I woke up this morning in Lake Como. Hard to imagine: it's been a long day, including a delayed flight, a two-hour drive on this end, and my son's entire wardrobe is currently presumed to be somewhere in Europe, hopefully headed home soon. After ten days in Tuscany, Baltimore never looked more drab.
When I go on vacation, I always worry, even if just a little. I have patients (fortunately just a couple) who fret for weeks in advance about my absence-- the funny thing is that the patients who worry most about my vacation tend to be the ones I worry about the least. There is always at least one psychiatrist available for emergency coverage-- for this trip there were three doctors covering-- and I remain torn about whether to leave my contact information. These are competent, experienced psychiatrists who can manage any emergencies just fine without me, but what if??? Not to mention the fact that it's rare that anyone actually calls my coverage for anything other than prescription refill authorization, and even then, folks usually have checked their supplied before I've departed, or somehow they manage. So, if I leave contact information and I hear nothing, I can assume everything is fine. Or if I call and check my voicemail, and there is nothing earth-shattering, I can also figure everything is fine. But if something isn't fine, if I'm checking my messages, calling people back, getting aggravated about the non-urgent things people want (...Oh, despite the "I'm away and unavailable" message, repeated demands that I call back as soon as I return because there is going to be an issue with the patient's insurance next month...not my idea of what needs my immediate attention upon re-entry) then am I really even on vacation? I feel like one of Seligman's rats in a learned helplessness experiment--the light isn't on, it's safe, if the light is on, watch out here comes the shock.
Really, though, Doctor, it started in my professional childhood. A newbie to private practice, I was off for just a few days, and having not yet figured out that they could live without me, I gave my contact information to the covering doc, also a newbie. I left worrying about a patient who had uncharacteristically missed an appointment with me the morning before my departure. As my husband packed the car, I made one more call to his house and left yet another message on his machine. His mother, upon hearing my messages, called the covering doc (who then called me) to say he'd been killed in a car accident. There was nothing I could do, but I spent my short vacation second guessing myself-- was it really an accident? Could I have, should I have, done something different-- the accident was his fault, was there something I could have foreseen about his mental state that predisposed him to being in the wrong place at the wrong time? I also spent my trip grieving the tragic loss of a promising young life, I was very fond of this gentleman. If I had it to do over, would I have simply not wanted to know for a few more days? Even asking feels selfish.
I haven't found the right answer, nor am I really looking. I don't let myself check my voicemail, it tends to aggravate me. It is, however, the first thing I do when the plane lands, while I'm waiting for the baggage to arrive (or not), and I always feel a bit of relief when nothing too bad has happened. No one I was worried about called; there was however a message from a new referral asking that I call her back right away as she wanted to be seen within 24 hours (hmmm... ClinkShrink, do you see 'em that fast in prison??).
And for this time, the answer was that the morning I left, I emailed the covering docs with a phone number for my international cell phone. Jet lagged, feeling like it's 4AM, on my twelfth (or so it feels like it) load of laundry, wishing for my Tuscan hilltop, but mostly glad to be home.
And can you believe that neither Clink nor Roy posted any pics or cartoons while I was gone???