Archive for November, 2011

Elegy to autumn

Now, I’m pretty used to be analytical, and most of medicine is about comparison, either with ‘the norm’, or the other side of the body. To find a pleural effusion, you’re looking at how one lung base sounds compared to the same spot on the other side. To work out if a knee is swollen, you look at the uninjured one. To assess a child’s development, you compare them against what a child of their age and experience ought to be doing.

Perhaps this is why I find myself referring to last year constantly at the moment. This run up to Christmas was the hardest time, in many ways, of all of my time with depression. There were a lot of painful moments, this time last year. I was pretty deadened. The changing leaves didn’t make me look closer for their beauty, but for their relationship to dying, as that was all I was thinking about. Everything was empty. Now, after a week of 9-5 lectures, I appreciate being able to concentrate in a way I couldn’t do for months, last year. I appreciate waking up and feeling exhausted, but not wishing I’d not woken at all. In the last month or so, I’ve got my ‘medical mojo’ back – I can approach patients and speak with them, and examine, without feeling like I’m having a panic attack or that I’m distinctly substandard. When my depression was both in its early, middle and late stages, I had real problems with that – as though patients could see my diagnosis and would assume I was useless, or that I was useless, and would never ever be a good doctor. You have to have a certain level of confidence to go and talk to someone with terminal cancer, or a sick child, or ask to do a pelvic examination. Medicine is no place for wallflowers, and my confidence is taking a long time to come back.

This time of year always makes me nostalgic, probably because it has so much packed in that a lot of my childhood memories are of walking home from school in the twilight, or waving sparklers, or carving pumpkins, or picking apples from the garden to make crumbles. The cold, clear autumn days are my favourites of all the year. They remind me that change isn’t always bad, or forever, and that all phases and stages, both good and painful, end at some time. We move on. We grow.

It was early autumn 2003 when my dad went to rehab for the first time, and deep winter when he came out. When we picked him up, we had to bring his winter jacket as he’d gone in with just a jumper. It was autumn 2005 when I applied to medical school, had my first set of interviews, and felt like my chance of escape was growing closer. It was autumn 2006 when I started medical school, which really was my lifeline, and what had got me through the previous three years at home. In 2007, I lost my last grandparent as the leaves were falling, spoke at a funeral for the first time, and mourned the loss of a generation. This week two years ago in 2009 marks my change, at last, after months of questionning and wondering and fear, from plaintive agnostic, to quiet, startled Christian (this is a post in itself). This week, last year, marks the anniversary of the day one conversation with a person I misguidedly trusted, led me closer to death than I hope to be again until I am old and worn and ready.

The autumn for me is a time of heartsome remembrance, an elegy to what has changed, and what starkly refuses to alter. This year, I am two years into faith and those two years have hardly been easy or straightforward. I remember the wounds of last year, and carry them with me. Those autumn days where my mood was hibernating, marked me. However, my years of faith have marked me more. My faith has survived, my prayers are still stumbling, my heart is still learning. Eight seasons on, I am still singing. Eight seasons on, I still see God when I look at the changing leaves and see the death of the year beginning, in all its glory. Eight seasons on, I can see how much ground I’ve covered, and am able to look forward and wonder where I will be in another eight seasons. This is my favourite time of year.

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I kind of feel like I’ve stepped back into the fire since I got back from my trip away – as though a week of peace tricked me into a false sense of stability, and that letting things go for a week just made them come back amplified when I turned my attention to them once again.

In church on Sunday evening, I found myself crying and crowded out, the first time I’ve had that total, overbearing feeling of weight, that leaves me short of breath and panicking, ¬†thinking, ¬†¬†pleasegodjustmakeeverythingstopandslowdownbecauseimjustnotbigenoughforthisanditstoomuch

I’m finding it hard at the moment with F and her depression, alongside trying to get myself as firmly sorted as I can. It’s exhausting. And sometimes, just sometimes, I can’t bear to be kind and clear and brave and supportive when she talks about ‘not wanting to give in’ and go for counselling, or ‘being strong enough to not need or benefit from it’. Sometimes, after cheering her up and stopping her crying, it’s me that ends up crying next door – I’m not nice enough to fully accept that she doesn’t mean to cause offence or that it’s not a personal gibe at me and my issues. Part of me just wants to start yelling that if she thinks I ‘gave up’ last year, she’s bloody wrong. If she thinks it’s an easy option, she’s wrong. If she thinks it takes more courage to bury her head and not try something that’s pretty well evidenced to work, than give it a shot, she’s wrong. Sometimes I get so annoyed that I can’t get away from depression at all, whether its mine or someone elses. I just want it to leave me alone. I just want to have a few months where it doesn’t rule every thing I do and think about, and choose. I’m no saint. I’m running dry again. I wish I could handle this better.

I’ve also realised that the last few weeks have been so busy and irregular and stressful, that once again, I’ve got myself off the right road and I’m feeling lost. I’m panicking. I stopped fixing on God, and lost sight of him. There’s been so much to think about that I didn’t notice when I stopped praying and stopped talking. And although I know it should be easy to get back, for some reason I just feel blocked off and shut off, shut out. And I feel like I need someone who knows me and know about last year to pray for me, and pray the right things, but there’s no-one at church I trust enough with it, not after last year. I feel like I need to find the way back home, back to God, but I can’t see it. It doesn’t feel right. I usually hate being prayed for, due to a combination of hating feeling like I’m the ‘centre of attention’ (please don’t look me in the eye, God), and other reasons. But right now, I feel like I need it. Right now, I feel like I need someone alongside.

As of next week, I will have been a Christian for two years, and yet so often I still feel so green and uncertain. After last year, depression moved my faith backwards and I had to unravel all of the wrong things it fed me. My faith is a panicking faith, an onmygoodnesspleasehelpgodpleasehelp faith. My faith, and the things depression did with it, almost killed me last year. My faith, and all the things God did with me, got me through, last year. And yet, at the moment, I feel like I’m shouting against white noise, into the wind. I’m trying to be still, and know. I’m still learning. I have so much to learn. I have too much, to learn.

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I am just back from a lovely break up North, which was all the more wonderful as I’ve been hosting an American friend, and her grandmother, for the week. My friend S is one of those people who seem to have a tattoo across their forehead that says ‘world-changer’. We met working at an American summer camp for people with special needs, four years ago. She is awesome. Sorry for being off the radar, but we’ve not had internet since heading off on Wednesday. This is a little rambly – sorry!

They arrived last Sunday and after getting them settled in, S and I went for icecream (I like that this is the most American thing I have done in living memory) and talked. One of the things I love about her, is that unlike the vast majority of people I know, she has absolutely no fear of the word ‘depression’. She uses it where it should be used. She does not dress is up and make it tapdance so it seems less threatening. She does not brush it off. She does not refer to it as a habit I fell into, or a path I mistakenly went down, or a series of bad judgements. And, in doing this, she makes me feel more separate from depression than I have for so long; often, I think my close friends still mentally prefix me as ‘depressed-Char’, or see it as part of who I am, a part that is here to stay. In naming it so frankly, S called it out. She gave it parameters and borders and drew a line, where depression starts and I began. This is crucial, as for so long, depression made me think that it was indeed, here to stay, that the chapters without it in my life had ended, and that my future was just one bad, sad day after another. It’s taken so long to feel as though I’ve ‘come back’, and returned from wherever depression banished all of my drive and passions and sense of self.

She is also much more frank, and direct than any of my other friends, who know about this year. Not one of my close friends has ever asked me where I’m standing with alcohol when I pass over the wine bottle, or turn in early from yet another party. No one has ever had the courage, or gumption, or wherewithal, to ask where and how I am. In being direct, S made me feel a little less like a modern-day leper, turning away from societal norms. She made me feel like just another person with just another set of issues, rather than someone standing out from the crowd due to everyone else giving a wide berth and ignoring the elephant in the room. S was pretty much riding that elephant, metaphorically speaking. She made me feel less like a problem, and more like a person, with a problem. I am grateful for this. S has been reading this blog, and came halfway across the world to check in with me. If that’s not an expression of friendship, I don’t know what is. So often, depression (and recovery) leaves me feeling alone and bereft, and despised. Friendships like these, are the antidote to that. I’m not sure you can get through depression, or any mental health problem, without a cheer squad.

Depression causes so many problems as we all have our brand of misery, and people who have not met it personally, struggle so greatly to grasp that depression isn’t just a bad day, or even a bad week; it casts a false impression as, afterall, we have all been sad, have we not? We have all cried, and surely, depression isn’t too different from that? And yet, this feeling of false understanding is often the most damaging to people living with it, as we cannot explain how it hurts and scars and takes an age to heal. It’s not just a bad day or a bad week. It’s so much more. My flatmates and close friends are brilliant, but didn’t know how to approach my depression, and as a result, didn’t know how to approach me when I had it. Because of this, I was ashamed, and took to hiding. Having someone who understands that I am separate from it was invaluable. Having someone who understands what it means, helped me begin to heal.

As a firm lover of period dramas, I am still fairly convinced that I truly belong in the eighteenth century, dancing with men in regimentals and doing charitable works in whatever time isn’t spent making jam and embroidering cushions, but I also love that I am living in an age where I can have a friend on the other side of the world, and see them every now and then. I love that I live in a time where ‘goodbye’ rarely means forever, and au revoirs are entirely possible. In just under a year, I will (fingers crossed etc) finally be earning and out of student-dom forever. I’m looking forward to being able to bring home the bacon on some au-revoirs.

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Being the change

So – I’ve got a post about the visit of a dear friend from the special needs camp I worked four years ago, who is visiting from America (with her grandma – and it’s been AMAZING!), but this is just a short one in the meantime.

I had a good meeting with staff today about the medical student mentoring scheme I’m setting up, so am feeling pretty positive. I’m really excited to be a part of improving the experience of struggling students at my university. I love new projects, and am starting the learn that one of my strengths is in moving and shaking things – I love seeing gaps, and filling them. It’s kind of like God gave me a passion for real-life tetris.

However, I’ve also taken a leap of faith this week. After being in accident/emergency, I really felt like I needed to come to a decision about how I will approach alcohol, and patients with related issues, when I practise. In short, this comes down to the ‘man or mouse’ approach – will I run from it and avoid it, or will I look it in the eye, and apply my strengths to making a difference? I want so badly to be a part of the solution, not the problem. I want so badly, for there to be a reduction in alcohol related harm in my city. I want so badly, to get people off the long road of dependancy, before they can’t get off it at all. I know that this choice may strike some as a little foolhardy, and I certainly know that I may find it hard at times – but at the end of the day, I cannot be a doctor who does not manage alcohol, as it affects such a huge proportion of people. And because of that caveat, I am choosing to actively seek opportunities to help change things. I may be part hedgehog, but there will be no mouse in me from now on.

So – I emailed one of the A/E docs whom I have an incredible amount of respect for, and have also had quite a bit of contact with as I’m a medschool rep so have to email staff fairly regularly. I asked if she knew of any focus groups for alcohol issues, and whether they’d welcome a junior member of staff, at some stage.

She replied, copying me into the head of the most appropriate group, and in this email, described me as ‘a truly excellent student’. This actually made me cry a little, as it feels as though I’ve finally got away from the horrors of last year, and after a rocky and unconfident start to fifth year, I am back on track. I am a good student, and someone has recognised that. I am a student who cares, and someone has seen that in me. Last year gave any of my already unsteady self-esteem enough of a kick to the teeth that most of the time, it’s like my radio’s set to a station where the only song playing is ‘I’m not good enough and I can’t do this’, over and over again. That description, which I imagine this doctor didn’t remotely think would mean so much to me, feels like an affirmation. I can do this. I can be part of a change. I can be part of a solution.

I am so thankful to this woman and her unconscious encouragement – but I am also so very thankful to you, my readers, who encourage me every single day. Thanks for sticking with me. I love all of you a lot.

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