One Rule from a Working Life

“What is to give light must endure burning.” — ANTON WILDGANS (not, as we were brought up to believe, Viktor Frankl: yet another thing someone should have told us)

Some nights I dream of fighting off rabid squirrels, ripping them to shreds with my bare hands as they cover me with tiny pinholes of venom. A nightmare on high-amygdala-alert. My brain’s trauma center is saturated. This is how I know I’m working too hard in our world of health care in the new age. Other nights I push through hundreds of patients in a waiting room as cluttered as a Hieronymus Bosch painting. Nothing bad happens. Just one soul after another. They need miracles. I need more Viktor Frankl quotes. I swim to the surface for breath.

When I do vicarious trauma trainings for other health care professionals, all I have to offer is some neurophysiology, some diagrams of the walnut-size limbic center tucked mid-brain behind our noses. Is it a weak metaphor, the little peanut amygdala tucked in the walnut of the limbic system like a truffle? With the light switch always on? Pumping bad chemicals through too many food references? The recommendations seem condescending. “Celebrate successes big and small.” Which Viktor Frankl did not say. Nor did he really say that famous line that followed us through our training, that we have framed on our office walls, that we too must burn if we are to heal others. 

Some nights it’s a liver blown up against the snow. An accidental patchwork of phlegm and bright persimmon clots. Or is it pomegranate? It’s a nightmare, after all. I picked persimmons—not pomegranates—in an Israeli field amid bugs and vermin the size of squirrels. I was young then. There was no snow in the Israeli field.

More recently it has been a heart gnawed apart by its own impulses. Its septum pulling apart, Purkinje fibers sparking, sputtering. Then I roll over on my Zio patch or my Holter monitor, whichever I have strapped to my chest this time, and I remember, with a start that wakens me, that it is my own heart under investigation.

Its thinning upper septum, missing septal artery, left axis deviation. But still a good squeeze. To give light I must keep on burning.

Nina Gaby is a writer, visual artist, and psychiatric nurse practitioner. Her writing has been published in anthologies and journals, and her visual art is held in collections including Arizona State University, Rochester Institute of Technology, and the Renwick Gallery of the Smithsonian. She has maintained clinical practices in both New York and Vermont, specializing in general psychiatry and the addictions; has taught at the University of Rochester, St. John Fisher University, and Norwich University; and presents trainings and workshops in the arts and writing.

This essay first appeared in print in Quarter After Eight, Vol. 23 (2016).