Posts Tagged ‘alcohol’

It’s not been a good day. I was in clinic this morning and was already feeling cross as the junior doctor I was sitting in with didn’t seem to think it was important to tackle the fact that one of the patients was drinking 16 units a day, and had what his GP called ‘unexplained stomach trouble’. You don’t need a medical degree to join the dots, sometimes. It needed sorting out. It’s tough, asking about drinking, especially as ‘problem drinkers’ don’t exactly respond well – but at the end of the day, it’s in the job description. Sort. It. Out.

At lunchtime my current hospital had a talk scheduled from.  one of the mid-grade doctors who was speaking on ‘how health professionals can stay healthy’. Most of it centred on his battle with dependancy on alcohol, prescription opiates, and non-prescription drugs. Let me be clear that I’m so impressed that he’s now off everything, giving back to the abstinence programme he went through, getting his career on track, and is brave enough to stand up and say what he did in front of colleagues – it’s brilliant.

However, what is not brilliant is being taken aside at the end and told I didn’t look as though I was engaging with his talk, and was it because I have the mistaken view that addiction is not a disease, and certainly not one doctors get? Because, you know, it could happen to me too….

Excuse me, for getting angry when he said that although he has not used since the birth of his son, that his son is not why he abstains – his own self-love, is. Excuse me for not wanting to look in depth at his AA keyrings (which are given at certain time points of abstinence – a month/two months etc) when I’ve seen my dad come back with them enough times, and when he falls off the wagon, start over. Those keyrings represent a lot of achievement, but they also represent a family who are waiting on eggshells for someone to start again, at the beginning, and plunge everything back to uncertainty. They represent months of children being neglected as they are less important than sobriety, which is  just one more thing they love more that you.

I’m sorry, but I believe that when you chose to bring a child into this world and raise them, they should be your first priority. Call me an idealist, call me old fashioned, but if you don’t want to do that, give that child to someone who will. Parents should be staying sober for them, over themselves. They should be protecting them. My father loved his whiskey more than he loved us. My mother loved our reputation as a clean living, achieving family, more than she loved us. Yes, you get sober – but the first reason should be for your children and spouse, who’s lives you have turned upside down. Otherwise, you’re just chosing yourself again, as always. This doctor said he stayed sober for himself, not his young son. I have an issue with that.

I know that substance use, misuse and dependancy is something I struggle with, and I have worked to tackle this head on by doing placements, projects and assignments within the field of substance misuse medicine. I do not bury my head in the sand. I tackle my issues head on. Sometimes I learn a valuable lesson. Other times, like today, I get completely incinerated. I don’t need some evangelist for recovery telling me about the difficulties he’s had; I’ve seen it. I’ve come through it. I remember it, every time I see someone drink more than they should, every time I have a sip of wine, and every time I don’t, because I know that it will be too much, too painful for me. Coming off alcohol and other drugs is so difficult. I have a lot of respect for those who manage it, including my dad, and I will correct anyone who claims otherwise, who claims that it’s just a weakness of will, and that  people chose a life of dependancy. Just don’t expect me to congratulate anyone for sorting their life out and leaving their family in the lurch. My dad is sober at the moment, yet I am in recovery from depression not entirely unconnected to his prior habits and am still tethered to counselling. His drinking has left me scarred and scared. His addiction has painted me black, too. It, among with other things along the way, broke me and I still don’t know if I’ll ever achieve that elusive ‘wholeness’. I don’t know if I’ll ever stop bleeding out and hurting. The effects don’t stop when someone puts down a glass for the (yet another) final time. The damage grows and continues. It continues to infect and supporates in quiet corners, in quiet people.

So – I’m feeling pretty fragile today. Strangely enough, this time I didn’t seek it out, the pain just found me. It’s never far away. I know that recovery from depression is a tale of hills and valleys, a trail that we follow for months – but I was hoping for just a few more days in a row without crying. I was hoping for a few less reasons to feel that once again, I just can’t handle parts of this world we’re in. I’m trapped again. I hate that out of nowhere, my issues with drinking spring up and crowd me out. I was upset enough that I left the ward early. I never do that. It got the better of me. It beat me. I can’t, can never, let it beat me.

The odd thing is that the other day, I was back in counselling after a month off and we were talking about drinking, and L (counsellor) asked if I would seek a medical specialty that didn’t have a large number of patients with substance issues – and I said, and stick by it, that although I wouldn’t dedicate myself to it, I want to be part of the solution to this. I want to give something positive back. I want to help people get clean. I want to stop the cycles and the sickness that flows through families. I will not bury my head in the sand. I tackle my issues head on.

Today, though, it was a bit much and I could do with a hug but am home alone.

God, how long is this going to be too much? How long?

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I’m back from home now and have a week until I start my final year of medical school. I know it’s going to take me a while to bounce back, as it always does, so have been thinking about how to get through the next few days. I’m feeling a bit numbed to everything, a bit crowded out, and have a feeling it’s going to be a tough session. There were some good things last week, as I caught up with my oldest friend, who, after thirteen years, is more of a sister, and also a male friend I was very close to (read: desperately but sadly unrequitedly in love with) in my last few years of school – they were both really encouraging, and it was good to talk about stuff with people who have known me since childhood. I love them both a lot.

I was back in counselling again this afternoon and am feeling pretty frustrated. L and I talked a bit about this week and family stuff in general and at one point, she asked who had supported me when my dad was drinking when I was younger, who I turned to and talked to, and all I could say, was, ‘no-one’. Until my ill-fated first encounter with a counsellor in my second year of medical school, I hadn’t really told a soul. I’d done it alone. I was too afraid to tell anyone, too ashamed. I’ve never really thought about it – aside from wanting to help make sure that other kids don’t go through that, some how. And it wasn’t the answer I gave that hurt, or the realisation I get now that I wasn’t that old to be handling as much family stuff as I was, or the sadness I sometimes get now, that my family aren’t the supportive group I’d like them to be, who accept me, warts and all, through thick and thin – it was the look of intense pity on L’s face that really broke me. I don’t want pity, I don’t want any of the ‘poor little you’ comments, or that look on someone’s face that suddenly makes you realise that things were pretty crap to be honest, a lot crapper than most people’s time growing up was, that look that cements what you’ve suspected for so long, that somewhere inbetween the birthdays and holidays, as you grew taller and older, you were broken and damaged by the world around you, in a way most people manage to escape.

Sometimes you have that moment where you just know, that you’ll remember that slice of time forever, and that’s how her look made me feel earlier, as though it’s burned in, branded into my memories. I keep waiting for things to get easier, to find some release from all this, for counselling to start to heal all those wounds that have become such a part of me, and it’s yet to happen. I know I feel raw, at the moment, and tired of it; I know I feel as though I’ll never get through this, that my wounds will always be open, that my heart will always be covered in a layer of dust, cast in shadows (aware this is slightly hyperbolic – sorry, may edit later). I’m feeling like a bit of a hopeless case at the moment – that I’ll be someone who always gets through on paper, most likely very well – but that behind closed doors, I’ll always be falling apart, I’ll always be on the verge of destruction. I’ll never find rest or peace. I’ll never gain the freedom I’m meant to have, through Jesus. I need to get better at figuring out which wounds are able to heal and which aren’t, and accept them. I’ve got three weeks off now, and am kind of angry about it – I want to get through and over this, and this just draws it out for another few weeks, but there’s nothing I can do, and it’s no-ones fault. Must learn patience etc.

I’ve got lost of positives to focus on this week – I’m meeting a doctor I really respect to talk about this extra project, and on Friday it’s the learning disability church group I help with – I’ve missed the last few meetings due to exams, and am really looking forward to seeing them all, they’re so easy to love, and it’s always a real boost to my faith, if only because who doesn’t feel close to God after dressing up in a sheet to act out one of the Parables, as Jesus, to help someone understand more about who he was? The week can only get better.

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I shouldn’t really be blogging this week as I’ve got exams on Thursday and Friday, but to be honest, I’ve had enough of revision for one night.

On the 13th, assuming I manage the (slightly ominous) task ahead of me, I’ll have handed in everything I need to enter my final year of medical school. This time of year always makes me pensieve, as it feels like much more of an end to a year, than 31st December does, after so many years in education; it signifies yet another year gone, more hurdles passed, and another step closer to being a doctor, which has been my dream since childhood, and was the single thing that kept me going for a long time.

Sometimes I feel like the issues I’ve accumulated over time from my dad’s drinking have been such a defining characteristic of these years as they’ve been there, growing beside me, since I was just entering my teens. My funny relationship with alcohol has hung over my time in medical school since the very first day, when I was given some tutorial case about alcoholism to present to a group, and afterwards, went to the city train station, and wondered if there was anywhere I could go to escape, anywhere at all, from drinking, and realising that there wasn’t. There’s nowhere it doesn’t reach. There is nothing it does not touch. On that day, I stopped myself crying, went back to my accommodation, and went out on the first medical student social, and got drunker than I’d ever been. It didn’t help. I’ve struggled my way through parties and as the ‘sober one’, looked after more than my fair share of inebriated friends. I’ve cleaned up vomit and been reminded of doing the same for my dad. I’ve sat in hospital rooms while people got their stomachs pumped, and been reminded of long nights there as a young teenager, waiting for him to sober up. I’ve drank to forget, and hated myself the next morning. I’ve watched other people drinking, and been afraid of the changes coming over them. I’ve chosen placements that would bring me into as much contact as possible with substance misuse to drive it out of my system, and despite being ironically good at talking to these patients, ended up losing another year to depression, because of it.

At the moment, I drink very rarely, and even then, it’s often a fine line between having a lovely evening, and completely collapsing inwards, hating that I am drawn to the looseness it gives me, and wondering if I’m one glass closer to developing a dependancy. My biggest fear is that I might go down the same route and cause as much havoc with unhealthy drinking that my dad did. Feeling controlled by depression was bad enough, but being in the thrall of alcohol would be more than I could handle. I’m both afraid of it, and drawn to it. Since I was diagnosed with depression, I’ve hardly touched alcohol, and even then, it’s been a rare glass of wine, and that’s mostly been because at times, I feel like reaching for the gin and seeing, just seeing, if it would make things hurt that little bit less, if it would make me forget, and that attitude at the back of my mind scares me senseless. Sometimes, when I’m not sleeping, and really feeling low, drinking until I drift off feels like a good option, an easy way to make it through a few more hours. Although I’ve never acted on any of that, just knowing that my brain is wired like that, is horrible.

I was back in counselling yesterday and didn’t really say much – all I’ve literally been doing for the last month is studying, and after having a few days feeling almost-if-not-quite-next-to-normal, I didn’t want to wreck that just before these huge exams I’ve got coming up. I’m still crap at being counselled – I never know how to start, or what to say, or how to turn what I have in my head, to words on a page, or words spoken aloud. It’s supposed to get easier, but it never does. I know that at some point I’m going to have to have a fairly major ‘alcoholism’ discussion in counselling, and I’m dreading it. It makes me feel physically sick. It’s probably the one thing I find hardest to talk about, but I also know that if I don’t manage to push myself through therapy properly, I’m just going to lose more years to this. I don’t want to feel trapped by it anymore. I don’t want to feel defined by it anymore. I feel so broken by it, so incapable of managing it. I want to keep the past behind me and not have to keep running just to keep infront of it all the time. That conversation is coming, and I need to be prepared.

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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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Home Truths

I finally emailed the student support staff contact (also known as The Dragon as she can best be described as a cross between a basilisk and a denim shirt dress) yesterday as, after finding out that the research project I must complete in order to pass the year has hit yet another brick wall (for once, through no fault of my own), I’m really feeling the strain. I have so much to do, and the closer I get to the deadline, the harder it would be if the medical school were to force me to repeat a year – I would literally have to restart about four days after being failed, on the same rotation I will (Hopefully) have passed the exams for. I’m working round the clock, and if there wasn’t this project to be done, would be well placed for my forthcoming exams – but it’s not enough. Add to this a stubborn streak of perfectionism that doesn’t want to admit that I’m going to have to accept being a pass-grade medical student, and therefore not able to deliver the very best care I can to my future patients, the fact my flatmate’s father has just been diagnosed with a serious illness, and nerves going off the scale as I’m going home this weekend which is always difficult, and the mix is a potent one. It’s like being in the eye of the storm, with no light at the end of the tunnel.

The dragon emailed back yesterday and I’m still working up the courage to read her reply. Yup, that’s how ridiculous I am at the moment. NB to self, emails don’t arrive with a  smack round the head attached. For those familiar with Harry Potter, I’m expecting a Howler.

My temper is fraying again at the moment, and I just feel so petulant about everything – I feel angry when I meet patients with horrendous diseases that won’t be cured, I get livid when medical staff dismiss mental health problems as just something else a patient complains about, I get tearful when I realise that no matter how good my hypothetical management plan is (they make us do a lot of these in preparation for our first doctor jobs), the lady it’s meant for is going to die, painfully, and soon. And I know that this is all part of my depression – it turns me from a usually mild-mannered, self-controlled pillar of common sense into an incendiary mess. It takes my judgement and clouds my rationality. And I know that once I’ve been burned out on vigilante-style over-caring and worn myself out by throwing daggers at the world, the apathy will set in once again, and I will find myself unreachable and hard as stone, lost to existential crisis (and evidently, melodrama).

I’ve had two weeks off counselling due to Easter and the bank holiday so have until Monday to get myself together again. I know I’m slipping again – the sunshine here is glorious at the moment, that bright, clear light that looks as though it should be able to purge any stain and drive out any dark corners, but all I think is that as sure as the days keep getting longer, I stay in this haze of depression, and often, I wonder if that last six months have been worth the effort at all; should I have given up and given in, when I had the courage to do so? Is there any point in slogging on, when I feel so far beyond my capabilities, and the hurdles, they just keep coming? When I ‘think about my options’ (ahh, the joys of counselling lingo), there’s always that lingering thought in the back of my mind that dying would solve so many things, and although at the moment, it’s kept at bay, realising that it’s crept back alongside me is worrying.

I’m home this weekend, as my older sister who moved to Australia in January is home for a flying visit, and it’s my mum’s 60th in a few weeks. My younger  brother is going too, which will be good. It’s hard though – my family know nothing of my depression, counselling, or academic issues (they don’t manage stress well at all, and despite both parents having mental health problems themselves, tend to deny their existence) and playing to the crowds is so hard, and often, being with my dysfunctional family makes me feel so alone and isolated; I don’t have the family support that my flatmates have. I don’t have decent relationships with them. I’m jealous sometimes, of people who ring their mum for advice all the time, and look forward to going home. We’re all together rarely, really only at Christmas, and it usually ends in tears, with my sister insisting on being the centre of attention and being incredibly selfish to the detriment of everyone else, my brother getting increasingly angry because of my sister, my dad retreating somewhere as he can’t cope with emotion, and my mum and I crying, her after drinking a few too many, and me stone cold sober and out of depth. When I go home, it reminds me how dysfunctional I am (Philip Larkin comes to mind here) and how unfixable. The house just seems to seethe with distemper and sadness. It makes me feel so disconnected, and numbed, watered down, these are people I should feel so bound at the heart to, so in step with. It makes me feel as though I never left, and am still a young teenager, juggling a family centred on alcoholism that’s spinning out of control, and sinking. Home means a different thing to everyone.

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