Why is Love So Hard To Take?

How is it possible to gain 25 lbs in 4 months?!

I shook my head in frustration as I looked at the 13 year old girl’s growth chart I was just about to see.  Or rather, the data point way above the 99th percentile growth curve.

How many times had I talked to H and her mother about limiting the cookies and chips?  How many more times will I have to say that regular, plain old water is actually fine to drink?!  I glanced at the sports physical questionnaire I was supposed to review before going into the room and surprised myself with the soulless laugh that reflexively came out.

“Sport: Bowling”

Great.. how was I going to nicely say that bowling wasn’t quite the form of exercise I had in mind?

Deep cleansing breath

I tried to utilize the weekend’s meditation mantra to help wipe the irritation from my face before putting my hand on the door handle → This is what it is now.  

Yup.. this is your life, M.  Just accept it.  You said you had a strong passion for preventive care, now prove it.  Go on in and beat that dead horse for the 7th time today.

Fighting the urge to back away and flee the building, never to return again, I plastered that fail-safe smile I keep in my toolbox for moments such as these.  Unfortunately, that smile was starting to show some signs of wear from overuse.

“Hi H!  How are you?”

*Shrug*

“What have you been up to this summer?”

*Silence*

A staring match of chicken ensued.  Who would be the first one to break?

Finally H’s mom cut in.

“H had a mental health crisis this summer that I’m sure she doesn’t want to talk about, but I did tell her I was going to bring it up today because it’s important for your doctor to know,” mom said with her eyes trained not on me, but on H.

*Sigh of exasperation*

“She had some suicidal thoughts and did some self-harm behaviours, but she’s in counseling now and is doing better.  Right H?”

“Be careful!” H avoided the question as she tried to stop her little 4 year old sister from launching herself off the exam table step.  “You’re going to hurt yourself.”

“H, please.  This is your appointment.  I’d like you to participate.”

*Eye roll*

“I’m fine now.  I just need my physical.”

What happened?

Sitting back in my chair, I studied her.  The buoyant, excitable 9 year old I had met when H’s family first started coming to see me had been replaced by this sullen teenager in bedazzled Converses who now had the telltale signs of cutting on her non-dominant forearm.

“How are you sleeping?”

“Fine.”

“Tell me about the things you’re eating.”

“All junk food.”

H stuck her chin out defiantly as she declared this, almost as if to say, I dare you to tell me I’m fat.

“Food and exercise have been sore topics for her… so we’ve decided to stop pushing it,” mom rushed in.

I nodded my head and opted to redirect the attention to her sports physical form, trying to buy some time to figure out how I was going to handle this situation.  The energy wave I was riding from the frustration I had built up prior to entering the room was quickly dissipating, leaving me with nothing.  All my tools had been swallowed by this vacuum.

“Well, at this point in the exam, I kick out parents – you can wait out in the waiting room and I’ll get you when we’re done!”

Mom looked hesitantly back as I shut the door in her face.

“H, was there anything you wanted to say now that your mom is out of the room?”

“No.”

“Look H, I know you don’t want to talk about the food and I know you don’t want to talk about the weight.  And I respect that.

But I just want to say that sometimes we treat ourselves poorly because we don’t think we deserve any better.  Sometimes we eat junk because we feel we are junk.  Sometimes we say and do terrible things to ourselves that we would NEVER say or do to anybody that we love, but somehow we think it’s fine because we have forgotten how to love ourselves.”

I glanced at her left forearm again.  About 20 linear stripes of scored skin.  Mementos of a time when there was so much turmoil and pain in her heart, she was overcome by the urge to get it all out in the open onto her physical person just to make it seem real and tangible, if only for a moment.

This, I understood

This hurt had bubbled up in me during 3rd year of medical school when I punched a hole in my bedroom wall while living at my parents’ house.

The urge to wreck everything in my path in an effort to have the shambles of my dead dreams pulled out of the turbulence in my mind.

The first time I admitted to J I was burned out and didn’t know what to do.

The first time I was seriously tempted to back away and escape a life in medicine.

But, this very moment in time was about H, not me.

My gaze returned to her eyes and saw the first hint of emotion she let out all day.  Tears threatening to overtake her sunken eyes.

“I wish for you to have the same love for yourself as the love you have for your sister.  To protect yourself as you protect her.  To have the same understanding and kindness for yourself.

Because you deserve it, H.”

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3 weeks ago, I found myself in my old bedroom in Michigan, unpacking my dress for a wedding for a friend from residency.

“Look, M.  Your sister covered up the hole,” J waved to get my attention.

Pictures of my sister and I were placed strategically over the gash I had left almost 10 years ago.  The fail-safe smile I’ve been using for the last 2 years didn’t even hold a candle to the joyful faces peering out at me.  I almost didn’t recognize the person that was supposed to be me – carefree and wholly present in the moment.

Whereas I had wanted to display the gaping scar in the wall purposefully as a warning to never let myself get that far again, my sister chose instead to cover it with love.  We both knew the wound was still there, but she who has always had the gentler heart was showing me a better way, even now.

Love is the answer.

So why is it still such a bitter pill to swallow?

 

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Photo taken at Boracay, Philippines.