Doctors Orders: Welcome to the Fall of Slow
Thoughts on burnout, health, and rest
When I unexpectedly got admitted to the hospital this summer for cholecystitis, I told the ER doctor that this was my first time being admitted to the hospital, besides my C-section in 2022. Even that was a scheduled, planned, medical event — I had placenta previa and so my medical team recommended a planned C-section. Though I’ve been in the hospital before, this emergency hospitalization hit me in a different way. It was surprising, humbling, and scary.
What was most unsettling to me is that after removing my gallbladder, my surgeon said that the organ was inflamed and had “been angry” for months. He gave me a picture of my gallbladder, apparently should be purplish when healthy. Mine was red and white and angry and also showed the huge stones that were there. I sent it to my dad (a retired anesthesiologist) and he texted back “Pooj, you have suffered with this for a long time.”
To add insult to injury, two weeks after my gallbladder surgery, I was back in the ER with a kidney stone. Rude! After 48 hours of the worst pain of my life, this stone stopped hurting, and luckily I did not need another trip to the OR.
And so marked the beginning of my Fall of Slow.
Probably quite obvious to those who care about me — the universe was basically screaming for me to slow down, but I couldn’t listen. I thought I took this summer slow (slow for me: most Friday’s “off”, saying no and canceling a ton of obligations), but it’s apparent I need to be slower. I need to practice what I preach and also be willing to take responsibility for the shadow side of my workaholism — there is ego wrapped up in my patterns, for sure.
I feel the need to caveat this by clarifying that stress and burnout do not cause gallstones or cholecystitis or kidney stones. Gallstones are common after childbirth and in women in their 30s and 40s (the way we were taught to think of gallstones as a probable diagnosis in medical school was “3Fs” “fat, female, forties, after kids” – in hindsight, so problematic, yes). Nearly 10% of the population walks around with asymptomatic kidney stones. But, stress can cause you to make less than optimal decisions about what you eat, how much you move your body, and whether you drink any water.
I’ve been burnt out for a few months now, trying as hard as I could to “rest” and go slowly. But, yet, it took something physical, a picture of my giant, chronically inflamed gallbladder for me to stop for 4 days. I’m sheepish that even as a psychiatrist, after writing a book called Real Self-Care, I’m still guilty of dismissing my needs, and only stopping when I physically CANNOT do more.
In my therapy sessions with my psychoanalyst, we’ve talked about my embarrassment around the fact that it took something being physically wrong with me for me to stop working. I told her that this was the first time in recent memory where I felt a sense of relief that my “rest” was sanctioned. The relief that only comes when you are bone tired, exhausted, and medically excused to take a break. So it felt in my brain: I finally had a justifiable reason to focus on myself and my health.
But I reject that idea. I don’t need a medical emergency to sanction my rest. I can sanction that myself.
Hence, the Fall of Slow.
What’s the Fall of Slow?
I had thought the cure to book launch burnout was “rest”, but, I’ve learned that the process of rest is an active one. It doesn’t mean just laying around slothful (though it can, and sometimes it does!). I’m giving myself the Fall of Slow for my active recovery from a climactic life event.
Prior to the book launch, people kept saying to me that writing and launching a book was like birthing a baby. I’ve had 2 births over the past 2 years – my son, and my book. Because I was so focused learning how to be a mom, and on the logistics and operations of launching Real Self-Care, plus my private practice, it was hard to give all the things all the space they needed.
As a perinatal psychiatrist, I know that birth is transition, and now that the book is out and I’m the person who is speaking on behalf of it (an author), it’s sinking in that this is my new life, and it’s up to me to decide who I am inside of it. I’ve learned that while rest is important, I actually needed another turn of RSC: Boundaries, Compassion, Values, Power.
How does one move through transition when she also has a public persona and an audience? I do not know who this next version of me is yet. I need to give myself space to meet her, and to get to know her.
The Fall of Slow means giving myself permission to STOP. To stop doing the stuff that feels too hard, the stuff I have to muster energy for.
It’s giving myself permission to PLAY. Keep doing the stuff that comes naturally and doesn’t feel like work — like making a random Reel about suicide awareness week (dark, I know, and I felt organically inspired and playful making it that reminded me of when I was starting out on Instagram years ago) and doing an interview with Tressie McMillan Cottom for the Ezra Klein show (because anything with Tressie feels like a Hell Yes). Do the stuff that brings me energy, allow myself time to luxuriate. For example, I went to a fancy hotel lobby in downtown Austin the other day, spent 5 dollars on a latte, and curled up on a velvet couch to read a sci-fi book. (For the curious: Wool, Book 1 of the Silo Series).
And it’s permission to go INTERNAL. Ironically, launching a book called Real Self-Care, about the process of internal self-care work, took me away from myself internally. This is my coming back. I’m going back to my Real Self-Care compass and thinking about what values of mine underlie my professional goals, and also the roles I hold in my life (mother, partner, doctor, friend) – and assessing which roles I want to take up the most time.
What does it mean for this newsletter?
Over the next few months, while I come back to myself and figure out what’s most important in this season of my life, you likely won’t hear from me every week. I’m going to write this column when I feel moved to write it — and I’m not sure what that will look like in practice. In order to give myself permission to get to the other side, I need to apply the principles of my Fall of Slow. I need to STOP (remove the pressure of a weekly cadence), PLAY (allow myself to be curious), and GO INTERNAL (think about what I want this newsletter to be, and what role I want it to play in my work and life). Thank you for being here, for being part of this community, and for coming on this journey with me.
xo,
Pooja
Fall of Slow. It’s happening on my end.
I’ve recently become quietly annoyed by the question “what are your plans for the weekend?” It’s usually harmless but I always take it as “you should be doing something this weekend.” But, as you highlight, there’s such value in slowness...in tending to yourself or your space. A weekend of reading and reflecting. We don’t need to go go go all the time.
1. I'm so proud of you for voicing this
2. I find that I constantly refuse to listen to my body until they decide that the only way I'll pay attention is through some physical, chronic issue that makes me realize my need
3. YES to care and rest and pausing and saying no not just through the physical rest but through all these other avenues!
I'm always supporting you in this. You wrote a brilliant book. You're changing lives. AND you get to practice sacred, careful, curated, magical rest. Thank you for being your honest, wonderful self with us.