I don’t feel so hot. No, that’s not quite right. I feel really lousy. That’s more accurate.

I’m really not much of a complainer. I go to work unless I simply can’t rise from bed and crawl to the shower. The entire staff, my family, and every patient who walks into my office, all feed off my mood. No matter how I feel, how up or down I might be, on the outside it’s always a good day and I’m always feeling great. That’s the way it is, and that’s probably the way it’s supposed to be whenever you set the pace, and it’s certainly what’s expected of a doctor in the office. I get that, and that’s what I’ve done all of my adult life.

Except now. I’m feeling really lousy, and it’s so bad that I’m having a really hard time hiding it.

It’s partly physical, and it might be medical. No one, patient and doc alike, ever really thinks of the doctor as susceptible to human frailty of any type. Sick day? Yer a doctor … you don’t need no stinkin’ sick day! Just the same, there are a couple of things which just aren’t right.

My hands hurt. Pretty scary, eh? I’m an eye surgeon; the quality of my kids’ diet depends on the health of my hands. Nothing too big dealish right now, but just enough to engage my consciousness, oh, all day. And my shoulder, the one I hurt 3 years ago doing push-ups, it’s been buggin’ me after a little kayak rescue adventure on the 4th of July. The gym hasn’t been the sanctuary it’s been for me over the last couple of years.

I’m a Crossfitter — we measure everything in the gym. I’m not making any PR’s (Personal Records) on repeat WOD’s (Workout of the Day) to speak of. In fact, my times and loads on repeat WOD’s are actually off by about 10% or so.

Is that it? Is that all this is about? A few dings after 51 years of being a knucklehead athlete?

Sure! It would be cool if that’s all there is! But there’s this little bump in my neck (probably just left over from a virus), and a general decrease in energy, generally poor quality sleep. My tolerance for the little inconveniences in life is nil. My ability to let the myriad little discourtesies that are directed at a doctor or a boss is at an all time low. I’ve turned into every physician’s nightmare: the doctor as a patient.

Who watches the watchers? Who looks out for those who are tasked with looking out for others? Who is there to care for those who dispense care?

Medicine is the ultimate looking glass. Patient or doctor, you spend pretty much all of your time on one side or the other. As much as we as docs try to empathize with a patient it’s simply impossible to do any better than sympathize, even if we have the exact same symptoms or diagnosis; our experience is never the same. We speak the language so our conversation with our own doctors is different. They nearly always treat us as colleagues first, patients second. We either get a pep talk or end up with the “blue-plate special” work-up.

Me? It will likely turn out to be the result of the unrelenting grind of being a doctor who takes care of patients. The countless little cuts from non-medical folks who are involved in the “care” that make it more difficult to do your job. The incessant bleating in every media outlet about the “problem with doctors.” The patient, or family member of a patient, who has received state of the art, best in class care and the best possible outcome, yet finds it necessary to complain about something. It will likely be the endless weight of carrying the financial health of 15 families on my shoulders like so many other small business owners.

When the doc does go down he/she never goes alone. Private practice or huge institutional setting, we are each an integral part of a complex micro-economic and social ecosystem. Set apart, but never truly separate. We never go down alone.

I have an image in my mind, a slow video of waves washing over a rock which sits at the mid-tide mark. It’s a substantial rock. Sturdy. Large. Not unattractive. Steady. I imagine people walking by all day, every day, occasionally glancing at the rock, but mostly just peripherally aware that it’s there. A crab underfoot might prompt a jump to safety, a daydreaming beachcomber might stub a toe, but mostly folks just don’t really think about the rock. Nobody notices that after years and years of twice daily tides the rock has started to show some wear. A tiny crack here. A little chip there.

I don’t feel so hot, and high tide is nigh.

Darrell White is an ophthalmologist who blogs at Random Thoughts from a Restless Mind.

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