Resilience

In my four years of training...that's 4/5 with only 20% left , I've had the privilege of working with all different types of people. I've sat afloat in the home of a hoarder, accompanied an agoraphobic elder to the dentist, suited up in gown, gloves, and mask to assess the psychological functioning of a cancer patient in isolation, celebrated the 60th birthday of a transgendered man with paranoid schizophrenia & stage 4 metastatic breast cancer, waited alongside a diabetic 10-year old before sending him through a world class MRI machine. I've watched 3 people slowly fade and then disappear. The culprits: Cancer, COPD, and Cholecystitis.

"The work we do is hard", a colleague of mine once stated as she shared how she finds it difficult to refrain from becoming too attached. She asked me how I manage to remain uninvolved. I told her I didn't know, but that I did notice I have this uncanny ability to leave what I see, do, and say in the place I did it and only pick it back up when I return. I told her I thought it was what might make this profession perfect for me...that I could be passionate about but at the same time stay uninvolved and continue living my life at day's end. Slowly, I'm learning there's a fine line, the one that helps you maintain a balance between being professional and being human, the one that makes you a good psychologist and a great psychologist.

I've been working with Spinal Cord Injury patients at the Veteran's Hospital. I loved it from day 1. I loved everything about it: the interdisciplinary approach to care, being able to learn on my feet, the neurosurgery rounds...everything. I was still uninvolved, yet I felt like a true growing professional...until this week.

Mr. M came in for his annual evaluation at the SCI clinic on Tuesday. He was my last annual evaluation of the day. He had a diagnosis of MS w/cerebellar atrophy (which I had no idea what that was). I went in w/my clipboard and neuropsychological testing screens. The notes indicated he had expressed some problems w/his memory the previous year. I thought it might be helpful to get a better understanding of his possible cognitive decline. He was a pleasant looking man who was cooperative and smiled a lot. I shook his hand and introduced myself... and then he spoke. "HWWE---LLLLLO", he said slowly, exerting all his energy to greet me. I realized he had dysarthria.

In lieu of the pain in his lower body, the MS, the braces on his legs, the inability to manage his own bowel & bladder care, the fact that he had no living family members, he told me in long drawn out words that his only complaint was wishing people would take the time to listen to him while he worked his hardest to get his words out and that all he wanted was to have a conversation. I was speechless for a moment. I had an agenda that needed to be completed. I made a quick decision and in that moment, I put down my clipboard, boxed up my neuro testing kit, and decided to have a real conversation. The social worker came and went and I stayed w/Mr. M. I had a hard time understanding his words but 2o minutes into the conversation, I felt I could understand what he was saying. He was 85 and most of his good friends had passed. He said he was okay though. He liked to visit Walmart and wheeled into town almost everyday. He grew up in Washington state, but loved living in CA. He misses his parents dearly and wonders when it will be his turn to pass. I stayed with him for a while. He asked me if I had anywhere to be as the clinic closed at 4 and it was just about 5. I told him I didn't need to be anywhere important and in that moment I realized that I had crossed the line. Resilience is powerful thing. It's what keeps Mr. M positive through all the crap and puts me to shame when I catch myself thinking about what I wish was different in my own life. It's what gets me involved and what makes this work difficult for me. Resilience.

We talked a while longer and then the paratransit came. I walked him out to the van and said goodbye."Thank you for working w/vets", he said. 'Thank you for serving our country", I said.