This past weekend I went apple picking with a few friends / fellow PGY2 co-residents. We filled bags with red fruit, purchased freshly made apple cider donuts, and sipped on flights of ciders (all
socially distanced and mask-conscious, of course). Back home, my apartment terrace is decked with pumpkins and chrysanthemums, and my big summertime box fan has been stored away under the bed. Stores are now selling all manner of ghost-bedecked paper goods, cinnamon and spice-scented candles, and crawly decorations. Autumn has arrived, despite the fact that the weather does not seem to have received the message (as I write this, today’s high is supposedly 82 degrees). Autumn is my favorite season for a number of reasons, but at the top of the list is definitely the sweeping crescendo of the changing leaf colors, a dazzling backdrop to the rest of the seasonal joys. The leaves always make me contemplate change and cycles, journeys with no clear end but chapters that open and close, the impermanence of everything in life. How are we different now than before? What are the ways in which we are the same? As these questions peer out from behind crimson- and orange-clad branches, I can’t help but appreciate how well they apply to our collective experience with the coronavirus pandemic as well. Things will never be quite the same again, but reflections and specters of our pre-pandemic lives will gaze back at us from within our new ways of living and being.
The more I reflect on these thoughts, the more I realize that my own path through residency reflects this very same process marked by cycles and change, by things lost and gained. New sources of strength and confidence now stand where the ignorance and insecurities of intern year nested. New challenges have sprung from the foundations laid by the hard work and practice of my first year. And just like the turning leaves, innocence and naiveté have crisped and fallen from their high perches. Having just finished my PGY2 rotation in the APS, I have been confronted with the ways in which health systems--as currently designed--are not built to address certain challenges, have faced the swirl of emotions at completing repeated emergency evaluations of patients who have nowhere left to turn but the ED, and have photographed my own internal landscape of coping strategies and distress tolerance. But there is a type of great beauty in watching the swirling dried bodies of these leaves drift down, a sense of clarity and coherence about the challenges that we must address as practitioners in order to start solving tough problems. Yes, there may be a cold winter in which familiar branches will now stand bare against chill winds and (hopefully) snow. Yet these very branches will again explode into tender new shoots next spring, as they always do, year after year. As French philosopher Henri Bergson said, “To exist is to change, to change is to mature, to mature is to go on creating oneself endlessly.”
In a time when so much is changing so rapidly, I have decided to hold onto the following things tightly in order to remind myself of the identity of my underlying tree despite the changing foliage. 1) My dear colleagues forged into close friends in the crucible of residency. 2) The anticipation and excitement of watching myself develop into someone with significant exposure to psychiatric illnesses and clinical experience in caring for them. 3) A growing appreciation of the tremendous help we can provide to certain individuals, and the vast open spaces waiting for improvement in how we do so. Finally, this reminder of the value in embracing small incremental changes and patience in the pursuit of personal betterment: “Drop by drop is the water pot filled. Likewise, the wise man, gathering it little by little, fills himself with good.” - The Buddha, from The Dhammapada