When Burnout Doesn’t Get Better (or How To Break Your Own Heart)
This is a little bit about burnout. And a little bit not.
It’s taken a long time to write, because the favourable narrative, the one I kept waiting for, is the one of recovery. That’s what makes it into the TED talks.
I waited, like a good storyteller, for this satisfying conclusion to come along — so I could dispense the wise lessons I had learned, and reassure people that, although the journey was hard and frightening, things do get better.
It didn’t come. Sometimes the story you are living is just a handful of threads that you are still holding, and they have not yet met their end.
Instead, all I have is the truth of what happened and how it felt. After a decade of never having fewer than 2 jobs at once, often putting myself through night school at the same time, and outwardly appearing — or so I always told myself — quite a successful and together person who somehow never needed to sleep or rest or stop worrying…
What follows is this. Simply the story of how my heart and I, for years patient adversaries, all at once went to war.
It rains in Salzburg.
I’m not sure how we will ever explain this time, afterwards. When you could travel to another country for £50. On a whim. But there it was and there I was, needing nothing more than to be in a place where I could look at mountains for a few days. Unfathomably, I had decided this would somehow solve things.
The restaurants are crowded with patrons shaking the not-quite-yet-December rain from umbrellas and tired feet. I am nudged along the bar to accommodate more profitable guests, ever closer to another solitary customer. One of those men, which is every man in every city; the nondescript besuited business traveller that seems to inhabit the whole world at once.
“Am I bothering you?,” he asks, several stilted minutes into a non-consensual attempt at conversation.
If you need to ask... If I say yes, what will you do with your anger? Follow me to my not-home?
This man is, he thinks, experiencing a meet cute. A scene from Lost in Translation. Whether romantically intended or not. Two erstwhile solitary souls brought together by the tides of fate in a strange city. I, meanwhile, am looking at my plate wondering how much food I can reasonably leave behind without later waking in the middle of the night from hunger.
But suddenly I am no longer listening. I have climbed stairs today and my heart is… starting to do things my heart has not done before.
It is an unassuming Saturday. I pause in the doorway of my living room, realising that my heart is throttling in my chest as though I’ve just run up a hill.
“That’s odd,” I think.
The next morning I stand, door of my flat thrown open and suitcase on the step, contemplating whether or not it is a good idea to get on a(nother) plane with a racing heart, chest pain, shortness of breath and a developing cough.
I am 28, I rationalise. I am young. Too young. It has been 12 hours. If I was having a heart attack, I would know about it by now.
It is nearly Christmas.
Or at least, on my planning schedule it is. Everything must be accounted for at least two paycheques in advance…
It’s been a week since I stood in the doorway. I have since been to Sweden and back, to hug my friend and kiss her babies, all the while knowing something was wrong, wrong, wrong. Now, I am sitting in the ER of a hospital whose staff are so preternaturally beautiful that my friend Dee wonders whether we have wandered on to a television set.
She fills my hands with cups of water and the silence with jokes. I never seem to know what to do with my hands these days. One often rests over my chest, as though trying to keep my heart inside.
Before, in the taxi, my fingers were cold when she took my phone to cancel an afternoon meeting on my behalf. I couldn’t, she reasoned, make a good impression when half a sentence was the most I could get out between breaths. I squeezed my fingers repeatedly as we edged painfully through 40 minutes of London traffic, watching my nails whiten and then go pink again as the capillaries refilled, reassuringly, with oxygenated blood.
We are eventually ushered into a side room. The nurse smiles at me, gently, as though I might be somehow unpredictable. They think it’s unlikely, but they just want to make sure I’ve not had a pulmonary embolism — when a blood clot travels to one of the main arteries in your lungs.
They are going to take care of me.
No one tells you what to do when your body starts to feel like a house that no one lives in. When you are no longer the most capable person in the room, but instead are left looking back up at the world through the only narrow beam of daylight that has made it through all that water in the still ocean above you. In the real world, where there are laws of physics and explicable things, this phenomenon is called Snell’s window. Here, it is more like a one way mirror.
I start to suspect this may be more than a momentary fit of exhaustion.
My heart flutters its wings at the cage of my ribs like it is somewhere it is not meant to be. And I keep looking around for a place to set it down. Let it free.
I take two weeks off work. It is all I can afford. I am self-employed.
Friends come by. They bring sugary food and we watch every single terrible Christmas romance Netflix has to offer, speculating in our most forcibly normal voices about the bizarre industry that churns them out.
I perch, oddly upright, on the sofa, feeling peripheral. Like a ghost in my own living room. Without anyone there to witness me, I become terrified I might disappear.
Back at the BBC, I regularly go to a single stall bathroom on the 5th floor, where no one can hear me, to have a brief cry and try to breathe normally.
Right now, I am not good at my job, but I am somehow doing my job because I have no other choice.
The building dates from the 1920s, and it’s likely decades worth of people have cried in this same bathroom for decades worth of reasons.
It’s an oddly comforting thought.
Every country I have lived in has now collected the repeating topography of my heart at least once.
“Just to be sure.”
Sometimes for minutes, pulling off the sticky electrodes after a businesslike glance at a trace which is on its textbook best behaviour. No tremors of seismic significance. All 4 chambers co-operating under observation.
Once, for a whole day. The pads an odd, weighted warm reassurance against my skin, and the wires sticking out at odd angles beneath my jumper, like I am a ready and willing yet grossly incompetent informant, sitting painfully innocuously on the #257 bus.
“Press this button anytime you feel the palpitations.”
I wake in the night, heart climbing out my throat, and pummel the button.
Just to be sure.
They don’t want young women dying of undiagnosed heart defects. They are always kind. They never tell me that what I feel happening is not happening. But it will not kill me in the sudden small hours of some unexpected Tuesday, and that’s all that they can do. I am being assailed by nothing more than my own mind and they cannot help me.
My doctor, to whose bemused perusal my problems are always eventually returned, prescribes propranolol. A beta blocker. These little pink emergency pills will live with me for the better part of two years. The smaller ones for everyday, the larger ones for neutralising stressful events like travel and job interviews.
This new chemistry hums through my veins, spreading like a warm, reassuring glow. It blocks the β-adrenergic receptors in my heart. My lungs. My blood vessels. My adrenal glands continue to churn out their eponymous hormone, accustomed now to overproduction, but no one is home to receive it. My heart rate reduces. My blood pressure follows.
Propranolol in oral form has a half life of 4 hours; its respite brief and hazy and comforting, like floating on a cloud. It crosses the blood brain barrier, taking up intimate residence.
One does not simply stop taking it one day.
The dosage needs to be reduced slowly. Painfully slowly. It comes with side effects. Waking up in the night in full fight or flight because you have seen a shadow in the corner of your room. Trading one set of ghostly apparitions for another.
Three years pass.
I live across the world, on the shores of another ocean. The cells in my body slowly trickle through the hourglass of renewal that will eventually mark them all, some years hence, as Made in Canada. My whole body will belong to this land.
Even my heart.
Now, it races when I see the mountains. When I go hard enough in a kickboxing round. When I bike up a hill. For the most part. It goes back to getting gently bruised in the usual ways. By loving people and losing them, by learning to grieve. For the most part. The pink pills no longer live on my nightstand. Haven’t for over a year. Though they always travel with me — discreetly packed away in my cosmetics bag when I go somewhere new. Unexpected.
Just to be sure.
Some days, like today, my heart thunders away in my ears like the mountain creeks in spring, swollen with snowmelt and roaring with stories of a long and heavy winter. I rest my hand on my chest as if to soothe it. Like a frightened pet, or child stirring from sleep.
Sometimes, success stories aren’t linear and healing is not an arrow straight path. It’s cutting your way through the forest.
Things don’t always get better. They get… different.
There has been medication and therapy and exercise and meditation and yoga and long, peaceful walks by quiet rivers, and more therapy of a different kind. Changing jobs, changing careers, changing countries, and a general… slowing down of sorts. None of them has been the singular answer.
Better is a relative concept. There are things I was able to do before, that I’m not sure I could do again. Or would want to. There are things I can do now that I could never have dreamed of before.
Maybe that’s getting older, maybe that’s getting better. I honestly can’t say.
These days, it’s harder to concentrate; harder to write things, read entire books, care as much about my job. Things I used to really treasure about myself are gone or different.
Maybe, over time, they will slowly knit themselves together, like an old wound. I see flashes of them sometimes. But maybe not.
This is where we get to the part that has bothered me — there is no ending. That’s the first thing anyone who knows anything about story will tell you. You need an ending.
I wanted mine to be that I came here, reordered my life, fell in love with the land and got better. Healed by the mountains and the ocean and the wild skies.
That’s definitely partly true. And it will likely get more true with time. But there is nothing immediate or easy about it. Healing takes a lot more work than simply waiting, it turns out.
What never gets easier, is watching other people barrel towards the same inevitability.
I know how they will feel, suspended in mid air when they suddenly run out of cliff — limbs flailing, briefly comical, like Wile E. Coyote — before gravity asserts itself and there is nothing but air, air and ground far beneath. I know that they will wake up one day to a body that feels like an ill-fitting suit they are wearing underwater.
So in lieu of an ending, I think what I will say is this: if someone who loves you, really loves you and you know wants the best for you, says stop?
Sit. Listen. Ask them why. Ask them what they’re seeing and what they’re frightened of and what they would like you to do.
Because breaking is the work of a moment, and repair is the work of a lifetime.
(If you are experiencing burnout right now, and if so I am deeply sorry, my amazing former colleague Ella Dawson has written a fantastic piece There Is No Cure For Burnout, which in my mind cannot be bettered)