December 14, 2019

Health : Vulnerability

Two of my doctor friends and I signed up for North Face's Endurance half marathon race this year.  We did our internal medicine residency together, which for me has been the hardest test of endurance in my life, so it seems fitting that we continue challenging our stamina together.  We've all done half and full marathons before, but this trail run is known for its beautiful strenuous steepness, and we were excited for the challenge.  In some subconscious show of solidarity, all three of were unable to run it due to injury and illness.  The goal, and the factors that forced us to relinquish it, have made me reflect on what endurance means, what it gives and what it takes away.

I stupidly dropped a bike lock on my toe over the summer.  When the initial x-ray was read as not having a fracture, I continued my regular activity.  My threshold for seeing someone for the persistent low level pain is pretty high, because it's hard to find a convenient time to see the doctor when you're a doctor.  After a couple months of this, I cave and schedule an appointment for a time when I'm not seeing patients.  The appointment is cancelled, and I don't reschedule it until there's an opening during another time I'm not seeing patients.  When I'm finally sitting at Kaiser waiting for the foot doctor, I get a text from my doctor friend and running partner: "Are you around to pick me up?  I'm about to get a cast and can't drive my car home."

We realize that we're attending foot appointments in buildings right next to each other, both getting bad news.  When I leave my appointment to get to hers, we commiserate over the prospect of immobility.  Movement being a primary source of self-care, we know it's going to be hard.  She tells me how the worst part of it is that she kept running with pain because she could tolerate it, kept delaying seeking care because she wanted to do her job.

As I've written about often here, I love endurance.  I love endeavors that take a long time and require patience, and this is true for me on all levels: mentally, emotionally, physically.  It's why I like audiobooks more than podcasts, novels more than short stories, cross country more than sprints.  And in my work, why I chose primary care, for the languid slow change that happens over long periods of time getting to know people.

My instinct is to equate this faith in endurance with an aversion for rest.  Over four years at my job I've accumulated over 260 hours of sick time because I hate staying home.  I do take full advantage of holiday weekends and vacations to climb and travel, but I have trouble taking time off for the pure sake of being away from work.  My dad worked 16 hour days managing our liquor store every day of the week, only taking a few hours off on Sunday morning to attend church.  My mom worked her job all day and then joined my dad at the store in the evenings.  I have absolutely no memory of them ever taking sick days.  Besides having that endurance as a role model, I already have so much more choice and liberty than they did; it's hard to be idle.

Honestly, I have an incredibly supportive, loving work community who is always encouraging me to take more time off, so I can't blame the environment.  My co-workers actually gifted me a spa day for Thanksgiving, and not trusting that I would actually take the time to use it, schemed with G to make sure that I would actually make it to the spa (you all are the BEST and I did make it to the spa and it was amazing).

I'm trying to trace the deeper roots, because lately I've become angry with whatever it is that makes rest and endurance mutually exclusive, especially for women.  Specifically: mental, spiritual, emotional rest.  I exalt this keep-going mindset to a degree where I personally feel like I'm being negative or self-pitying for simply being tired.

For a good half year of therapy, I spent the first ten minutes of the hour in silence or asking my therapist how she's doing, because I didn't know how to talk about "negative" things.  I told her I didn't like to complain.  Although she gently re-framed that language, she also told me at one point that she was looking forward to me complaining.

When I was having a particularly rough time and wrote my last post, my very kind and insightful co-worker told me she was working to be more vulnerable and appreciated my vulnerability.  She said to me: "Vulnerability is very different from complaining."  I'm grateful for her capacity to see my fear without my ever explicitly expressing it, and for her generosity in dispelling the foundation for that fear.

Because people are kind and because I'm very lucky, during this time so many people in my life have reminded me that it's good and important to feel anything that arises.  That even if what arises is sadness, anger, impatience, or something else on the spectrum of heavy, it doesn't mean that I'm disappointing or discouraging others.  And that this attention to myself is ultimately what keeps me bound to other people.

So for all the people out there who value going the distance, I just want to explicitly tell you what I've learned from those who love and care for me. That the pace changes along this path, and that even if it seems that something external is forcing you to alter your speed, you are not weaker. That to endure is to rest.  Because with rest comes the space to be vulnerable,  and this baring of your pain and fatigue gives so much strength to the world.

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