No Beeper

It's vacation now. We're in Orlando, with our six children. It's a vacation for the children, of course, not for the parents. Last year, in the summer, we were at Club Med -- another vacation for the children, not the parents. My beeper is off. I turned it off yesterday, for one week. The last time I turned it off, was at Club Med. Dr. A covers for me. He isn't a partner of mine. He's just another doctor in town who covers for me. I have a solo practice, so almost all of the time (except about one week per year or so) I carry a beeper. It's there so that my patients can reach me when they need me. Right now, they can't really get a hold of me. Dr. A can reach me, but he would never do that, nor would he really need to.

It's good to be there for people. It's a feeling that makes you think you're important. But you can't be there for people if you're not there. When I say "be there for you", I mean more than just being physically in the same location. I mean really present with your mind, listening, and willing to help (if you can). If you can't help someone, then just "being there" for them helps. That's because they're no longer alone. Being alone in the face of suffering can be overwhelming. So it's important that at least someone can be there. That's why beepers are important (so I can "be there") and that's why it's important that the beeper gets turned off.

When the beeper is turned off, that's when I'm not there for everyone. I'm there for me. I'm there for my family and me. That's all. So it's a respite. It's a time to take refuge. Responsibility is wonderful, but it also is difficult. It causes fatigue. I think it would be better for me to turn off the beeper even more than one week per year. That would create more rest. Rest is necessary for all of us. It allows us to be well cared for. Then we can "be there". But when we aren't taking good care of ourselves, we can't.

It's wonderful that I have a colleague who will help me with this. I have spent a few years without anyone to "cover me". Then, I couldn't turn off my beeper at all. So it was harder to do a good job of taking care of myself. Many of my colleagues are not happy. They aren't able to take good care of themselves. It's making it impossible for them to really be there for their patients. They are angry, frustrated, hurt, dishonored, rushing, and worrying. So when they go into the room with a patient, they just can't really be completely there. Their thoughts about other things get in the way, their schedule gets in their way, their fears and angers get in their way. Many of my patients complain to me about my colleagues. Unfortunately, I have almost no power to help with this. When I try to get my colleagues to take good care of themselves, they won't listen.

I have this problem with the caregivers of my patients. They don't ever turn off the beeper. They don't find a colleague like Dr. A to help them. They don't take good care of themselves. So they become tired: "burned out". I see them spending all of their time attending to very mundane tasks -- cleaning, cooking, changing sheets. But they don't have any time or energy to actually provide emotional support: to listen, to care, to share. I see this coming at least a year before the caregiver. I try to explain it, but I haven't been very successful. Some people feel that their responsibility precludes good self-care. But this is not correct.

When we try to do something, we are imperfect. So our best intentions may not be enough. We may try to do something wonderful, but we don't know that it will work. We try to take care of someone. But our care may not be exactly what they need. We think it's our responsibility to continue - no matter what. But it isn't. It's our responsibility to take good care of ourselves. Then, when we are well we can see more clearly what is most important. That is what helps us to combine our best intention with a practice that is effective in achieving our goal.

It's a very good idea to turn off the beeper.