I have this group of friends that I text with a lot. In fact, we text pretty much every day. For about 5 years running.  We all went to med school together.  We birthed, grieved, succeeded, and failed together too.  It's been a magical existence, this life, but made much more so by their enduring and fierce friendship.  

In one of our 100-message-long text discussions, this idea of the Leaky Heart was conceived.  It was borne out of conversations about burnout, stress, what we absorb as people dedicated to well-being, healing, and growth for ourselves and our patients.

All of us felt, to differing degrees, like we were becoming more permeable and affected over time.  Like the protective layer over our hearts and spirits were becoming weaker or more leaky as we spent more years in practice. 

That might seem completely obvious to anyone else. Yet, it was surprising for us.  There's this feeling, when you continue into pratice and you really get into your groove, of invincibility.  A fluidity. Almost effortlessness. 

So how is it then that we are getting better at what we do and simultaneously feeling more weakened by our work?   

There are concepts our there like Compassion Fatigue and Trauma Stewardship.  We know that in our kind of work, the heart grows weary.  The accumulation of stories, grief, loss, and energetic input is weighty.  And in time, the weight drops you to your knees.  

This is where exercise, sleep, nutritious food, healthy relationships, and fantastic support matter.  To hold that weight, it takes strength.  We can build that; we can maintain it.  

But this Leaky Heart...it's a different thing.  It's feels like your heart has become Swiss Cheese with large, unobstructed holes.  Things get in that don't belong there.  Things leave and you feel like all the air just left your body.  And to alter that cheesy structure will cause it to collapse altogether.  Your heart will simply break.  

Was it preventable or inevitable?  Perhaps it was necessary to become open and (w)hole-hearted.   So how can we rebuild strength and resilience when the heart has become leaky?

Maybe we don't.  Maybe, like a well-built cairn or a well-played game of Jenga, there is no longer any amount of precision or finesse that can be applied. 

Maybe we step away.  And admire it.  

Take care of your hearts, Sunita