notes from above ground

xxxv

I got home for the day and said, “I feel terrible and I don’t know why.” My roommate said, “It’s because your soul has been slowly sucked out all year.” Good point! I’d forgotten for a moment, because I don’t like thinking about the above ground when I go back underground. It feels like an act of self-injury to rehash the soul-sucking events of the day, week, month, year. When the day ends, all I want to do is escape the above ground.

I hope there’s still some soul left in me. And I hope that the soul that’s been sucked out can regenerate. Maybe the remaining soul can replicate like mitosis. Or maybe soul is one of those things that doesn’t regenerate. If that’s the case, I might come to regret my decision to "stick it out."

The orthopedic surgeon gave us a lecture on bones today. At the end of the lecture, being that the weird year is coming to a close, she left us with some career advice. Advice is the wrong word. It was more like a series of warnings. She told us that we're going to be very busy in the future, that the weird year will look like child’s play when we’re actually doctors. There are no limits on the workweek when you’re a real doctor, and we will be exploited accordingly. She mentioned in passing that there are “some of us” who are trying to change things within the system, but that change happens slowly.

I looked around at my classmates—all of their eyes fixed on her, faces stoic, sitting silently, knowing that they’d all signed up for this career, that it’s too late to turn back.

I don’t think it’s too late. I think we can turn back. Can’t we? Maybe they don’t want to. Maybe I’m making a big deal out of nothing. I’m one of those spoiled kids who doesn’t know the value of hard work and the reason for the downfall of Western civilization.

If I could speak to the surgeon now, I’d tell her that I heard her loud and clear. I’m glad she told us about some of the ways she’s being exploited, because now I can see things even more clearly. I’d tell her that I respect that she finds meaning in her work, but that she doesn’t deserve the soul-sucking.

Her cautionary tale reminded me of a conversation I'd had with another surgeon a few months ago. She was reconstructing a man’s jaw bone when she told me that each night while lying in bed, she visualizes the next day’s procedures, start to finish. She can’t sleep until she’s gone through all of the steps of each procedure. If she accidentally imagines the procedure being done on the incorrect side of the body, she has to start over. The above ground has a way of trickling underground, demanding attention, even for surgeons who have endured decades of weird years, even in the precious few hours of sleep that are allotted to them.

I can’t tell whether I feel sorry for these surgeons or resent them for participating in a system like this and normalizing it in the eyes of the next generation.

Before her words of warning/advice, the orthopedic surgeon told us that there are some kids who walk on their heels because of some problem with their leg muscles. She said they build up callouses—"heel pads"—from all the weight pressing down disproportionately. They can't walk any other way, so their body has no choice but to accommodate it. "It’s a good thing the body is so good at building callouses," she said. "If it didn’t, the heel bone would eventually poke through the skin." Instead, the skin becomes thick and strong, and the heel-walking becomes less painful over time.

I think doctors build up callouses like that, too. Like the heel-walkers, they live their lives in ways that biology didn’t intend, and they build up callouses to prevent their psychic pain from poking through and hurting them.

But the callouses prevent the doctors from feeling things for what they are. And it’s not like they have to walk on the heels of their psyches like that. There’s no physiological mechanism that’s making them do it. Maybe if doctors didn’t have their psyche pads, everyone would be too sensitive and nothing would get done. But doesn’t it also create a barrier between them and their own suffering?

They must know, on some level, that the callouses are maladaptive, right? I guess the problem with callouses is that the body doesn’t really notice them. The build-up is too subtle.

Maybe one day they’ll wake up and notice that they have a big callous on their psyche. They’ll come home from work one day, ask no one in particular why they feel so terrible, and someone will tell them that it’s because their soul has been sucked out and replaced with a callous. Someone they love will die, and it won't hit them the way they'll expect. They’ll realize that they haven’t felt as much of anything in a while. “When did that happen?” they’ll say.

I don’t want to have psyche pads. I’m not going to go back to drinking the Kool-Aid. I can’t. I see now that the abuse isn’t going to end.