Curveballs

I ran into a crowd of baseball fans this week while heading home from work.  It was refreshing to see so many children waiting excitedly for the game – hoping to see their favorite team bring home a win.  Knowing our team, I had more tempered expectations.

Baseball

However, this got me thinking about life and expectations in general.  Growing up, both are generally set for you by your parents.  You go to school, do homework and chores, maybe participate in some extracurricular activities.  Life was rather predictable, at least for me.  Adult life tends to vary a lot more, but it seems like most people choose a path that includes some combination of leaving home, getting a job, marrying someone, raising kids, then retiring a few decades later.

But what if life throws you a curveball?  I doubt my patient planned to get in a car accident.  I don’t think my friend expected to stay in Germany.  I certainly wasn’t trying to have a psychotic break.

Unfortunately we can’t turn back time.  We can, however, decide what to do next.  Maybe it involves altering your expectations.  It might even mean ditching your original life plans and coming up with something new.  (Luckily, adults are allowed to do that.)  I almost quit medical school after being diagnosed, but so far I’m glad I didn’t.  Hopefully that continues!

Image source:  Baseball, By Tage Olsin – Own work, CC BY-SA 2.0, https://commons.wikimedia.org/w/index.php?curid=176153

Another day, another week.

I feel so uninspired today.  It feels like this week was just a ton of work and not much sleep.  Oddly, I’m not all that tired.

It’s funny how that statement alone would be enough to trigger a raised eyebrow from my psychiatrist.  Those of us with bipolar disorder know that sleep can be one of those tell-tale signs of what’s to come.  Every year, as summer approaches, I sleep less and less.  The opposite happens going into winter.  It’s like clockwork.  It’s also why I love the summer months – I’m awake, I’m happy, I’m energetic, I’m motivated, and I get so much more done.  Sound familiar?

I probably meet the criteria for hypomania for a couple weeks, if not more.  I try to take advantage of this as much as I can, since I always go through this unproductive slump over the winter (when it’s awfully cold and grey here).  But I always try to be on a lookout in case things spiral out of control.  There’s a fine line between hypomania and mania, and I’ll admit I’m often guilty of sneaking up as close to it as I can.

It’s so tempting to ignore it when it’s not negatively affecting your life.  However, there comes a point when hypomania is no longer advantageous.  When you’re wired and anxious and distracted and reckless and doing a billion things at once because you think you’re superman, you’ve crossed that line.  It’s a shame we can’t predict when to treat hypomania, and when to wait.  I am lucky to have circadian rhythms to tell me when it’s time to do something and come back down to earth.

Despite being a medical student, I tend not to take medications unless forced to.  It’s a little hypocritical.  I’ve seen and know just how effective psychotropic drugs are, and I’ll even encourage others to take them…just not me.  I choose to take my daily lamotrigine, but otherwise I’ll stick to living life on the edge – tempting fate.

Learning to be a doctor

I saw two patients this week – I was terrified.  It had been a long time since I talked to a real patient and I didn’t want to mess anything up or say something really stupid.  Luckily for me, those patients were super nice and had actually volunteered to let me practice.  They allowed me to take medical histories and perform full physical exams, even though they’d been poked and prodded so many times during their hospital stay.

Student_Nurse-_Life_at_St_Helier_Hospital,_Carshalton,_Surrey,_1943_D13888

Student Nurse- Life at St Helier Hospital, Carshalton, Surrey, 1943

Balancing patient care and medical education has always been a tricky issue.  No one wants to be the guinea pig for a brand-new medical student.  On the other hand, we want capable, experienced doctors when they finish training.  So how do we reconcile that?  No amount of book studying or simulations with mannequins prepares you for the real world.  Many medical schools hire actors to pretend to be patients, but we don’t see the very sick patients with sepsis or pneumonia unless we go to the hospital wards.  So somebody has to be their first, or second, or third…

As students, we are grateful for the patients like the ones I saw, who generously allow us the opportunity to learn, as well as take care of them.  And we do contribute to their care, I promise!  Med students often carry the fewest patients (compared to nurses, residents, and attending doctors who could be covering the entire floor!), so we have much more time during the day to get to know them and learn everything that’s been going on.  Then we pass along the info to our superiors, who go in and double-check details or do the stuff we forgot about.

Chinese_Garden_Singapore_Pagoda_Staircase

Medicine is an apprenticeship, and our mantra for learning is see one, do one, teach one.  (Ok I’m exaggerating – maybe more like 20.)  It seems quite daunting at first.  We achieve competency through experiences, and eventually we gain the confidence and skills to practice medicine alone.  However, we also learn how to learn.  The medical field is always advancing and changing, so we must keep up, even if there is no teacher guiding us in the future.  It’s a never-ending journey.

I’ll fully admit that I am a little nervous about anything new that I haven’t learned about or can’t do.  Some of my classmates seem to jump right into it, but that’s just not me (unless I’m manic…)  I tend to be more cautious and reserved, choosing to watch many more times before feeling comfortable enough to start trying.  It sucks to be the “slow one” when grades and evaluations get handed out, but I’ve decided I’m okay with that.  Because in the end, I’ll have learned everything too – thanks to my wonderful patients.

Images sourced from WikiCommons:  (top photo) Ministry of Information Photo Division Photographer, Stone Richard; photograph D 13888 from the collections of the Imperial War Museums., Public Domain, https://commons.wikimedia.org/w/index.php?curid=24378701 (bottom) By Bhadani at the English language Wikipedia, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=31775731

First times

Botswana_sunrise

You always remember your firsts: first kiss,  first car, first day of college.  There’s something magical about it that always sticks with you.  Although this blog post is hardly groundbreaking enough to merit such nostalgia in the future, it is nonetheless the first time I’ve started a blog.

I toyed with the idea many times, but I wasn’t sure what I wanted to write about.  Should it be a diary?  An advice column?  Random musings on life?  I settled on a chronicle that perhaps combines all of the above: a chance to document my experiences now, so that I can read it many years down the road and see what’s changed.

Icono_Normativa

But there’s another reason.  I want to write about what it’s like to have bipolar disorder as a medical professional-in-training.  When I was first diagnosed, I spent a lot of time on Google searching for success stories of other physicians or med students.  I wanted proof that it could be accomplished, and that this diagnosis wasn’t a death sentence for my career.  Instead, I found quite the opposite.  Several sad stories in the news, very few examples of doctors, lawyers, or other professionals who admit to having the illness, and even fewer support groups.

Depression is so prevalent in these fields that it has become accepted as a problem that needs to be addressed.  However, bipolar disorder still carries enough stigma to prevent people in our fields from “coming out”.  I don’t know of a single physician in real life who’s bipolar.  I completely understand, as I too write this blog anonymously, due to potential professional consequences of disclosure.

I hope to chronicle the obstacles but also successes in my life, so that if someone were to stumble upon my blog, they could maybe identify with them and take comfort in the fact that they are not alone.

Source of images: Botswana Sunrise – CC BY 2.0, https://commons.wikimedia.org/w/index.php?curid=203583; Book – By Raúl Ruano Ruiz – Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=22768706