When Plans Fall Apart

And some thoughts on rebuilding

Content Warnings: suicidal ideation, eating disorders, exercise addiction, chronic pain

Career Crises & Chronic Pain

“There are few more excruciating experiences than when something that has become a part of who we are changes… When things we’ve come to accept as a part of our identity and worth change, it can feel like we are being stripped of who we are.”

— Amber Lyon, You Are A Magnet, 115

Last week, I was supposed to begin a new semester of my doctoral program. Instead, I submitted the necessary forms to take another medical leave of absence. Until now, I’ve avoided writing about the ways in which my chronic pain has impacted me professionally. I think this is partly due to the fact that I’ve grown weary of attempting to justify how debilitating the pain is; I’m quietly convinced that no one really believes me about just how bad it is, since I can hardly believe it myself.

Another reason I’ve been reluctant to share this stems from the fact that, as is often the case with writing, I know it will force me to confront an uncomfortable truth — that I’m in the midst of a career-related identity crisis.

I’m not a procrastinator. I respond to emails promptly, I check things off my to-do list as quickly as possible, and I have no problem ruminating on a problem in my head — over and over and over — until I’ve reached some clarity. Yet, I’ve been mentally steering clear of the topic of academia. I feel a sense of dread deep in my stomach when I think about checking my school email; interestingly, this is perhaps the first time that I can recall successfully “compartmentalizing.” I’ve never been able to avoid over-analyzing an issue I’m having — until this one.

After finishing my MA, I was unsure whether I wanted to pursue a PhD. I had initially entered grad school intending to apply for doctoral programs after my MA; however, when that time came, I was extremely worn out and knew I needed a break. Additionally, applying for PhD programs is both time-consuming and costly, so I wanted to be certain this was the right path before committing to the process. But after spending time working a 9-to-5 job on the administrative side of academia, I ultimately decided to apply with an ‘I’ll just see what happens’ attitude.

I did my best to go in with no expectations, but I really wanted to get into a program. I love school. I was very lucky to have wonderful experiences in both undergraduate and graduate school; I’ve had dedicated professors whose passion felt contagious. I love reading, researching, writing, teaching, leading and engaging in thought-provoking discussions, and just being in the classroom. Given the supremely sheltered nature of my upbringing, I felt as though my entire world opened up during college — there was so much to uncover, and it was exhilarating for me.

Admittedly, I also felt like not getting accepted would make me look like a “failure” to family and friends. I was miserable working a more traditional, administrative role, yet I also felt significant uncertainty about the “right” career path for me. I wanted to figure it out as quickly as possible — not only for financial reasons but also because I hated feeling unmoored and was privately embarrassed by my apparent lack of clarity and direction.

After I found out that I had been accepted to a program in New York, my partner and I moved from Chicago; subsequently, this meant that my partner also took a new job, we downsized to a much smaller apartment, and our monthly expenses increased while my level of income decreased. I give this context to emphasize that it felt like there was a lot riding on this decision — financially, obviously, but also in the sense that my partner made considerable sacrifices in order for me to pursue my dreams, which is something I’m forever grateful for. However, this is, given my unanticipated hiatus from school due to medical obstacles, also a source of tremendous guilt for me.

When we moved to New York City (a dream come true!), I never could have anticipated how the first several years of my doctoral program would turn out. My chronic sciatic pain following back surgery has derailed my life and my academic plans in ways that still feel unbelievable. The pain inhibits me from sitting. I can’t sit, for any amount of time, in any position, on any surface, without pain. I have tried every available treatment option to alleviate the pain; nothing has worked. Countless doctors’ appointments, invasive and non-invasive surgical procedures, injections, and a myriad of other remedies have failed.

During my first academic semester in NY, the pain became so severe that it prevented me from being able to focus or think straight during classroom discussions, lectures, meetings, etc. Ultimately, after a lot of resisting and panicking, I realized that taking a medical leave of absence was really the only option (a decision affirmed by my doctors, partner, therapist, and trusted friends). It was also suggested to me that, given how my body was already under high physical stress due to the pain, the intensity and rigidity that I approached my graduate work with was likely not helping anything.

One MLOA turned into multiple — as of now, my situation hasn’t changed. An EMG test done by my neurologist confirmed that I have radiculopathy — permanently (most likely) damaged nerves in my lower back and sciatic region. This means, essentially, that there isn’t a “sure-fire” fix. Since this news, I’ve tried experimental medications to no avail. All that to say, I’m now in a position of overwhelming uncertainty. I feel like all my plans and goals have gone out the window. I thought I would be years into my PhD at this point; instead, I feel like I’ve done nothing but waste time. I have nothing tangible to show for the past few years, and my seeming lack of productivity has caused massive amounts of self-doubt.

About midway through writing this essay, I’ve experienced one of my worst pain flare-ups in at least six months. I’m baffled and frustrated by this — at this point, I’ve adjusted my life as much as possible in order to avoid things that generally cause the pain to spike. However, there are times when it seemingly pops up out of nowhere, despite my best efforts to evade a flare-up.

Significant flare-ups in pain have historically triggered some full-on breakdowns. The manifestation of such severe pain physiologically quickly turns into panic (Why is this happening? What did I do to cause it?), disbelief (How is it possible that the intensity of the pain is still so bad? Am I delusional? Am I making this up? Do others think I’m over-exaggerating?), despair (I can’t believe how drastically this situation is impacting my life and that there’s seemingly no end in sight), and frustration with my body itself (I’ve done all the “right” things, I’ve changed my entire life to accommodate the pain, I’ve rested, nourished, and given my body ample time to heal… Why does none of it seem to matter?).

In some of my lowest moments, these thoughts have resulted in suicidal ideation — there have been many very high-pain days where I’ve thought to myself, “If this is going to be my quality of life permanently, I’m not sure that I want to keep going.”

While currently in the midst of this most recent flare-up, I’m specifically noticing how acute my feeling of desperation is. Over the past few years, I’ve had a sort of escapist fantasy during some of the most painful moments where I envision cutting off my legs, delusionally imagining that it would — at the very least — get rid of my sciatic nerves completely.

In general, I have the urge to temporarily distract myself from my sciatica with other types of pain. For instance, one of the treatments that I’ve tried is dry needling. My PT would insert a long needle directly into my “trigger points” — there are a few points in my lower back and upper glute areas where the shooting pain originates and radiates from. Similar to acupuncture but just a different technique (based on my understanding), the goal was essentially to alleviate muscle tension. I was surprised how badly this hurt; I dreaded it the first few times, anxiously anticipating the sharp pain. However, I quickly started to enjoy it. I felt as though I genuinely “craved” the treatments, not because it alleviated my sciatica, but because it was a short-lived reprieve from it. It provided an outlet to temporarily escape the sciatic pain by distracting me with a different, yet still intense, type of pain. Similarly, exercise used to be a way for me to escape my mental “pain” by redirecting my focus into the type of physical pain that comes from excessively strenuous, endurance-based movement.

The prospect of going to more doctors, explaining in detail my health history, everything I’ve done to treat the chronic pain, having more exams and tests done, and potentially re-attempting treatments I’ve already tried in the past is… very unappealing. As anyone with a health condition that requires numerous visits to different doctors knows, the process can be distressing. When all the evidence you have suggests that the available treatments won’t be successful, I think it makes sense to feel defeated and pessimistic. If you’re in a situation similar to this right now, I’m tremendously sorry for what you’re going through — it really is so, so hard.

(Note: I am in a position of immense privilege — my access to health insurance, various resources and support, my ability to still present as able-bodied, the fact that I do not require use of a mobility device, the color of my skin (which plays a significant role when accessing healthcare), and my financial status are just some of the many privileges that I possess. There are systemic issues within our healthcare system that create barriers for so many individuals, and I recognize that my journey toward recovery has been eased greatly by these privileges).

A “Strong” Work Ethic: Commitment or Compulsion?

“But what do we do when the person we had to be to receive love as a child cannot function in the adult world? When who we’ve had to be no longer fits with who we want to be?” (Lyon, 34).

During my unplanned leave from school, I’ve tried to make the most of my time by dedicating myself to eating disorder recovery.¹ I can recognize (most of the time) that I’ve made a lot of progress (though there are still moments that are quite difficult). As such, I know that this time hasn’t truly been “wasted” — prioritizing my health and recovering from a deadly mental illness is, objectively, one of the most important things that I could have been doing. I’ve come to realize that, in some ways, academia was a convenient distraction — an outlet for me to pour my energy into, allowing me to ultimately ignore my eating disorder and exercise addiction. I was running myself into the ground; I worked nonstop — seven days a week, all day long, no breaks — full steam ahead at all times. I worked, I exercised, and I slept, with hardly anything else mixed in (like eating).

Writing this essay has made the parallels between my experiences with academia and disordered eating/exercise glaringly apparent. School — and professional environments in general — and my eating disorder have always felt like the areas of my life where working as hard as possible (even when it was clearly at the expense of my health) led to the approval I so desperately sought. They’ve also posed seemingly straightforward outcomes. If I threw my time, energy, and attention into researching, writing, editing, studying, and out-working peers, I could get high scores and positive feedback; if I threw my time, energy, and attention into restricting, running, cycling, training as hard as possible, pushing my body to its absolute limit, I could lose weight and achieve “societal acceptance” and a (false) sense of worth.

In my opinion, based entirely on my experience in the environment I was raised in, one of the potentially damning parts of Christian ideology is the idea that humans are fundamentally, intrinsically “bad” and “sinful” — consequently, I grew up thinking that I needed to earn value and “goodness” (and to avoid going to hell, which is really what it all boiled down to) by adhering to a strict set of rules and rituals. I was never told that my worth was inherent; instead, I believed it was fully dependent on actions.

Growing up in a household where “laziness” was the greatest sin, I learned quickly that the key to receiving love and praise from my parents was to appear as disciplined as possible. What became a survival tactic morphed into my identity. Through college and into adulthood, I was only ever praised for having a “strong work ethic,” being “motivated,” having “self-control,” and a slew of other similar expressions with positive connotations. Until my eating disorder reached its peak severity about three years ago, no one in my life had expressed concern that my attitude toward productivity — specifically in the contexts of work, school, and exercise — was potentially problematic or unhealthy.

The dopamine hits I got from receiving praise from professors and colleagues I deeply admired felt so satisfying. Ample research shows that exercise also releases dopamine, which explains why exercise can become addictive. Embarrassingly, I also felt as though I was achieving my goals by losing weight (as a consequence of over-exercising and under-eating), which likewise triggered more dopamine.

Whatever feelings of meaningful productivity I used to possess have vanished over the course of my MLOAs. Being forced to pause my academic career while simultaneously stopping my disordered eating/movement behaviors has felt like a profoundly intense withdrawal. I’ve spent the past years feeling as though I’ve been entirely stripped of the two strongest pillars of my identity: academia and my eating disorder. I based, likely subconsciously, my worth and identity on these two things — both gave me a sense of purpose and accomplishment. Now that both have been taken away, I’ve had to grapple with what — or who — I’m even left with.

I recognize the values I was exposed to growing up are no longer the ones that I want to hold — I don’t want to base my self-worth on external metrics (like productivity, thinness, and professional achievements). I don’t want to spend the rest of my life adhering to a rigid schedule, forcing myself to push my mind and body to extreme limits simply because that’s what I was taught real success means. Just as I’ve chosen to abandon oppressive religious organizations, I’m doing my best to stop participating in the racist, classist, and ultimately dangerous systems that perpetuate diet culture, fatphobia, and unhealthy beauty standards.

The mantra of my life has been “go go go; more more more,” but it’s apparent to me that this is wildly unsustainable. I was killing myself — literally — by physically and mentally doing as much as possible, never giving my mind or my body a chance to recover, always trying to cram something else in to feel like I had spent my time in a valuable way. My body was starting to give up (as one’s body does when deprived of nutrients, sleep, and rest), and I had no choice but to listen.

Building Something New from the Ground Up

“How many times do you hold so tightly to what you want to happen that you end up resisting what is actually happening? How many days go to waste like this?” (Lyon, 256).

“It may appear to be the breaking of your world as you know it, but the beauty of destruction is in the rebuild. The parts of you that are on the floor may have felt like you, but they were never really the truth of your being… You get to pick and choose the pieces you will use to create your new world. You can either try and replicate and repair the one that has been or build something new.” (Lyon, 118).

I’ve spent a lot of time resisting the reality of my current circumstances. Up until my experience with sciatic pain, I’d (very) naively assumed that if I followed the rules perfectly, if I completed all of the steps, if I obeyed every single direction from my doctors, then surely it could be “fixed.” During the first 18 months of this journey, I think that I was equally distraught by the pain and by the fact that I was doing everything “right” and nothing was changing.

I think that the time I’ve spent being angry about the lack of a viable solution and the hours I’ve spent grieving the loss of my pain-free body have ultimately been necessary parts of my journey — while it would be nice to have moved more swiftly to acceptance, I don’t think that was realistic for me. Similarly, I’ve also spent a fair amount of time grieving the loss of my thinnest body, even though I’m fully aware that that body was very sick. There are still moments and days when my new body feels foreign and difficult to accept. But, I know that both my chronic pain and my eating disorder have forced me to confront things head-on in a way that I might have continued putting off until the damage was irremediable.

I don’t believe that everything happens for a reason. Yet, I’d like to think that I do possess the ability to find light amidst the darkness (or, at least, to eventually turn pieces of my darkest moments into some form of light). I want to believe that I have the power to adapt and that I can still create a beautiful life, even though, as Amber’s quote says, it truly feels as though everything I’ve built my life and identity around until this point has been completely destroyed.

I honestly don’t know what all of this means for me when it comes specifically to my academic plans. It makes me feel sick to my stomach to think about not continuing my PhD — this seems like a bit too much to wrap my mind around right now. However, due to the level of my pain, it’s physically impossible for me to rejoin the program currently (a fact that can be hard to accept, depending on the day).

But, I really can’t overstate just how outrageously lucky I am. Not only do I have access to resources and support — both financial and emotional — but I have the tools and space necessary to pursue other opportunities while in this state of uncertainty. I don’t know what the future holds with my degree, but I do know that I love writing. I’ve found a lot of meaning and connection by sharing my writing on this platform, and it’s something that I would like to lean into more (even though I still have a lot of self-doubt). It brings me a lot of joy when someone resonates with my experience, and it’s comforting knowing that talking about some of the challenges I’m facing helps others feel less alone.

After taking so much time to mourn and be angry, I’m feeling ready to make the most of the opportunities that I do have in front of me, rather than focusing on all the things I’ve lost. It’s such a profoundly beautiful gift to have the chance to pursue new paths and to write new stories about who I am and what I value — it’s one that I don’t want to take for granted any longer.

If you have any thoughts on the themes discussed here, I’d love to hear from you! You can find me on Substack, where you can read more of my essays, comment on this essay, and/or DM me! (PS — Substack is FREE!)