Global Doc: Rebound

Author: Dr. Vincent DeGennaro Jr. ’02

I’m so tired. I haven’t slept well in two months, awakening each morning with a tightness and flutter in my chest, hours before my alarm clock rings. My eyelids are constantly heavy, full of the smoke and smog of Port-au-Prince, desperate for respite.

Paul McCartney’s refrain plays over and over in my mind: “Let it be.”

Part of me feels burned out from constant travel between my two homes in Haiti and Florida. Frustrated with the consistent dysfunction of the Haitian government — and, often, of the institutions I work with — I’ve decided to leave an organization I’ve worked for on and off for 12 years and launch a new organization called Equal Health International. While I’m proud of giving birth to a new entity, the pressure to fundraise, organize and implement becomes ever greater.

In this turbulent transition, I can draw upon wisdom I’ve accumulated during my decade-plus in global health: Positive thoughts are fleeting; negative emotions pile up and linger. The beauty of a given day, the grateful patient, the connection with another human being fades more quickly than does the destructive pull. Resilience is everything.

I must remember that just above the clouds, even in the worst tempest, the blue sky is still there, calm and serene. I need to remember as well that those we count as adversaries aren’t bad people. We all make decisions and act in accordance with what we think is best. Nobody is perfect. People grow and change; sometimes friends separate ever so slightly over time.

As the times grow difficult, true friends step forward to stand beside us, or better yet, pull us back to the forgotten place where we really need to be. When I’ve needed it over the last two months, people I thought were only colleagues sprang into action, protecting me from harm on one side while reaching out to create new opportunities on the other, relaxing the tense coil within me along the way.

One day, I’m glum and cross at the situation. The next day, I simply wake up happier. The clouds disappear and the blue sky appears again. I focus on the positives, the wonderful people in my life, the blessings bestowed on me. I enjoy saying hello to casual acquaintances at work, have a jovial interaction at the market, or perform a random act of kindness for a stranger.

Focusing on the needs of the less fortunate helps. As a doctor, treating a patient with breast cancer counts, but I understand what I do as more than a job, certainly as more than a robotic function of my position and education. Instead, I find myself offering an extra smile or expressing interest in another’s trials, minimizing my own and, I hope, relieving theirs in the process.

Psychologists call what I’m feeling the “rebound effect.” It occurs when we’ve been through a particularly trying time in our lives. After a prolonged period of difficulty, the brain and the spirit bounce back, often higher than they were before. People who pass through a near-death experience may awaken the next morning, refreshed and simply grateful to be alive. The simple pleasures resurface, perhaps noticed again as if for the first time. The body, accustomed to the stress hormones of the trial period, rebounds and may experience feelings of joy brought about merely by the absence of suffering.

Other studies have delineated post-traumatic growth. In contrast to post-traumatic stress, which is actually less common, post-traumatic growth produces a renewed sense of empowerment in place of despair and fear. For example, a parent who loses a child in a school shooting may become an advocate for gun control, speaking out against the evil that took their child but finding a renewed sense of purpose in a life forever changed.

Perhaps this is our brain’s healing mechanism, honed through millions of years of evolution. In lives full of difficulty and loss, if we as a species were crushed permanently by each tribulation, we would have long since become extinct. But I am bouncing back, rising up. The clouds part, the blue sky is there, and we may come back, stronger than before.

Vincent DeGennaro is an internal medicine doctor and global public health specialist in the University of Florida’s Division of Infectious Diseases and Global Medicine. He works mostly in Haiti with the nonprofit Equal Health International. See his An American Doctor in Haiti blog.