cutesy baby face on a petite body. You’d have to peel back so many layers to get to the core of this onion. Online though, I have to cut out the superfluous BS – I know I only have your attention for 5 minutes tops.
But, I digress. Looking back at my recent posts it’s true – I have been on a positivity kick for the last 2 months. I can see where people would mistakenly think I’m very zen. Saccharine even. In reality, I actually would avoid that person like the plague if I saw her coming down the hall. The overabundance of happiness would grate on every last nerve. Too much inner peace is just not natural.
Who is this person I’ve become??
Dressing the part
In dealing with people who are always having their worst day ever, I’ve had to learn how to shield myself with a cloak of positivity. It’s like my white coat without the MRSA. It reminds me of my World of Warcraft gaming days when you’d get the purple gear: +15 positivity, +15 shield, +50 patient satisfaction.
I’ve had to borrow this cloak of positivity as I’ve been pulling myself out of burnout. It’s been useful as a tool, but now it’s time for it to go back in its toolbox.
Why would I do that, might you ask? Isn’t there a huge benefit to staying positive?
Positive thinking is over-valued
We have put so much emphasis on staying positive I believe it’s become a hindrance to living our fullest human experience. We’ve bought into delusional positive thinking which is completely divorced from reality.
We always want to “be happy” and feel good about everything, and in the process totally discredit the importance of allowing ourselves to admit that sometimes life sucks.
Sometimes we just need to throw ourselves a pity party. Sometimes discomfort is what urges us to move forward. Sometimes pain reminds us we, in fact, really do have it good.
When the goal is to “stay positive”, it can pacify us into staying in a bad situation with terrible consequences down the line.
This didn’t really become clear to me until I received a phone call from a patient when I was on call a few weekends ago. The message on the page I received stated,
“Patient’s mom just died. Can’t sleep. Needs to talk to doctor.”
Unsure of what I was getting myself into, I called the patient up.
“Hi.. thanks for getting back to me so quickly! I just realized how bad that text sounded. I’m not suicidal, I only need something to help me get through this rough time. I’m just trying to stay positive for my family.”
“Stay positive… ?”
“Yeah. I mean, I’m the one who’s taking care of all the funeral arrangements and the viewing and family members coming into town. I can’t afford to break down.”
“Your mom just died.. you’re allowed to grieve.”
“I… I can’t. Not right now. I can’t do that to them.”
“When would be a better time than now, with your family? To be able to remember her together? To celebrate her life together?”
“… Look, can’t you just call me in some Xanax? That’s what I need. I just need to get through this.”
In our quest to “stay positive” at all costs, we seek to numb the other aspects of ourselves that make us human.
This poor woman would not allow herself to experience grief over her own mother’s death. She wouldn’t allow herself to see her heartbreak was due to the fact she loved her mother dearly. She couldn’t accept that she needed to mourn to eventually allow her to move on with her life.
No, instead she was looking for the quick fix so she could be that pillar of strength for her family. The one who would be a positive guiding light to help them find their way, not realizing she was the one pushing them away.
Sometimes my patients need the cloak of positivity. Other times they need a reality check.
I told her,
“Death is supposed to be hard. You’re supposed to be sad. How can you give everyone else grace to grieve but not allow yourself to do the same? I can’t give you Xanax. There is no quick fix for this. What you need to do is reach out to your support groups which have already gathered around you and just have a good cry together.”
I don’t know if that’s what she did. I don’t know if she’s written a bad review on ratemydoc.com. And I really don’t care.
We all walk around trying to “stay positive” and buying into the delusion that everything is ok all the time. It’s just not. That’s not life.
Life is hard. But the hard times make us appreciate the good.
Life is painful. But the pain prods us to make a change.
Life is just a continuous ride on the struggle bus. But without the struggle, we become complacent.
So forget positivity
Sometimes everything might NOT end up being ok, no matter how positively we try to frame it. It’s better if we recognize that lie for what it is so we can move forward and actually change our situation, instead of putting up with the status quo.
Let’s allow ourselves to wallow in the filthy pit of our despair for a second, as long as you know it’s just a short visit and you can ask for help getting back out.
Let’s practice gratitude instead of saying positive affirmations that look good with a hashtag. Like real thankfulness for what’s good in your life. If you don’t have anything, then maybe you should make something good happen.
Let’s recognize there is beauty in the world, but sometimes life is not always beautiful.
But, let’s remember that cloak of positivity is still there in that unorganized toolbox. So just in case we need a security blanket to hide in for a quick second or 2 months, we can do that too.
Your response to this patient was ignorant. She was asking just for some help to sleep so that she’d have the energy the next day, and probably few days, just to be able to adequately handle all of the extreme emotional issues that she was being called upon to do. She wasn’t asking for a crutch to help her deaden her thoughts and emotions, she just needed some sleep. Given your response, it seems that you’ve never had a close family member, who you love dearly, die and have to be the only one who takes care of all the arrangements. I’ve done this and it’s excruciating and exhausting. A couple of extra hours of sleep helps you feel genuine emotions, not the fake ones that come with sleep deprivation. It also helps you concentrate on making reasonable decisions while picking out caskets, burial plots, expensive flower arrangements, and all other ridiculously expensive things that go along with a funeral. Unscrupulous funeral directors rely on high emotions and little sleep to get the grieving family to fork over more cash for things like circular medallions that have pictures on them which are attached to the casket. Adequate sleep also helps you make important decisions about how to properly eulogize your loved one, write an honorable yet realistic (and short) obituary (another source of excess, unnecessary cash), protect the family home during the viewing hours, church service, funeral service and family gathering afterward, and how to deal with incendiary family relationships that will inevitably erupt during the proceedings. You projected your own biases on your patient (that she wanted to deaden the pain) instead of just listening to her (she needed sleep). Talk to a trusted colleague about this situation to avoid it next time and learn how to not project your needs and emotions onto your patients.
I appreciate your comment, and I wholly agree with you on the importance of sleep especially during such an emotionally charged situation.
However, from my standpoint this patient was asking for a controlled substance and I do not take these requests lightly, especially on off hours for a patient that is not mine but a partner’s. There is already a lot of concern for controlled substances out on the streets causing people to overdose/abuse including narcotics, benzodiazepines and benzodiazepine-like medications, including Ambien.
As much as I would have liked to help this person’s suffering, it’s a liability to call in these medications for patients you don’t know personally. Moreover, our ability to even do this these days has been limited by law BECAUSE of the above risks. The conversation you had read was highly edited and didn’t include all of the details, but your concerns were addressed and I asked her to contact her personal doctor with whom she does have a relationship with during business hours.
The onus has come down on physicians handing these medications out, and I am trying my best to provide good care that does not endanger patients. I hope this provides a different perspective.
This post is very old. But since I had to manage 10 phone calls from benzodiazepine addicts last time I was on call on Sunday. This post triggered me to answer.
Although you do have a point about the need to sleep and the agony a funeral brings, xanax is not always the answer. As a doctor we also have to weigh the benefits and the possible adverse outcomes.
I see patients almost every day who have been on benzodiazepines like Xanax for years after they started it when they had to organise a funeral. It’s an addictive product and as a doctor you also have to protect your patients against medicine addiction.
This comment somehow made it into the trash – thankfully I saw it and saved it!
Thank you for this comment – on one hand, it’s hard to see someone suffering, knowing we can offer something that can help take the edge off. On the other, we know the dangers of prescribing medications with addictive potential. It is a responsibility we do not take lightly