Friday, September 20, 2013

Full Moon Blues


I really believe that people (including, or maybe especially me) are crazier when the moon is full. I know it’s unscientific and an old wives tale but in my experience it bears out that my roughest workdays are full moon days. This week the full moon was on the 19th, and the 18th-20th have been really, really challenging. It doesn’t help that I’m on call, so I’m not even getting away from it in the evening. I told my husband this evening that from now on I’m checking the phases of the moon before I sign up for call.

I say this in part because I’m feeling bad about an interaction I had at work earlier. It had been a very, very busy day with a number of frustrations and so when I got a call around 3pm that there was yet another patient in the emergency room and that the patient was not suicidal and not homicidal and only there because of a relationship problem and wanting some counseling I felt frustrated.

If you don’t already know, the ED is not the right place to go for counseling. If you are in crisis, if you are suicidal, if you are homicidal, if you or a loved one is hallucinating or delusional, then yes, please come to the ED. Please come right away and let us help you stay safe and get to the next step in care. But the ED is not a good place for counseling. It’s noisy, it’s busy, you’re likely to wait a long time, and you’ll be seen by someone who won’t be following up with you so you’re just going to have to tell your story all over again anyway later when you get referred to a counselor who will see you long-term. That said, if you show up to the ED in my hospital looking for counseling, you will get seen and the ED physician will page the on call behavioral health staff to come talk to you. Which is what happened this afternoon.

I got the call to the ED through another person and I went down to the ED to see the patient. I ran into the person who had paged us and I gave him a bit of a hard time, stating that while I was there to do the consult I wasn’t happy because it really wasn’t an emergency. He got really mad at me (I think maybe more mad then my comment called for, but I shouldn’t have said it) and then walked off. A few minutes later I approached him and apologized and said, “I’m sorry, I shouldn’t have given you a hard time.” He grunted something at me and wouldn’t look at me, so I have the impression he’s still mad. And I feel bad about that, because I try really hard to get along with people in my hospital and to be professional even when I’m under stress. And I feel bad because I know I will work with this person again in the future, and I need to have a decent working relationship with him. But like I said, it’s been a super rough couple days and I think I get affected by the full moon too.

I’m trying to think about this the way I would talk to a patient about it. I’m reminding myself that I’m not perfect and that I can’t expect myself to never have a bad day. I’m reminding myself that I did show up to see the patient and that I saw many other patients today and hopefully did some good. I’m reminding myself that I’ve had many good interactions with this person, and if he can’t cut me a little slack one time, especially after I apologize, then the problem and fault lies more with him than with me. (Although I’ve also had that experience – someone holding a long term grudge against me and treating me badly because of a negative interaction that followed many good ones – and it still feels terrible even though I know it is the other person’s problem and not mine.) I’m reminding myself that I’m just not in control of what another person thinks or feels; I can only be responsible for my own behavior.

I’ll be honest. It helps, some, but I still feel bad. So I think I’ll be more careful about avoiding call on weeks with a full moon.