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Modern love: Nursing a wound in an appropriate setting

By Thomas Hooven
New York Times
MODERN-LOVE-NURSING-WOUND-NOV15
Brian Rea for The New York Times - Brian Rea

I started my pediatrics residency on the cardiology unit, which was appropriate: My heart had a giant hole in it. Just after I graduated from medical school, as I was moving into my fiancee’s New York apartment, she ended our relationship. We went out to dinner that night, and after we came home she told me we were through.

She and I had been together 12 years, engaged for two; we had a wedding planned for three weeks later.

“I can’t believe you’re doing this,” I said from the edge of her bed.

“I know we’ll always be best of friends,” she said.

I left just after sunrise, suitcase in hand, feeling as if I had just fallen from a moving train. It seemed unimaginable that I was meant to report for duty at the hospital in less than a month. My new employers were expecting a freshly minted physician full of knowledge and an eagerness to heal. As it was, I could barely remember my name.

I took a cab to the airport, booked a flight to my father’s house in Minnesota, and stayed there until it was time to limp back to New York to start my residency. I spent the hour that was supposed to have been our wedding ceremony sitting in the crook of a tree, staring at the suburban horizon. The evening was silent. The weather was perfect.

The loneliness inside

After returning from Minnesota, I moved to a marginal block in a neighborhood of highway access ramps and overpasses. Plastic bags blew along the empty streets.

Brief walks to and from the hospital and solitary meals with dust motes swirling in my sparse living room were all that interrupted the otherwise constant blur of rounding on patients in the dim morning hours, writing hundreds of medical orders, and updating parents who ranged from frantic to silently resigned.

There are rules about the number of hours a training physician can work in a hospital, but the limit remains high: 80 hours a week. When done back to back, and filled with children suffering from complex illnesses, weeks like that tend to metastasize, leaving room for nothing else.

When I started my work as a doctor, it took every bit of concentration to put aside my private sadness and focus on my patients. I was lost, and it’s a wonder I didn’t hurt anyone. In moments of downtime, and especially in the depths of night when the unit was quiet, memories of my ex and my longing for her would overtake me. Like a persistent virus, loneliness lived inside me.

At the end, surrounded by cardboard boxes we had spent the day hauling into her living room, I asked over and over why she was leaving me. She couldn’t articulate a single reason.

It seemed the most brutal response possible.

Now, more than five years later, her response seems less surprising and more diagnostic of why we failed. Our relationship had never developed the vocabulary necessary to express the many colors and intricacies of adult emotion. We had no language for negativity. She must have sensed that, and realized we were headed for serious trouble.

Healing comes slowly, but it comes. A budding pediatrician must observe lives cut inexplicably short - the 14-year-old girl with cardiomyopathy who had a heart attack before my eyes and died staring at the ceiling. But he or she is also privileged to witness how most gravely ill children overcome or bypass their challenges. They mature. They become wrier. They pick up idiosyncrasies. They smile despite themselves.

My patients and I also healed together.

For me, healing started through a desire to be a better doctor. The drive to improve my skills as a physician - to recognize diagnoses, know disease mechanisms and determine the correct treatments - buoyed me and eventually pulled me out of my sorrow. The long days that were at first such a Sisyphean cycle became a new refuge. For a time, the study and practice of medicine was my only and perfect partner.

From pain, understanding

My ex and I are not in touch. Our relationship, so long in the making and so quick to end, was like an ornamental piece of crystal: aesthetically pleasing but lacking resilience and, once shattered, irrecoverable.

Looking back at the various romantic (and not-so-romantic) dating experiences I had afterward, it’s hard to separate my growth as an emotionally conversant partner from my development as a capable physician. Both happened simultaneously and gradually, through stretches of triumph and sorrow. There were no “eureka” moments. And neither ever really ended.

The turmoil I experienced as an intern left me with a deeper understanding of how pain works: how it feels, how it ebbs and how it leaves you less naive. I also learned to open up to important facets of life that my previous relationship had locked out: unhappiness, uncertainty, regret. Comfort around feelings like these is crucial in both medicine and intimate relationships; it’s the basis of empathy. I didn’t understand that before my ex left me, and I learned it the hard way.

By the time I met my wife, I was a changed man and a real doctor. And our love developed differently from any I had experienced before. Less like a crystal vase, more like a basketball, our relationship is made for bouncing - for the good and sometimes rough play that modern professional lives generate. We do have fights, but they do not threaten our foundation. They deepen it.

I would not return to those difficult and lonely days any more than I imagine my young patients, now grown, would return to the wards. But I would not choose to have avoided that experience, either.

Thomas Hooven is a pediatrician in New York.
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