I was a burned-out doctor. Ayahuasca saved me

Part 1, written January 2019

 Being a doctor in an inner-city hospital is hard.  Burn out is real, and I write this as an inspiration and way out of it, to have joy and fulfillment from work once again as a doctor. 

 I trained as an obstetrician-gynecologist in a very large urban safety-net hospital which I loved, and after a few years of various jobs, locums and international work in the Caribbean and Africa, I now work at a safety-net hospital in northern California.  I became chief of GYN during this time and had a set of twins through IVF 6 years ago.

 I first became interested in Buddhism in 2008, shortly after my dad’s death.  I meditated on and off for several years, I tried the vipassana and Zen traditions and seemed to gravitate naturally towards the former.  At first, the practice was rather haphazard and random as a novice, but over time I developed a regular practice and had East Bay Meditation Center and Spirit Rock as Spiritual refuges for me.  

 I went to Peru in Sept 2018 not quite knowing what I was getting into.  I knew I was going on a meditation and yoga retreat with a well-known dharma teacher, Spring Washam.  I knew I was going to “dabble” in plant medicine but really didn’t know the power of Ayahuasca.  I had known Spring for several years before journeying to participate in her retreat in Peru.  In fact, she helped me during my own very difficult pregnancy six years prior.  Our paths crossed many times on various retreats.  I now know that is not a coincidence; this is what is referred to as synchronicity.

 She knew the work I was doing at the hospital and would comment from time to time on how hard it was.  But she was not the only one that would give me props. Friends, patients, random acquaintances would acknowledge my hard work, and I would always blow them off.  I shrugged off all the complements and acknowledgements about my work and raising young twins at the same time.  

 I was in bad shape before I left for Peru.  I was leading a very busy life, working and taking care of my children.  I can’t say life was any different than any other working mom in the USA.  But something was wrong.  I was overwhelmed all the time and the smallest event that did not go according to plan was hugely devastating to me.    I gave up my position as GYN chief.  I knew I wasn’t doing a good job. I was inefficient and not focused.  I had no desire to work. My soul was in trouble.

 I was seeking something more but couldn’t exactly say what it was.  I knew that meditation would bring me calmness, quiet and spirituality that I was looking for.  But it had been about two years since my last retreat at Spirit Rock.  And I loved Buddhist dharma.  I grew up as a Catholic, and I didn’t really feel like I belonged.  Buddhism really made sense to me.  I saw a flyer for Lotus Vine Retreats and thought perhaps I might learn something about plant medicine and patient care.  I was approaching this more from an academic angle. I saw Spring at a fundraiser, told her I thought I was interested but hesitant due to the logistics of having young children.  She said, “just do it!”.    Taking two weeks away from my family and work seemed nearly impossible, but with Spring’s voice in the back of my head, I made it happen.   

 I can only say that now with certainty two months post Peru, that I am out of the fog.    15 years of medical practice had really worn me down, both physically and my spirit.  I didn’t even know it until part way through the retreat.  

 The first ceremony was very physical.  I had a very hard time with the medicine and I was purging quite a bit and very disoriented.  I was taken outside of the the Moloka (meditation hall) and I remember Spring trying to get me to climb a set of stairs to go to a resting place where I could lie down. My body was such a mess.  I was hot and cold, I couldn’t see straight, everything was spinning, and I was on the verge of vomiting all the time.  It was like I was having the worst hangover of my life.   I didn’t think I could move.  I didn’t know how hard climbing one flight of stairs could be.    At that point, she said to me, “you can do it, you deliver babies” and I thought to myself, “what has that got to do with it?” And I ended up climbing the stairs to end up in a place I could lie down.

 And perhaps that was the turning point.  The next day, I had my consultation with the facilitators about what I was hoping to get out of the retreat.  And Spring mentioned Post Traumatic Stress Disorder(PTSD).  I had no idea what she was talking about.  Why would I have PTSD? For the most part, I had a smooth sailing life.  I was fortunate enough for my family to pay for college and medical school.  I worked hard and did well.  I eventually met someone and had a family.  I had a few personal tragedies and hardships such as the death of my father, and taking care of both parents with cancer, but I would definitely count myself as one of the lucky ones. 

 But during my consultation, Spring she said she could feel all the trauma from work coming out of me when she was touching my foot as I was lying down feeling so ill during ceremony #1.

 I really had no idea how numb I had become at my work.  Friends would marvel at the work I did, helping babies being born and keeping childbirth safe for both mothers and babies. I also took care of non-pregnant women, among them, women with chronic pain and women with bleeding issues were quite common.

  For 15 years, I have blown off all the work that I do.  I never realized that delivering babies was an amazing thing. Perhaps I never found it that difficult mentally.  Diagnoses and treatment plans were not that hard to decipher and put into place.  

 But looking back, I had a large amount of guilt as a doctor.  I never felt I was as good as my colleagues.  Why couldn’t I be more compassionate and patient.  Why is it when I went the extra mile, I got really irritated, or just chose not to.  I hated when my patients cried.  I would think “oh no, now I have to deal with this?”  I hated seeing trauma patients.  These were especially difficult.  Our pregnant trauma patients were taken care of by general surgery with  OB consulting, so it was easy for me to manage from afar, and barely lay hands on the patients.  I always felt guilty about this, not knowing that what I was really doing was just shielding myself because I could not let anything else in.  

 How did I get so numb?  I think for many healers, it was a build up over time of many things.  Working 100 hours/week for 4 years during residency was the start of it.  The mind plays tricks on you to make you get through it, not realizing you are in an abusive situation.  The motto on our first day of residency was ‘what doesn’t kill you will only make you stronger”. I embraced that more than any other resident.  By the time I was a 4th year resident, I was known as being tough, able to handle anything.  The junior residents would look up to me because I was so strong.  But this came at a cost.  I was grouchy and I wasn’t a very nice person. I was taught to just “suck it up” and keep going.  I learned to put myself and my needs last.

 During my first few years of practice after residency was over,  I over-extended myself completely. I really went out of my way a lot for my patients.  I had a patient who was in her early 40s who lost her baby - her first pregnancy at term.  I really spent a lot of time with her and her husband, beyond what anyone would expect. This sort of thing was common for me.  

 And as I write this, we have had two babies die in the last week at work.  Over 15 years, I probably have helped take care of several patients whose babies have died either before or shortly after delivery.  How do we do this?  When you are the doctor on the labor floor, bad stuff happens.  Not all the time, just once in a while.  And when it happens, it’s catastrophic.  Losing a baby has got to be one of the worst life events ever to experience.  And what are we OBs expected to do?  We deliver a dead baby, then we go to the next room, put on a smile and deliver a well, healthy baby.  And we keep going... and keep on going.  The healthcare system does not allow us time to grieve and no time to process our own feelings about this.  

 I also spent my younger years developing a non-profit organization that did work in Africa and the Caribbean.  I put my heart and soul into this organization and spent most of my free time working voluntarily for this.  Over time,  I felt myself preferring to organize from afar, and taking care of actual patients became very tiring and emotionally difficult.  I couldn’t give anything anymore.  I would say things to myself like “I have to do the right thing” and I knew I was tired, but I would continue to over-extend myself, it was part of our training.

 Eventually, that didn’t work anymore.  I think the breaking point was the death of my father. After his passing, I really was very numb and while I could fake a smile and pretend to love my work, deep down, I knew something was wrong.

 Several years later, my trip to Peru changed everything.  I did 8 ceremonies with Spring Washam, the Shaman, two other facilitators and a group of about 20 participants.  I noticed that there were some very successful people there, they all must have been searching for different answers.  As the traditional Western meaning of success didn’t seem to be what they were looking for.  

 After the first ceremony and spending some time really thinking about maybe having PTSD, and consideration for quitting the retreat, I persevered.  With the 8 ceremonies, I felt like I had really done a full circle with my life.  I really started appreciating childbirth and the work that I do. When Spring said “you deliver babies”, what she was saying was that I am strong, and I do beautiful work. Seems rather un-real- how is it possible that I have delivered thousands of babies and I never really felt like I understood the joy behind it all? And even for my own pregnancy as well, which was very difficult with both maternal and fetal complications.  I now see how much I removed myself from my pregnancy and turned it into a clinical event.  

 I now know that what I was doing before the retreat was trying to escape for several years.  The buildup of my work, and the difficulty of home life with very young twins - I would carefully calculate a schedule that allowed me to escape my reality on a daily basis.  I thought I was being mindful and practicing equanimity with the ups and downs of life, when in fact, I was just plain numb, living in a delusion and completely tuned off from my feelings.  

 And now the fog has been lifted.  There is still work to do, and the challenges of every day big city life have not changed.   However, when I go into a room to see a patient and I am smiling, I am truly smiling. It’s not fake anymore. And I am taking more time, engaging and listening more, and realizing “hey- I used to do that” - I used to really care about them and it feels really good to do that again.   At home, I am experiencing more joy with my kids.  I enjoy their hugs and their cuddles more, their laughing and their love.  

 I continue to meditate and practice self-care.  I still have work to do, but the retreat was a huge accelerator in the right direction.  I continue to be mindful about slipping back into bad habits.  I am so thankful that I had the opportunity to attend the retreat, see more of my true self, and be able to feel again.  Occasionally, I do slip back into being disengaged at work, but I am able to see it more easily and correct it.   The two weeks in Peru was one of the most challenging things I have ever done, but I am living a happier and more joyful life, at work and at home.  My heart is more open now and I am able to give my patients the compassion they deserve.