Groundhog Day

Wake up. Glass of water. Check on Lonna. Assess the overnight. Then the morning medication ritual begins — crush each pill individually into a fine powder, mix with water, draw into separate syringes, and inject through the medication line of the GJ tube in a specific order, because some can't go in together, some need to be spaced, and if you get the sequence wrong you'll hear about it from her body later. Then flush the line. Then connect the nutrition formula to the J line, set the pump rate, check that everything is flowing correctly, and write it all down in the log.

The transplant team required the log. They were very clear about it. What they were less clear about was whether they wanted the paper version or the digital version — because we kept both, and depending on which clinic nurse you got that week, you might get praised for the digital log or mildly reprimanded for not having the written one. One source of ground truth, people. Pick one. We eventually figured out that the paper log was what the clinic wanted to see, and the digital log was what kept us sane at home. So we kept both. Par for the course.

Noon medications. Dinner medications. Bedtime medications. Flush, check, log. If something is off — a temperature, a number that doesn't look right, a symptom that wasn't there yesterday — you evaluate it, you document it, and you decide whether to call the transplant team or wait. Waiting is its own skill. So is knowing when waiting is the wrong call.

Welcome to Groundhog Day.

The days blur not because they're boring but because they're relentlessly full of the same things that demand your complete attention every single time.

The Groundhog Day problem in caregiving isn't the repetition itself. Repetition you can handle. What makes it hard is that the repetition never fully routinizes. A missed medication isn't a minor inconvenience — it's a potential crisis. The routine is relentless and the vigilance is permanent and there is no clocking out.

The log saved us more times than I can count. Not just for our own tracking but for every new nurse, every hospitalist who walked into the room at shift change and needed to understand a situation in sixty seconds that had been building for months. The log was institutional memory. Without it we were starting from scratch every time a new person walked through the door — which in a complex medical situation, is constantly.

If you're in the grind right now: write it down. Not for posterity. For next Tuesday when the on-call doctor asks what her tacro level was running last month and you need to answer immediately and correctly. One source of ground truth, whatever form works for your situation. Paper, digital, both. Just make sure the people who need it can find it and read it.

But the log only addresses the operational side of Groundhog Day. The emotional side is harder and less discussed. There's a specific kind of exhaustion that comes not from doing too much but from never being fully off. You can sit perfectly still in a hospital chair doing nothing visible and be more depleted at the end of the day than you were after running a marathon. The vigilance is metabolically expensive. Your nervous system is always running a background process — scanning, monitoring, ready to respond — and that process doesn't pause when you eat lunch or take a walk or try to sleep.

I played tennis with a group of guys in Houston — fifteen of us, indoor courts, because nobody with any sense plays outside in Houston in the summer — and those sessions were non-negotiable. Not because tennis fixes anything. It doesn't. But for two hours my nervous system had permission to care about something completely different. The score. The serve. The guy across the net. Nothing about lung function or lab values or GJ tube connectors. Just tennis. The temporary complete displacement of the caregiving brain is not a luxury. It's maintenance.

Find your tennis. Whatever it is. Guitar, golf, running, woodworking, cooking something complicated, reading something that has nothing to do with medicine. Passive things — TV, scrolling — don't do it. The caregiving brain will multitask right through them. You need something that requires enough of your attention that the background process has to actually pause.

The other thing that helped with Groundhog Day was the CaringBridge entries. Writing about what was happening gave the day a shape it wouldn't otherwise have had. It forced a narrative — beginning, middle, end — onto what was otherwise just an undifferentiated stream of tasks and waiting and small crises. The day you wrote about felt different from the day you didn't. More purposeful. More survivable. You don't have to write publicly. A private journal does the same work. But do something that imposes a shape on the days.

The last thing I'll say about Groundhog Day is this: the repetition eventually ends. When you're inside it, it doesn't feel that way at all. It feels permanent. It feels like this is just what life is now. It isn't. The phase will shift — toward recovery, toward a new normal, toward something. Hold that knowledge even when it's hard to believe. The current knows where it's going. Let it take you.

“I kept hoping we would be able to go for that lunch we planned that kept getting postponed for one reason or another.”

Casey King spent over two decades as a caregiver for his wife Lonna, who lived with scleroderma and underwent a double lung transplant in 2023. He is writing The Caregiver's Trap: A Roadmap for When the Caregiver Needs Care.

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