How I Learned to Give Permission to Myself | The Doctor Weighs In
By Gavin Clark
Medically reviewed by Margaret Cary, MD, MBA, MPH
A medical student finally learned how to give permission to himself to explore his memories and experience his emotions.
Permission is a heavy word. When we are young and have little agency, permission takes on the most superficial meaning: asking for something tangible. It’s innately tied to something we want in the hopes of bettering the moment.
As we grow and our desires begin to intertwine with those around us, permission begins to involve incorporating others. We ask for dates and we ask for intimacy.
Either way, you cut this, though, we are asking something of someone else on behalf of ourselves. For some, this is where their understanding of permission ends. It is as neatly contained in wanting something that can be provided to you.
For some lucky others permission carriers a third, more potent, meaning. One with an internal locus. It is a chance to ask permission of ourselves for ourselves. Some come to this conclusion naturally and without effort. Others require outside help. I am one of those latter types.
* * *
My parent’s wedding
The first time I wore a suit I was five years old, and I looked sharp. I know I did because there is hard photographic evidence. Also, my parents told me so.
I can’t imagine the story that they sold me on to get me into that wool monkey suit. I know it wasn’t playing into my sense of vanity — my brain hadn’t developed that far yet. Knowing my parents, they probably plied me with kindness, threatening me with a good time, so to speak. I couldn’t have imagined a better incubator than those two.
Looking back that’s probably why I was so excited to be the ring bearer at their wedding and the suit came along with the job. That’s right, you heard it here first, I am an old school full-blooded bastard child.
But this was California and my parents had put more than a healthy distance between themselves and any churches, so no one minded very much. Besides, it was too hard to pay attention to anything much beyond just how well everyone was dressed!
I am sorry to say the wedding bliss was short-lived. They separated six months after that day but wouldn’t manage to make it official for another thirteen years.
Those months were strange. I don’t remember the fighting nearly as much as my five older siblings’ reactions. The house was a charged ball of chaotic energy. I was confused, but my siblings were terrified. They spoke less, laughed less. Their silent tension slowly built into a barricade.
They had already seen our mom go through this with their dad. They knew the pattern. Arguments in private turned into strong words. The vitriol that refused to be contained to the bedroom would ooze into the rest of the house ignorant of time or place.
The “family dinner” would no longer be sacred. I could feel the expectant tension as my siblings waited until something would be said that couldn’t be unsaid. They were waiting for the sign that they would have to move — again.
I siphoned their emotions because I felt like I couldn’t find my own. And, I poured my love and energy into them, trying to spread their burden onto one more set of tiny shoulders. I wanted so badly to prove that I would never take a side and that my brothers and sisters were my family despite only sharing a mother.
In the end, their clairvoyance proved spot on. We moved out before I turned seven. It was probably better that way, that house had become too hot.
My new childhood home
Moving felt fresh (messy, emotional, sweaty freshness). After a little real estate Goldilocks-ing, we managed to move into what I decidedly call my childhood home.
It was an old avocado green 1950’s single floor house with two bedrooms. It had an un-insulated outbuilding my mom would convert into her own living space. A flimsy chain-link fence guarded the front yard.
My favorite part of that house was the hallway with an in-floor gas furnace hidden just below a grate that would have fit into any Film Noir scene.
On brisk winter mornings, the five of us would crowd into that three-by-seven hallway and straddle the grate. We thrilled by the warm eddies of air swirling up from below.
Jasper, my golden retriever
To round out the picture we went ahead and got ourselves a soulful golden retriever, Jasper. His eyes were the same caramel color as his coat. He seemed entirely human to me. In fact, he’s the reason I honestly believe in reincarnation.
The only thing he loved as much as us was the fact that we lived en route to the junior high. Every day around 3 pm, he would stand on his haunches at the corner of the fence and make a head-petting machine out of the Conga line of kids that passed. He probably managed to double his dinner that way too. As these things happen, one day the gate was left open and Jasper got out.
Walking up to my yard I had the visceral sensation of stepping into a cloud of frenzied emotion. I remember it tasted like metal. It pulled up on me from some deep place, displacing my breath, and thickening my tongue.
My dog was dead.
I knew it before I saw it. My family was huddled as if over that heater, trying to shelter from the cold. But it was Fall and they were in the middle of the road.
Their pain was so palpable and so big, I couldn’t get in the way. I didn’t have the bandwidth. Instead, I walked inside and grabbed a sheet.
My dog was dead, and he was blocking traffic. I eased his body onto the sheet with my brother’s help. We began to haltingly drag the dog out of the street. We had to pause every so often because my brother couldn’t see through his tears.
“Go inside, I think I can get him,” I said.
My twelve-year-old body made slow work of it but I managed to get him into the backyard. I found a shovel and started digging. I didn’t stop until I was down to my shoulders.
It probably took hours. I don’t remember the sun going down or my family coming outside to stand watch. All I knew was that I had to do this part. I could focus on the other part later.
Besides, my family was already feeling it more than I probably could. We said goodbye that night with the heavy finality of a closing ceremony. I wanted to go inside. I was so empty.
Maybe I’m hungry, I thought.
* * *
Many years later, I was off to college with all the trappings therein: exams, girlfriends, parties, and friends, and too many hangovers.
I had risen through the ranks from a bushy-tailed Freshman to a wise and all-knowing Junior. I was through with the Gen Ed courses and it showed. In fact, I was taking the most rigorous physiology lab course of my life that included vivisecting a frog.
This was big. But bigger still was the forty-page lab report that was due in about a week. It was timed perfectly to overlap with my quarterly exams. It was time to buckle down and prove what I was worth — after all, medical school was on the line.
As I’m getting my mind wrapped around this final push, I get a call from my mom.
Too busy for Grandma
“Grandma’s doctors say she isn’t doing well,” she said, laden with heavy undertones.
Grandma had been transferred to a 24-hour care facility once her early-onset dementia had progressed too far for us to keep taking turns caring for her. Now her disease was picking up speed.
They were confident that now was the time to get in any last goodbyes. My family was driving north and could detour to get me. I had been too busy to see her, other than over summer break. It looked like now was no different.
“I can’t mom, I have too much going on right now”.
I instantly hated those words. It felt like the easy way out. But it was true, too.
A vision of my last coherent conversation with my Grandma flooded my mind. We were spending the day on the patio watching the geese when she suddenly became present. Then the light behind her eyes changed (brightened maybe?) as she looked up at me.
“You know, I was a nurse,” (I didn’t) “and I am just so happy that you’re going to be a doctor,” she said with conviction, finality, and purpose. There was nothing to discuss, she was proud that I was going to be a doctor.
I didn’t go on that final goodbye trip. Instead, I got another call a few days later, she had passed.
I had so much work to do.
* * *
Years later I started bartending to make ends meet while I applied to medical school for the second time. It was a hip bar, built into a cabin with exposed Edison bulb lighting. It has intimate corners for quiet conversations.
As a part of the job, I made engaging conversation with anyone that seemed to want it (and probably a few too many that didn’t). I met Lacy there. Whip-smart and lithe. I didn’t stand a chance.
We dated in an engrossing whirlwind, sprinting past conventionality and milestones. We were operating on a deeper level of intimacy than I was used to. And it happened so quickly.
It might help to mention that she was a yogini, trained in that mystically centering art that eschewed so much of convention. Her emotional mind and logical mind seemed to work in tandem. They seemed to be a tag-team that could tackle anything that stood to challenge it.
I was completely impressed. When she felt something she truly felt it. She had no need to make excuses. Her ability to be present was uncanny. What’s more, she asked the same of me.
The wedding invitation
We had finished eating dinner and were sharing a bottle of wine one night at her chic apartment in the city. The wine was letting us skip the surface talk with a misbegotten sense of warm confidence, smooth sailing.
It was amicable, fun, light, and flirty. Our laughter bounced around the small room, disturbing her snoozing cat. We smiled back and forth exchanging excitement for the present and thrilling in each other.
She stood suddenly, “I have to run and grab something real quick.” She flitted out of the room, returning with an RSVP card for her sister’s wedding. Eyebrows arched, eyes bright with mischief, “Well…?”
Is she just testing my reaction?
“Well, what?” I said as I looked at the card and saw that it had already been filled out with both of our names. I guess I was attending.
“I’ve RSVP’d for us both!” Yup, I was unwittingly attending.
Something about this doesn’t seem right.
Shouldn’t I have been asked… on second thought, shouldn’t I be feeling excited?
I cannot recall the next few lines, but I can tell you that they were not what she expected. What I do remember is that her eyebrows stayed the same — excited, piqued, probing — but the eyes changed. Their previous vibrancy had become tarnished like old silver, the indescribable shine dimmed.
It was one of those rare moments where premonition meets reality. We were navigating rough seas with thunderheads closing in. The room was getting hotter and the words more desperate. Maybe we had had too much wine?
Suddenly she snapped me back into reality. It wasn’t anything she said per se, but somehow she just stopped. Stopped me, stopped her, it felt like she stopped time.
“Talk to me, I know this isn’t everything that’s going on.”
Yes, it is. Of course, it is. Why wouldn’t it be?
“You can talk to me outside of this, outside of us.”
What does she want?!
“I’m giving you permission. It’s okay to feel. Talk to me.”
As suddenly as the waters of our night had shifted, something in me was altered. I pushed myself up from the table. I couldn’t understand what was going on. My mind was reeling and completely filled. I couldn’t think. What I was feeling seemed to be completely out of proportion for the moment.
Related content: Seizing Permission to Live Life on Your Own Terms
I haven’t had permission before.
I had to leave. There were too many lights and I was too exposed. I walked to the bedroom and moved to the bed without touching the lights. My throat was raw and hot, my stomach a tightening and writhing mass.
She came and laid with me then as my head spun. She picked up a mantra, “it’s okay, you’re okay. It’s okay, you’re okay.”
It felt like a dam had burst and my emotions came roaring and tearing through my mind. I was helpless to control it.
It smashed through this year, the loss of sense of self after failing to get into medical school for the second time. And, into memories of the years before.
There was my inability to be the man my Grandmother thought me to be and choosing instead to miss a final goodbye. As a child, I never mourned my dog or the loss of my family unity.
She gave me permission to take a moment for myself
So many emotions engulfed me in short succession. These were things I hadn’t felt before. Or maybe I had? Or maybe I had but just not enough. I was dizzy.
She had given me permission to take a moment for myself and see what was really going on. I don’t think I had ever done that. And, I don’t think she or I expected it. But this was the honest answer to such a simple question. Why had I felt for so long that I couldn’t ask it?
Other medical student stories:
A Mother’s Howl: A Medical Student’s Lesson on Giving Bad News
My Grandparent’s Agonizing Deaths Taught Me to Be a Better Doctor
We stayed like that, in a sort of altered plane of existence for as long as I needed. The stacked dominoes of my memories, my traumas, the moments I needed to apologize for fell over each other in rapid succession.
I don’t know how long we were there or for how long I mourned. I just know that it was the sort of place that hurt so much it felt good, like turning the shower almost completely hot right before stepping out. It makes you feel clean for just a minute longer.
Permission had taken on a whole new meaning. So did catharsis.
This story was initially written for a course the author was taking called “Reflective Essay: Writing Your Experience.” It is one of the most popular electives at Georgetown University School of Medicine where the author is a medical student. It was developed and is taught by an adjunct faculty member, Margaret Cary, MD, MBA, MBA, PCC. In addition to being a writer and educator, Dr. Cary is a leadership development coach, trainer, and contributor to TDWI.
Gavin Clark, MS attended the University of California Davis where he received a BS in medical microbiology. He then went on to receive his MS in physiology at Georgetown University. He is now a second-year medical student at Georgetown University School of Medicine where he is a member of the Health Justice Scholars Track as well as the leadership team for the Georgetown chapter of Medical Students for Choice.
He chose to enroll in Dr. Maggie Carry’s narrative in medicine course in his second year, during which this essay took form. While personal narrative is new to Gavin, he has been writing poetry and short fiction since his early childhood.
Alongside his passion for medicine and writing, Gavin has explored a penchant for food and drink. As a professional bartender, he has mixed martinis in a Michelin Star restaurant and margaritas in a bar sitting over the Pacific Ocean, all the while exploring the art of storytelling.
He is excited to integrate his love for narrative into a long career in medicine.
Originally published at https://thedoctorweighsin.com on November 14, 2020.