Writer’s block. I have it. I can’t make myself write these days. Maybe it’s because I’m always tired. Maybe because I’m always busy. But that’s not true, is it. When I’m not busy, I don’t do anything for me. I don’t prioritize what my soul needs. Maybe it’s fear – when I write, I can go quite deep and these days, deep hurts. Between the divorce, single parenting, my mom’s injury, my dad’s deterioration, work, financial stressors, living in a mess of a house, etc – it’s all too much. It’s hard to let myself sit, and open the floodgates for the inevitable maelstrom to wash me away.

This week, I joined an online writer’s conference that is going to explore motivation and the obstacles in the way of writing. It’s just what I need, and right now there is a “write-in” session – an hour of sound-off zoom time with over 150 writers all buckling down to write. No prompts, no guidance, just time. Writing time.

So here goes nothing.

Last night I drove home at 2 a.m., from a particularly busy and exhausting evening shift. Work is really hard these days, because our volume in the ED has been exploding. It’s hard to know why, but the sheer amount of new patients coming in is overwhelming. Not only are there tons of patients, but many of them are actually quite sick, or quite complex, or both.

For example, last night I met a nice elderly woman who came in for pain radiating down her left thigh. She has a longstanding lower back disc herniation (slipped disc). This can cause quite a bit of pain, especially radiating down the legs. She figured this pain was the same as the pain she had a few years before, just a bit worse. In the end, it was true that her spine had not really changed on the CT that I ordered; unfortunately, she also – incidentally – had a new cancer. That’s the thing about my job; as an Emergency Physician, I diagnose a new cancer almost every shift. Crazy as that might sound, it’s par for the course when I see so many patients every day. But imagine – you come to the hospital for one issue, only to find yourself sitting in a room with a stranger who is telling you that you have a terminal illness. I literally sometimes think of myself the angel of death half the time, seemingly condemning my patients to a future they hadn’t even considered when they woke up that morning.

I shouldn’t be so negative, because often my investigations save the patient’s life despite the horrible diagnoses that result. About a year ago, a friend of mine came to see me during one shift complaining of right lower chest pain. She figured maybe she pulled a muscle between her ribs while working out. I placed my ultrasound probe on her chest, then her abdomen, meaning to have a quick look at her lungs, gallbladder, heart and aorta, and ended up also checking both kidneys, liver, spleen and uterus. When I got to her right kidney, nestled below her beautiful healthy liver, my heart sank. I am not a radiologist, but having seen thousands of healthy kidneys over the past fifteen years, I know what an abnormal kidney looks like. And hers was markedly abnormal, with a huge mass protruding from it. A CT came next and confirmed that this young woman – barely older than  I was – had an enormous renal cell carcinoma (kidney cancer).  I rapidly organized a urology assessment, and within a couple of months she had surgery to remove the malignancy. Fast forward to today, and she is healthy as a horse, back at work, and smiling every time we cross paths. To her, I am not the angel of death – I am her guardian angel.

This is one of the paradoxes inherent in the work that I and my colleagues do. We assess, diagnose, investigate and treat; sometimes we save, and sometimes we condemn, and sometimes we end up doing a bit of both. The complexity of the emotional toll this takes on me and on physicians like myself, is hard to understand if you don’t do this every day like we do. I spent sixteen years married to a man who wouldn’t listen to any part of my day, who didn’t want to know about my life’s story, who was so scared of medicine and doctors (though married to one) that he shut me out. I spent my entire career until the divorce, coming home and not talking about my day. I kept it all inside, except for brief moments of release when I would find the time to write, like this. Now, three years post-separation and two years divorced, I still struggle to let the stories out. To let the feelings breathe. To give words to the pain I carry around all the time. I feel like a flower that was never allowed to bloom, like a tree that could never drop its leaves in autumn. Writing is an outlet for me, and sharing these tales gives me freedom, gives me purpose. It’s about time I got back to this, and started posting my stories again.