Don’t Try to Understand

One of the most overused, and I’d argue misused, terms of endearment is “I understand”. This phrase is almost always uttered after you’ve just said something that the other person isn’t sure how to process emotionally. I’m here reading a report about how physicians once again top the list of professionals most at risk of suicide. When I mention it to a friend, the refrain almost immediately is, “I’m not surprised. I understand why they’d be depressed.”

I can’t hold it against someone for wanting to sound empathetic and rationalizing something so profoundly difficult to grasp. One would assume it’s the weight of the job that drives the depression. But this line of thinking requires one to jump from A to Z while ignoring everything else. After all, many of the happiest and most career satisfied medical professionals are at no less risk to suicide. Happy doctors kill themselves too. I can’t even begin to unpack, appreciate, or pretend that I could speak for any of the medical professionals that took their life. I can say that there’s a lot more heaviness to the life of medicine than balancing life or death

I am now winding down my 2nd degree program, and the first of what will be two master’s in the medical field, 8 years into higher education and I am looking at least 3 more before I can even treat a patient. One thing is for certain, I’ll never be the same person I was 10 years ago. It’s like a fever dream, a flashback to a past life. So many pieces of my person had to be stripped, left, ignored, pushed aside but are never forgotten. Like a laceration that refuses to scar, it all rushes to the surface every so often…perhaps a repressed memory is the best analogy. It boils up unexpectedly reminding me all over again of what it took to get where I am, and how much more will be asked before I am done.

It’s hard to go through anything alone, without a shelter, but it’s harder still to have the refuge of a friend or lover become just another gear in the machine. In the chance that someone reads this with a genuine curiosity into the mind of this life or a similar profession, I’m sorry I cannot really enlighten you at all. This open letter is mostly a bulletin. A plea for the caregivers in your life, the people who’ve chosen a career that asks them to perform the most humanitarian acts while gambling with their own humanity. Don’t know what I mean? I can’t explain it.

I can’t explain to you what it feels like to choose nights at the library over reconnecting with one of the closest friends you ever knew, only to hear that friend passed away a few months later.

I can’t explain to you what it is like to wake up in sweats because of nightmares that someone died on your watch because you missed those two days in pharmacology class because you didn’t want to miss your best friend’s wedding.

I can’t explain to you what it feels like carrying guilt for every free moment that you don’t give to someone else.

I can’t explain watching everyone you care about grow up through photographs and digital videos.

I can’t explain what it’s like hearing your brother going through the hardest days of his life, and only being able to offer a 20-minute text conversation.

I can’t explain to you what it’s like having to pretend to have an honest connection with 50 people a day, only to simultaneously internally disconnect from every situation.

I cant explain what its like to worry you might one day forget how to connect altogether.

I can’t explain the crushing weight of everything I’ve had to let go of and will have to continue to give up knowing that if I stop now, then all of it was for nothing.

I can’t explain what it’s like hearing someone breakdown into tears at least once a day, asking for help with a pure vulnerability, and knowing that I can only answer with trite consideration

I can’t explain the fear that I may someday forget how to feel something, anything real.

I can’t explain that compartmentalization isn’t a real thing, that we’re wearing one mask at work and another at home, and sometimes won’t be able to hang up the mask

I can’t explain why I’d let you in one minute and close you out the next.

I can’t explain why I sometimes have a very real belief that the pain or longing is what gave me the focus and motivation to make it this far, making me afraid happiness = complacency.

I can’t explain that I don’t hate or regret that pain.

I can’t explain how I won’t have time to be heart-broken, guilty, remorseful, angry, hurt, jealous, etc. because one small break in focus could end a trusting stranger’s life.

I can’t explain knowing that a misplaced decimal could take someone’s father, mother, brother, daughter away forever, and then going to eat lunch.

I can’t explain the fear that I won’t be good enough, smart enough, fast enough, imaginative enough; that I won’t have read the right article or the right book or go to the right seminar.

I can’t explain to you what the sound of a doctor’s voice is behind closed doors when they mention the patients they’ve lost, or what it’s like to just continue working after.

I can’t explain how many days I question if any of this was worth it given that my success rate will likely never be much better than chance.

I can’t explain that even in writing this I’m holding so much in because I’m afraid telling you would change you too.

I can’t explain that you don’t understand, and that I don’t need you to.

I’ve worked continuously side by side with social workers, law enforcement, and medical professionals of all types. Each one could fill volumes with what they can’t explain to you. Some careers change you, sometimes into people you don’t like…and sometimes you don’t like the fact that you do like it. The change is permanent, but it’s not subconscious. We see it. We feel it. We see what it does to those around us. We remember who we were and who we could have been, and most of us struggle daily to be better for our friends and family and the coming up short cuts deep. All we can do is swallow move to the next day or quit, and then everything up to that point was wasted. I’m not asking you for special patience or lenience for any of us, just don’t commiserate where you can’t. Most of us end up settling down with people in similar fields because we know there’s no need to explain, but if you’re in a “mixed” relationship, don’t feign empathy or attempt to lift their sour mood. We really don’t want to use you as a salve for our wounds. We want you to just be you, something separate, something better, something that reminds us that we’re more than we think. Don’t say you understand why they’re late again, or quiet, or cancel on your dinner plans over and over. Just wrap them in your arms and let your heartbeat remind them that they still have a home.



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Levi Barnum

MHsc Integrative Medicine. PA-S1. Scientist. Humanist. Humorist. Idiot.