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Posts Tagged ‘stress’

I’m coming to the end of my stint in Accident and Emergency, and although it’s been hectic, frantic, difficult, and I’ve not had much time at all to stop and think, let alone pray, I’ve actually felt quite close to God these last few days. I was working the nightshift over the weekend, and was aware that it was going to challenge me as, at the end of the day, our Friday night culture is pretty focussed on binge-drinking, and the ER is where they all end up, being assessed by people like me, with a white coat flapping round my knees, stethoscope poking out of a back pocket.

After a pretty labile week, I was dreading these shifts a great deal. I prayed on my way in that God would show me how to best use my hands, and be of use.On my way in, I found myself praying that whatever came through the door, God would show me how to use my hands and be of use. I prayed for strength to get through, and compassion to help treat my patients as well as possible. That prayer was answered. Although my head found certain things difficult, my hands never stopped helping.

My nights didn’t get off to the best start; within ten minutes, I’d been projectile vomited on by a woman I was trying to mop up a bit, leading to a change of scrubs and coat and derision from the nurses, and pretty much the minute I stepped back into the ER, I got covered in blood after trying to put a drip in someone on bloodthinners, as they jerked their arm halfway through. After changing once again (surgeon en route saying ‘weren’t you covered in a different bodily fluid like….ten minutes ago…are you going for some kind of record…?’), I managed to keep my white coat clean till morning, and the hours passed in a blur of seizures, overdoses, falls from heights, heart attacks, and of course, the angry, drunken, injured masses, bleeding on floors, shouting at staff, and dozing in corners. My hands were kept busy, though at times, my heart was heavy.

When I think of practising medicine, I think of doing it with my hands – percussing chests, feeling pulses, testing coordination. I think of my hands getting method-memory at how to position IV lines, feeling bellies, and test joint stability. Obviously, medicine is also about listening, and speaking, and hearing – but so often, it’s the palm on a shoulder that patients are comforted by. It’s the fingers that push pain meds through their line, that quiets them. It’s the hands that compress their chest, that keep them alive. It’s a practical profession.

These are the hands that stitched up bleeding heads, sampled a lot of blood gases, and put in more cannulas (drips) than I could count. These are the hands that held the hands of an old man whose wife lay dying. These are the hands that were squeezed in solidarity as a broken leg was straightened. These are the hands I use to learn my trade. These are the hands God gives me, to love my patients. These are my hands.

I have moments, sometimes, where I look at what I’m doing, and wonder if it’s been worth six years to get my basic medical degree, and at least another ten, before I am near the top of whatever training scheme I chose – I spent two hours peeling a dressing off an infected leg yesterday, which to be honest, is a job anyone with a strong stomach, could do.  Then, however, come the rare moments,  that remind me that I am exactly where I want to be, in both the good, speak-easy weeks, and the ones which challenge and threaten to break me down. It’s those rare but beautiful moments of true connection, of one hand on one shoulder, of one person comforting another, that make me love the path I have chosen more than anything. It’s those fleeting experiences where I can put all of my knowledge and training into practise, to help someone, whether it’s by explaining a bit about chemotherapy, or how a chest drain works, or just listening to their story, that remind me that being in medical school is the best gift I’ve ever been given. These are my hands. These are God’s, hands.

When I am working with my hands, my head is less busy and less chaotic; it focusses on the task, and blinds everything else out. Last week, with its triggers and tempers, I benefitted from being able to switch off, though as always, there’s only so long I can go before I start to crack a little. Now, I just need to get through my next exam on Friday, before I really collapse. By my calculation, this is then 29th exam I have sat since starting medical school and not including my year out to do a BSc. No wonder I’m tired….

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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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