There are multiple levels of tired. This is something I’m finding. There’s plain ol’ run of the mill body tired, where you’ve worked too much, or stayed up too late, or been in the sun too long. Then there’s mentally tired where you’re just overwhelmed again and again until you have such fatigue of learning things or analyzing things that you need some brain rest before burnout sets in. Then there is emotionally tired, which is when you’ve had to feel all the things and you just can’t feel anymore and the numb sets in. 

When you’re body-tired, you sleep. You rest. You do things you like to do. You recharge. When you’re mentally tired, you read trashy novels (like Janet Evanovich. Don’t judge me), or you binge on Netflix and cookie dough. When you’re emotionally tired, maybe you can unplug, cut out toxic people, do some yoga. You find solutions. 

But what happens when you’re soul tired? When the emotional has given way to the mental, and the mental has given way to the physical, and you’re just soul deep tired. No amount of sleeping, or shopping, or book reading, or movie watching can fix it. I’m pretty sure that’s where I am. 

I have always prided myself on being a strong person. Someone who can take care of herself and other people and never show when you’re scared or hurt or uncertain. Those feelings aren’t productive. I have always considered them signs of weakness. I think that is part of why I was drawn to medicine. I had this desire to be the healer rather than the victim. To understand why things happened rather than assume they were the result of some uncontrollable force. I wanted to take out the fear that comes along with loving the ill. I have centered my career and maybe even my life around this desire. 

What I didn’t anticipate was the emotional distance from people that this creates. How you automatically shift into data gathering and interpretation when the ones closest to you are sick. And how the fear doesn’t go away, it just disguises itself as problem solving, as if failing to give into your fear means that it’s not a ubiquitous presence in your mind, right next to the false sense of control you have cultivated. You condition yourself not to cry, not to hurt, not to hope. Just gather the facts and accept them as they are and move forward with wearing your poker face. If you display any evidence of the uncertainty you might feel, the people around you lose faith and crumble. And so you let the weights pile up, and you compartmentalize until your brain and your soul feel like a self-storage center. And you forget to just be a presence for them instead of trying to fix things.

That can only last so long. For me it lasted through 5 deaths and one on-going severe illness. But there is no one who can sustain, long-term, this robotic existence. It doesn’t account for the human side of things. It doesn’t take into account how you trade relationship for some semblance of control over fear. It doesn’t factor in that the only way to make sound decisions as a healthcare provider is to remain objective, and that the only way to remain objective when your family is on the line is to distance yourself. 

And so, you create the distance, mile by mile, until you are so far away from anyone and everyone that you can barely see them as a speck on the horizon, and you finally stop running long enough to catch your breath, bent over with your hands on your knees, wringing with sweat and desperate to feel something, anything, other than this tightness in your chest that comes from running and breath-holding and forgetting how to just be with your people.

This works for a while. Until you bottle up things for so long that you spew all the contents of your soul onto innocent bystanders like a 2 liter Dr. Pepper that fell off the tailgate when you were unloading the groceries. (Not that I have any experience with this). And just like you can’t put the Dr. Pepper back in the bottle, you can’t unsay the words or uncry the tears or un-slam the doors. 

So far the things that I have learned are that feeling all the things is more courageous than the numb. Accepting support from other people instead of being the strong one might make you feel pathetic, but it also makes you feel held. Staying when you want to run away might make you feel trapped, but it can also make you feel loyal. And being honest is harder than being nice but it might make you feel free. My soul is still tired, but I’m working on it. If I figure out the rest, you’ll be the first to know.