Always you have been told that work is a curse and labour a misfortune.
But I say to you that when you work you fulfil a part of earth’s furthest dream, assigned to you when the dream was born,
And in keeping yourself with labour you are in truth loving life,
And to love life through labour is to be intimate with life’s inmost secret.

~On Work – Kahlil Gibran~

The years fell quickly away as I walked through the front doors of the emergency department. It felt like only a few weeks had passed. As I walked slowly down the long corridor, I greeted long-familiar faces, my ongoing difficulties mobilising reminding me acutely of the long path I had traversed to get here. In my imagination I had assumed that when I came back to work I would be completely fit and well. Unfortunately, my myositis had relapsed two weeks before. I had rapidly gone from walking 3 km a day to struggling to walk around the house. However, I was now coming to terms with the fact that I would never be completely well, and would have to work out how to cope with a very small amount of work with my ongoing unstable disease.

I was greeted enthusiastically by a longtime colleague, who was the doctor in charge of the department that day. She hugged me and gave me full permission to be a “princess”. I could see whatever patients I thought I could physically cope with. She was just happy that I was back. The plan was to do four to six hours every Sunday and see how my body coped. My mind was now firing on all cylinders which was the most important thing. I was ready for some mental challenges after two years spent researching my own two rare diseases.

Ironically, the fact that I was still so weak made returning to work far less stressful. I could not just assume I could step in at the same place that I left off. I was under no illusions that I was anything like the person I was two years before. But all I could do was do my best and not stress about the future. Perfection was not something I could strive for. Connection was now my goal.

Of course, technology was the main barrier to seeing my first patient. Resetting my password required a phone call to the state-wide help desk. Once the password was sorted, fortunately the Emergency Department patient list looked exactly the same. I scanned down the short list of patients waiting, and the next one in line looked perfect for me. A 90-year-old woman with several medical problems. The nurse looking after her said she was delightful, so off I went to enthusiastically practice my history taking and examination skills after my two-year hiatus.

I eased myself slowly onto a chair, cheerily introduced myself, and asked my patient to tell me her story. After two years of being unwell and struggling to tell my own story, it actually amazed me how well she was able to give me the timeline of her current and previous illnesses. When she apologised for not being able to recall a specific detail, I gently reassured her. We first went through her current problems, then back into her past history. I asked about where she lived, what work she had done, and what hobbies she had. We shared a love of knitting, and she showed me the blankets she had knitted for the Soup Kitchen and Cancer Care.

She was frustrated with her current level of function as over the last two years she had slowly but steadily declined, becoming increasingly weaker and frailer. After an active life as an aged care worker and helping her husband on the farm, she now struggled to walk to the letter box each day. I sympathised with her feelings that being too exhausted to knit or read did not make for a very satisfying life. I encouraged her that if we could work out why she had become more unwell over the last week, she would hopefully be able to return to her knitting, even though she would never get back to her strong and healthy self from a few years before.

The day was reasonably quiet for a Sunday morning in Emergency, with minor injuries trickling in and only a few unwell patients. The overnight patients were slowly being sorted out by the morning shift, and specialists wandered through to offer their expert opinions on management and possible admission. One of these specialists was the respiratory physician who had told me twelve months before that maybe I should see a psychiatrist as I had seemed very anxious about my illness.

I had replied at the time that I was too sick to talk to a psychiatrist. I was so sick I could barely eat. He countered with the idea that I should be going for walks down the hall while I looked at him in amazement. I was glad I could manage to get to the toilet unassisted. My blood tests were normal, and I have the failing of looking well. Everyone had come to the conclusion that I wasn’t sick and that my symptoms were purely due to anxiety.

As I walked past, I knew the choice was mine. I was wearing a mask and bright purple scrubs. He definitely wouldn’t recognise me. In the past, I probably would have continued on my way without making eye contact. But I was a lot tougher now than I used to be. I decided to face my fear and stop to chat with him. I was going to have to talk to him about a patient eventually.

He was known for his kindness and soft-spoken nature. I had long suspected that he had probably been used as a fall guy by the other specialists, hoping that his more placid personality would be able to broach the topic of my illness being complicated by depression more gently. Unfortunately, this tactic had not worked – it had been like a red rag to a bull. Once again, nobody believed my story!

But in my heart I knew this was not really his fault. So I stopped and said hello. We had a lovely conversation about what had happened with my lung abscess and the excellent result of my surgery. Intellectually, I had already forgiven him. But being able to talk and share my progress with him meant that I could now forgive him emotionally as well. It was as healing for me as antifungals and immunoglobulins.

The morning sped by quickly. I had wondered whether I could physically last four hours. But I had little walking to do, my patient’s bed right in front of my desk, with my nurse enthusiastically running errands for me. A lot of the time was spent sitting down, writing my notes, looking up possible side effects of her recent medications, and waiting for results to come back. In between I chatted to my colleages about their patients. Working in Accident and Emergency is a very collaborative job, each of us sharing our knowledge from our past experiences. I knew the only stupid question is the one you didn’t ask that you should have!

By the time I had all my ducks in a row, it was after 1 pm, and the afternoon shift was arriving. I spoke to the on-call physician, organised my patient’s admission and the extra investigations needed before heading home, tired but very happy. I felt I had been a blessing to my patient and her family, listening to their concerns, explaining the process, and outlining the tests to come. She was already looking better after a few hundred mls of IV fluids of rehydration, with some colour in her cheeks and a sparkle in her eyes. Her daughter looked relieved with her rapid improvement and thanked me for my time.

They had also been a blessing to me. A chance to listen and connect, share and support, my knowledge and my sympathy joining together to give a patient hope and peace. She would probably never be completely well and active again. But then again, I probably won’t be either. But even in small ways, I can be a blessing. I also realised that even if I am unable to continue working as a doctor, I can still bless everyone in my circle of influence in small ways. I can listen to other people’s stories and see the world through their eyes. Working, both paid and unpaid, is really love, doing what we can in ways big and small to bless others.

Work is love made visible.
And if you cannot work with love but only with distaste, it is better that you should leave your work and sit at the gate of the temple and take alms of those who work with joy.

~On Work – Kahlil Gibran~