In Shock: My Journey from Death to Recovery and the Redemptive Power of Hope

by Rana Awdish

I knew love and pain and sorrow could keep us together, but it could also reduce his life to waste.

I was relying on them to keep me alive, and yet I was left feeling as if they were not entirely worthy of my trust.

We often get the big things so perfectly right only to fall apart on the smallest detail, like the four cents saved per line.

The emotions of patients are encoded in their behavior. It’s an easy task to recognize a crying person as sad. But a compulsively attentive patient, documenting every lab result and asking well-formulated questions about antibiotic choices, is less easy to decode as anxious. I myself didn’t recognize my own anxiety at the time. I believed I was appropriately adapted to my environment. An environment that required intense vigilance and anticipation of some impending cataclysm. The casual complacency I observed in others struck me as horribly naïve. Every solicitation to “just rest” filled me with contempt. I knew what would happen if I left the watchtower untended. I would die. I believed it was entirely up to me to ensure my own safety.

There were large pieces of me that were still submerged.

The odd thing about being completely terrified is that it cannot be maintained as a constant state. Though I certainly tried.

I became tired of being scared. Tired of imagining every worst-case scenario, running imagined contingency plans. As days passed without my worst fears coming true, I began to feel that perhaps all the anxious worry was, in fact, actually useless. After all, it wasn’t really preparing me for anything, except to die. And if I did die, well, that would be how the story ended. I divested from any outcome. I stopped believing worry could change anything. I learned to wait and see. More often than not, the following day brought with it some small but tangible measure of improvement.

had to learn to soften; I had to learn to accept my body’s limitations. I had to value humility and choose to surrender when my first inclination was to force. I had to work each day toward a goal that seemed unreachable at times.

By clothing myself, I was in effect reintroducing a version of me. A bloated, scarred, disabled and inferior me. What should have felt like a victory felt instead like a resignation.

I had lost my sense of myself as a strong, capable, independent person.

I thought he should have married someone else. Someone as healthy as a thirty-three-year-old was supposed to be. I thought he got a raw deal.

On the ride home, I was angry at Randy for not memorizing the topography of the route. I couldn’t comprehend how he could forget something as important as the location of the potholes. The stabbing pain caused by every bump in the road was a quick remedy for any delusion I had concocted of getting out more often.

I didn’t know how to try harder to recover. I felt trapped in a body that was traumatized and broken.

I learned that what was true of pain was true of most feelings. I didn’t have to just submit to them, I was actually central to their construction. I could build a story of sadness and read it to myself, or I could choose not to. I could choose to honestly examine whether I was using the loss as a tether for feelings I didn’t know how to part with. I could redefine my identity and claim my desired emotional state. I could choose not to feel guilty for not feeling everything all at once, at the precise moment it was expected of me, because the feelings would continue to come, for years. And with each go-round I better understood how we could peacefully coexist.

Hope was not, as I had believed, an unrealistic, unfettered optimistic emotion. Hope was an orientation, a way of being in the face of a reality that was not of their choosing.

The trouble with outward manifestations of illness is that they are provocative. People interpreted my lack of hair as an invitation to discuss my relative health in a way that they weren’t empowered to when there was no visible indicator of illness. Everyone seemed concerned, and genuinely horrified for me, to have to exist in the world while looking so terrible.

I am not sure I understood what was motivating my behavior. I know I didn’t recognize that an emotion was driving my compulsive research. I would not have characterized myself as particularly anxious. In fact, I would have labeled it something else entirely if asked. I was advocating for myself. I was educating myself. I was taking an active role in my care. In retrospect, I can recognize that I was also completely terrified and, not knowing how to quiet my fear, took the only option I thought available to me: to attempt to bludgeon the feeling into submission with data. The problem with responding to emotion with data is that emotion doesn’t recognize it. Ironically, I was making the same mistake with myself that physicians make with their patients. I was not naming or tending to my own emotion.

Did I actually want to know the relative tensile strength of varying types of mesh? No, I didn’t. Did I on some level believe that I needed that information in order to make decisions about my surgery? Yes. On some level I believed that I did. But it was never going to work. I was scared. I knew my surgeon had thoughtfully considered each and every option and had chosen a plan that took so many different variables into account that I wasn’t even capable of enumerating what they all were. He is brilliant and trustworthy and thoughtful. But fear doesn’t respond to data.

Emotion shuts down the rational, cognitive portion of our brains. Anyone who has attempted to reason with an angry spouse or use logic to get a toddler over a tantrum understands this on a visceral level. Emotion demands to be acknowledged and appeased before it will disengage its controlling grip on the higher centers of cognition.

We cannot change that which is true and sad. But we can acknowledge it. We can humbly witness suffering and offer support.

Because shame and guilt and sorrow always float.

Who we are when everything is stripped away, in our barest moments, is something we don’t routinely examine. When a horrific loss uproots us, we leave pieces of ourselves behind in the soil, the structure on which we built our identity reduced to nothing more than an absent appendage, left behind to rot. We define ourselves, our very identity, by our relationships, and when we lose someone, in the exchange we lose a noun that defined who we once were. We return to our lives as truncated versions of ourselves. We cease being wives, mothers or daughters as we accrue losses. We become the next version. I was not able to be the physician I had been, and I was no longer an expectant mother. I would always be a patient. In the ruined, rotting parts of who I had once been, I found dignity and beauty in the decay.

I saw how much we all hurt in the same vulnerable places. The shame of doing your best and never having it be good enough left its mark on each of us.

In lieu of actually feeling our feelings, had we subverted them into quick, pithy one-liners to deflect emotion?

“I thought I was going to die in the stupid elevator.” I added a half-laugh to my cry. “No one was going to let you die.” “That’s the thing, we can’t stop it. We don’t ‘let’ people die, they just die. We can’t stop it.” I thought of my team after our patient’s death, their faces as sad and raw as circus clowns who had just wiped off their painted-on masks.

I realized that his willingness to witness my suffering had changed it somehow. He held what he saw and was never repulsed by it. He didn’t attempt to evade it, but he also didn’t intrude on the parts that were wholly mine. Because he understood there were parts I was possessive of, accepted that while I wanted him to know what I felt, I also needed him to know my pain was unique to me. Not all of it could be shared.