On the beauty of the thorns

Jill Gilbert, MD, discusses pandemic fatigue, loss of connection, and frustration over the collapse of the social contract.

For someone like me who grew up in New Orleans, New Years has always been a big event, celebrated with kale (for luck) and black-eyed peas (for prosperity). The new year was a time of hope, a time to imagine a better tomorrow.

It also marked the approach of Carnival, a time to enjoy life and all its glorious frivolity. This New Year, however, felt more like groundhog day. Although case counts are slowly decreasing and governments at all levels are revoking mandates for masks, hospitals are still struggling. COVID-19 is still killing people who don’t have to die – more than 6 million worldwide at press time.

I myself am experiencing the pandemic fatigue, the loss of connection and the frustration of the collapse of the social contract. When polio and smallpox vaccines were developed in the middle of the last century, people recognized that the good of the whole depended on everyone doing their part.

Unfortunately, the politicization of COVID-19 vaccines has overturned the social contract. The so-called right of individuals to endanger not only themselves but all others is demoralizing for us who have dedicated ourselves to healthcare. I suspect many of you think the same way. However, our patients still need care and, above all, compassion, even when we feel we have very little to give.

Towards the end of 2021, I needed … something, even though I wasn’t sure what it was. My mother-in-law provided much needed credit when she gave me a holiday gratitude journal. This diary asks you to record and reflect on the positive things you experience every day. Over time, this practice allows you to recognize the natural ebb and flow of life events and change the way you perceive them.

My mother-in-law thought of this gift after visiting us in November when I was having a hard time. I thanked her. I also thought, “Who has time for this?” The diary stayed on the kitchen island for 2 weeks.

Then, one day, a colleague said that gratitude helps him get through difficult times. Synchronicity hit me and I took the diary.

I soon realized that putting pen to paper allowed me to contemplate the fullness of life rather than just the negative moments. Writing my thoughts gave me perspective. When I find myself focusing on the negative, it helps me understand what 19th century French novelist Alphonse Karr meant when he wrote: “Some people complain that roses have thorns. I am grateful that the thorns have roses ”.

So how does this apply to you? Many of us, myself included, have the unfortunate habit of thinking in binary terms, especially when we are tired or stressed. It can be difficult to find a middle ground in those moments.

Right now, if you’re finishing your first year of scholarship, fatigue is starting to take its toll. You may also wonder if this scholarship or institution was the right choice. I urge you to write one thing you are grateful for every day. This can restore your perspective and you will see that life, in all its confusion, can be beautiful.

Recently, a young patient of mine who has a terminal illness told me that he wished to die in Medina, the second holiest city in Islam. That evening I wrote in my diary what a gift it was that he had asked me to accompany him on this very personal journey.

Before the diary, I would probably have focused on the fact that my patient was dying and succumbed to the sadness my career can bring.

The diary gave me time and space to reflect, to accept that nothing is perfect or binary. I can often, if not always, find something good among the bad guys. My hope is that, having cultivated perspective, the thorns of this world will lose some of their sting and I can replenish my spiritual reservoir and renew my compassion.

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