The crying game…

The Terminator: Why do you cry?…
John Connor: I don’t know. We just cry. You know, when it hurts.
The Terminator: Pain causes it
John Connor: No, it’s when there’s nothing wrong with you, but you hurt anyway. You get it?
The Terminator: No.
Terminator 2: Judgement Day

I read something recently that really shook me up. It was as if someone had switched on a bright light and exposed a great and hideous truth.

I don’t cry. I don’t cry at work, I don’t really cry when I’m stressed and, until the last few years, I didn’t really cry at movies or books unless they packed a big emotional punch. It was part of my Vulcan armour and was why one of my friends still jokes that I’m cold inside. She is a paediatrician and cries all the time, particularly at work – both from the emotional trauma of treating sick babies and from the stresses of working in a busy and understaffed hospital job.

This friend of mine is actually roundly criticised for how much she cries. She’s dissolved into tears on too many shifts and in front of too many senior staff members. She’s been labelled a ‘trainee in difficulty’ and has had to attend special meetings to discuss her progress. At one point they were even considering extending her training as they were so concerned about her lack of confidence. Sadly, they completely missed the point – crying is her coping mechanism. In a moment of snotty and tear-stained release, her stress is gone and she’s ready for the next challenge. She’s never cried in front of patients or their families so could never be described as unprofessional, and she’s never backed down from anything. Despite what her supervisors may think, she is succeeding in an impossible role.

I don’t have that and, if I’m honest, I didn’t think I needed it. I have always admired her ability to be that vulnerable in front of her colleagues but believed that I was different. I didn’t need that sort of reset or release. Also working as a doctor, my role is similarly stressful and involves similar emotional trials, but I’d thought I had just got used to it; I had built effective walls that kept my work out of my life and kept my heart and real self out of my work. My self-care has always been to enjoy life outside of work anyway, and it’s even more true now. I could break bad news every day and shrug it off as I walked out of the door to head home because I have exciting plans for that evening or someone amazing to spend that time with. I could disclose death and cancer, have frank discussions about poor prognosis and failed treatments, and then go home and not only be unaffected by it but be refreshed and recharged by the time away. I was used to it.

Except that I now cry at movies.

I cry at movies all the time. I sobbed at Ghost and at La La Land. I even cried at Fast and Furious 7 for fuck’s sake! (Although I will defend that film to the end – Paul Walker’s devastating and abrupt exit from the franchise following his death was handled with a dignity that you would not expect from a series of movies for motorheads and I am not ashamed of crying like a baby!) And it’s not just movies. I weep at TED Talks, I cry watching TV and when reading. Emotion can swell up inside me and threaten to spill over at sad dog videos or Christmas adverts featuring old, lonely men. I honestly don’t recognise myself sometimes.

I’d perhaps naively thought it was just because I have more to lose now. I’d over romanticised my new emotional responses, thinking I was feeling the losses portrayed on screen more keenly because I had my own someone whose loss would devastate me. My emotional response now had a beautiful face that has a hold on my heart and was not just an intellectual empathetic reaction. I also wondered if being in a relationship, being in love and being vulnerable, means that I am no longer trapped in my emotionless castle. I simply feel more now and this sadness is an inevitable counterpoint to the extremes of happiness that I now regularly experience.

I don’t know. Maybe it’s all of these.

But I suspect that the BMA’s Secret Doctor is right. Maybe this should be a wake up call that I’m actually not doing so well. That the stresses of the NHS as it crumbles around us are taking their toll. That I haven’t become numb to the effects of death, thank goodness. To quote the Secret Doctor, ‘maybe the truth was we just don’t ‘get used to it’ at all.’

When I thought about it more closely, I realised that none of this was new information. I already knew that I was under more stress than ever before and I already knew that I was exhausted more often than not. I have more responsibility now; I am the one who recognises impending death and has to speak to the patient and their families, I’m the one making decisions to withdraw active treatment, I’m the one supporting the family through this as much as I can, while also being the one who has to do so much other work as well because there’s no one else to do it. It’s hard. Frankly, it’s almost impossible. My bosses know this but can’t do much to fix it. They make heroic efforts to find additional staff but no one wants the job, and my current hospital is so worried about our wellbeing that they are genuinely getting a therapy dog just for stressed doctors. But none of this can lift the entire load and we all inevitably take some of it home. And so I end up crying at movies.

I’ve been trying to work out why this bothers me so much. Why am I so shocked that I have what would generally be considered an appropriate emotional response?! Is it because the emotion that I thought I was managing has leaked out in unexpected ways or is it because, indirectly, my job is making me cry.

And, to my shame, I think it’s the latter. The fact that my job could make me cry also makes me feel like a failure.

I wrote the bulk of this immediately after I read that Secret Doctor blog in early February but put it aside as I wasn’t sure of its purpose, other than as another public scream against what is happening in the NHS right now. But when another bullshit task was loaded on my already saturated day earlier this week and I found myself forcefully blinking away tears of frustration because I was damned if I was going to cry over this, I realised that my reaction to crying is important and terrible and outdated and is another sign of internalised fucking misogyny because no matter how bad it gets, I won’t cry at work as I cannot stop feeling that the consequences would outweigh the benefits.

I don’t want my colleagues to rush around comforting me, I don’t want them to think this job has broken me, and, most shamefully of all, I don’t want them to think I am weak. That I’m not strong enough. I don’t want anyone to think less of me because I cried. would think less of me if I cried. I don’t feel this way about all types of crying – crying when genuinely sad is liberating and cleansing, my father cries a lot from joy and I love that about him, but crying at work would feel like I’ve been defeated and I don’t want to feel like that.

Why do I (we?) feel so negatively about crying? When I understand and value my friend’s use of tears as a stress response, why am I so reluctant to try? And as a feminist working in an industry full of professional women, why I am so fearful of appearing as that stereotypical hysterical lady, particularly when I don’t tar others with that same brush? Does anyone but me even think that way about crying women anymore?

But I know I’m not the only one, and this was reaffirmed again this morning in a blog post on how men just don’t trust women’s emotional responses:

Until she convinces me otherwise, I assume that her emotional reaction to a situation is disproportionate to my opinion of what level of emotional reaction the situation calls for. Basically, if she’s on eight, I assume the situation is really a six.

I’m not going to cry in public and in front of my colleagues when a significant proportion of them will think I’m overreacting! Who benefits from that?

I am OK, I really am. I’m just not in love with my job in the same way that I was, say, four years ago, and I am not used to it. I had acknowledged the stress I was under before realising that it was leaking out anyway, but I am once again in awe of my body knowing what I need before I do and by it’s ability to turn my secret emotion into an actual physical outpouring that does make me feel better.

And to those of you who can cry and who aren’t hobbled with my old-fashioned views, I cannot tell you how jealous I am…

Being a doctor makes me more likely to be crying at movies

11 thoughts on “The crying game…

  1. I don’t quite know what to say. Except maybe “Thank you.”
    We are both disabled, with complications. We love the NHS and its staff with a passion – we have a lot of contact with it.
    We can’t go back to the US (Silverdrop’s home country), because we are uninsurable under their inhumane system.
    We do appreciate your work, more than we can say.
    So… thank you, from the bottom of our hearts.

  2. Oh my word. I have to read this again later. I am not a cryer in my head but recent years have had me crying in the most humiliating and obvious of places. I decided to embrace this vulnerability but I do wonder if it will inhibit my career success. I still can’t stop it though.

  3. This is a deeply humbling post. As I man I am so angry with the reactions you describe of those of my gender to women in your profession who cry (in fact if they ever react like this to anyone in any profession). I believe it is a sign of emotional strength and of empathy. No-one should worry about crying. I never cried myself much – even when faced with bereavement of close ones. In fact I later realised that is was probably because I couldn’t cry. But that has changed. Recently I was rushed to hospital and had to undergo life-saving emergency surgery. The NHS – people just like you – were astonishing. They had to do amazing things under unbelievable pressure and they were just brilliant. I wrote a thank you letter at the end, and could not stop crying as I wrote it. Even now, a year later, I am welling up as I pen this. I am sure that you are one of those brilliant people working in that brilliant organisation called the NHS. Yes, it is under terrible pressure, and I am sure you and your colleagues have massive workloads too…but please keep going and keep crying if you want/need to. Please.

  4. This is beautifully​ stated Livvy! As a person who rarely wears my heart on my sleeve, I cry a lot more than I wish I did. I’m happy to cry with a friend as they share a sad story, or at movies, or at weddings, but I hate that I cry when criticized or angry, for instance. My boss, a woman, once gave me the advice to “take a big drink of cold water if you think you’re going to cry” which is silly, and doesn’t really work, anyway, a lot of good things to think about in your post. I hope work gets better for you, too. Xoxo

  5. Your boldness in what you wrote is astonishing, and upon reading I had an eureka moment. Your consciousness that it is also your body’s way of protecting you. I am like you, for years I never cried and even know stressful work conditions do not make me cry, but I cry at adverts, Call the Midwife, TV programmes films, kind words, a tweet, a comment. I have seen gruesome deaths at the hands of violence, I have witnessed the aftermath of Domestic Abuse more times than I care to remember, I have scraped somebody’s child up from the pavement accompanied them to the hospital, then went home and drank and drank but I never cried. I have despaired at intolerable workloads and never getting home at reasonable hours. A invisible shield put up to protect yes perhaps, but now in my later years I cry a lot. Your searing honesty about your feelings and coping and work has really entered my soul and my heart reaches out to you. I blame the NHS for a family members death (he was young) but I have seen them save the life of other family members, the good outweigh the bad and I know how resources are stretched and I admire the dedication of NHS Staff and the sheer grit and determination in making a crumbling system work, not enough resources and cuts to the bone. We rely on the NHS System to be there in our need and am grateful that we have such a system, and the knowledge that there are doctors like yourself stressed, coping and (then releasing tears elsewhere) and I thank you x

  6. I’ve been percolating this in in my mind, trying to work out a ‘good’ comment to do it justice. I’m not sure this comment will, but I’m about to go and drink a lot of wine and then another week will be here and it won’t get done, so…

    I cry all the time. At work, at adverts, when I’m telling stories about things that have happened, when people tell me stories, even when I read blog comments. I don’t mind crying. It’s part of who I am. In fact, I did a work psychological testing thing once of the the key pieces of feedback on how to manage me was “Pay attention but don’t overreact when they cry. Tears are a part of their life and they feel others’ joy and pain more poignantly. Work out how they can use that.” That was a real step change for me workwise and made me realise that my emotional response to things were what made me instinctively understand what would raise thousands of pounds or change a policy-makers mind. I have since had a one line brief for a film: ‘make every person in the room cry’. I did!

    I do get frustrated by my quick tears when I am trying to talk through an important issue where someone has behaved poorly as I think it can give people licence to not to listen to you as they can chalk it up to an over-emotional or irrational reaction and I think that’s wrong. But generally speaking I embrace tears and describe it as squeezing a spot!

    HOWEVER, there was one occasion when my tears gave me cause for concern. Ten years ago next weekend I was held up at gunpoint in my corner shop. It was all a bit of laugh for a few days and the whole police and centre of attention at work thing was entertaining. But one evening I was on the bus home and I caught someone staring at me. It was only then I realised I was crying. And not sobby loud snotty crying but silent tears dripping off my face that I hadn’t realised was happening until I spotted a stranger’s concern. It was then I realised the body’s ability to subconsciously indicate/try purge stress and trauma.

    So even though I’m not a Vulcan and mostly harness my crying power, I can completely understand how the change in your crying pattern is an indicator of something to address.

    Xxxxx

  7. I wrote something yesterday on my phone but…..Well that’s a lesson in itself.
    I am a nurse of 30 years and more, no longer in clinical practice. My first ever clinical placement as an 18 year old, in 1980 was on an oncology ward. It was a time of learning about humility and humanity but an emotional time for such a young person. for me it was characterised by a man who had a late diagnosis of Carcinoma of his penis, pieces of which dropped into the bath when I bathed him. It was a wonder I didn’t walk away right then, given that my grandad was also dying of cancer at the time.

    We weren’t encouraged to express emotions, indeed it was discouraged as you describe. On the day my grandad died I had to beg for a day off, it counted towards the 5 days of sick leave you were allowed per year.

    Over time, as a nurse I have experienced fear, anger, pain and despair along with misplaced hope. Often I felt trapped between the latter two emotions. In the main I have found it difficult to cry, much easier though to be angry, more so to just bottle it all in. We were told that we would and should become used to death and suffering, somehow removed from it.

    I am not and never have been someone who cries easily, and certainly I have found it difficult to do so at work. Equally there are few films in which I have shed a tear either. I have envied colleagues, both medics and nurses able to sit and cry with patients and their families, For years I felt I was in some kind of suspended animation, unable to show my real emotions and to show I actually cared for my patients. In the end I had to walk away from clinical practice, because I started to demonstrate signs of burn out (my own diagnosis) I thought this was something temporary. but it is not.

    It wasn’t until my dad was diagnosed with cancer that I realised how deeply affected I had been by past experiences and of what was to come. Finally I was able to understand. I cried with and about my dad as he struggled through his final year. At the end I cared for him at home as he struggled to cope with the reality of his life and death, and as I recognised how I had previously failed to understand human suffering. I recognised my need to express my own feelings and to show that I really am human.

    Even now, as I sit next to a man in films, concerts and during programmes like the Pottery Throw down where my Dominant partner is able to express emotions I am not. I feel that my life in healthcare has done something to my ability to show empathy and emotion in specific situations. It leaves me sad, but sadly in the main, unable to cry.

    Probably I need to blog about this myself.

    Thank you Libby, your beautiful and thoughtful post deserves more than this random response, but it has caused me to want to explore much more about the way we can, do and are allowed to express emotion as healthcare professionals.

  8. This made me think so much of the time before I had my burnout in 2012. At first I kept my tears for myself, not showing my frustration at my work, but at home I cried. Eventually I cried about the stupidest things and then I started crying at work too. And still I told myself and others around me that everything will be okay. That I was okay. I wasn’t but I only knew that after I had the burnout. When I returned to work 5 months later, the tears were never far away. It took me until last year, when I went from five to four days of work to finally be healed from the stressful time back then. It sounds like you have already recognized the things I never did back then.

    Rebel xox

  9. I’ve been trying to decide whether to comment here or to write my own post in response.

    First, this is a brilliant post, Livvy. Tears are such judged things – not least by ourselves. I used to cry rarely and only in extreme circumstances. Then I started the sobbing to random adverts, films, soaps etc. In this last year, I have cried more than ever before. Stress, loss and change have cracked my hard shell and now the tears often flow. I have cried in many places. I recognise it as something that I need to do. Life is crushing me and stretching me out way beyond my stress limits. Crying is more than a release, more than a safety net. Crying is something that I currently feel is as therapeutic as a walk in the country. If I try not to let those tears out, then I end up shut down and unable to function. It isn’t good. I know that it is a big red flag about my emotional well-being. I also know that it isn’t the tears that are a problem. The tears are an important response to the rest.

    I hope your stress levels improve and that the cats, the therapy dog, your love, your friends all help to balance your emotional health and well-being.

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