“Relax your shoulders and relax your heart. Let go and give room for the pain to pass through you. It’s just energy. See it as energy and let it go.”

Michael Singer, author “The Untethered Soul: The Journey Beyond Yourself

How do you handle the sad and disturbing things you see at work? The dark side of humanity, if you will.

Perhaps you’ve taken care of victims of domestic violence, sexual assault, child abuse, or elder neglect. Or maybe your patients are severely depressed and suicidal and relay their deepest, darkest thoughts to you. Or perhaps despite your valiant efforts, you have a patient die. 

I have had a few shifts lately in the ED seeing some cases such as these and despite my morning ritual, meditation practice and general stress management, these sad cases had been upsetting me, sticking with me, even disturbing my sleep. 

As I thought about how to handle the unsettling emotions, I was reminded of a concept I learned from Michael Singer’s book “The Untethered Soul: The Journey Beyond Yourself”  which perhaps you too might find useful.

In his book, the author says to always keep your heart open and let the feelings pass through you. He cautions to never close your heart as this actually traps the emotions in and then they keep circling through you over and over, weighing you down, burdening you and sometimes even causing psychosomatic illnesses. (I’m sure we have all seen this in patients so often.)

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Singer explains that you must feel the feelings as they come up, even if it makes you sad or tearful or upset. Notice them, sit with them for as long as you need to, relax into them and let them pass through your heart and your body. Don’t be afraid of the negative emotions. (After all no one always only has positive emotions. Everyone’s life, even those who seemingly have a “perfect life,” has 50% positive and 50% negative feelings.)

When we feel the emotions and let them express themselves, we allow them to pass through us.  And this is how you process sadness and negativity with compassion for not only your patient, but also for yourself.

This is how you get to continue going on feeling whole for yourself, for your family and as a doctor. This is how you go through life with an open heart, capable of experiencing all the positive emotions of joy, connection, fulfillment and peace, too. 

Now I know this all sounds like “fluffy emotional stuff.”  This is not stuff we are taught at school or even by parents, but as doctors we are going to see the dark side of humanity and come face to face with some horrifying things. It’s inevitable and we must have a healthy way to deal with and process it so we don’t close off and also miss out on all the joy in life.

I know it’s hard while we are at work to feel the emotions in front of patients or coworkers. After 12 years as an emergency medicine attending, despite the countless tragedies I have witnessed, I have yet to cry with a patient or staff member for that matter. Perhaps I should consider being more vulnerable as Dr. Sonali Mantoo writes in her recent blog article, “Daring Greatly: Vulnerability, Courage and Shame in Medicine.”

But when I feel the emotions or tears welling up at work, I usually make a b-line to the nearest washroom and shed some tears there in solitude. Or later it hits me at home after a hard nights sleep or sometimes on the weekend. Whenever it hits you, my friend, I encourage you to keep your heart open and let the feelings pass through you. You can even journal about it or talk about it with a confidant to help you process it.

This technique has been helping me tremendously. So, next time you face those sad feelings try this and let me know how it goes in the comments below.

Archana Shrestha, MD
 is a practicing emergency physician in Chicago. She is coauthor of “The Chronicles of Women in White Coats” and Cofounder of the Women In White Coats blog. She is also an online health and fitness coach. Her healthy living lifestyle blog can be found at MightyMomMD.com and she can be followed on Instagram @MightyMomMD

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