Coping strategies

There are lots of things I want to say today, but I am not so sure if I necessarily have the eloquence to put all my thoughts and emotions into words. Nevertheless, I am going to try.

I got upset yesterday, very upset in fact.

Normally, I get Monday mornings off to attend the regional Anaesthetic teaching for intermediate trainees in the region. In the 2 months at my current placement, this has not been a problem so far… This coming Monday, I am due to attend my ARCP (Annual review of competence progression) with the deanery heavy-weights. This is an important meeting, which I am invited to attend in order to justify to the deanery that I have made enough progress this academic year and should be admitted into the next level of my training without need for remedial training. Seeing as the time of my meeting falls in the period of time when I am normally off for teaching anyway, I did not think much about informing the Anaesthetic secretary about my ARCP. Besides, there have been too many things happening in my life recently that my ARCP has been the last of my concerns (another bout of palpitations, co-ordinating my appointment times for my 24hr tape, revising for my exams, going on the advanced trauma simulation course…).

On Thursday, I received the rota for what I’m down to do at work next week… Sod’s law states that the department will be seriously lacking in Anaesthetists on Monday. And so, the natural thing was for them to say “you can’t go to teaching this Monday morning, come to work as we have put you on a solo list– you will do some service provision that day.”

Now, normally I would not argue about being occasionally used for service provision. However, the ARCP is an important meeting in my training and I know that I am entitled to attend it. I broke the news to the Anaesthetic secretary yesterday morning- I apologised for not having told her about the meeting in advance, but also explained that I did not think it would be a big deal as I am normally off to teaching on Monday mornings anyway. BUT OH THE BROUHAHA THAT FOLLOWED! She got so mad at me and said that I should not make such assumptions. She said that she could not possibly cancel Monday morning’s list, and that there are no other Anaesthetists who could cover. She went off in a huff to complain to the clinical director.

The whole issue was finally resolved when they asked if one of my colleagues who would be working over the weekend (and should thus be off on Monday morning) would come in to cover the list. He agreed to the locum and that was it, *bam*, problem solved. Nevertheless, the secretary kept giving me such dirty looks. She then came to me and said “E wants a word with you.” I knew I was in trouble. I went to see E (the clinical director) in his office upon being summoned. He was so rude to me in that he did not even so much as lift his eyes from the computer screen throughout the time he spoke to me. He kept saying that what I did was “not cool, just not cool.” He was disapproving and annoyed. He even dug up an issue from the past regarding another colleague and his ARCP (This other colleague needed to go for his meeting but was on call. Similarly, there were simply not enough people to cover him for the time he needed off to go for his meeting. E had asked if I could come in on my day off to cover the shift, but I had to say no as I was on study leave to go on a course that I had booked onto over a year ago and paid £300 for!). I was so angry that he had tried to use that against me- you asked me if I could cover, and I told you I could not because I am on a course! It was not as if I did not agree to it because I did not want to, I DIDN’T BECAUSE I COULDN’T!

So anyway, E (still not looked up from his computer screen for a second) then waves me away and says “forget it, that’s the end of it. It’s ok now.” I did not know what else I could do, so I apologised profusely to what I assume to be deafened ears. I felt so helpless. I knew that it was my fault that I had not informed the secretary about my ARCP. I knew that this grief was all potentially preventable if I had some common sense. I knew that it was my fault. BUT I APOLOGISED! Is it so difficult to accept my apology especially when the crisis is now over? I was so freaking upset because I had upset these other people.

And so I felt rotten for the rest of the day. When other Anaesthetists came to ask me what had happened, I just could not control my tears and just started weeping. I remember that there was a patient (awake, under a spinal anaesthetic at the time) on the table and I had to ask the anaesthetist I was speaking to to watch the anaesthetic whilst I excused myself to go outside and calm down. To be honest, the way E and the Anaesthetic secretary treated me made me feel like I had let the whole wide world down. Come on, so I forgot to tell you that I needed a morning off for an Academic meeting– why did you have to make me feel like I had committed some kind of abomination?!

In all my being upset-ness, I do think I have my personality to blame as well. I don’t know why and who I inherited this from, but I feel guilty about anything and everything all the freaking time. I feel guilty when I’ve done something wrong, and even when I have done everything right. I feel guilty when I upset people, and feel awful when other people upset me. In my stupid head, I weave stories and remould truths so that the finger of blame always points back at myself. I have had to actively remind myself not to apologise for nothing, not to say sorry for the times when other people are at fault.

I have since been working through my coping strategy. The same coping strategy that I automatically employ whenever I get upset. I go through the same stages, in the same order until I finally feel normal again. Every single time.

Stage 1: Sadness and disappointment. Often accompanied by an overwhelming sense of irrational guilt. Regularly summons tears. Often resulting in swollen eyes, a blocked nose, and a self depreciating remark along the lines of “you are useless!”

Stage 2: Anger and self defence. I see red before my eyes and my heart turns over in its fury. Almost always accompanied by a tirade of cussing and abuse (in my own presence only). I start thinking of come-backs I should have made, reasons to defend my case, things I could have said to put that person back in his or her own place. I am a wild, angry and hurt animal. Steer clear or run the risk of being bitten.

Stage 3: Avoidance and silence. Directed towards the people who have upset me. I am not ready to talk to you or look you in the eye yet. I am still angry and upset, but no, I will not confront you about it. Leave me alone, I will engage with you again when I am ready. Commonly known as the cold shoulder.

Stage 4. Resignation & acceptance. Nothing else can be said or done. It is the way it is and it sucks. Get on with it and try not to get in the same situation again.

Stage 5. Letting go or escapism. Letting go, however, does not always translate to forgiving and forgetting. Escapism: Let’s not talk about it anymore. No really, I don’t want to broach this subject ever again.

I am at stage 2 at the moment.

I know that my coping strategy is not the most effective and healthy one of all. I know that God is probably shaking His head in disapproval of the anger and the cussing, of the letting go but not forgiving. I know in my head that darkness cannot drive our darkness, only light can do that; I know that hate cannot drive out hate, only love can do that. I know that God demands me to forgive. He set an example and expects me to mimick it. He forgave me when I still hated him, and continues to forgive me as I continue to hurt him and make him sad. But how hard it is to do so! My sinful human heart is soaked in bitterness and malice. It wants to be selfish and desires to hurt the people who first hurt me. I am pulled back and forth all the time– forward towards kindness and mercy by the wings of God’s angels, yet backwards by the shackles of sin that tug so painfully at my ankles.

21 So I find this law at work: Although I want to do good, evil is right there with me. 22 For in my inner being I delight in God’s law; 23 but I see another law at work in me, waging war against the law of my mind and making me a prisoner of the law of sin at work within me. 24 What a wretched man I am! Who will rescue me from this body that is subject to death? 25 Thanks be to God, who delivers me through Jesus Christ our Lord!

Romans 7:21-25

May the Lord help me.