The Frozen Lasgne

I think its all starting to hit me...just when everyone has stopped asking if I'm "OK" I'm finding my answer not to be as clear cut as before.  Not to worry -- I'm still "OK", I think I'm just past the "survival" and the "Denial" and the "glad to be home"  phase and am into a bit more of the "now I'm back to work - -holy shit I feel tired" phase.

That's basically my biggest complaint - - I'm tired.  I wake up in the morning and I'm tired. I lie there for 30 minutes...and I'm still tired.  Yesterday was my first day back at work - -and usually after I've been away for a while I come back to work with a whole new sense of energy.  I walked into the room to see my first patient yesterday and I felt this wave of fatigue hit me.  And every patient I saw after that just made me more and more tired.

 Its an interesting thing, how the body manifests sadness as fatigue.  I didn't realize at first that this is what it was, but last night, for the first time since this all began, I had dream after dream about TOby being in the hospital and in the ICU.  The dreams weren't scary or anything -- there were balloons and friends and lots of medical jargon.  But its a sign to me that this whole ordeal has been integrated into my subconscious and maybe its finally "taking its toll".

Don't worry -- I'm fine.   If I wasn't fine I wouldn't be writing this.   I expected this.  Its part of the healing process.  I"ll get through it and I'm still doing well.  And as with everything in life, its giving me insight into what patients go through . SO often we see people come in complaining of "fatigue" and its OBVIOUS to us that they're depressed, or anxious or smoking too much marijuana (that's the HARDEST thing to enlighten them on).  And now I'm experiencing, probably in a much milder form, that feeling of being completely drained all of the time, despite my best efforts to sleep, eat and exercise.  I get it.  The mind and the body are connected.  And hopefully a good dose of normalcy will help both to recuperate.

Its been interesting how this whole experience has affected my work.  Last week, one of my palliative patients started the end stage of her dying process.  I was glad that I was back.  The family and I have been through a lot together-  its been a long process and we've had to work through  the denial and anger and luckily were given the time to make it through to the acceptance phase before this lovely lady died.  I could tell the family was relieved to hear that Toby was OK (which meant a lot considering what they were going through...) and that I was around.  So I drove over to do a home visit last week.  As I pulled out of my driveway I thought, "I should really be taking them one of the frozen casseroles that we have in our freezer"  - -people were so generous to us when Toby was sick.  And I realize now more than ever how so VERY Important a home cooked meal is.  We wouldn't have eaten ANYTHING if ti hadn't been for the baked goods and casseroles given to us by such kind friends.

So I left my house thinking that a home cooked meal was probably just what these people need as they sit vigil over their dying loved one.  And then I remembered the frozen lasagne in our freezer and felt guilty for not having brought it wiht me.  Which is odd- - I don't USUALLY bring meals to my patients.  But the further I got from my home, the more I wished I had brought the frozen lasagne with me.  SO much so that by the time I got to Wasaga beach I turned into the Superstore and parked my car.  Its at this point that I had rationalized that even a non-home-cooked-frozen-lasagne would do.  Its at this point that I  "checked myself" --   The conversation went something like this,

me : "I really want to buy this lovely family a frozen lasagne - - what's so wrong with that"

devils-advocate-brain :  "That's not appropriate"

me : "WHY isn't that appropriate?"

devils advocate : "Because doctors don't DO that"

And so I thought about it and concluded that the reason our medical insurance providers advise against bringing things to patients is because it may make them feel "awkward" and, according to them - -its a slippery slope.  And if I thought about it, I suspect if my mother was dying, I wouldn't want my doctor getting all "chummy" on me - -I'd want her to use sound clinical judgement and tell me her clinical assessment of my mother and then leave me to my grief.  But human beings aren't compartmentalized like that.  And our roles aren't  black and white. My new founded compulsion to buy this family a frozen lasagne stemmed from the "human" aspect of me. Not as their doctor. Not as their friend. But as someone who has been through something horrible and knows first hand HOW practical and useful frozen food can be.  

So I rationalized to myself that I would take them dinner on THREE conditions :

1.  I brought them frozen lasagne and a salad.  No garlic bread. That took it one step too far.

2.  That I would be VERY casual about it when I got to the house and give it to them in the grocery store bag and very quickly say, "I brought you some dinner for when you're hungry" and encourage them to put it in the freezer ASAP and not look at it or dwell on it so I could get on to my purpose of being there -- as a doctor.

3.  If it seemed at ALL awkward that I had just brought them dinner I would simply say, "Not to worry- -its not home made or anything!"  which would hopefully minimize the whole weirdness and brush it off.

So I got to the superstore and bought a frozen lasagne  and a small thing of cesaar salad.  I handed it to the husband when I got there and he was very grateful for dinner but didn't make a big deal of it.  I only had to use the line about it being "not homemade" once when he mentioned to his daughter how kind it was of me to bring them dinner.  So I left feeling good about my new quirky compulsion.

I actually FORGOT about the whole lasagne incident for a few days....until the patient passed away and I went to the visitation.  Those are always awkward when you're the doctor.  And being fond of palliative care, its not an uncommon occurance.  I always feel like there's SOME family member who would like to take me outside and tear a strip off of me for "not doing more" for their loved one.  So far it hasn't happened.  But this visitation wasn't without its awkwardness because the damn FROZEN LASAGNE came back to haunt me.

After having rehearsed my standard "visitation lines" in the parking lot (I swear, I do all my best thinking in parking lots these days...) I entered the funeral home and walked straight into the son of the deceased who immediately BURST into tears and said, "Dr Boyd! Thank you SO much for the LASAGNE!!!"

I have to admit. That's not one of the standards.  My brain quickly ran through my prepared lines - -"I'm sorry for your loss"..."Our thoughts are with you"..."If there's anyhting I can do - -please just ask"....

Before I could think of any more my mouth opened and out came..."Well, it wasn't home made or anything!"

The son smiled (slgihtly)  and then ushered me inside and introduced me to more family members.  It wasn't long before the husband was by my side, thanking me for all of the care I'd provided to his wife etc...he concluded by introducing me to a group of people and saying, "This is our doctor. She brought us a lasagne for dinner"  This was met by silence. (OH my God -- it WAS Inappropriate).  Again, before my brain had run through the USUAL visitation lines out popped, "Oh, don't worry, it wasn't Home made or anything!"  

A few chuckles.

At which point the uncle pulled me aside.

"That was very nice of you to bring the lasange. You mentioned it wasn't home made. Where did you buy it?"

(OH, good gracious -- Did the Superstore sound tacky?  Would it be more personal if I just said I found it in my freezer?  Or was that creepy?)

Not to worry- the uncle interrupted himself, "you know, we usually just do our own lasagne's in the microwave.   I believe YOURS required the OVEN"

No, I hadn't read the instructions on the frozen lasagne.  I was so worried that it was the wrong thing to do that I had just picked up the first one I'd seen. Was reheating a frozen lasagne REALLY that complicated? I stuttered a somewhat inappropriate, "Well...all lasagne's are different..." remark before being whisked away to meet the 3rd son who I had yet to met.

 "Ah yes," he said, "You're the doctor! Mom was so fond of you. ANd thank you SO much for the lasagne"

I paused.

I waited.

And finally (after glancing around to make sure no one overheard) said to him, in a pitiful whisper, "Oh it was nothing.  Its not like it was homemade..."

I left the funeral parlor CURSING the devils advocate of my brain.  ALthough there was no RATIONAL reason why taking a meal over to a family who obviously needed it was a bad idea, the OUTCOME of my new founded awkwardness left me with once DECISIVE decision : Next time I think I'll make a home made one.