You know, I get it. I understand that, when you attend a session to talk about drug shortages and the speakers are a congressman, directors of this, and senior researchers of that, the conversation is going to be at a certain level. That is, aimed at all stakeholders except for us. You know, the ones who could die if the problem isn’t fixed.

This week, I sat in on one such session. (When I wrote about drug shortages a couple of weeks ago, I wasn’t aware that there would be an event that corresponded so well.)

This weekend I got my first taste of being in the sandwich generation (caregiving for both parents and kids at the same time). Millions of people juggle these responsibilities and still have to balance everything else that comes with adulting, including some of my friends. But more of them are like me – childless by choice – and have often discussed how this was one of the few stressful situations we would never have to deal with.

Like them, I decided a long time ago that I wasn’t going to have kids, and my one parent is very healthy. My perpetually low energy is a large part of why I made that decision, so imagining what it would take to look after both the previous and the next generations simultaneously was always an exercise in futility. My brain treats it similarly to imagining what a dragon looks like – I can think about it, but I don’t have to invest too much because dragons don’t actually exist.

There are a lot of elements to a care regimen – people, insurance companies, research, lifestyle habits, chemical intervention. Most of these vary in how much weight they have in the overall treatment scheme, depending on what a pain in the butt they are at any given time, and what your condition is doing at the moment. But there is one – just one – that is terrifying to deal without. That would be the medication.

Clinician shortages have been a fact of patient life for a while, and COVID just served to highlight how dire the situation could get. Oh, and also make it worse by exacerbating burnout, disenchantment, and heightened stress. The National Institutes of Health reports a loss of over 300,000 clinicians in 2021. That’s a lot.

The American Association of Medical Colleges estimates a shortage of 86,000 physicians by 2036 (this does not include nurses, physician assistants, and other clinicians who help distribute the workload more evenly). This may not seem like too much spread over 50 states and five territories, but those of us who already have to wait months for appointments or who can’t find a doctor when ours retires can tell you how bad it is now, let alone how bad it will be then.

Like many of us, I have struggled with my weight for most of my life. And I can honestly say that I am one of the few for whom societal and family pressure (appearance had zero weight – pun intended -- in my family when it came to parental expectations, or grandparental expectations, for that matter) had exactly zero to do with it.

Lucky me.

No patient I know has a consistent level of functionality. Every one of us has symptoms that require care and attention to mitigate their effects on our lives. You can go months – years! – with the same symptom pattern, which can allow for the development of a routine. Routines are boring, but they are also a relief. You act in a certain way that doesn’t cross your symptom(s), and it acts as expected.

Until it doesn’t.

So, turns out my little saga doesn’t end with the surgery.

Because of previous eye surgeries for retinopathy, getting multifocal replacement lenses was not an option. That means I came out of surgery still needing external corrective lenses.

Before the cataract surgery, I discussed options with my surgeon, and chose to be nearsighted. I have been since fourth grade, and I thought it would be easier psychologically to stick with the familiar.

Every Passover, I spend the holiday dinner, or seder, with friends. We talk about the Jews’ Exodus from Egypt, and how that story applies to today. This year, one of the topics we discussed was, “How do you feel broken right now?” It was supposed to be a reflection on current affairs.

That is not how I took the question.

My initial reaction was, what do you mean right now?

Apparently, depression doesn’t go away just because you’re distracted by other medical issues. Neither do medical equipment malfunctions, insurance issues, or the energy drain of condition management.

Luckily, throughout the cataract process, my other conditions have been stable. Mostly. Enough that I could sideline them for a month and maintain my peace of mind, anyway.

But the depression is the refrigerator hum right now, and has been, as much or more than the diabetes, since I started treating it.

There are a lot of things aside from medication that I have incorporated in order to pull myself out of where I was that will also help me take measure of where my depression stands.

Does it sound weird if I talk about my depression the same way I do my other conditions?

It feels a little weird.

Cataracts grow about as quickly as sand moves, or so my ophthalmologist says. So, for 31 years, I’ve had a glacially slow cloud moving over the middle of my lenses. So, the first thought I had after surfacing from my first dose of anesthesia in decades, was OMG, color! I hadn’t realized how much the world had dulled as I kicked the surgery can further and further down the road.