The unintended lesson

Saturday I awoke feeling extremely anxious. I was on call and I had a number of patients who were active and as soon as I relaxed my brain enough about one of them to get to sleep, I'd get a call from someone about another of them, then I'd have to think, rethink and second guess myself about each patient each time before I could fall asleep. Ultimately, I got four calls and had a couple of patients I was worried about that I didn't get called on so as the list of thinking and rethinking was getting quite lengthy I was happy when the sun finally rose. Usually I can take myself by the hand, go over my thinking once, decide what I did was right and be done perseverating, but I just could not Fri/Sat night. Fortunately, I recognized this as a symptom of needing a yoga class or a run and opted for the next yoga class in my local studio which encourages dropins--"all levels."

A branch grows into the gap on a marsh boardwalk in New Foundland.

Class was great; I felt so much better afterwards that it was remarkable to me that I still looked like the same person. I did have one question, however. I noticed that the teacher wanted us to breathe more quickly than my body seemed to want to breathe. He seemed like a person who had thought a lot about yoga and why he was doing what he was doing so I asked him for his thoughts. He explained it to me and I didn't understand most of it so haven't retained it, but then he said, "if you breathe more quickly, you'll feel more invigorated." At that point, feeling more invigorated was the last thing I wanted so I asked, "what if I don't want to feel more invigorated?" He looked confused and maybe a bit angry and I feel badly that I asked because it clearly hurt his feelings. He had no idea of how to answer and said a lot of words, but eventually came to if I breathe with everyone else it will be good for the whole class because we'll be modulating our energy together. I thanked him and left. (People who know me well know that this is an answer that will always make sense to me. "If you do it this way, it will be good for everyone." "OK. I will, then.")

I've thought a lot about this interaction especially in light of my own interactions with people where I am the one who "has thought a lot about these things" (i.e., the doctor-patient relationship where I'm the doctor) and realize that he could have said "I am having a hard time here imagining anyone who wouldn't want to be more invigorated. Maybe I don't understand what you mean by invigorated. Please tell me what invigorated means to you." It would have been helpful for both of us. When I think about saying that to patients, it seems stilted and silly because of course we know what "less pain" or "invigorated" means, but now I wonder, really? I have tried from time to time to get people to explain what they mean by a particular word and usually am met by annoyance on the part of the patient. "you know, dizzy?!" and I think that's because I didn't stress enough that *I* was not understanding. I think people have thought I was either being deliberately obtuse or pointing out that they were not using the right word. I wonder if this is an example where bringing myself into the conversation explicitly as *I* do not understand would be a useful twist. It also feels weird to me to say that many words together when someone is trying to tell me something, like it interrupts the flow *a lot,* but maybe that's the point that the flow is not going someplace useful if it goes without me (in some cases).

This situation also makes me think about what I have said to people 100 times since getting leukemia, "I thought I was empathetic before and pretty good at understanding what it might be like for patients, but it turns out that there was a lot I didn't get." Now, I am wondering what in daily life I'm not "getting." Like, I think I'm pretty empathetic and good at imagining what the world is like for those I interact with, but maybe not. It seems the rift around each of us might be bigger than I previously thought, but also may be more easily breachable than I imagined. Hmm, by using myself as a bridge for those of you who do not mind topologically impossible metaphors.

May the gap be minded, noted and crossed.