Letter 30: Full of Hope
When we change our attitude
Hello, 2022!
Happy New Year and welcome back! During our holiday hiatus, we (Emily and Molly) were able to rest, read so many books, and focus on our families. We hope you were able to do some of the same. While the break was lovely, it’s also a joy to be back in this space. I can’t wait for you to read what we have in store this year.
Emily Fleming (@emflem) returns for our first letter of 2022 with a word about tackling the difficulties of being human in a new year. A new year can seem hopeful—a precipice for new opportunities and new attitudes. But what if your previous year was tumultuous? (We realize that for many—including Emily Fleming—“tumultuous” is putting it nicely.) Emily wisely realizes that there’s not much we can do to change our circumstances; however, we can change how we respond to those circumstances. This mindset shift may seem small but it is absolutely life-altering and even empowering.
As you read Emily’s letter, feel free to think about your own experience: What are you choosing to leave behind in 2021, and what will you take with you into 2022? We would love to hear from you—we’ve missed you!—Emily & Molly
I know I’m not the only one who feels this way, but man, 2021 was a difficult year.
When the pandemic hit, things felt very scary. As scary as 2020 was, throughout much of the year, there was a unifying sense of community that was comforting. Maybe the ship was going down, but there was still a chance we could right it, and at least we were all in it together. We ended the year full of hope, as I had just received my first dose of the Moderna vaccine. My husband’s first dose was scheduled for a few weeks later. Things were starting to look up.
Maybe I should have seen it coming, but the polarizing effect of the vaccine rollout was incredibly devastating for me. Families and communities—mine especially—were fractured over differing views on the vaccine, and ultimately, the pandemic as a whole. For me, vaccine hesitancy made my job as an emergency physician many orders of magnitude more difficult.
The COVID-19 vaccination rate in my county remains less than 45% to this day, and our community’s hospitals became a battleground. We were fighting to save the lives of the unvaccinated; fighting with patients and family members over their refusal to wear masks; fighting over bogus treatment protocols; fighting with administration to increase staffing. The logistical challenge of accommodating a large and rapid increase in our patient volume was physically exhausting. The weight of the emotional trauma we carried was suffocating. The screams of the family members of those we could not save can never be unheard.
While I love—and regularly engage—in shared decision-making with patients and families, having patients reject life-sustaining treatments while yelling at me about conspiracy theories didn’t feel like a healthy way to participate in those kinds of discussions. I couldn’t imagine walking into an Apple Store and telling them how to fix my computer, or prescribing a method for the mechanic to fix my car. But these patients were expecting to dictate their own care, demanding that I treat them with unproven medications of their choosing, after refusing the one effective preventative measure modern medicine has to offer. My experience and expertise meant nothing to them because they had read about it on the internet.
For the first time in my career, I seriously contemplated leaving clinical medicine entirely. My job felt like a genuine threat to my mental health; every shift was an assault on my psyche.
My diagnosis was burnout, plain and simple. But how to treat it felt less clear.
I grew resentful of my situation. I chose medicine because I genuinely loved it. Most shifts, I would still have at least one patient encounter that was completely soul-renewing. In those instances, I knew I was serving as an instrument for good, and it was incredibly fulfilling. The thought of walking away from it all and missing out on those kinds of encounters bitterly cut me to my core. But continuing to subject myself to this unpredictable, traumatic, and now hostile, environment felt like inflicting self-harm.
For the entirety of the pandemic up to this point, I had viewed myself as a vector of information. My responsibility as a medical professional was to educate the public, my friends, and my patients on best practices for getting us through this crisis. As the situation grew dire in our hospitals, I felt desperate to do whatever I could to get us all out of this, not only to save lives and help us return to normal but also to improve my work environment and make my career feel more sustainable. I grew frustrated when my efforts at spreading factual and evidence-based information did little to turn the tide. James Clear’s article “Why Facts Don’t Change Our Minds” did wonders for helping me understand why my campaign was so ineffective, but the understanding still didn’t change my situation.
As it turns out, unless I quit my job, I am powerless to change my circumstances. Despite my former delusions of grandeur, I don’t have any control at all over the course of the pandemic, or the many ways in which it directly affects my workplace environment. I have stopped holding out hope that there will be a swift and sudden end to all of this. But I have found comfort in this truth: while I can’t control what happens to me, I can control how I react to it.
Without putting too much of a Pollyanna spin on it, there is power in knowing that I don’t have to be tossed about by the changing tides of whatever the future holds. I have reclaimed a sense of agency, knowing that by changing my attitude, I can influence my own experience.
“Hope is the feeling we have that the feeling we have is not permanent.”
Mignon McLaughlin
Emily’s Five Intentions for 2022
Reading before bed is a habit I’m continually trying to build. I fall asleep faster after reading, while mindless scrolling on my phone can keep me up well past my bedtime, with an overstimulated head full of racing thoughts that can’t quite settle down. The practice helps me make it through the ever-growing stack of books on my bedside table.
They say, if it ain’t broke, don’t fix it, so I’ll be continuing my practice of looking at life one week at a time. My work schedule changes constantly, and I’ve found that monthly planning can feel too overwhelming. My husband and I take Sunday evenings to look at the upcoming week and decide who is cooking when, which days we handle bus stop duty and school drop-offs, and who is shuttling to/from after-school activities. It helps establish some routine for our kids in the face of our ever-changing work schedules.
Over the past five years, I’ve built a habit of regular physical exercise that is serving me really well. I have set goals for myself in the past for how many days a week I want to exercise, or how often I want to ski, or which runs and courses I want to tackle, and have ended up falling short. I know that the point of goal-setting is to reach them, but I found that I lost sight of my progress in the pursuit. This year I’m actually trying to set fewer goals. A good foundation for regular exercise already exists for me, so this year I’m just trying to enjoy the journey.
My creative pursuits have always seemed to take a backseat to checking off items on my never-ending to-do list. I tend to wait until I have the time, rather than being intentional about making the time. Of course, all too often, there is never any time left. Over the years I have accumulated supplies in support of a photography hobby, a desire to learn the art of hand lettering, and craft projects too numerous to count. This is the year I intend to make the time, at least twice a month. I will carve out space in my life to just. . . create. I hope to end up building a habit as a result.
After nearly two years of carrying the weight of the world during this pandemic, I want to be more intentional about engaging in frivolity, and sharing when I do. I have felt like a representative of the house of medicine in my public persona, both online and in my community, and it has kept me feeling like I have to act with reverence at all times. While this is partially true–I do have a standard of professionalism to uphold–I am also just a person. With a sense of humor. I think it will help me cope more effectively if I am able to allow myself to be seen as the multidimensional human being I know myself to be.
With gratitude,
Emily Fleming
P.S. What are you choosing to take into 2022? What are you choosing to leave in 2021?
Links for Further Reading & Emily’s Past Letters
“When You Can’t Change the World, Change Your Feelings” By Arthur C. Brooks
(via The Atlantic)
Adjusting your attitude is easier than you think.
“Vaccine Refusers Risk Compassion Fatigue” By Chavi Eve Karkowsky
(via The Atlantic)
After the horrors that health-care workers have endured during the pandemic, many are struggling to sympathize with people who won’t protect themselves.
“Why Health-Care Workers are Quitting in Droves” By Ed Yong
(via The Atlantic)
About one in five health-care workers has left their job since the pandemic started. This is their story—and the story of those left behind.
Such a great article. And I am leaving cable news in 2021 and bringing in more fun fiction in 2022.
I love the line "engaging in frivolity" - this is what I have been thinking! I read the Twilight book Midnight Sun because WHY NOT, I LOVE VAMPIRE LOVE STORIES. And I have been going to a hip hop dance class. We don't have to be so serious. I love the idea of sharing it too! Thank you for the encouragement!