Long weekends and tiny epiphanies

I think I know how the panda feels sometimes

The last three weeks I've been running a project looking at communication between doctors and patients.

The last weekend I lost my brand new (less than 24 hours old) iPhone 4S.

These seem like relatively unconnected events, other than that they both happened to me. One, however is a causative agent. One is a symptom.

I know it is the most over-used cliched post for a blogger to talk about their experiences of depression. We get it, you feel blue sometimes, get over it etc. etc. But this past three weeks have had me becoming re-acquainted with something I thought I was entirely over. In what I now view as a former life, I was lab monkey who worked by themselves for 8 hours a day in a lab where I was the only person there, for months at a time. During that job, something broke inside me. I tasted despair and such crippling psychic pain that I had days of missed work where I would pad around my crummy flat and wonder what would happen if I just stepped out in front of the bus that went to my job, rather than getting on it.

It was, to say the least, not a time I remember fondly. The more I've learned about clinical depression, the more I am sure I was suffering from it. Not that I ever sought medical advice at the time or subsequently. I probably should have, with hindsight. But whatever. I think the loneliness of working a job that was going anywhere, by myself damaged me in a profound way.

I've written about this before in a brief post when it seemed like a more distant time.

Things changed when I moved to London, started nursing and making a positive difference in the world. Everyone I helped, healed me a little bit. I worked as part of a team who spent a lot of time together, worked hard, partied hard. I got married and learned to trust and share my space with someone. Learned that maybe I didn't have to bear the occasional weight of existential dread by myself.

But running this project for the past few weeks has involved me living as an observer, watching, not interacting or involving myself in some of the sadder aspects of human existence. 8 hours a day, by myself, in a crowd of people.

I think you can see where this is going.

I didn't pick up on it at first. Then slowly things happened. I passed up on going to the gym. On going to my Krav Maga classes.

Then I went drinking on the Saturday night. I was back with old nursing friends and we tied one on. We painted a small patch of Soho red. It was an explosive release of... Something for me. And I got drunk. blind drunk. In the process lost my 'phone and didn't care, because I was too busy drinking and trying to savour being a part of a group again.

Monday I was still a bit hungover. But, I pulled myself together enough to get stuff done and in recounting the weekend to med school friends, suddenly realised what was going on in my mind. This realisation has made all the difference. I'm now spending my spare time on the ward revising and learning and talking to the medics. Engaging with the world.

I guess my point in all of this is sometimes you're not as healed as you think and maybe it's a reminder to be on your guard against demons you thought you'd vanquished.

(Oh, and the sad panda shirt is from the A Softer World line at Topatoco)

Getting hands on

Mr. McGuire: I just want to say one word to you. Just one word. 

Benjamin: Yes, sir. 

Mr. McGuire: Are you listening? 

Benjamin: Yes, I am. 

Mr. McGuire: Plastics. 

Benjamin: Exactly how do you mean? 

So we've had six weeks of PBL tutorials, statistics and communications seminars and clinical skills sessions and now, like so many baby birds, we're being let lose from the nest lecture theatre to fend for ourselves. For a bit.

My first rotation is 6 weeks of plastic surgery, allegedly with a hand specialist. Which carries all manner of silent terrors for me as I find the anatomy of the hand and forearm crazy complicated. And being in a theatre gives me all kinds of opportunity to fail to observe some anachronistic aspect of human interaction and get bawled out for my troubles.

But the upside is I have a fair bit of post-surgical HDU nursing experience and know the general tone of surgical ward life. And in many ways my current form was birthed on the wards of an NHS hospital. I don't mean that in a creepy "buffalo bill" kind of way (well, maybe a little bit...), but who I am now is very much the product of having lived and worked in the healthcare environment for quite some time. I hope I can fit back into the pace of things like a hand in a glove. No pun intended.

And then there is the undeniable fact that surgeons are the people who reach into the very living flesh of another person and fix them. This is something incredible to be sure. I can understand where the idea that surgeons sometimes see themselves as gods might come from - If you can make someone better with your hands and bit of know-how, you could forgive yourself for being changed from the experience, too. I look forward to seeing the fixing happen first hand (again, no pun intended) and to find out how the life of surgeon actually works, when they're not writing up post-op fluids or taking down dressings at 9am (don't get me started...)

I don't know if I am a surgeon (though I have nursing friends who promise to disown me if I become one!) or a medic, and to be honest, I don't know if it's relevant for me to wonder this without more experiences to form an opinion. To pass the first year without resit or hinderance showed me I can do this, that I am med student (hear me roar!). What I make of my opportunities and experiences waits to be seen, I guess!

PS There will be Malta pictures, once Flickr stops being in a strop with me.

Talk meat to me

So for our date night last week, Mrs Absentbabinski and I went off to Bodean's in Clapham and ate the finest Kansas-style barbecue that South London has to offer.

I had the "famous" Bodean's Burn Ends (see left), which comprised of about a pound of barbecued beef and pork which was the most delicious thing I have eaten in months. The restaurant is the wonderful line of booths with ESPN playing on flatscreen TV's and ice-cold Sam Adam's or Blue Harvest (my choice and hers, respectively).

We had clam chowder to start and that may have been a bit of a mistake. Understand that in London, when you order a main it is very rare that you end up too stuffed to finish it. Bodean's does American fare so faithfully that a few mouthfuls of the delicious pulled pork the meat sweats were upon me; by the final mouthful of beef I was beginning to regret my greed. I couldn't finish the fries. Mrs Absentbabinski had a sirloin steak that she struggled with. There was no probability of desert - A rarity in our household. Belt buckles were loosened. Top-buttons undone and brows dabbed. We both felt nauseous on the bus home. Every burp smelt of barbecue sauce and self-disgust.

Would I go back and repeat this? Oh hell yes.

Knowledge-worker hands

One of the things that revision time always gives me is time to reflect. Nominally, I'm sat on my bed looking through powerpoint presentations, or reading old notes, trying to condense pages of information into bullet points so that I can remember and regurgitate it on demand.

Revision is boring. Occasionally I have learn something for the first time because I missed (by choice or by the fairly dreadful course planning) the lecture, but mostly I am revisiting or, indeed, revising, my knowledge base. Whilst I slog through the material I will confess my mind starts to wander a bit, and one topic that I keep on coming back to is my role in life as a man, whatever that means. And like any good physical exam, I start at my hands.

The phrase "knowledge worker hands" I stole from Merlin Mann, and it refers to that nice soft palm and fingers experience that comes from living via the keyboard or whiteboard. When I nursed, my hands were invariably dry or cracked from the alco-gel or the soap I used dozens of times a day. There were callouses from pushing and pulling things all day long. I came to see them as nurse's hands. Working hands.

Since the start of my course, my hands became softer, better hydrated, fewer (if any) callouses. And I have begun to feel a certain disdain towards them. Maybe it's a loss of identity, or a natural distrust I have of soft hands on a man (utterly ridiculous, I know), but my hands became knowledge worker hands.

I've started climbing recently and I now sport callouses and scrapes and an ever increasing grip strength. I've started practicing Aikido again, after many years away from it and realised that I had lost any sense of the "killer grip" my new sensei talks about. The grip that when applied to your wrist causes your hand to claw up. I've picked up my guitar again and I notice my fingertips are soft and hurt after a short time of playing. I wonder if this is all a response to how I see medicine in some way. I know that it is hard and demands so very much, that surviving the long hours and ability to think on your feet is a skill. But my hands soften and that bothers me on a very fundamental level. I don't really understand why. Maybe this is material for a midlife crisis that's just been delivered a few years early.

My feet are runner's feet. My hands must not be knowledge worker hands.

Go figure.

Contagion

from riz94107's photostream

It was inevitable. I have succumbed to some horrid little virus and I am laid up in bed.

My wife brought this back with her one day from the school in which she works. Those bipedal plague factories by which she insists on being surrounded. After going climbing yesterday I came down with shivering a blocked nose and sudden urge to clamber into bed. We'd invited some friends around for dinner and I thought would man up and try and play mein host.

We got to the end of dinner and I felt like I had not got better at all. Since I was a child I've known I was getting unwell because my flesh felt like it was crawling off my bones. A bit like a spidey-sense, but not nearly as cool. 

I'm not running a temperature and I suspect by tomorrow I will be well enough to return to school. I doubt my PBL group will have suffered due to my absence and we kinda know what the disease of the week is before the case even starts which is nice. The one thing that being ill has allowed me to do is sleep. I slept for greater than 8 hours last night (waking once for my alarm which I'd forgotten to turn off). And it was glorious. Even with an over-arching crappiness that surrounds me, I can't remember the last time I slept for so long. I don't know when it will happen again.

You are not a unique and beautiful snowflake

This is not you

Just a quickie, but I just thought I'd share an experience I had yesterday that has really helped me deal with the self-doubt and associated shit that this week has brought to the surface.

I have a very good friend with whom I go drinking and she has a good friend who has just taken his entry exams for the Royal College of Surgeons.

Apparently the night before his exams, he too was wracked with self-doubt, suggested it was all too much, how could a person remember all this, he should chuck it all in now etc. etc.

My friend, Hazel, opined that this was just how doctors (and by extension, med students) are, full of self-doubt, neurotic and constantly feeling overwhelmed by the volume of knowledge they are expected to have.

So, in one respect, yay! I'm not behaving in an abnormal way, my negative emotions are validated and guess what? It doesn't mean everything is doom and gloom, it's probably just a emotional survival strategy.

In another respect, boo! I am not a beautiful and unique snowflake and hey, guess what? My emotions really aren't anything special!

*sigh* I jest, I'm feeling a lot better and more capable. And maybe just a little bit apprehensive about the future ;)

Have you got what it takes?

So it feels like I need to work on my clinical self-confidence.

I'm finding the transition going from senior staff nurse to wet-behind-the-ears-med-student hard. It's hard going from being on top of your game, in a comfortable place - the go-to guy full of how-to and confidence - to being uncertain and feeling vulnerable. Before I started this course, I didn't realise how fragile my ego is.

It's compounded by being surrounded by a group who are effectively the top 10% of the class. Imagine the equivalent of a class filled with the girl who has a dozen different coloured highlighters and does extra reading for fun. I know I've earned my place here, but it doesn't make me feel any more comfortable. I know this is all in my head and I should just deal with it and crack on with the work...

It's pretty tragic that this is taking up so much of my run-time, as the course is full of work I need to do and is more than capable of giving me stuff to worry about. I think I just feel like the fact I'm an awkward nerd who tends to make friends on his own terms, is being thrown into sharp relief by the naturally gregarious and socially-engaged behaviours of med students in England. Why that is the norm, I don't know, but it's just helping me to relive a whole bunch of shit that I thought I'd dealt with in high school but apparently really haven't.

Good grief, this is a wee bit self-indulgent, isn't it? Hopefully telling the internet my deepest, darkest worries will help me get a handle on them. It would be really nice to be over all this kind of nonsense so I can really focus on worrying about how much I need to learn in four years!