[Part of a series on surviving your mental health internship.]
I got the call that my sister Amy was dead at about 3:30 on a Wednesday afternoon, about four months into my internship. I was on campus and at my desk in the graduate assistant office. The connection was bad and I only understood several words at first, but everything snapped into place instantly and clearly as soon as I heard “didn’t wake up.” It was the call I had been expecting for most of my life. Amy was that child in our family… the troubled child. When something that you have always been expecting comes to you so out of the blue, one of the first things you notice is how suddenly you don’t know what to do. I did not know what to do. For days, I did not know what to do. I did not know what was reasonable to do.
Amy and I were close. We talked all the time. In some ways, she had been doing better than ever. She graduated from college. She had several years of alcohol sobriety. She had a job as a center manager for a small MRDD center. But, she had a long-standing back injury. The Monday before her death she had back surgery and came home with a bottle of pills. Tuesday night she took too many and didn’t wake up. Amy had a complicated relationship with those pills that went back decades. Whatever the pill, Amy always took too many.
I was in the graduate assistant office to do work for the university before going to my internship class later that night. As I walked back to my desk, I noticed that my hands were shaking. People were asking me if I was okay. I felt somewhat removed from my body, as though I were somehow taller and looking down on things. Again, I wasn’t sure what I was supposed to do. As I drove home, I had to keep looking at the speedometer. Strange, I thought, I have absolutely no perception of speed.
When I got home, I called my internship site. I spoke with one of the supervisors who asked me what I wanted to do about my schedule. I did not know. I did not know if I was allowed to call off work at the agency. I had never thought about the possibility of having to take several days off without weeks of notice. I told her I would go to work on Thursday, but I might be flying home on Friday. I asked my wife to make our travel plans to fly home on Friday afternoon. She picked me up at the agency on Friday evening and we went straight to the airport. Again, I did not know that I did not have to be there. I did not know there were situations where it made sense to clear my schedule. I worked a full day on Thursday and nearly a full day on Friday. I also went to class on Wednesday night, just hours after the phone call. I told the professor about my loss… in case some of it seeped out. I asked him not to share it with the class, because I did not want it to interfere with class dynamics (there were only four of us in that class all sitting around a small table, some part of me hovering above just beneath the ceiling).
I had many profoundly unwell clients. I had many clients with passive suicide ideation. Some had been hospitalized during that month. I felt, for some reason, that I could not abandon them to attend to my own trauma. Thursday was a full day of sessions and Friday morning was full with sessions and a three-hour partial hospitalization group in the afternoon. I managed to hold everything together. The only thing I missed was an important window to start the grieving process. I still feel like my grief was arrested by the pervasive stress of my internship experience. Much of that stress was my own doing.
I guess my advice to you is fairly obvious. If someone you love dies during the course of your internship, make sure that you take care of yourself first. Your clients and the agency will forgive you for unplanned cancellations to attend funerals, etc. There will be plenty of reasons to put yourself last. Because I did not know what to do, I just carried on as though shouldering everything was the most sensible thing to do. I piled on more. I carried far more than was necessary, reasonable, or healthy. In your internship experience, I that hope you can find and prioritize ways to take care of yourself first. You should think about that now, so that when you really need to take care of yourself you know what to do… what is reasonable to do.