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The Doctor is Sick by the Web Master
This piece was written a week after I returned home after an inpatient
psychiatric hospital stay. I added to it about a week later. What
is amazing about this is how much my thoughts have evolved. Now, six
weeks after returning home, I have a much brighter perspective,
although some of the worries remain, and new questions have arisen.
The
Doctor is Sick
The
doctor is sick. Her feet are swollen, as if her heart is failing. But
it is
strong and beating faster than usual, as she runs her fingers through
her hair.
Her vision gets blurry sometimes, and she has to hold onto something
when she
stands up. Otherwise she will fall down. The doctor is sick
because she
is taking medicine to make her well. Lithium, Seroquel, Depakote. Mood
stabilizer, anti-psychotic, mood stabilizer. Two pills, four
pills, three
pills. Plus a multivitamin because Depakote can cause her hair to fall
out. Skinny and fat bottles, next to her bed so she won’t forget.
As if
she would forget.
The doctor is sick because three weeks ago tomorrow she made a concrete
plan to
take her own life. She wrote five letters, the longest to her
sweet and
supportive husband. She put some pills and some alcohol and the letters
in her
backpack and made it to the front stoop before she sat down, her heart
breaking, and called her best friend.
The doctor is sick. She is sicker now that she is home. At the
psychiatric
hospital, she was the doctor, and she held “office-hours” (24 hours a
day) to
answer questions about GERD, schizophrenia, stomach aches. This made
her feel a
lot less sick. Everyone said she was very clever. She is only a
medical
student and offers a disclaimer with her advice (along with the
suggestion that
they should see a “real doctor”). But to most of the patients she is a
doctor.
And she feels the calling to be a doctor. Deep down inside
herself she
feels she was born to be a doctor. In the psychiatric hospital,
she felt
alive when she gave advice. It made her feel she was helping
people. She
lives for people. And it distinguished her from the rest of them.
They
were her friends and she shared illness with them, but somehow she was
different. Sometimes this gave her comfort. Other times she held
onto
them as anchors in the madness they were swimming through together.
Those times
she found comfort in being the same as them. Exactly the same.
The doctor is sick. On her discharge sheet, 18 days after admission,
her
acceptance of this fact (“judgment and insight”) was judged “fair.”
This is
because the doctor does not believe in her diagnosis. She does not want
to be
sick. She wants to be the person she was before. Well, the person she
was minus
those highs and lows. She would trade in the agitated anxious state
that caused
her to drop out of her pediatric rotation. She would trade in the days
spent in
bed in college, while everyone else seemed to be having fun. She
would
trade in the Google searches of “suicide methods.” She would
trade in the
panic that caused her to stop her rotation, and therefore caused her to
stop
playing with the pediatric patients in the playroom at night, after her
clinical duties were finished. In the playroom she was not a doctor or
a
medical student. She was just someone’s playmate. She held the little
hand of
her little patient and she felt like she was exactly where she was
supposed to
be. She knew she belonged when she helped her patients forget
they were
sick.
The doctor is sick. She is drinking hard lemonade, even though it makes
the
dizziness worse. The doctor has a swollen face and swollen fingers and
her
wedding ring does not fit anymore. She has gained ten, no fifteen
pounds
because of the medicine, and she knows her husband has noticed.
The
doctor knows that she has enough pills beside her bed to end her life,
but she
also knows she is calm now. She is calm in a way she has not felt for
as long
as she can remember. She thinks back on college, on that two month
period where
she slept until 2pm, and only got out of
bed to smoke marijuana and to change the CD on her stereo. She thinks
back on
the way she pulled the blanket over her head and she remembers that she
wanted
to be dead. Later that year, she remembers writing her treatises on the
meaning
of life, of the world, of peace and joy and love, on her desktop
computer. She
wrote and wrote and wrote, as she often did, and sleep did not seem
very
necessary or desired. She felt she was more connected to the world than
anyone
else on the planet. She felt more intensely than anyone else on the
planet. She
ran five miles a day, fifteen miles on Saturdays. Tears streamed
down her
face as she bicycled back from her volunteering job with the elderly.
She felt
so much love and she felt so different from everyone else. Tears came
again
when she read literature; she felt alive with politics and meaning and
urgency. Her heart pounded and she felt words run through her
mind that
told her to keep working, harder, and that she was capable of more
efficient,
more emotive, more effective, more productive work than anyone else on
the
planet. She had more insight than anyone else on the planet. But
all of
this was directed to help other people, and so she was connected to the
whole
world.
The doctor feels sick now
as she recalls those events. Now she fears her past
is part of this illness. Those thoughts and actions that were her
proudest
moments, the organizations that won awards and accolades, the papers
that got
high marks, those were just consequence of neurotransmitters being
sucked in
and spat out in the wrong ratios. It is that simple. Something we can
fix with
around ten pills per day, pills that will make the doctor better but
will make
the doctor sick. What about the doctor’s sense of humor? What about her
energy?
What about her wild dancing and her disinhibition? What about her
ability to be
the life of a party even when she is stone cold sober and everyone else
has had
four or five drinks? What about her accomplishments and her intensity?
What
about her ever-present belief that the world’s people are all
connected, and
she is to play a small but important, even vital, role in bringing them
together? Sick, sick, all sick.
In the hospital the doctor
would dance sometimes. She would be dancing,
twirling, laughing, making others laugh. Then, in the same day, she
would burst
into tears and she would sit in her bedroom, blanket over head, turning
over
the possibilities for a sure but painless death. She didn’t have much
time to
think on it because soon it would be time to line up for
medicine.
Next…it’s time for her office hours, reassure other patients, pretend
she is a
doctor. But soon enough…the shrink beckons her for the daily
session, and
she is reminded of his infinite wisdom and her relative
ignorance. She
nods and agrees with some of what he says, believes it even when she is
talking
to him in his little room, but not later, when she is back in bed,
nighttime,
waiting for nightmares. The psychiatrist says she that her frantic
sleepless
days before Christmas, the ones where her friends couldn't understand
why she
couldn't even sit down for lunch ("You're going to have a stroke!"
one of the less tactful ones declared), the ones where she feigned
listening to
someone talking while in her head she entertained a disorganized,
discordant
symphony of thoughts trying to hammer out a requiem, a death
march...those days
were a “mixed state.” Mumbo jumbo. Now that she is bouncing
from
one extreme to another, she might be "ultra ultra rapid
cycling." Nonsense. She tells herself she is just
moody.
And at least now there are moments of heady delicious delight, no
matter if
they are brief. So she is improving! And she has reason to
doubt
their boxes and their labels, as she reads on this illness in those
rare
moments where her mind is still, and she finds there is controversy
surrounding
every diagnosis and delineation. And so that is fuel for her
disapproving, disbelieving fire. All of this is just expression
of
eccentricity, she tells herself, and these lousy doctors don't
appreciate
someone as brilliant and beautiful as me. But later, watching the
nurses
as they fill out their assessments of the day, she wonders how sick
they think she
really is, and she hates herself and this lunatic frenzy and she is
embarrassed
and ashamed. If she does not believe she is sick, then she has to
blame
herself, and that hurts. But she can handle that pain and that
bleeding,
for she alone can suffer pain and bleeding like no others, and that is
part of
what makes her beautiful. But she is not sick. According to
them,
the doctor is sick every day and so she stays in the hospital. She
retorts, “Of
course that is what they say. Isn’t that their job, to call me crazy?”
And
then, “If I was not crazy, wouldn’t that put them out of business?”
Nightmares have tormented
the doctor since she was a child. But lately
they are more twisted and they pull her out of the safety of the day
such that
she plunges, screaming, down, head-first, into black night,
afraid. Some
of her medicines exacerbate nightmares. In one awful dream, she
is a
patient, then a doctor, then a patient again, and she keeps waking up
inside
the dream to be transformed into doctor or patient, one then the other,
it
never stops. So first she is giving medicines, then she is being
intubated, then she is finishing rounds, then she is enduring
electroconvulsive
therapy. Finally she drops out of the dream as if from the sky,
and she
is shivering and afraid. Now as she dozes, she awakens to every
noise,
and the shadows look like people, and she knows the nightmares wait for
her
again, so she fights sleep. Paxil made her hear voices (the
psychiatrists
proclaimed this as “classic” for her illness, she shrugged her
shoulders in
response) and so now she listens carefully, holding her breath, in bed,
trying
to hear voices. She thought she heard something. Of course,
now she
is hypersensitive. Now it is hard not to describe everything as
“classic”
for the illness. From junior high onwards, she was “classic” if
she thinks
about it. What nonsense! Her vision is 20/20 in
hindsight.
Who wouldn’t find madness in their past if they looked hard enough?
The doctor is sick.
The night lasts forever. Somebody opens the
door because at this hospital, they check every fifteen minutes, 24
hours per
day, to make sure the doctor has not slit her wrists or hung herself or
found
another way to end her sick life. For this reason, they have
confiscated her
shoelaces, and she has to floss at the nurses’ station. She
startles as
they open the door, and screams out loud. They reassure her they
are just
checking on her, and now they are gone, and the doctor is left to
imagine them
walking down the corridor to the nurses’ station, shaking their heads,
saying,
“Boy oh boy, that doctor sure is sick!”
The doctor is sick. Who is
she anyway? She is not even a doctor! Just a third
year medical student who is fighting, fists up, her descent into
madness.
Has she won? She is trying to find a way to accept what she is. Does
that mean
she is a winner or a loser? It is chronic, but manageable bipolar
madness. There are lots of other people like her. But it is
still
overwhelming, and she is not even sure she wants to join anybody else.
She never defined herself as part of any group
before. Now she tries to get back to
normal, but what can that mean now, after all this time, after release
from a
mental hospital, after taking a leave from school, after swallowing ten
pills
per day (every day, for the rest of her life?), after finding out she
is so
sick? It is time for her meds. She hasn’t told most of her
classmates or her parents because she doesn’t want them to find out
that the
doctor is sick. She doesn’t want to know if the doctor is
sick. She
doesn’t want to ponder if the doctor can ever get well.
She misses seeing her
patients. Tears are in her eyes and she swallows her
sadness as best as she can. She aims to keep a brave face, but
she is sad
for what she has lost. She tries to shake that off, but it keeps
returning, like a virus it sneaks up on her and she is shivering,
feverish with
grief. She hears stories from her friends as they continue to
round,
heal, cut and sew, take histories, stay up all night, get yelled at by
senior
physicians and she wants so much to be there. She is in nowhere
land. To
some, a few, those who know the twisted tale of the last few months,
she is
sick. To those who know nothing of it, she is her usual slightly
eccentric self, but well. But really she knows she is a liar and
a
fraud. Because somewhere in the middle she exists alone.
Well, no,
she is not alone. Her husband stands by her and he is
wonderful. He
holds her and laughs with her and tells her she is beautiful and
amazing.
But she misses seeing lots of people; she thrives on people.
Doesn’t
anyone understand that she needs people to be alive? Is that so
wrong? Is that so sick? She feels sorry for herself, sorry
for what
she must give up, sorry that she must graduate a year later, sorry that
she
cannot be with people, sorry that she feels so sorry so much of the
time.
And then she gets angry with herself for feeling so sorry and so sick.
Every now and then the
doctor sees another side of things. She surfs the
Internet and she reads books and she finds out about lots of smart and
creative
and beautiful people who were sick like she is. These people have
twisted, wonderful abilities but so many of them plunged to their
deaths or
swallowed pills or died so young. They wrote books or composed
symphonies
or made people laugh or created works of art but then they died.
And so
she is left feeling strong and beautiful sometimes, but also lonely and
sad
that all those souls have deserted her. She is sad that they have
left
her in this madness, and she must fight to stay alive all by
herself. Then, every now and then, there are flickers of wisdom
and
insight and she knows she will stay alive and she will create beautiful
things
too, one day.
The doctor is sick.
Getting sick really stinks. She admits,
“Nobody, especially not me, counted on the doctor getting sick.
Please!
Enough!” She concedes, “I won’t forget this. I promise. OK,
I have
learned my lesson now. Please, enough of this!” She pleads,
“I need
the doctor to get well. I am afraid of being the doctor that is sick,
so
afraid.” She ponders, “Does this mean I will never be free?
Does
this mean I will never be well? Does this mean I will never be a
mother?
Oh, God, does this mean I will never be a doctor?” There is silence
because she
asks these questions of herself, and she has no answers, no office
hours
today.
Somebody better call a
doctor.
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Coming soon: more reflections, stories, poems contributed by medical
students, residents, and physicians...
If you have something you would like to contribute, please contact the
web master.
Please realize that anyone struggling with mental illness or what may
be signs of mental illness, including substance abuse, should first and foremost get professional help. This
site in no way replaces that essential process. Please, if you
need help, get it, before you do anything else. Click here for
suggestions on how to do this.
About this site:
This web site is not intended to substitute for medical advice.
It was created by a 3rd year medical student who was diagnosed,
early in her 3rd year, with bipolar affective disorder. Contact
the web master with any and all suggestions at mdmentalhlth@yahoo.com.
Last update 10/19/04.