Ep #73: Giving and Receiving Help

Katrina Ubell:      You are listening to the Weight Loss For Busy Physicians podcast with Katrina Ubell MD episode number 73.

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Well hello, hello. How are you my friend? Welcome back to the podcast. This is going to be an interesting podcast this week, and the reason why is because I've had a very interesting week, as you are going to find out about today on this podcast. So today is Wednesday and last Wednesday around this time I just thought I had maybe a little stomach upset, a little indigestion, didn't think I really had anything going on. Then I thought as the day progressed maybe I'm getting a little stomach virus, just a little stomach bug kind of thing, and then as these things do, it became very clear to me that something was really wrong with me and I ended up having appendicitis and I had to get my appendix removed in the middle of the night.

It was just so out of the blue, so like, “What? I'm 42 years old. Seriously? Like people still get appendicitis?” I mean, of course I know they do, but it just in my head, I know this sounds kind of ridiculous, I just never thought I'd get appendicitis. Like does anybody? But I don't know, I just never really thought that that would be something that I'd have to go through, but it was. So all in all really I had … I mean, can you say I had an excellent experience? I guess, I would say I had an excellent experience. I was very well cared for in the ER at Froedtert Hospital which is the Medical College of Wisconsin's main hospitals. So a few shout outs, Amy Kenny in the ER was my ER attending. She was awesome. And a big thank you to Nick Berger and Travis Webb who were my surgeons who fixed me. Really appreciate it. And of course all my nurses and the other support staff.

What was so interesting is how short of a time I was there. I was seriously there for 16 hours and that was it from when I walked into the ER to when I left all patched up again. It was really very, very interesting.

I thought that this was just such a great topic to talk to you about because I wanted to talk to you about the concept of giving help and receiving help. When something like this happens, you just suddenly need to have emergency surgery, you need help. And in our case it was mostly centered on having someone stay with our kids in the middle of the night while I was in the OR so my husband could be there with me, and then also driving our kids places like to and from school for the following day. It actually worked out great because I had the operation in the middle of the night on Wednesday night, so then we just had Thursday and Friday to help get covered with school and then we had the weekend.

And luckily, I'm telling you, I know this sounds kind of ridiculous and crazy, but if I had to have appendicitis, it really seriously happened at the perfect time. I know that sounds totally bizarre, but the week before I had been doing a whole bunch of other things that I'm so glad I got done, and the week before that we were in Jamaica. I mean I really would not have liked to have had appendicitis in Jamaica. Then tomorrow I'm actually flying out of town for a week. So it's just perfect. I feel up to flying tomorrow. In the last two days I kind of finally am feeling like I've got my bearings again. The pain is definitely so much more manageable. Everything is functioning in my body the way it's supposed to be, eating normally again, all of that. So it really was, I'm just so grateful that it happened when it did. If it had to happen, it really was the perfect time.

But I want to just mention because I think a lot of us physicians are like this, that I am an under reactor and I tend to really downplay things, particularly when it comes to myself. The first way that this came up was that I was just really doubled over in pain, breathing as though I was in labor, and still thinking to myself, “You know, it's probably ridiculous that we're going in the ER. They're just going to tell you that it's just a virus, it's just a really bad virus.”

Then my husband pulls up to the ER to let me out before he parks, and I'm like, “Okay, you could just go home,” because it was dinner time, and we have a 12 year old who's trained to be a babysitter and so he had everything managed and covered, it was no problem at all, he had a plan. But I just, in my mind could not think of one reason why Matt, my husband, should be sitting there with me doing nothing while I could just fend for myself. I mean, what could I do? I was just going to have to sit there and wait and then have them work me up and see what was going on. We even had not like an argument, but we even kind of went back and forth. I was like, “What? No, you don't need to stay.” He's like, “I want to stay.” I'm like, “Okay. Sorry, I just keep thinking I can just do it myself.”

And we even talked a little later. He was saying how I wasn't thinking about this at all, but he was saying how from his standpoint he was thinking, “What if you're sitting in the ER and you're decompensating and no one's paying attention? Like I might need to tell them. If something's really wrong with you. What if you become septic or something and you really are needing some help? Are you going to be able to fend for yourself?” And I just, that had not crossed my mind. I guess, I felt good enough overall that I hadn't thought, “Well, what if things really go bad.” But as we all know, sometimes these weird freaky things happen, especially to doctors and second only or first only to doctors. We're only second to nurses who also have these super weird things happen to them.

So anyway. He came in with me and I got to ride around in a chair in the ER for about 45 minutes until they were able to get me a room and get me some pain medication and all of that. I started to change my opinion about the fact that I might be still overacting when Amy Kenny did her abdominal exam and the pain was actually moving toward the right lower quadrant, we all looked at each other, we're like, “Okay.” She's like, “Yeah, my list of differential options 1 through 10 are appendicitis.” I'm like, “All right. Okay, this is the real deal.”

Anyway. We have no family that lives in town to help us in a situation like this, and I know many, many, many of you don't as well. Maybe you do and they just are people who you can't count on. Sometimes that happens too where we're like, yeah, like, it's kind of my expectation or my thought that my family would do that, but really when it comes down to it, they're not people I can rely on. So receiving help can be super tough. When things like this happen that are just completely out of the blue, totally unexpected, you have to make decisions pretty quickly.

For Matt and me, our tendency and kind of probably our family culture for better or for worse, not that we ever really sat down and purposefully thought about it this way, but we try to just kind of do everything ourselves and not need help and just kind of have things covered. It doesn't mean we don't ever carpool with people or kind of share the load, but we're just kind of people who are like we can handle it, we're totally competent people, we'll figure it out, and I interestingly have so much of an easier time if I can just pay someone to help.

I was saying to him text our old nanny and see if she has a day off coming up because maybe she could come and help us. She is the person I thought of first because it doesn't feel to me like I'm being a burden if I'm hiring someone. I'm actually exchanging money for the value that they're offering to me. What's so interesting about that thought, like I don't want to be an unnecessary burden on someone, is really that it's just a thought. I've realized that this week. I mean I never really had given it a lot of thought, but you guys know I talk a lot about what are facts and what are actual thoughts, and being burden on someone is literally a thought. Because who decides if you're a burden? Well, I get to decide if I'm being a burden and then someone else can have their own opinion about that. But that doesn't mean either of us is right or wrong. It's completely fully a thought. I don't want to be a burden and then I get to define what that means.

In some ways by having that thought I'm making my life harder for myself, thinking, “Well, I don't want to reach out to people just asking for them to help us out of the goodness of their hearts because then I'll be a burden.” All of that is completely just fabricated story in my head, that doesn't really serve me. It's really interesting now kind of in hindsight how it all ended up unfolding in the lessons that I've learned from this process.

The only reason any of our friends who were in town knew what was going on was with me it was because earlier in the day I had arranged a carpool for my son to get to and from choir practice with another family that we know at church. It was kind of a big deal for him to be able to go because they're doing a musical in a couple of weeks and my son has the lead role. It's important that he be there. But we're like, “You know what? This is a medical emergency. He's got to watch our other kids. They're four and six. They can't stay alone. So sorry, it's just going to be the way it is.”

This friend, this family friend, we definitely carpool with them on a regular basis, but they're not a family we're super, super close and tight to. They're kind of people living in the neighborhood and we know them and they're great people and we really enjoy them, but we aren't super, super close with them. We know them through our church because we a few years ago were invited to be part of this small group. We periodically a few times a year get together with everybody and we all thoroughly enjoy each other. It's just life is busy and everyone's got a whole cluster of kids and all their stuff going on and it's just not really possible for us to all get together more often. But they all do live in our neighborhood, every single person is right nearby us.

Once we were in the ER, my husband Matt reminded me that we had to let them know that we couldn't drive because we were going to drive on the way back and they were going to bring our son there. Well, they couldn't even come and get him because he needed to stay at home. I of course all kind of preoccupied with my own issues going on had not remembered that we needed to do that, so he sent her a quick text and said Katrina might have appendicitis, we're in the ER or something. Just that text what our friend Alison, what she was then able to set into motion for us was totally remarkable.

I have to say I was not involved during this time. I was off getting CT scans and talking to the surgeons and advocating for myself that I have the surgery sooner rather than later and things like that. Matt was handling all of this, but what he told me is that they really just immediately leaped into action. Alison started a group text with everybody in the small group, all the other women, and just said, “Tell us what you need and we'll figure it out.” Like, How can we help you?” He kept saying, “Oh nothing,” or, “I don't know,” or, “I'll let you know,” like we do because we don't want to be a burden. And truth be told, he didn't really know yet. We didn't know for a while if it really was appendicitis. Then the CT confirmed that.

Then when it was going to be time fur surgery because this is a level one trauma center so if a big trauma rolled in, of course I was going to take a back seat. So the resident had to talk with the attending to figure that all out. So there's just a lot we didn't know. But then as these things go, they decide, “Okay, yeah, no, we're going to do it right away. The OR is going to come for you in probably just a couple of minutes.” It's like, “Oh, okay. Well, let me tell my husband so he can get his … run over here.”

Even then I'm still thinking to myself, “He doesn't need to come. He can just stay with the kids. I can have surgery by myself,” which I really do think I can think do, but again, not from his standpoint. He's like, “No, I think I'd like to be there in case a decision needs to be made, or something is happening, I would just like to be there,” which is so funny because of course I understand that. I mean if he's having surgery, of course I want to be there. It's like when it's me I just, I think that's ridiculous. Why would you have to stay here? So funny.

He had gone home when I was waiting for my CT because they had said the wait was multiple hours, like maybe even three or four, so we were like, “Okay. Why don't you go home and we can get him off to choir, you can get the kids all settled, get them off to bed, and if you just have to tell our 12 year old, ‘Hey, listen, I'm going to leave in the middle of the night. Set your alarm. Get up. We'll make sure someone's taking you to school. We can do that.’”

When it became more clear that I was going to need to have surgery and we knew the diagnosis, then it was just sort of that question when it's going to happen, and he said they were practically badgering him, “Just let us help. What can we do?” We're so grateful that they did that because when they did say all the sudden, “Yeah, okay, we're going. They're going to come for you. We're going to get ready right away,” I texted him and said, “Yeah, I'm going soon. Come as soon as you can.” He literally wrote to this group and one of them said, “Let me wash my face. I'll be there in 10 minutes,” and she was.

That's that kind of connection, someone reaching out. She didn't have to do that. But it was so helpful knowing, hey, there is an adult in our house, there's somebody who's going to be sleeping on our couch until Matt can get home again to just make it this the best possible situation we can for our family. Then even after that they had in the group text going like who could help with school drop off and pick up. Then it turned out that I was able to go home, I was released to be able to go home super early. I mean, they literally keep you like six hours after this and I got out of the OR at like 1:00 in the morning, so there's like a shift change at 7:00, they're like, “You're done. You can go any time.” I'm like, “Wow. Okay. That was super fast.”

So I reached out to them again and said, “Hey, guys, Matt can maybe come get me at noon in the middle of his day. But if anybody is available to just come bring me home from the hospital, that will be amazing,” and Alison was able to do it. She swung by, picked me up, took my by Walgreens so I could get my prescriptions and brought me home, made sure I was settled. I mean, I couldn't have felt more grateful. It was so helpful to Matt who was already juggling everything, trying to do his whole day, and manage me and the kids and everything. Sue made us chili and picked up the kids, and I just said to her, “I'm just so grateful. Thank you, thank you, thank you so much,” and she said, “You know what? You're totally welcome. Happy to do it. And I know you'd do it for me.”

That's really what this ends up coming down to, right? When you accept help, it means that you're allowing people to love on you. I in the past would make accepting help mean that I'm being a burden, that somehow I guess maybe that I am showing some sort of weakness or something, like I should be able to figure everything out on my own. And whoever decided that? That's not the rule of the world. That's not how the universe works. We help others and then that help ends up coming back to us.

When you allow people to love on you and to show their support, psychologists call this the tend and befriend response. This is what women in particular, men can do it too, but women in particular will utilize during stressful situations. Interestingly I had just been reading a book about stress and I was like, “Oh my gosh, this is the tend and befriend response. Look, it's happening right here.” The Wikipedia definition of the tend to befriend response is that it's a behavior exhibited by some animals including humans in response to threats, and it refers to protection of offspring which is the tending part and seeking out the social group for mutual defense which is the befriending part.

Apparently females from many species also humans form these really tight stable alliances and bonds during stressful times, and by doing that tend to utilize the fight or flight response less. It's seeking out friends during stressful times for support, and research shows that particularly in women stress really encourages pro social behaviors. Pro social behavior is saying, “Yeah, my husband's home tonight, I can come and sleep on your couch. For sure, I can do that for you. Don't even think twice about it. I'm coming it.” It really is against our nature to not let people help us in times of need because it's internally driven in us to help. If you've ever been someone who's been trying to help someone and they won't accept it, sometimes it feels a little frustrating, it's like, “Stop it. Let me just help you.” That's exactly what was happening here.

Could I have flown my mom in last minute and asked her to drop everything and fly in first thing and help us? Sure. There's lots of options. But having spent some time developing these relationships when life was stable definitely paid off here because I had these relationships with these people in my smaller group so that when we were in need we don't need to do super drastic things like flying someone at the last minute to be able to help. We can rely on the people who are already around us, who already love us and want to help us and are able to do so.

I also wanted to talk about when something like this happens to other people that we know, how we're sometimes not really sure how to respond or reach out. This is kind of the flip side of it. Now you know of somebody that really could use some help and you're like, “I just don't even know what I really could do.” Or maybe you can think of some things that would be great, but they just don't fit into your life.

You might be in a position where you're like, “I'm totally on service,” or, “I'm on call,” like, “I can't make a home made meal for somebody. I can barely make up food for myself, for my own family.” We've got our own stuff going on. I know that happened to me when I was in practice for sure because I literally could not commit to doing any of the driving because I was at work or I just didn't know when I'd be done so I was just totally unreliable in that way. Making another home cooked meal to deliver at a certain time for someone else, like I just didn't even really see how that was possible. Sometimes it would be easy to think like, “Oh, I'd like to do something,” not really come up with any idea that I really could implement that I felt like would be helpful and then I'd end up doing nothing.

It's important that we allow ourselves to access that tend and befriend part of our nature and sometimes it literally can just be letting the person know that we're thinking of them and that we're rooting for them, whatever it is that they're going through. That can be enough, just letting them know of the support that you're offering. It could just be a phone call, sending a little handwritten card, or maybe having flowers sent can be helpful, or some other kind of token gift type of thing or something that actually might be helpful to them in terms of their recovery if it's something that's health related.

I would often during that time solve my problems by asking myself, “How can I throw money at this problem,” like if I couldn't make a meal for a family, I could send them a gift card to a local restaurant that delivers. I have even ordered pizzas for a family and had them delivered at a convenient time for them. It doesn't have to be complicated or involved. It literally can just be a small gesture to lighten their load. It's a great thing to do for them and it helps them, but it makes us feel good, it makes us feel connected to that human part of us that wants to respond to a stressful or difficult situation in this way.

It's so easy to think I know I've had these thoughts, “Oh yeah, I should do something for them, I have to think of something,” and then getting busy with other stuff and kind of forgetting and not following through, or just thinking that all my ideas are kind of bad and not doing anything. Doing something, anything to help them is obviously good for them, but it also helps yourself because then you're being helped to show up in your life as a human with resources to share in a way that you can be proud of, you can really be proud of yourself and know that you're the kind of person who shows up in that way for the people that you know. Even if you don't really know them. Maybe it's an acquaintance but it's still somebody that you feel like you'd like to reach out to.

That's the thing with the tend and befriend response. It doesn't have to be people who are very, very close to you. Sometimes in big tragedies people become instant friends and start immediately working together, they don't even know each other's names. It doesn't have to be necessarily something like that.

When you know that you're strengthening those connections with other people who you may not even know that well, it really helps you to build and develop those friendships that are so important, that I keep talking about on the podcast, having those relationships with people that you know, okay, in my time of need they have my back in my time of need and I've got their back in their time of need. It may look like totally different ways, like if I'm not a stay-at-home mom like I maybe can't run over at 10:30 to do x, y, z and collect a package or something, but there's other things that for sure I can do and it's important to know that.

Just think about that the next time you hear of someone in your circle or kind of outer circle going through some sort of struggle. Think about that tend and befriend response. What can you do to aid them, assist them, help them that is not something that's going to totally throw your life off course or be anything super crazy, but is really going to be something that helps you to show up as the person you want to be, honors this instinct that we have, and at the same time probably ends up helping you to foster some more deeper relationships and friendships with people.

As a final huge thank you to Alison, Sue, Sara, and Carla and for their families for being flexible so they could really help us out, so grateful and appreciative to all my small group friends, and to all of your listeners of this podcast as well. All right, have a wonderful week and I'll talk to you next time. Take care. Bye-bye.

Thanks for joining me today. If you liked what you heard here, be sure to hit Subscribe in your podcast app so you never miss an episode. You can also get my Busy Doctor's Quick-Start Guide to Effective Weight Loss for free by visiting me over at katrinaubellmd.com.