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.