Over a
month ago I published a pretty personal post here about the unpleasant
experience of going through burnout and the practical measures I
was undertaking to deal with it. As a number of things have happened since, I
thought it was time to write an update.
After six
and a half weeks on sick leave, I went back to work last Monday. It wasn’t an
easy decision to make. The enforced pause certainly helped me to clear my head
– to an extent, at least – but the renewal of energy, a “recharging of the
batteries” which I had hoped for, didn’t seem to be happening. I spent much of
the time sitting at home, reading a lot and the normal, unthinking energy which
was available to me for so many years for doing all the myriad things from
housework, to visiting friends, to managing all the basic affairs of everyday
life, to writing didn’t really kick in. Oh, I did manage to do the most
necessary things and even a number of other things which weren’t strictly
necessary but everything was still shaded with a heavy patina of effort; the old lightness which I had
realised I had lost and the loss of which had so shocked and pained me didn’t
appreciably return.
Very well,
I thought to myself, taking time out hasn’t been the panacea I had hoped it
would be. Panaceas rarely are all they are cracked up to be anyway; cure-all
nostrums are usually the province of snake-oil salesmen and the treatment of
suffering in something as complex as the human psyche is also likely to be
complex – a process involving various elements in dynamic relationship with
each other and needing time and space to develop. I had started taking
medication, I’d begun a process of therapy which will (if all goes well and my
health insurance can be given the proper signals to get them to finance it)
grow into a longer phase of classical psychoanalysis, I had discussed my
situation with professionals, family and friends and had productive talks with
my employers concerning certain negative aspects of my concrete work situation.
Now the time had come to take the next step, to climb back on the horse from
which I had fallen.
And so –
not without a large dose of trepidation – I went back to work. One of the
changes I had negotiated with my employers was that I will, for the foreseeable
future, be exclusively assigned to work in the new project we are developing; a
middle-term residential group for the care of very sick children (sometimes
accompanied by their mothers), who are in need of continual, often high-tech
medical support in order to continue their healing process, or just to go on
living. At the moment, the group is composed of four children (aged between six
months and eleven years) and two adults (who are only there temporarily, these
places to be ultimately available to children as well) in temporary,
provisional accommodation. Permanent, custom-built quarters are presently being
completed and we will be moving in there before the end of the year.
Six
patients all in need of extensive, complex, permanent, time-consuming intensive
care, with two nurses always on duty; there is plenty to do. The first
twelve-hour shift saw me exhausted at the end but it was a good kind of exhaustion – that kind of tiredness which comes from
having worked hard doing tasks which offer a sense of immediate value and
worth. In the course of the week I found myself quickly adjusting to the
physical demands of the job. And I realised that the enforced pause had, in
fact, done more for me than I had thought. I found myself better able to cope
with the various time-consuming idiocies enforced on anyone working in any of
the over-developed, over-regulated, under-staffed, under-paid, misfinanced
lunatic complexities which are a characteristic of health-systems all over the
world. The senseless bureaucratic and administrative hurdles which
independently uncontrollably burgeon in any system beyond a particular level of
complexity, which would have had me seething with frustration a few months ago
(this itself a symptom of the fact that I had gone way beyond my own tolerance
levels), I could now accept with a lot more serenity as part of the inevitable Catch 22 reality in which all of us in our mad modern
society are more or less caught.
I am not cured – this will be a long journey, and
relative health and sickness are always just a snapshot of an instant in the
constant complex dynamic interactive process which is life anyway. But I find
myself seeing things more positively and see grounds for hope that my basic
levels of essential energy will increase in the doings of things rather than
waiting for them to grow so that I can do things.
I decided
to be basically open with my colleagues (without going too much into details)
about the reason for my absence. I received unexpected support for this during
the week. The manager/trainer of one of the most prestigious Bundesliga soccer teams, Schalke 04, Ralf Rangnick, resigned his
position last Thursday with immediate effect. The reason he gave was the
spectacular, honest admission that he was suffering from an exhaustion and
burnout syndrome. While, as with most news items in our high-speed,
media-driven world, it will be a seven-day wonder, such public announcements do
help the process of bringing various manifestations of mental suffering and
illness into the realm of more serious open discussion and further the process
of dismantling taboos, clichés, speechlessness and misunderstandings about such
issues which are widespread in our societies.
Returning
to work, I discovered that others had very different difficulties to deal with.
I have written about Jenny a number of times here before. To recapitulate:
Jenny is a three-year old girl, who is deaf and dumb, suffers from a partial
facial paralysis, a dangerous weakness of her respiratory musculature, an
inability to swallow and some balance and coordination disturbances. As a
result, she has a tracheotomy tube in her throat and spends long periods daily
on a respirator. She is also very intelligent and extremely lively.
Complicated
gene tests have confirmed a couple of weeks ago that Jenny suffers from something
called Brown-Vialetto-Van Laere syndrome. This, of course, means nothing to
her, but it tells us that her prognosis is very bad as the general course of
the illness is progressive.
Jenny was
dealing with two much more urgent problems. A month ago, my colleague Jan, who
was the member of our team who had the deepest relationship of us all with her
(in a very real sense, a replacement father-figure), suddenly and completely
unexpectedly died in his sleep. He was two years older than me. At exactly the
same time, Jenny contracted a very serious case of pneumonia, which
necessitated a stay in the Intensive Care Unit in our local hospital. Given the
fact that she is living with a hole in her windpipe where nature never intended
that a hole should be, this is the kind of thing which can happen; it almost
certainly won’t be the last time. When she returned, it had to be explained to
her that Jan would never be coming back.
She has
understood that and – we think – she has accepted, according to her own
categories, that he has not abandoned
her. But she misses him and suffers from his absence.
She greeted
me like a long lost friend (which, I suppose, I was to her) and seems to have
transferred some of her fixation with Jan to me. She stuck to me like a burr
all week long, appointing herself my assistant nurse and accompanying me when I
went to the other children to take care of them. This has been made somewhat
more complicated by the fact that she needs extra oxygen all the time at the
moment, so that I spent a lot of time lugging her oxygen tank with me.
For the
events of the past weeks have weakened her. After a maximum of four hours, the
effort of breathing independently has so exhausted her that she has to be put
on the respirator for a couple of hours. Her continence – which she had
achieved shortly before the illness commenced nearly a year ago, lost then and
won back again in the past six months – has taken a hit. This annoys and
embarrasses her, but she’s got enough determination to get it back once more. And
she retains the capability to put all of her intelligence and creativity into
continually working on marvellously extensive and sophisticated communication,
despite her deafness and lack of speech.
Given her
confirmed diagnosis, we are haunted by the dark suspicion that she may have
already seen her physical zenith. Perhaps. But we shouldn’t write our prognoses
without figuring in Jenny’s determination and stubbornness. They are part of a
complex, fascinating personality which makes her occasionally amazingly
frustrating but more often supremely rewarding to care for – sometimes simultaneously!
Engaging
with Jenny has, at any rate, done me good. It is an intense, positively
strenuous relationship which, in the way which children determine, takes place
primarily on the emotional level of the ever emerging now. A condition which leaves very little room for depression. And
for all that I am deeply thankful to my young friend. Having climbed back up on
that horse, I sense that I am not alone; Jenny is there too, sitting in front
of me.
Though the song seemed appropriate to me anyway, the fact that David Coverdale celebrated his sixtieth birthday this week makes it even more so.
Pictures retrieved from:
