My Answer to the Commenters

I started to put this in the comments and then just decided to post it as a regular post, because it was turning into one in length.

Thanks for writing, everyone. Thank you especially 5150 for reminding me that it will fade. I kept telling myself that during the worst of it…that it wouldn’t be forever like this.

I have zero benefits or anything. The one private disability insurance I bought probably wouldn’t cover this as a pre-existing condition and it only replaces about $700 a month of income anyway (a percent of what I am paid by the hospital and not the government – and the government pays most of my salary). Jjunior docs have no benefits at all – we are almost hourly wage employees – do not even have personnel benefits at the hospital that the cleaning staff has.

The option would be another job. I constantly remind myself that approximately 99.999999% of the jobs in the world are something other than “physician.” But it seems like such a shame, when I am so close to finishing training not to just suck it up and pull through.

On the other hand, when I find myself on the roof again and again, I keep telling myself, just walk away. You have a choice. You do not need to do this.

And the worst part of it is that it isn’t the practicing medicine that is killing me. It’s the bickering with the nurses who walk all over me, the paperwork, the phone hassles to get tests done. It’s not the essence of the job itself. Sometimes I even think that being decent to people and helping ease their way through something is what is keeping me going.

Another thing is that I quit taking the Wellbutrin and the lithium a few days ago and feel immensely better. One of them was doing something bad to me. I’m not sure which one…but I could feel it physically – shaking, throwing up, feeling drugged and surreal. You’d think that that was a creeping up lithium level, right? But it also came with a terrible agitation and that unreal feeling was never something I got from lithium. It felt like that first time I took the Wellbutrin and flipped out. Lithium, even at its worst, always chilled me out. I semi-wanted to call the shrink and ask what he thought but never managed to have a free moment to do that while it was a decent hour. And don’t even think about getting to a lab to have lithium levels done during business hours. I’ll probably slowly restart the lithium today.

The other thing I am slowly coming to accept are some limitations. While the idea of leave scares me, I realize that I just can’t keep up with my peers with the no sleep thing. They consider a day after call a day off. I can’t even move, and if I don’t sleep through until the next work day morning, I’m crazy. This saddens me. I used to be unstoppable, so ambitious, wanting to take care of everything, be the best at everything.

And I’m also coming to accept the idea that since my good cocktail is gone, I just may never feel totally well again. It’s been a year now, or almost a year…and nothing is any better than when I first started. That’s what sort of fucks up the idea of taking leave to fix the meds – the meds may never get fixed. I may never be what I was.

I think I could be okay with that if I could do a few things that are really important to me. First is to write – which I can’t really do in this state. Others are a creative habit that I can no longer do because my hands shake too badly, and flying, which I can’t do because I’m always on the edge of vomiting anyway. My three passions in life have been stripped away, which is hard. Maybe I just need to throw myself into medicine, which is something I can still do well, and find a real life in it, which is something I never have been able to do. Satisfaction, sometimes. Purpose, yes. Pleasure at using a skill for the good of others, yeah, I guess.

But passion…never.

Yes, I am a tremendous whiner, compared to so many people whose lives have been much more devastated than mine, I’m bitching about having a job as a physician. But still, a dream lost hurts, no matter how grand or small, and I dreamed of something so very different than this squalid sleepwalking broken-down life I am left with.

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15 Comments

  1. i love you sara…

  2. Not a whiner. Not at all.

    I should have checked out what was available to you before I made a suggestion; my bad, and I’m sorry.

    I have a good friend who suffers from migraine, and residency was one long headache for her. Literally. Sleep disruption is toxic to everybody at some level. That macho shit about being able to manage without sleep made me crazy when I was a resident, and it makes me furious to read about it now. Get what rest you can.

    And yes, it’s the job, not the work, that is dragging you down. You’re a good doc. The system sucks.

  3. I love how expressive you are

  4. Your welcome.

    You should read “Just Here Trying to Save a Few Lives,” but you probably don’t have the time. It’s about an ER doctor, and she path towards finding meaning in her life, and therefore in medicine. It’s probably one of the best memoirs I’ve ever read.

    Being a doctor increases your risk for suicide, so I imagine that means many things, probably the biggest is that it’s very stressful.

    Just because it’s been a year doesn’t mean the next year won’t be better. I have to believe that because I’ve been in a depressive episode for almost a year now, and I want to live a more healthy life as well.

    I say, if you love to write–write. Writing has always been my companion, no matter how bad things are, I can still write (although with varying degrees of effectiveness). It doesn’t mean it’s book material, but it doesn’t matter because i’m finding myself, my strength in writing.

  5. My thoroughly unsolicited advice 🙂 Keep going and finish your training. I think finishing your training will give you more options should you go to another of the 99.99% of the jobs out there, say…I dunno, going into medical writing, or into the private sector related to healthcare– medical applications, insurance, non-profit/foundation work, education, internet companies focused on health. Another thing, it sounds like you are in a hectic environment– E.R.? Sleep deprivation? Fast-paced. Not to say that other jobs don’t have their own troubles (and…paperwork, phone hassles)… but I can imagine that working say, in a VA clinic or something like that may have less stress, if you want to stay in medicine yet not in an E-Room. Something tells me you would not find this satisfactory. I told myself as long as I have my job, I would find the parts of the job I am passionate about and remind myself of those positives, until I find my “real” job of which I have passion. Is there a way to find another creative habit that doesn’t involve the motor skills required of your former? My tdoc keeps reminding me to put more pleasurable events in my life… sounds like you could use some more pleasant events to get some life satisfaction. Oh my, novella! Take care! ❤ BL

  6. I dont think you are a whiner at all.
    I think what you say is really valid.

  7. Hey Border Life – I can’t wait to get into clinic work, regular days, regular patients. As part of training and just generally having no seniority, you have to do OR and ER duty for 30 hour shifts. I cannot describe how much I hate this kind of medicine. And you’re really right about lack of pleasure, I just plain don’t have time. I think if I had just a little bit of time to do something I wanted to, it would be so much better. But all I can do is sleep.

  8. Hi Sara,
    As per usual, i wish i had something useful to say…if only you could get through the next few hellish months, it sounds so overwhelming, if i am reading you correctly.
    i wish you could get just some tiny bit of real pleasure or relief in life, i know it would probably be such a help.
    Thinking of you,
    tracy
    love your darling blue haired girl pic!

  9. Hi Sara,
    When you wrote “The other thing I am slowly coming to accept are some limitations. While the idea of leave scares me, I realize that I just can’t keep up with my peers with the no sleep thing. They consider a day after call a day off. I can’t even move, and if I don’t sleep through until the next work day morning, I’m crazy. This saddens me. I used to be unstoppable, so ambitious, wanting to take care of everything, be the best at everything.” I saw myself in those words.

    Accepting limitations and a level of disability after having been a “limitless” personality before becoming sick is so hard to do. You mention that disability benefits are lacking, but what about concessions to help you work with a disability.

    For example when I began getting really sick I approached my employer about working a four day work week. Or I have heard of some people who have bipolar disoder having their pdocs recommend they not work shift work , or evening work, even if it is required by everyone else. Mental illnesses are disabilities and in most countries there are laws in place to ensure people with disabilities are protected at work.

    I know my pdoc would have written notes for me to not work night shifts…keeping your sleep rythyms constant is extremely important if you are prone to mania or depression. Does your government, or emplyer have some kind of disability review board that you could get info from?

    I feel for what you are going through. It is so hard to accept we are different than we were. I believe though, there are ways to help ourselves (reduced work hours, set schedules, wake and sleep times that are consistent, routines to reduce stress and of course medicines (when they work). I am thinking of you and wishing you well.
    …aqua

  10. You are not a whiner.
    Is it possible to do it part time so you have more time for extra-hospital pursuits?
    Some training programs in Australia are quite open to part time (GP in particular).

  11. My doc did offer to arrange for me not to do the shift work stuff – the thirty hour shifts. As is, I’ve completed almost the minimum of them for my training, but it’s customary in my program that people do a lot more (they are scheduled monthly, not over the course of the whole training). But I refused. If I can’t do the job, I can’t do the job, but I’m not doing less than everyone else.

    It’s strange but the worst stigma is in the medical world. There was a girl with bipolar who got a similar exemption in medical school, not for all the rotations, but for surgery and some things she told them ahead of time she wasn’t planning on being. (She wanted to be a psychiatrist.) They said fine, no problem, but then at the end, they made a note on her final status letter from the medical school, effectively blackballing her from ever holding a job as a doctor or receiving any training position.

    And part time? Sounds really interesting. Who does that?

  12. And I did decide, after working thirty hours on, twenty off for the last ten days, which made me crazily scarily suicidal (standing on rooftops), that if it gets to that, it doesn’t matter if I am in the middle of a fucking shift. I’m walking in and quitting. If I someday die from this disease, at least I want it to be after I fought and took as much as humanly possible and really just broke.

    But because of this $3 an hour miserable job? It is SO not worth it.

  13. General practice is the most flexible training program. Emergency is also open to the part time training thing (but that does involve shifts, much more human hours than 30 at a time though).

  14. Hi Sara,
    I’m worried for you. I am going to e-mail you.
    hugs,
    …aqua

  15. Bipolar and back on earth…

    sleep sleep thing.

    Your body telling you that you need to sleep is something I found absolutely the most important …. I eased of the drugs…. But on the bright side while I was experiencing my first manic whirlwind I did learn a lot. I was so hyper…. didn’t know what was going on and lost my ability to sleep as normal. I think I set the whole thing off by staying away too much. Sleep deprivation is not something you want to experience with mania. Reality was a bit touch and go. I have had to rediscover my humanity and put my feet back on the ground.

    You may at first cling on to the drugs like a lifeline but I have been able to ease off of them. I have been on lithium epival and a few others. I don’t know if its just time or effort on my part but I seem to be slowing this roller coaster.


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