An Afternoon Off (July 23rd, 2024)
It’s around 2:00PM on a Tuesday and I’m currently on the pediatric infectious disease service. More specifically, though, I’m back in my apartment drinking an espresso from my Moka pot. I note this not because I’m lucky to have gotten off so early today, nor the fact that I’m working with arguably the kindest attending the entire hospital—I come in at 12:30PM tomorrow too—but because at some point two years ago (the previous year of my medical education, M2 year, clerkship year) I would have felt guilty about leaving the hospital so early, and at not having to come in tomorrow so late. Why? It’s hard to say. Clerkship year has its ways at sinking its claws into you. The doubt-thoughts that most likely would’ve spurred the guilt thoughts would’ve gone like this, probably: “I’m not getting a serious enough education,” “I should really ask to stay to make the best impression possible,” “Was Dr. N just testing me somehow?” “I should’ve just stayed—what does this say about my medical school” All-in-all, it’d be some Stockholm-y mixture of shame at not being worked hard enough (in a system that claims its methods absolute, and its pedagogy somehow timeless) as well as fear of scorn from onlookers who wish nothing more than to poke holes. These anxieties come from what the Buddha called “Wrong view,” which is in part the belief that there is an unchanging being to which all the aggregates belong/occur to. He called wrong view “the most blame-worthy of all things.” Re-contextualized, there is no ‘future-me’ who must fulfill the arbitrary criteria of others (as well as his own) in order to allow the ‘present-me’ an inch of happiness.
Two years ago I would’ve worried this entire afternoon, as well as all tomorrow morning. I don’t even need to search that far back in order to find more recent examples of this. (I know I keep writing that only the two-years-ago me would’ve been anxious at leaving, and that I’m somehow now above all of that, but this recent example sort-of deflates that whole idea…) Just the other day I was dismissed by Dr. Y at noon, and I thought because she didn’t explicitly tell me to leave the building, I should stick around. Until when? I don’t know. To do what? Watch my resident do nothing. And what happened when she returned from her meeting? She told me to go home again. “What are you still doing here?” To which of course I had no reasonable answer. What I could’ve said, what the only accurate response would have been, would have been something along the lines of “I stayed because I wanted to curry favor (which I clearly did not) and because my desire for consistency overrode my sense of skillful means or logic.” Go home… Go home!
Once again, every anxiety that I’ve had about this year so far has turned out to be comically untrue. Why I let these self-defeating anxieties take me over again and again, I’m unsure.
How do I relate to the idea of disenchantment? I have asked myself this same question—‘why do I listen to my anxious thoughts?’—countless times so far this year, and still when they arrive, they are seemingly the most attractive phenomena in the world to me! What is the seductive power of an anxiety like the ones I mentioned? Consistency and stability, probably. The attractiveness of thought like “am I getting the most rigorous education possible?” is not knowing whether or not my education is rigorous. It can’t be! How would a thought deliver that information to me? What the attractiveness of that thought is, why it takes over so easily, is really the comfort and stability of knowing whether or not I am the type of person who wants a rigorous education!
This distinction is important to note because it is precisely this type of (really quite meaningless) information that anxiety provides the parched mind. This, really, is why these types of thoughts are seductive. At some level they’re very self-affirming! In going home and still thinking about work, I can “prove” to myself that I am a hard worker, even when I’m not working. But actually, this is only a consolation prize, and a very tenuous and frail mode of self-assurance at that: anxiety usually does a very poor job at what it promises it will do. What the thought really does is ruin both an understanding that I can be a hard worker without the piercing gaze of others, as well as ruin my free afternoon! Infinitely more skillful—if my desire is have a rigorous education—would be to just go study! Or, alternatively, accept my education for what it offers me, recognize how much I learn during my time in the hospital, and realize how much more time I am bound to spend there during residency. To be let off early is a BLESSING.
This returns us to the previous question, namely, what is my relationship with disenchantment? Does it depress me? Does it open me up? As Joseph Goldstein puts it:
“Do I feel angry at the ocean for having an under-toe? Or rather, does it allow me to swim safely and skillfully?
‘Disenchantment,’ here, would be the process of letting go of my ‘stable anxieties,’ (the ones that provide that tenuous but very repeatable and cling-able process of self-identification) in exchange for what really is a much more ‘unstable’ reality, a reality which is not repeatable and not cling-able. When I ask myself over and over again “what will X think of me?” or “will I be an X in the future or not?” I constantly and insidiously reinforce the illusion of the unchanging ‘I,’ to which my education and career is happening to. I am also ostensibly bolstering myself against this unstable, constantly-changing reality, for when an anxiety as such enters my mind, the pleasant vision of its fulfillment—a scene playing out whereby I make a good impression on so-and-so, or own a successful practice as a so-and-so—rushes in to stabilize my mind. Even the unpleasant visions, whereby I disappoint someone or fail in something, strengthen the idea (albeit in the negative) that everything is securely under my control, and if only I try hard enough nothing is left up to chance.
To become disenchanted—to ‘wake up,’ as it were—is perhaps even scarier than an unpleasant vision of the future or past. The latter at least provides a foothold, something of substance to hold on to. The former, on the other hand, asks you to firmly trust in the impermanence of things, the knowledge that, although you didn’t know why, or what for, the future is largely out of you control. You will become what you become. In fact, you’ve already become what you’ve become! Dr. N let you out early because he did—enjoy it.
This is in no way a prescription to give up, or be somehow flaccid in the face of life. One should of course still act with fervor and wisdom, but the additional and superfluous “what if…” will neither help me decide skillfully on my next course of action nor allow me to appreciate the present (the only real ‘future’ we’ll ever come close to having…). Still this acceptance, this waking up, this disillusionment is scary—it requires faith in the mechanics of the world, god, karma…
A very recent and poignant example: I set my alarm on my phone every night, and I have since freshman year of college. I don’t know exactly when or how it started, but over the past six or seven years, I developed and OCD-type behavior in regards to this alarm-setting process each night. Leveraged against the fear-potential of sleeping through a first class, I would check my phone alarm over-and-over again for at least 10 minutes a night. I’d start by setting the alarm, and then I’d proceed to flick my eyes across the screen repeatedly, starting first with the time “06:30,” then the little “on” button on the opposite side of the screen, then the little clock emoji that’d appear on the top right of the phone, and then finally with the charging battery sign next to it. In my head, each time my eyes completed this tiny circuit, I’d repeat to myself, “six-thirty, alarm is set.” Again, I’d go through my cycle of checking: time, on-button, clock-emoji, battery charging. “six-thirty, alarm is set.” Again, “six-thirty, alarm is set.” Again. Again. Okay. Just three more times. Wait. I messed up. Again… and this process would continue anywhere from five to ten minutes a night. After I’d declare myself ‘done,’ and put my phone down, if I had to leave my bed for any reason, I’d have to repeat the process from the very beginning.
The other day I got a new iphone—a model that when you set the alarm, it doesn’t show the little clock emoji on the top of the screen. So, the first night I tried to set my alarm, I was both extremely anxious and relieved that I couldn’t complete my routine! Anxious because I couldn’t think to myself the usual, somehow comforting “six-thirty, alarm is set,” but relieved because here I saw a way out! It was now or never to kick this pestering little behavior. Either I could make a new routine, or give up on the whole thing altogether. With a fair amount of self-restraint I chose the latter and haven’t spent more than five seconds setting my alarm since. Important to note: not once in the last six years has my alarm not gone off at the right time—nothing about that has changed now, except for my doubt that it one day will.
That little clock emoji is the itch in the back of my mind to ask myself over and over the endless series of “what ifs” and “what ofs—through mindfulness, though, it is possible to remove it from my home-screen, and thereby circumvent all the mental spiraling that follows. What is left can only be an appreciation for the moment, whether it be a free afternoon writing this entry, a late morning tomorrow, or a good-night’s sleep.