Clinician shortages have been a fact of patient life for a while, and COVID just served to highlight how dire the situation could get. Oh, and also make it worse by exacerbating burnout, disenchantment, and heightened stress. The National Institutes of Health reports a loss of over 300,000 clinicians in 2021. That’s a lot.

The American Association of Medical Colleges estimates a shortage of 86,000 physicians by 2036 (this does not include nurses, physician assistants, and other clinicians who help distribute the workload more evenly). This may not seem like too much spread over 50 states and five territories, but those of us who already have to wait months for appointments or who can’t find a doctor when ours retires can tell you how bad it is now, let alone how bad it will be then.

Like many of us, I have struggled with my weight for most of my life. And I can honestly say that I am one of the few for whom societal and family pressure (appearance had zero weight – pun intended -- in my family when it came to parental expectations, or grandparental expectations, for that matter) had exactly zero to do with it.

Lucky me.

No patient I know has a consistent level of functionality. Every one of us has symptoms that require care and attention to mitigate their effects on our lives. You can go months – years! – with the same symptom pattern, which can allow for the development of a routine. Routines are boring, but they are also a relief. You act in a certain way that doesn’t cross your symptom(s), and it acts as expected.

Until it doesn’t.

So, turns out my little saga doesn’t end with the surgery.

Because of previous eye surgeries for retinopathy, getting multifocal replacement lenses was not an option. That means I came out of surgery still needing external corrective lenses.

Before the cataract surgery, I discussed options with my surgeon, and chose to be nearsighted. I have been since fourth grade, and I thought it would be easier psychologically to stick with the familiar.

Every Passover, I spend the holiday dinner, or seder, with friends. We talk about the Jews’ Exodus from Egypt, and how that story applies to today. This year, one of the topics we discussed was, “How do you feel broken right now?” It was supposed to be a reflection on current affairs.

That is not how I took the question.

My initial reaction was, what do you mean right now?

Apparently, depression doesn’t go away just because you’re distracted by other medical issues. Neither do medical equipment malfunctions, insurance issues, or the energy drain of condition management.

Luckily, throughout the cataract process, my other conditions have been stable. Mostly. Enough that I could sideline them for a month and maintain my peace of mind, anyway.

But the depression is the refrigerator hum right now, and has been, as much or more than the diabetes, since I started treating it.

There are a lot of things aside from medication that I have incorporated in order to pull myself out of where I was that will also help me take measure of where my depression stands.

Does it sound weird if I talk about my depression the same way I do my other conditions?

It feels a little weird.

Cataracts grow about as quickly as sand moves, or so my ophthalmologist says. So, for 31 years, I’ve had a glacially slow cloud moving over the middle of my lenses. So, the first thought I had after surfacing from my first dose of anesthesia in decades, was OMG, color! I hadn’t realized how much the world had dulled as I kicked the surgery can further and further down the road.

When I was in 4th grade, my mom made the mistake of letting me brush my own very thick hair. The problem was, it hurt, so I only brushed the top. It looked fine, but the bottom layer developed large knots right at the base of my skull. They couldn’t be untangled, so they had to be cut out. It was the first time my hair had been shorter than my waist.

I cried for two weeks.

With any medical procedure, there are a ton of logistical details that come with it, along with whatever emotional burden you are already carrying.

Routine outpatient procedures are no different. Making sure you check all the boxes so you don’t inadvertently screw everything up is a chore and a half. (This is different from intentionally screwing everything up. You have no idea how difficult it has been to not self-sabotage, given my talent for it and my near two decades of delaying tactics.)

In this case, it’s not a lot of things. But it’s enough that I can’t procrastinate as I usually do.

One of my friends recently asked me how best to manage a chronic condition.

During the transition between noncompliance and acceptance, I clearly remember that all I wanted was to get to the point where I could relegate my regimen to a tiny corner of my life. I would be “normal” and it would become so easy and routine that the whole thing would take up no more of my attention every day than, say, brushing my teeth. I’m here to tell you it’s possible!

Well, sometimes.