Remembering November

On Saturday, a group of friends and I gathered to commemorate the birthday of Claire, who was one of our group until she died from bowel cancer in November 2009. She was twenty four, and wonderful, and eighteen months on, the world is still a much drearier place without her in it. Being together again at the weekend made me think about the last few months, and in particular, how fine a line I’ve danced with my own mortality; at the time, I was so irrational that I didn’t care about leaving people behind – I just wanted everything to stop. Now, six months on, I am at last,  glad to be alive, though when I’m in the middle of a trough, my thoughts sometimes still turn to the comfort of calling it a day, of letting go. Thinking of Claire, though, reminds me that although we are all  so impermanent, so fragile, our legacy isn’t. We all leave such big holes, when we go.

Yesterday was Monday, which means I was back in counselling once again. I’ve not talked with L about those darkest months, and part of it is because although I struggle enough with recounting the details of my families past, I can usually push myself to get straight facts out – to report, and not connect to it. It’s different when the topic is your own emotions – there’s nothing to hide behind. Every sentence starts with ‘I’ –  there’s no-one else to hang a narrative on. It’s just you, and your close call, and as always, the space between two chairs. I started to explain and didn’t get very far, to be honest. She asked me if I’d told anyone else at the time how dangerously reckless I’d been, and that opened up a whole new can of worms – in November I spoke to a girl from my church who had been ‘mentoring’ me (her self appointed title, not mine), as at the time, feeling desperate was dragging up a whole new batch of theological questions – and she responded by telling me I’d already sinned enough to forsake Heaven, left me crying and actively suicidal on the streets, and then broke my confidence by telling someone completely irrelevent at church, who did nothing to help, anyway. She hasn’t said a word to me since. Going back into church after that was one of the hardest things I’ve had to do – and still is, every week, and the whole episode  has hung over me and my faith like a fog since then. I’ve not taken communion since then, as I need to get around my ideas that I no longer have a claim on a symbol of eternal life. I’ve stayed away from a lot of church things as I don’t want to face her on terms other than my own, when I am prepared. I delayed going to counselling for another three months as the women who heads up the service, is the women this girl told about me, and I couldn’t face her, and hated the fact that the choice to involve her hadn’t been mine. This girl is training to be a counsellor.

I told L the bare bones and it was hard. Since the first time I stepped over the threshold of church, the familiar teachings of leaning on each other, and supporting each other through the tough times, have been constantly spoken of, yet when I did take the plunge, all I was met with was betrayal, and unkindness. The church let me down and they left me alone. I was surprised to see that L was actually quite angry about it – I’ve long stopped myself caring about it, or just pushed it away. I wasn’t expecting L to react like that – but it’s nice to know that I had a valid reason for being hurt by it.

Sometimes I wonder if having prolonged counselling would make anyone wonder how ‘normal’ they are – or if it’s just me. The longer I go, the more abnormal I feel – why am I so untrusting, so afraid, so incapable of opening up? Why am I so hard on myself, so self-loathing, so close to breaking? Why was I not built more stably, wired more accurately, cut less deeply? How is it that I can pose as being normal and ok, but as L strips away the layers, it’s like unpacking garish russian dolls and finding that the last one, the littlest one, is unpainted, and falling to sawdust. The last one, the littlest one, is lost and afraid. L tells me to sit less rigidly, to stop being so tensed – and I can’t do it. Even after nine weeks, I still don’t trust her enough. I still don’t really believe that at some point, she’s not going to turn and use what I’ve told her to hurt me somehow, just as pretty much everyone else has. I still don’t believe that she will be different, that if I lean on her, I won’t find that she’s suddenly not there, and fall down again. I still don’t believe, really, that she can help, and I don’t really want to tell her that – it’s nothing to do with her, it’s just me and my issues. Counselling – it’s a constant minefield.

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The Journey of a thousand miles….

…..begins with a single step, according to Lau tzu. It’s been a busy few days, and reader, now that my exams are a fortnight away, and my hand-in for my research project a week later, you will need to prepare yourself for a broken-record sort of blog for a while.

On Wednesday I went to a clinic to hand out some questionnaires for my project. My supervisors (who volunteer to have students, by the way) have discouraged me from doing clinic work since the start, mainly, as far as I can see, because they couldn’t be bothered to show me the ropes. As I’ve been feeling generally ill and run down this week, I was dreading it – I’ve come to hate this project and deadline, that has really ruled me for the last few months, and caused so much stress. However, I was pleasantly surprised, as the specialist nurse was lovely and very helpful, and most of the patients were keen to fill out my questionnaire, and as it’s not a department that get many medical students (it’s a very specific subspecialty), a lot of them were really interested in talking to me, and hearing what I had to say. It’s given me a real boost – which seems daft, as all I did was explain my project and send them off with stamped envelopes to post them back to me, but it reminded me that actually, I’m quite good at what I’m learning to do, I’m good at connecting with people and I truly want to be a doctor who makes a difference. This project has a long way to go until it’s finished, but at least this week, there was something positive that came out of it, which certainly hasn’t been the case for a while.

Now that I’m in exam-mode again, it’s easier to see that I have come a long way since my last set at the beginning of February; I can actually sit and concentrate for a couple of hours, and retain something, whereas back then, I wasn’t taking in anything at all, and was just sitting and either staring into space, or crying. I’m still not sure how I passed as well as I did. Whether it’s because I’m doing specialties that interest me a lot at the moment, or just that my mood is finally lifting a little, I’m enjoying learning again, even though after putting in about twelve hours most days, I’m ready to put down the books and sleep. I love learning, and when I just couldn’t do it, I couldn’t quite handle it, as so much of my identity revolves around studying and applying knowledge. It’s good to find the thirst for it again, even if I still have quite a lot of wobbles.

It’s pretty much a full year now, since I started sliding into depression, and though sometimes, I resent the time that has been stolen from me, I know that I need to look forward and not back. I’ve lost a year, so far, and I don’t want to lose more if I can help it. I want to enter my final year of medical school with a clean slate, without anything hanging over me. Feeling strongly enough to want something, also seems like a breakthrough. I still have my apathetic days, but just knowing that behind it all, I’ve still got that glimmer of what I was before this, a glimpse of what makes me who I am, is a relief. It’s good to be feeling 3D again after being flat for so long.

I’ve been in counselling for about eight weeks now, I think – I’ve managed to stick it out longer than the first time I tried, three years ago, and it’s strange how it’s become a part of my week – not precisely a welcome part, but there regardless. Sometimes I think it’s strange that it’s so much harder talking about something than living through it – it’s so much harder revisiting it, than being up against it in real time. And though I’ll never be a fan of pop psychology, I am learning from it, slowly, painfully but learning nonetheless.

So – it’s been an ‘ok’ few days, which I’m grateful for – here’s just hoping I get everything I’ve set myself to do, completed by the end of the weekend. The even keel is a nice place to be, even just for a little while.

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My candle burns at both ends….

I was back in counselling yesterday and felt quite angry for part of it; my counsellor, L, is always going on about how I have high expectations of myself and am hard on myself when they aren’t reached – and I would never disagree with that, but I disagree that it’s something I desperately need to change. When I was still at school, I know that in some ways being such a perfectionist did me no favours, but by the same token, that vigilance was what enabled me to get the grades and other things I needed to get into medical school; show me the doctor who doesn’t push themselves, and doesn’t always strive for improvement, and I will show you a substandard physician. Who would you rather have treating you? Someone who felt ok with putting in a minimal effort, or someone who was determined to do the best for you? I am much less of a perfectionist anyway, than I used to be, and am more relaxed than I used to be, and to be honest, having someone comment on how hard I push myself three weeks before major exams, and four weeks before a major deadline, isn’t that helpful; all of my peers are working themselves to the bone at the moment, and for medical students (and other related groups), it’s more than just learning for exams; everything we don’t know is a future patient we fail to treat, or at least that’s how it can feel. Every mistake, is a waste of time, a delay in diagnosis, an adverse drug reaction. I want to be the best doctor I can be; I don’t want to be a substandard one. Working hard and pushing myself is just a part of who I am; society is quick to judge the crowd who burn the candle at both ends, and tell us that we should slow down, but at the end of the day, are hardly celebratory of lazier people. I know that this depression I’m going through makes me even more self-critical than usual, and I do try to silence that voice, but, my tenacity is what makes me who I am. It’s why I’ve always been someone with a string of extracurricular activities, it’s why my patient visiting project as been a success, it’s why I’ve got through this year, so far, when so many odds have been stacked against me. I owe it a lot. Cutting it off is a bit like cutting off an arm. Being hauled up for it struck a nerve, but then, that’s what counselling does, at the end of the day. It’s no ball game, and if it is, there’s an awful lot of striking out. It’s not something that is ever going to be painless. It’s not something that will ever be easy.

I talked about a memory that’s come back a lot this week, as it was my mum’s 60th last weekend (which is why I was home), and I’ve been reminded of her 50th, which we celebrated round a hospital bed, as she was being treated for breast cancer. I was thirteen, she was in hospital a lot longer than expected due to infection and other complications, and home was falling apart as my dad drank himself silly and left me to sort out the mess and make sure my younger brother got to school and ate square meals. I sometimes think I was more grown up as a thirteen year old, than I am now. For her birthday, I made a cake using a new recipe book, and it went terribly wrong – the filling didn’t set and soaked through the sponge and ruined it, and I wanted to start again (here’s that perfectionist streak coming through), so was running behind time, and our dad threw an absolute fit infront of me and my brother, throwing glass milkbottles, swearing, and just shouting and shouting and shouting at us, telling us that he wishes we’d been taken into care so he didn’t have to deal with us, that it was our fault that mum’s recovery was taking longer than expected, and a lot of other things. I remember being absolutely terrified, and starting to cry before he said that he was going to the hospital whether we came or not.

When we left, it was the first time I’d been fully aware (or at least, that’s what I remember), that he was well over the limit and driving dangerously; he must have been driving under influence for years before that, and now I wonder how we got away with it, how we never had some terrible accident, after ten years of being driven dangerously. Ironically, it was with my mum behind the wheel that I ever came closest to harm as not only is she an awful driver but she also used to threaten to drive us off the road, to get away from the drinking.  Now that I’m older, I wonder how we managed that day; I remember hugging my brother, then eleven, and putting on a  smile as we went into the hospital room. I wonder how we did it. Now, whenever I see families visiting patients at the hospital, I always have a look at the kids, to see if they look they’re ok. I’d like to think that one day, I’ll be there to help one of them.

Talking to L yesterday was different somehow; I’m still slow to get started but I think we’re getting to know each other more now, and it seems that little bit easier. I still find it strange to have such one-sided conversations, in that I don’t know much about her at all, but it’s maybe getting easier. Or at least, just more bearable. I guess if you rip off enough plasters, eventually they stop stinging.

I had a nice perk this week which has given me some hope, to be honest. It’s so easy to get bogged down in negativity with depression, and be convinced that no one cares that much about you, or misses you when you’re gone. After skipping church on Sunday, a girl I know quite well sent me a lovely email just checking in (she knows I’ve got a lot on my plate at the moment), and I had an email from the leader of a church group I’m involved with that revolves around including people with learning disabilities, as I missed an event on Friday, saying that they’d missed having me there. A lot of the time, it feels like I’m not missed, or that wanted, or that useful to church- so it’s been nice to have those things this week telling me otherwise.

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Magic Eye mountains

I was thinking about Psalm 121 this morning. Something I find interesting about the Psalms is that they were often written in specific circumstances or for specific purposes, and yet, we in modern times still turn to them when our experiences are markedly different; few of us have hidden in a cave and pretended to be insane like David, after all. Psalm 121 is noted as a ‘song of ascents’, and although this is purely speculation, I always imagine it being sung by a group embarking on a vast journey over huge distances, in the steps of their forefathers, weighed down with animals and possessions, small and fretful children in arms, the sun beating down and the end nowhere in sight. Nowadays, certainly in the developed world, it is rare that we are forced to do arduous journeys for any aim other than travelling in its own right;  people run marathons and do cross-country cycles, but there is no sense of journeying away from a physical threat, and knowing that the end of the journey signifies not only personal satisfaction, but also safety, which may have been missing before (although obviously, there is unfortunately still plenty of places where emigration for safety is still a frequent occurance). In Psalm 121, I imagine that the singers were looking down the trail, towards whatever oppression they were escaping, and then upwards, to both salvation and safety, and thinking how far away it seemed and how the distance just didn’t seem to shorten, how the sun was burning them, and the dust of the trail making it hard to breathe.

We often talk of life being ‘a journey’, and usually, this focusses on the uphill, difficult stints – not many people find themselves contemplating the ease of a downhill pace, where no effort is required to move forward. Similarly, in terms of depression, we talk of ‘slipping’ and ‘getting lower’, yet it’s unusual to have a few days where we think about climbing moods and soaring spirits – in all areas of life, the easy times pass by, unnoticed, yet the hard times tip us into contemplation.

I’ve been thinking about what the ‘top of my ascent’ really is, recently; whether it’s a point where I truly feel I have waved goodbye (or more likely, flipped the bird) to my depression for good, or whether it’s reaching a place where I am more able to manage it, and feel less consumed by it. At the moment, the peak I’m aiming for is when I have finished all the extra bits I’m having to do, and once again, only have the standard commitments of medical school to worry about, like everyone else; no more ongoing projects, no more extra meetings, no more counselling. My peak is one of normality.

This Psalm also reminds me what I should be focussing on too; when I’m looking ahead to the challenges I’m anticipating, it can seem so bleak at times, just one chance to fall, to fail, after another, and I wonder how I will ever manage to reach solid, high ground, when at times, my resources seem so low, and my  heart so heavy. This song of ascents is pretty clear on this; my help comes from the Lord, the maker of Heaven and Earth. He created the literal mountains being climbed by the psalmist, he created the metaphorical mountains I am scaling. He knows the easiest routes and the paths to avoid. It’s a long way up, but God is guiding us over the rocks. It’s a long way up, but God is behind us, stopping us stumbling. I know that as I keep moving upwards, the vantage point on the last few months will keep changing and I will gain new perspective. I’m looking forward to reaching this next peak and being able to lay this year to rest, and move on, and lose the sense that I’m on borrowed time, and will always be playing catch-up. I’m looking forward to packing this year away, and forgetting about it’s power and pull for a little while.

In some ways, the path ahead of me is like one of those Magic Eye paintings; at first glance, all I see is the trouble, and the challenges, and the fear of falling. All I see is the pattern that went before, of gaining a little ground, and then, oh so quickly, losing it, and falling even further back. All I see is a future stretch of never-ending depression, of never-ending torment, and the possability of unchanging, unstoppable strife is more than I can bear.

But then, I remember a section from the Bible, or have a thoughtful conversation with someone, or see something that reminds me that the world isn’t quite as bleak as I sometimes think it is, and I am pushed  to look from a different angle, to refocus, and I see that behind and amongst that bleakest of patterns, that highest of mountains, is God, clear as crystal, hard as iron, and  I can’t believe I didn’t see Him there before. I can’t believe that all I needed to do, was take a step back, or forward, in order to see His footprint on the ground ahead and behind me. I can’t believe that He has been there all along, in plain sight, the focus of the painting, the thing we are trying to see. The pattern around Him means nothing. The superficial challenges, mean nothing; it’s all about the hidden layer of truth that we sometimes forget, or refuse to see. The pattern is just the top of the river reflecting the light; God is the undercurrent that guides it to the sea.

So, if you’re reading this, and feeling far from God keep an eye peeled (sorry) for those ‘Magic Eye mountains’, I hope you find one.

I’m back in counselling tomorrow – feeling quite anxious about it after last week and not entirely sure how to play it. This week, I also have a lot of bedside teaching from my head of year, whom is mentioned here; the only time he has met me hasn’t really been that encouraging, and I was in floods of tears at the time – not exactly conducive to convincing him that I’m a good student. It’s going to be an uphill week, so hopefully I’ll remember this Magic Eye thing myself.

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