You Can Have It All And Not All At Once

‘You can have it all and not all at once.’ Have you heard this phrase before? I first heard it when I was 32 years old, newly divorced and a single parent to my son, then age 4. I was working to run a school based health center for both the Department of Public Health and also under the guise of Boston Medical Center as my full time job. In addition, I was trying to keep up my part time private practice which I had recently downsized from full time and work weekends and holidays at Mass General Hospital. It was a tough balancing act and I didn’t always get it right. We also had a dog and lived in a fifth floor walk up apartment. Get where I am going here?

In my early 30’s I also ran many, many miles. I ran the Boston Marathon when I was 35 and five BAA half marathons in my 30’s – not to mention multiple 5 mile and 5K races. I was trying to have it all at once. I was literally chasing what I didn’t have on a regular basis and doing a lot to not feel pain and anxiety. This was also a time period in my life when I was back in court to keep my son many times. These occurrences cost me significant amounts of money and parts of my emotional well being that took me years to get back. 

My life was spread way, way too thin. I heard the phrase ‘You can have it all and not all at once…’ from my then nursing supervisor. She headed up all of the state’s school based health centers. I remember looking at her like she had three heads and several sets of eyes when she said this to me. I really didn’t understand what she was talking about at the time. Two decades later, most of my patients have heard me bring this up at least once in our work together. 

When I think of recovery from eating disorders and the medication that can help to heal and live a fuller life ongoing, I do see full recovery. This does not happen all at once. This takes time, teams, collaboration, willingness, hope, and trials often fraught with steps backward as well as steps forward. Similarly we may be experiencing discouragement of a changing body and getting comfortable with this ongoing.

Working and moving through getting better to become well as you’ll hear Amy Boyers, PhD, and I discuss in today’s podcast is also a way to see one can have it all and not all at once. Medication can help in the best doses and combinations for each individual human. Not forever, either. Medication can be tapered down and individuals may not need this any longer to give them that extra 20% of space in their brain that they now have created. 

I made shifts of my own as time went on. The school based health center lost its grant and I could not survive financially on half my pay in addition to my part time private practice. I cut out working weekends and holidays and took a full time job with better job security and the best mentor who I still consider a dear friend. I negotiated my salary three times over six months before taking this new full time job. I continued to build and get clear on the niche of my private practice. I still don’t have it all, all at once and this is no longer my goal – it’s actually the opposite.  

P.S. We’ve resumed TheNPRD Facts video series on all of our social media platforms. This week I covered bupropion (Wellbutrin) as an adjunctive psychopharmacological medication in the treatment of eating disorders. Check it out on InstagramFacebook and LinkedIn