Years of James 4:13

‘Now listen, you who say, “Today or tomorrow we will go to this or that city, spend a year there, carry on business and make money.” Why, you do not even know what will happen tomorrow. What is your life? You are a mist that appears for a little while and then vanishes.

First of all  – I’ve calmed down a bit from my last post – sorry for the ire, I’ve decided not to edit it as this blog is meant to be above all things, honest.

I had my last day on geriatrics today (exam tomorrow – eeek) and got my feedback on performance etc – and did fairly well though I am very aware of areas I really need to improve. If I pass everything (and am given a job), it’s exactly a year before I hit the wards as a junior doctor. It sounds like a long time, but there’s a lot to fit in.

I was taking lots of bloods earlier (old people with awful veins and lots of confusion are good to practise on – if you can get blood out of them, you can get it out of a stone….) and was speaking with one patient who I’ve spent quite a bit of time with. She said she thought she was getting depressed after being in hospital so long, and feels as though she’s got to the end of everything. We had quite a long chat and I switched into ‘psychiatry mode’ and asked all the questions I knew the consultant would want to hear about, and then used the screening questionnaire with her and reported back. It made me feel quite emotional (not that this is hard to achieve) – she had an episode of depression when she was close to the age I am now, and then a few more over the years, but has been fine for over a decade. It makes me wonder again  what my future holds. It also led to an interesting discussion with the consultant as he seemed to think that I’d be of the opinion that it’s normal for longterm patients to be clinically depressed – which to be fair, is perhaps what a lot of people might assume – but not me. Depression can be understandable, even reasonable, in come circumstances – but it’s not ‘normal’. No one is ‘meant’ to be depressed. Everyone deserves to have it looked into, and treated if possible and appropriate.

Sometimes, I start thinking about it, and see in my minds eye myself in a year, struggling in my first job, or in ten years, crying and crying with postnatal depression after my first child is born, in fifteen years, as they start to grow and the job-family balance gets harder to manage, in twenty years, when my (future) marriage hits the rocks or someone gets diagnosed with a horrible disease, in forty years, when people start to die, in sixty years, when I am stuck on a geriatric ward, unable to get back home, aware that the end is approaching.  I wonder how many more years I will lose to rainclouds, to sadness. I wonder if this sense of a horizon steadily gaining ground on me will ever leave me – if I will ever lose that sense of perpetually looking over my shoulder to see if the shadow of depression has followed me home. The solution to this is probably to stop thinking – but that’s difficult. Easier said, than done. I looked at this lady, and it was sort of like seeing the future – will it be me, someday, saying, yes, I’ve had depression since my early twenties, yes, I think, I know, it’s back once more?

Unfortunately, I have no silver ball or magic mirror. I don’t have the gift of prophecy, and am a little uncertain about those who claim to own it. I don’t know what the future holds. At times, I would quite appreciate God sending me a calendar with everything filled in for the next seventy years. Or a blackberry, that would also work and is easier to fit in a pocket. Either way – it’s not going to happen. I don’t know what will happen tomorrow, yet alone in year, or a decade. You can schedule and plan with the best of them, but life’s uncertainty and penchance for surprises when you least expect them, will catch up eventually.

I guess what this comes down to, once again, is faith – faith that God will protect me from a relapse, or guide me through it once again, faith that if and when I slide downhill, I will have learnt enough this first time round, to manage quicker, and better. Faith that God is bigger than me, and bigger than depression, and faith that he is more good, and loving, and powerful than I will ever know. This week has had its challenges – but at least this time, when faced with adversity, I spoke up and spoke out and didn’t just run away immediately. I’ve moved forward. I am different to who I was, a year ago, and I’m learning all the time, how to find my path and stick to it. My faith is so clearly stronger than it was a year ago – it made it, tattered, and torn, through last year. It stayed with me, through all darkness and deadness and suspicion. It’s been weighed and found adequate. It’s here to stay, even if it has to fight for its place from time to time. It’s here to stay, even if it’s still just a mustard seed.

Well, if all else fails, one of my patients told me today that I’d do well down a coal mine (he actually worked in the mines near where I grew up, and is currently delerious with an infection and still thinks he’s down them….) as ‘you need pretty girls down in the dark to light the place up’. This cheered me up quite a bit although as he’s registered blind and I’m no model – and certainly not a luminous one – it’s not exactly accurate. Not quite the career I had in mind, but you can’t beat an octogenarian for putting on the charm offensive at every turn….I’m going to miss medicine of the elderly!