Hello, World

I logged in having received notification of a new comment. I am always both somewhat embarrassed to come back to this blog, and also somewhat superstitious – that if I come back to this identity and look at it and revisit it, I might somehow fall back into this pit, or if I come here and write that things are better, I am tempting fate.

But reading the lovely comments left here again made me incredibly thankful that I spent the time writing this site when I was in the middle of the storm – knowing that it might be a light or comfort to someone else, or just plain old normalize the experiences, or help someone weather having to visit the doctor or emergency. I find the older writings of mine too painful to read, for the most part. I do live in terror of falling back into this place.

It still continues to get a fair amount of traffic – mostly people wanting to know what will happen at the doctor or for emergency care if they go for self-harm (the most hits are for some version of that question), if the doctor will know that they did it, why they have to wear paper gowns, various specific drugs I have taken, or cyclothymia. However, one of the top search terms is “doctors who self-harm” or “how to talk with patients who self-harm” or “can I be a doctor if I self-harm?” (YES!) Somehow I seem to have become an expert on this, though I’ve never done it.

As for me, for those following the rest of the story: I did end up relocating to the States and took a job as a GP in a smallish, somewhat obscure city, working at an urban clinic and hospital that do mostly charity work. Drug abuse is rampant here, including prescription drugs, and while that can sometimes be exhausting to deal with, often some of the underlying causes people end up in that situation are similar to what I have experienced and maybe I am helpful to some of these patients. Due to the financial situation of many patients, I am doing a lot of psychiatry because they cannot afford to be seen by a psychiatrist, and I think that my vast (ha ha) experience taking many of these medications and knowing what they feel like does help guide me. The bosses seem to appreciate me here, and I do feel like I fit in, in some ways for the first time in my life, as this part of the country is known for alternative spirituality and many of the GPs are involved in some kind of humanistic medicine, meditation, mindfulness training. One of the psychologists at the clinic where I work is starting a DBT therapy group, and I hope my schedule will allow me to co-lead with him, or at least participate in some way.

I continue with the same partner, stably. I have gained about 40 pounds from the medications, but have become the proverbial “fat and happy” woman. My writing talent has fled, however. I am no longer an introvert; in fact, one of the biggest changes I’ve seen in the medication is that people come up to me and ask me for directions. When they talk about personality psychopharmacology – well, that’s my clear evidence that it exists. Something has so profoundly changed that even passers-by notice it. I do not like this.

The sleep disturbances from doing the job are difficult on me. The other day I worked a night shift, and then went to a meeting and one of my new doctor friends said, “You seem a little manic, eh?” Joking, but that terrified be as I was a bit garrulous and inappropriately jocular. This terrified me. Sometimes, before sleep, I slip into morbid fantasies about what would happen and how various coworkers would react if I had another meltdown. My emergency plan is to take an extended sick leave and return to my country to recover if that happens.

At one of our meetings, another physician here who I greatly respect gave a talk about his experiences with mental illness which were astoundingly similar to mine (manic depressive spectrum disorder, long time of wondering if he was just “a self-absorbed asshole” before diagnosis) and left the same kind of relationship wreckage across his life. Unlike me, he stabilized and then went to medical school (definitely the easier path and the one I recommend if possible, but it can be done during medical school). He gives a funny, lively, and raw-honest talk about this and was open about his disorder while applying to medical school and further training and this job. I later found out he gives this talk about his suicidality at universities and medical schools all over the country, to try to reduce the stigma, prevent physician suicide, and give hope to other aspiring young people who feel like their lives have been derailed. I was incredibly proud of him, left in awe, but for a long time after that, every time I saw him, that was all I could think of. I wished I could be like him – someone people admire, who is strong enough to come out and tell the truth and remain standing, and not have to flee. But I’m not, especially since I came into my medical career with all of this stuff around me and was known in medical school and early career as somewhat unstable and highstrung. I don’t want to be like that again.

So yes, I am in some kind of remission, living in fear of the return; you can be a doctor if you are crazy; I don’t know what will happen if you tell your doctor you self-harm but a lot of doctors are crazy too and a lot are judgmental bastards. You can get better from being crazy but there will be changes to who you are. My answer to everyone seeking answers or solace here is an overwhelming yes, yes, yes.

Much love to you,my fellow touched, and may your next incarnation be more beautiful.


  1. Sara, I have really been missing you and your gorgeous writings.
    love, Milo

  2. I am happy when you are ^.^
    Keep it!!

  3. I just got around to reading this, but so glad that that – at least when you wrote it – you were doing well. Love to you, and the appropriate intensity of brightness. Hope the States are treating you well; I’d love to see you around if we were ever in the same place at the same time.

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