Dark Cloud, Bright Light

 The Waterloo Clinic in Sierra Leone.

The Waterloo Clinic in Sierra Leone.

Talking about life the other day with that friend in my head, the one sometimes called a conscience, I found out how long it has been since the last time we had the opportunity to speak. Me and myself have been disconnected for a while and until this night in Waterloo, as the sun sets and the clinic doors close and the voices stop, it is then when we realize how much we have missed each other. I turn on a candle and I place next to my bed. It throws a very weak light that moves around the room making the shadows dance and creating unfamiliar shapes.  I recognize some nice smell from the candle and then I put my head on the pillow, close my eyes and relax my body. No one is around. Just me. My mind switches on and the memories come as small raindrops hitting the conscience and soaking my whole body with different sensations. I try to bring something from the old memories, something that can calm my anxiety. For some reason recently I’ve been upset, tired and depressed, but now there is something even more powerful…

I keep lying on the bed, with my eyes closed; the light from the candle is weak. Suddenly some memories get into the room, a black smog penetrates my forehead, and I feel a cold and heavy sensation in my chest. That sensation then enters the rest of my body as a metastasis of a bitter emotion. I know what’s happening; I felt this before, during the long days of work in the clinic or during the long nights of work on my last project. It’s something heavy in my shoulders that take the words from my mouth, something that makes me frown and get frustrated. It’s the dark cloud.

The dark cloud gets stronger, especially after seeing patients the whole day, talking in different languages, listening to people complaining about anything and everything and always asking for help. I’m not blaming them, they are sick and probably I’m their last or unique resource, their last medical hope. But also, I’m human. I have the same weaknesses and limited resources of patience and energy as any other person, more limited than many of my patients. I am tested when someone knocks the door late in the evening asking for something or when they greet my friends in the street, but for me there is no greeting, only “doctor I feel pain here.” And the dark cloud just gets bigger.  I knew before coming here that it would be this way. Well, I was told, anyway. I knew this kind of immersion would be much more intense than other types of jobs. But it has taken being here to fully realize how intense this work is. The loneliness. The isolation. Low grade illness. A monotony of diet. All of this is enveloping me. I remember what I read the other day in a famous Medical website, an article about physician burnout and depression. A report that makes me even more depressed.

With my eyes still closed I’m surrounded by a deep darkness. I’m standing right on the edge of the precipice and it seems that the darkness that awaits me at the bottom of the emptiness is the only destiny I have left.

And then, a notion, a movement in my soul. I am relieved. I can see a small light approaching me; it is as small as a coin and shines with a yellow and warm light struggling against the darkness that surrounds it. Finally the light make a soft explosion right on my left ear, I recognize the voice, is my mothers voice. “Te amo hijo mio. You are my biggest gift; you gave me happiness and hope. Then you grew up and your dreams with you, and I had to share your attention and love. You became a doctor, a gift but also a curse if you see it like this. People will always see you as a doctor and they will always ask for your help. But you can also see it as I see you, a blessing of life, a resource of hope especially for the sick because you are an instrument of God— even if that makes you suffer sometimes. Be humble and treat everyone with respect because you don’t know how much they are suffering and how hard their rout in life has been. You are my biggest pride; remain my boy, keep young in your soul, be that beautiful child I have always loved. I love you”.

 The author at work.

The author at work.

New ideas hit me now. My conscience is overflowing, it rolls from my eyes and those tears are bittersweet. I feel shame due to all the mistakes I have made, the judgments I levy, the weaknesses that fill me. But even as I count my shame a new sensation takes hold of me. It fills my body. The anxiety retreats. Beautiful memories start in my mind… the smell of the wheat grass, the sound of the rain, my siblings laughing, the paper ships we made with dad, I’m running on the water, my little dog jumps around me, the hot milk after the shower, everybody sitting next to the fire, dad storytelling, mom is hugging me, my grandpa is smuggling a coin into my pocket and Grandmother is making very funny jokes. I continue like this for time enough to feel again all these different memories, to locate them again in my heart. I open my eyes; the candle light is shining as never before and I can see the whole room fully lit with new positive energy. Alone, I feel anything but. I feel as connected as I have ever been.

That night was like no other. That night I realized how important it is to be alone. I realized why why the saints, prophets and monks of any faith choose remote, lonely and peaceful places to finish their pilgrimage and reconcile themselves to God. I see, if only a little, that the way of struggle and intense suffering is the way to an answer about this life. We choose to volunteer here as a way of redemption and in doing this work we find our biggest struggles and our biggest vulnerabilities make us stronger humans. People that can look in the mirror. I fight these battles very differently now after nearly a year here. I respect my body and health much more than before, it’s a gift time spent here has given me. I still am learning and I’m not sure if am right or wrong, but there is one thing I will never doubt again: The power of gratitude is unmatched. The power of thank you from my patients is incredible. It overcomes almost everything. And when I am grateful, I am better.

The dark cloud remains, though not always so dark. I keep fighting it with nights like the one I have just shared with you. I fight it best when I allow the candles light to shine!

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Sergio Castillo1 Comment