
If you have been following my blogs, it is no mystery that I am preoccupied with the emotional aspects of healthcare. Throughout much of my writing I refer to the ways in which we can better care for patients, care for staff, and give care towards each other in medicine. What I want to talk about today is the importance (and nuance) of maintaining our emotional well-being in what have been referred to as harsh environments such as the intensive care unit (ICU). Relationships are the cornerstone of all of our lives; they exist everywhere and make up the bulk of how we function as individuals. A hospital unit is no exception to this, as staff navigate their day-to-day lives by speaking with a multitude of patients, patient families, providers, a variety of strangers, acquaintances, and close friends. I feel that sometimes this fact is taken for granted, the idea that relationships are so prevalent for us, and also their importance. How we interpret and digest these interactions with others can hugely shape our emotional wellbeing.
In my own relationships, I have learned many valuable lessons, but two very significant realizations have stood out to me at this point in my life: firstly, I am more aware of how the things I do (sometimes unknowingly) can affect people on deep levels that I did not expect; secondly, that the reverse is also true, someone can act in a way that they might consider to be rather innocuous, yet their actions have deeply affected me. I was recently on the receiving end of what I will refer to as the “silent treatment”, a tactic that is punishing and meant to send a strong message of disapproval. Children who receive this from parents apparently would much rather be yelled at than ignored, as the effects of silence can leave them feeling unworthy and utterly unloved. It is a small act (i.e. choosing silence), a non-act you might even call it, but it is one that hurts. Adults, unlike children, are able to decide that they are still worthy of love or decide to let it go, but that does not mean these experiences are easy for us or are not similarly painful and damaging.
Gathering a sense of self-worth internally, a sense that is strong enough to combat outright acts of neglect or harm towards us, is something that we all struggle with. The ultimate goal is to feel so secure in oneself that we are unmoved by others. In other words, we become so deeply in-tune with our own sense of self that we gain a personal understanding that we are worthy of being cared for no matter what anyone thinks of us or does. We must literally be the loving parents we may have never had as children, inside of our own minds. This means not criticizing ourselves so much. We usually look to others for approval of how we are being in this world, when really, you are the only one who needs to approve of yourself. We can never expect others to do this work for us, because other people are fickle! We cannot truly rely on anyone to give us reassurance and approval, and this isn’t their job. Their opinion should not matter anyways, because often those we are looking to for love may not have any to give. These individuals may well be looking for acceptance from others, just like you. We have to be our own advocates, but I can say with confidence that every single one of you is worthy of being cared for, no matter what.
This concept, that self-care requires a strong sense of self and compassion for ourselves, made me wonder whether our experiences could still be aided by a bit of empathy from others? We can never demand that others treat us with kindness, but I would like to inspire (in all of us) both the strength to care more deeply for ourselves and for us to become more aware of what we are dishing out. I truly believe that we “get what we give,” as the New Radicals say. A lot of people believe in Karma or will say things like “what goes around, comes around”. I believe that there is a direct and tangible relationship between the way we act (or how we are feeling) and the behavior that we draw out of others. For instance, when I am feeling defensive and fragile it doesn’t really matter what people say to me; it’s going to be interpreted as hostile or possibly critical. This is a good example of how we are responsible for our own feelings, which are not intentionally caused by other people. The way we feel is a direct result of our thoughts, based upon our internal understanding of the situation. The other person may have no idea they have caused us any harm. A defensive and moody disposition can also be sensed by the other person, and may cause them to be similarly defensive.
Despite the excellent care, the wonderful people, and the resilience that exists in hospital environments, I still witness a lot of dysfunctional interactions. I still see people choosing to ignore others, exclude people, lash out or yell, gossip, and disrespect others in a variety of ways. My question is: have we not learned how these actions deeply affect us all? We have all felt the lesser emotional responses of being annoyed, somewhat miffed, slightly aggravated; we have also all felt the larger sting and pain of feeling completely left out, outright abused, or completely wronged. The Beatles were not just making groovy music in 1967 — their lyrics to All You Need Is Love carry simple wisdom and knowledge. We have all felt the healing sensation of when someone touches our heart, the lightness and ease we gain, as love melts away all suffering without any words or need for understanding. You deserve to be heard, you deserve to be supported, and you deserve to be cared for, and I urge you all to start with yourselves.
The term love is synonymous (for me) with the term “care”, which I use so often. I have said before that care “involves everything we do”. Well, care should also be reflected in everything we think, say, and do. If my mind is set on judging others, it is likely that I am harshly judging myself by those same thoughts. Love and care should be embedded in the minutia of every part of our day, not only because that is part of having a deep respect for yourself, but also because it is what others deserve. The profound effect of therapy dogs, donated blankets, donuts in the lounge, a smile from a coworker, and a hug from a patient’s family member, are all simple acts of care and love. Can we imagine a hospital unit that is dedicated towards putting these tenets first, how we might all feel? There are no limits to what we can achieve, only the limits we place upon ourselves. At the level of the individual, you will be surprised to realize that once you decide to set boundaries for yourself and nurture your own needs and moods, you will often not notice anyone who is not feeling as good as you are. Being kind to yourself benefits YOU, and then because you have first securely fastened your own oxygen mask, so to speak, you can better assist others with theirs.

Flight attendant photo via flightdelaypay.com.