(Snippets of a) Life with Bipolar Disorder Type II & Clerkship [Part II]

I’m not lazy. I just don’t feel right. How can one pick a diagnosis from an intelligently collected pool of differentials, and then prepare to defend the chosen working impression when the mind refuses to stay, jumping off from isle to isle? And it goes on for days and days until physical and mental exhaustion cuts the trip. Those consecutive days of insomnia, guilt and diffuse anxiety end with short periods of relaxation and well-being. But the paperwork has been put off for an excessively long time and it is but too late to rewind time back to the deadline.

I’m not lazy. I just don’t feel right. Sometimes, when I talk to my patients, I’m surprised at the changing and stumbling pattern of my questions and physical examination. Routine often is a foreign, if not nonexistent, phenomenon. Every day is a new story in itself, requiring a constant revision of approach and perspective. At the end of the week, I don’t trust myself enough that I have mastered a system, or that I have woven a style to increase my efficiency as an interviewing, thinking, composing and monitoring machine.

I’m not lazy. I just don’t feel right at all. When I am unable to sleep for the whole of the 36-hour shift, I get cranky, groggy, weak and vulnerable to many insults—be they aimed intellectually, emotionally, psychologically, etc. After all, I am human, unadulterated by steel or ice. Like my characters in most role-playing games, my Mana and HP bars can be drained to dangerously low levels; and I am susceptible to functional disability and paralysis, if not death.

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