Joan Is Okay(34)

Bereavement?

A person only has one father.

I said I was aware.

Then were you not aware of the leave? It’s been a great initiative for our senior staff members with aging parents. We believe that even most well-seasoned health professionals should grieve.

I did know about the leave, I said, but thought it was optional.

The woman smiled at me again, but it could have also been a grimace. Despite her uneven eyes, she had one of those perfectly level mouths, of which the corners didn’t turn up or down.

Strictly speaking the leave was optional, as she explained, and could be waived for distant relatives, an aunt or uncle, a second cousin. But immediate family made up our core supports, our pillars, and those deep in grief, more or less lost in it, often don’t know how to feel about the death unless they take the full course of treatment.

I clarified that she was talking about bereavement and not an infection.

Bereavement is a wound, she said.

It was, but mine had healed. I’d worked through it already.

The woman took out a small tin of mints from her other blazer pocket and ate one. She didn’t offer me any mints and slid the tin back. In case it wasn’t clear, your month off would be compensated, and at your new elevated rate. You would simply be flagged as unavailable in the system. The time is meant for you to spend however you wish.

I said I wanted to be available at all hours. I felt that giving in to this request was giving in to pity, and my father wouldn’t have approved. He would have reminded me that there’s no such thing as a free lunch.

We see this a lot, actually, said the woman, crossing her legs. Doctors who refuse to rest as if it were a sign of weakness, but it’s not. Stopping momentarily to reassess, recenter, release—the three Rs—is actually a sign of strength.

I asked what would happen if I forwent bereavement.

Technically, nothing, she said, but we cannot guarantee absolutely nothing down the line. No one has refused leave once it’s been suggested, so should you pursue this path, you would be the first.

Beneath the blazer, the woman wore a yellow blouse that was stretched so tightly across her chest it reminded me of a cushion.

We are not trying to inconvenience you, said Yellow Cushion. We are only trying to help. Compared with other hospitals of our caliber, our attendings report being the most fulfilled. Research has shown that healthy attendings do better work and are protected from the forces of pettiness, internal competition, and deindividualization. This time is our gift to you. Consider it the hospital’s way of reaching its arms out and giving you a hug.



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MY LEAVE IN TOTAL would be six weeks, and that included the one month of bereavement along with two off-service weeks to make up for the many I had forgone. The leave was to start immediately on Monday, January 20, through all of February and the first week of March. Before Yellow Cushion left, she handed me a notice sheet with these logistical details bulleted out, including which attendings would be covering for me on each of the six weeks. The sheet was so unambiguous and well organized that it reminded me of one of my own handouts and I couldn’t get too mad. Then Madeline came in to pack up for the day and asked why I was just sitting there, holding a piece of paper and not facing my monitor again. I glanced at her. I didn’t reply.

Is it your mom? she asked. Oh my gosh, did she? Both parents back to back?

I said my mother was fine.

But your face, said Madeline. You look gray.

I felt gray, I said.

Doctors complained to each other all the time and to anyone else who would listen. The system is broken. Referring mostly to bureaucracy, insurance, the skyrocketing cost of care, Big Pharma’s focus on only lucrative drugs, the cost of medical training itself plus licensing, and the exorbitant salaries of some specialties like oncology. But who could have broken our own system if not us? And the system wasn’t so much broken as it was circuitous, self-blaming, and operating under false pretenses. A hospital is a business, and businesses like to make money whether that profit came from goods or the extension of human lives.

The medical system wasn’t perfect because no system is perfect, but I still admired it for being a hierarchical masterpiece of specialized skill. Moreover, how could a system be that flawed if it had allowed someone like me in?

Was I? I might’ve been—having my own moment of peak sadness like each of my residents and like Reese. But whereas they felt the training had stifled their personhoods, I relished that feeling of anonymity and of being a cog in the whole. So, what I was experiencing now was perhaps the reverse crisis, from having been repudiated by the group to be on my own. I could hear my father asking, What’s the plan, doctor-daughter, what’s the plan? I could feel the totally panicked doctor-daughter realizing she had no plan nor six weeks’ worth of person-y things to do.

When I continued to say nothing, Madeline felt my forehead and said I was a little warm. She plucked the notice from my hands and started to read.

Are you bereaved? she asked from behind the page, her eyes scanning line by line at an increasing pace.

I said I couldn’t be sure anymore. This all seemed too surreal.

Madeline then replied, slowly and softly, that she couldn’t lose me as well. Me and Reese. She couldn’t be on this side of the office alone after already committing to us as colleagues. When Madeline finally set the notice down, there was a look in her eyes, like that of a frantic gerbil about to go for a perilous sprint on a wheel. She knelt and turned my chair to face her. She expressed regret for what she was going to do, but she had to get her agitation out somehow and asked me not to take it to heart.