We are in this profession for a reason: we care. Maybe we care too much at times, although I am not sure that is possible so long as you stay within ethical codes and set good boundaries. My point is that as clinicians we do what we can to help others and that means that we have a tendency to be selfless at times. But at what point does this stop? At what point do we put ourselves first?
A few months ago I had a bad week; a really bad week. In the course of a week I lost a loved one, my beloved and up to his death, healthy dog collapsed and died in my arms and I learned that a dear friend of mine died while I was in session. Someone after the fact said that “your life was a county song last week, even your dog died.” My friends, like me, have weird senses of humors.
I learned of the relative’s death just as I was opening my door to get my next client (I prefer not to call them patients). My relative had been ill for years and I had not seen them for some time but it hurt. A lot. She had been a very important person in my life and now she was gone. I put on my “doctor face” and opened the door with a smile and started the session. The rest of the day was uneventful and it appeared that no one was the wiser as to how I felt though I may have been a bit more nostalgic or reflective in sessions; who can really say? I do know that no one said anything to indicate that I appeared distracted or otherwise less than normal.
A few days later I was doing yard work for a bit and sneaking away into my office during breaks to catch up on paperwork. I heard my “Brucie” doing his usual break neck run up the stairs followed by what would either be fast circles on the rug or him running up to his basket and pulling out a toy or two to play with, only something was wrong. Instead of the sound of tearing across the rug or the sound of his huge bone flying in the air (90 pound American Bulldogs can be very loud at play) I heard a dull thud and simultaneous pathetic sound yelp followed my my wife screaming. Running up the stairs I saw him there legs splayed painfully, tongue hanging out, eyes dilated and fixed. I knew he was dead or dying but I refused to admit it. I tried my own version of doggie CPR only to watch that last pulse come from his heart, followed by the involuntary spasms of the muscles finally at rest. My valiant trip to the pet hospital was to no avail. For 13 years he was a regular part of every day, now he was gone. Even the office felt weird come Monday.
My clients knew Brucie, well not really, but they kind of did though my examples; through my real world stories during therapy. Some “knew” him because my home is the floor above my office and if everything was silent, if you listened softy, intently, you could hear him snore just above my office. A few clients heard him from time to time through a silent pause in the session, sometimes followed by a “what’s that noise Doc?” It took me weeks to tell any of my client’s that the office mascot had passed away, and then typically after a query such as “what happened to the dog run that I used to be able to see through this window?” I acted calm in those occasions and simply told the client that our mascot had passed and it did not seem appropriate to keep the run without a dog to use it; we have no plans to replace him.
A few days later a client was looking for a job and I thought I may have had a lead for them. No big deal, just a possibility of a part time job. I gave the name of the store and who they should ask for. The client, never one known for their tact replied something along the line of “I don’t think she will be hiring anyone anytime soon Doc. According to the paper today she’s dead.” I was stunned and asked them the full name that was in the paper (I had given them only her first). The client was correct; my friend has just passed away. This was the second time in a year that I learned of a friend’s death while I was in session (I live in a small enough community that there is much overlap). Stunned, hurt and aching inside, I mustered a palliative “that’s a real shame. She was a great lady who had beaten Cancer in the past but I guess this time it was just too strong. You are right, they likely will not be hiring any time soon.”
I limped through the session, exploring other leads for the client and doing whatever else was necessary. We even went over a bit on time before I lead them out of the office with a warm smile, I think a joke, and a wish for a good week. After I heard the outer office door close I entered my private office, closed the door and had a short but productive cry before completing some paperwork and calling it a day. Thankfully this had been my last of 10 hourly sessions that day.
The following day I was supposed to be at a conference, serving as an assistant to the President of the organization (I was the President Elect) but I called out. She understood that I needed a day to decompress. I elected to take the day off and clear my head. Though too late in the season for good boating, I was determined to take my boat out on a lake, listen to my Zune MP3 player and read. I awoke the next morning to a broken pipe in the office that I had to fix and did not get my boat in the water until 2:30 in the afternoon. I did manage to listen to music for an hour or so (I had unbreakable plans in the early evening) and to break my prop on a rock; not exactly the rest I had in mind but still valuable. My week was a country song indeed, or at least a Ziggy cartoon.
The next day I was back to work helping others as I could. It took a month or so before I could shop in the store again but when I did it was good to see the rest of the family hard at work.
Years ago I heard an overhead page at work for a colleague who was supposed to be having surgery. I called the front desk to tell them of the error. She acted strange and hung up. Minutes later the clinical staff were called into the large work room and informed that Doctor Lenny had been found dead after not making it to his scheduled surgery. Some employees were allowed to go home, others “needed time to clear their heads” before going back to work. I was one of those or so I thought before the director pulled me aside as I was leaving the room. I had been picked to go brief and provide services as needed to the patients in the program. She advised me that they were now being assembled in the group therapy room but that I could walk slowly to it if I needed a minute or two to collect my thoughts. She offered this because she knew that he had interviewed me for the job originally and had been a work friend every since.
The purpose of this blog was not to be a downer, or to say look at me, I had a tough week awhile ago. We all have had tough weeks, I get that. There is a real disconnect in our job in that while we spend our days and nights encouraging our clients to show and talk about their feelings, we as clinicians are expected to be professional at all times; even if this requires unhealthy stuffing and hiding of emotions. There is a good rationale for this to be sure, but is it realistic to think that we will always life up to this standard? If we do live up to this standard, does it risk us looking like robots or hypocrites at times?
As a clinician, how have you dealt with such issues during therapy time? Did you end the day, share with a client, or use another technique? Have you dealt with the loss of a co worker? I would love to know.
Warren Corson III (Doc Warren) is a counselor and the clinical & executive director of a community counseling agency in central CT (www.docwarren.org).