Healing Doesn’t Always Have to Feel Like Apoptosis

“Just give it time.”

Anyone in the process of healing – from illness, chronic stress, heartbreak, or loss for example -- does not want to hear that. I’ve been on my own healing journey, in the midst of a busy clinical year, because life does not stop just because you’re in medical school.

If they’re like me, people who are healing are mentally focused on better times. Times of joy, strength, good health, feeling like themselves, memories with someone they’ve lost, or any combination of these.

Under stress, I want to return to these moments, my sense of “normal.” But I’ve changed. Cells under stress are injured and die via apoptosis or necrosis. Or they adapt. They change cell types (metaplasia) or strengthen (hypertrophy) as some examples for my fellow science-nerds. A few summers ago, a friend gave me the nickname, “apoptosin,” a play off my name “Tosin,” they claimed…Maybe I should call to clarify.

Nevertheless, healing has entailed adaptation.

I continue to see friends and family when feeling overwhelmed with school or lonely.

I hold on to special patient interactions in a busy clinic setting despite the reality of evaluations and incomplete notes pended in MiChart. Making a patient laugh as I accidently combined “marijuana” and “heroin” into “herijuana” because I spoke too fast taking a social history snapped me out of routine and made me smile.

I go on walks, despite being exhausted, bundled up, imaging a dog walking in front of me in the future.

I’ve grown my capacity to handle negative emotions on my own, while recruiting loved ones in due time.

I better nourish my body – with more protein thanks to my air fryer.

I remain steadfast and grateful for my education when I am discouraged and want to quit.

I’ve witnessed what healing means for patients as well. Healing entails, “two steps forward, one step back,” something my surgery resident used to say to patients post-op. I’d see patients regain their strength and then spike a fever, be somnolent, or report not feeling quite themselves the morning our team thought they’d discharge. My resident’s words encouraged them that setbacks are expected and normal, but not insurmountable. Adaptation, not injury.

Healing while being in medical training is hard. I have found that it is possible to heal when the stressor or illness or grief is still present. Not only is it possible, but it feels necessary. We selflessly care for others while quickly de-prioritizing our own well-being. My hope is that I continue to find ways to create space for healing on my journey to becoming a physician. It’s looked like eating my lunch silently in the middle of the team room after rounds before jumping into notes. It’s been silent car rides after clinic to decompress. It’s been calling a loved one to vent while lacing up my shoes to go out for a walk. These moments of healing, or revival are strung together and have become my life.

Does it feel like some days I’m undergoing cell injury and apoptosis? Absolutely. Is it every day? No.

Within the word, “revival” there’s a sense of restoration and renewed energy or spirit. Feeling “revived” is not an overnight sensation, to give credit to the well-intentioned phrase, “Just give it time.” It takes work, often interrupted by daydreaming of better times in the past. However, this year has taught me to use my moments of revival to haul my adapted, changed self, towards what the next chapter holds. Now back to studying…This pathology won’t learn itself.