Let’s Talk About Crying

Let’s Talk About Crying

Women in Oncology

Jul 25, 2018

Dr. Julia CloseBy Julia Close, MD

There are a wide range of criers. At the bottom of the scale, you find my husband: the type you suspect has some sort of congenital condition wherein tear ducts failed to form. (For the record: Pete, my husband, has a huge heart and is a wonderful human being. He just doesn’t cry. Ever.) At the top of the scale, you find the cry-on-command individuals. You know them: happy news, sad news, news that isn’t even news, always crying.

In between, there’s me. I cry at movies and funerals. I will shed a few silent tears with a patient I’ve held near and dear to my heart, or at the news that a close friend has finally been able to conceive after years of trying. Rarely is it the get-me-a-box-of-tissues-now crying, mostly the kind of crying that can be managed with a subtle and deep inhalation through the nose.

As much as I try not to, I view crying, mostly my own, as a weakness. A few years ago I attended a women’s leadership conference for early-career academics. We had spent the two days prior discussing a variety of issues pertinent to the advancement of women. On the final day, a speaker declared, “Let’s talk about crying.” She asked the audience of bright, successful women, “Who here has cried at work?” After a minor delay, as many of us looked around, hands went up. It was most of the attendees. She then asked, “Who is embarrassed about it?” Our hands stayed up. It was liberating to see how common this experience is.

She went on to give some of the best advice I have ever received. She told us we probably cannot make it stop altogether, although some have success inducing pain by biting the lower lip, or other subtle maneuvers. What she recommended is we own it. Name it. Declare it.

I had the opportunity to try this out a few weeks later. In negotiations over a new position I became frustrated about the proceedings. I felt the tears begin to well. Rather than fight it, as it was probably obvious to the limited audience present, I owned it.

“Clearly I have strong feelings about this. I suggest we continue this meeting at a later time and regroup.”

The parties present agreed. I left the room, pride intact. We had another meeting two days later—and negotiations went great.

I often teach about breaking bad news. I explain how to express empathy and, when needed, fake it. Part of this is acknowledging what is happening—identify the patient’s sadness, anger, frustration. A simple way to calm someone who is completely overcome in hard, shaking crying is to offer a box of tissues. This act of empathy acknowledges the emotion and, more often than not, calms the crying. We can do the same for our own emotions.

I have gotten better at confrontation. I have been an administrator on a variety of fronts for many years now, and I’ve learned (and accepted) it is not personal, which has reduced the triggering feelings for me. I’ve been yelled at and called names. I have felt frustrated at the proceedings. No crying.

However, I’m still not immune. Last week was one of those weeks.

I was not having a particularly bad week—every little thing was manageable. There were just too many little things. On Friday, the vet placed our English Bulldog puppy in a cone for a small corneal laceration. On Saturday, the alternator on my car went out. On Sunday, I decided to check the letter that had arrived on my recent vacation regarding jury duty—to discover I was to report on Monday. I called around and found clinical coverage.

Monday morning came. My dog’s eye looked worse. No problem, I dropped the dog at the vet on the way to jury duty in my rental car. I sat in jury duty, smug about what a good citizen I was being. I had life under control. Physician moms are a tough breed—we push ourselves on every front, and often succeed. We persevere. My plan: jury duty over at 5 PM. Pick up kids by 6, pick up dog by 7, drive to car dealership by 8, and stop by the eclectic pizza place on that side of town to feed aforementioned children an amazing dinner. All while my husband was working late. I thought, “What an amazing multitasker I am! I have got this working mom thing down.”

On the lunch break, I turned my phone on. Multiple message from the vet and my husband. Sparkles the English Bulldog needed to go to the university vet immediately, something about a hole in her cornea and—I am pretty sure—the vet said something would melt if not addressed immediately. Not sure what was melting, but I had never used that word in all my years as a people doctor, so it sounded very, very bad. My husband informed me his car was also in the shop, he had a waiting room full of patients, and would prefer I manage the dog emergency.

So now I needed I get out of jury duty, although the judge had said 4 hours ago that we were all needed and on one would be excused. I had not been picked for a jury yet, so at least I wasn’t deserting the criminal justice system completely.

I returned to the courthouse, where it turns out everyone even remotely related to jury duty was also on lunch break. I went to the information desk and explained I had an emergency, but not one listed on the reasons-to-get-out-of-jury-duty card. She called many people with no answer. As I stood there waiting, a variety of individuals came to the desk—most notable, a woman with three kids asking where her husband’s trial would be. Standing there, I thought, This is a really crappy day. But none of it is really bad: my dog will be fine, no one has a new diagnosis of cancer, and I’m not here looking for my husband, who may or may not go to jail. I just have a series of inconveniences, piled on each other. I can keep this together.

Finally, the very nice woman (VNW) at the information desk informed me that, while she did not mean to pry, if I could explain the emergency she would go find someone to explain it to and see if I would be excused. I started to tell her about Sparkles. I felt the tears coming. I thought, Do not cry! This is not a situation that calls for crying! The VNW said, “Don’t cry on me, or I’ll cry, and then I don’t know what we will do.” I cried, and VNW started to cry, and told me to go take care of my dog.

My dog had emergency surgery. Her cornea did not melt. She is still in a cone. I picked up my car, and my children, all on time. Rather than pizza I took the boys out to a Japanese steakhouse. I may any day receive a letter stating I am in contempt of court, but it has not happened yet.

Let’s talk about the crying part of this story. Immediately after the fact, I was disappointed in myself. Not only did I feel vulnerable, but I let that vulnerability show. I told a close friend about this, and she sent me this quote from Glennon Doyle, an author and activist:

“Bring all of yourself to life. And if you’re told you’re ‘too much’—smile and think: Maybe. Or maybe their capacity is too small?”

I’ve decided to own my tears from that day. Not everyone may agree, but my pet is part of my family. It was a hard day, I was stressed, and when I’m stressed my emotions come to the surface. It is part of who I am. I will continue to tame the raw emotion in many situations, especially at work. But at other times, I’ve decided to accept that for me, tears are part of experiencing life.

Dr. Close is a clinical associate professor at the University of Florida, where she is the program director of the Hematology/Oncology Fellowship Program. In addition to education, she is focused on performance improvement as the assistant chief of medical service in the Gainesville VA Medical Center. Follow her on Twitter @JuliaLClose.

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