After five grueling months as a senior clinical clerk, my mind gave in to exhaustion. I could no longer keep up with my responsibilities as part of the healthcare team and requirements for graduation. Isolation seemed to have made itself more acutely and severely felt when I am in the presence of people than when I was alone. My job has kept me almost always glued to my assigned patients if I was not called away by the staff or seniors. We were supposed to be the “eyes and ears” of the attending, the walking monitoring and reporting machines (although we were vehemently discouraged to consider ourselves as such), the intellectual laughingstock if somebody needs to get a booster of self-esteem. And then there were a number of shifts when I would only have one proper meal, barely two liters of fluid, and scarcely an hour to sleep or nap for 36 hours at a time. But this is the routine I had learned to embrace and love long ago; this was the life I had chosen. I could write as much but I would not complain.
What was relevant in that unhealthy routine was its significant impact on the prognosis of my condition. The role of good nutrition and healthy relationships in the maintenance of physical and mental health cannot be overemphasized. I can say much for disorders with both organic and functional components, such as mood disorders.
Let me lift a few lines right from my Psychiatry textbook.
Medications give hope but the time they take to achieve steady state levels and ultimately tangible clinical results and the necessity of regularly adjusting the dose and regimen is often frustrating. After one year of depending on them for control, I got to the point of considering (slightly) maybe electroconvulsive therapy, which has more promising adverse effects than guaranteed permanent benefits. But in this career, it’s all too risky.
Finding the right professional has always been a challenge. The practice of psychiatry, among others, is deeply rooted in culture. Forging an effective partnership between patient and healthcare provider requires certain skills, say empathy, that are not widely taught in medical schools. It’s no wonder that when some doctors do not know how to meet their patients halfway in terms of values and health goals, frustration can result and patients are lost to follow up, or entirely lost. Some doctors may be highly intelligent or skilled at what they do, but it requires talent to be able to work magic and truly “heal” people.
It took me more than a month to think really hard about my decision to take the rest of the year off. But it was worth it. I had been weak in denying I needed help. I knew I was already falling apart.
Now I feel the urge to be vocal for all those who have been suffering in silence, afraid to come out because of the stigma and the inequity of distribution of the much needed resources, information and human. (Few realize the power of social media. It can transform lives.) Not all mental illnesses are so debilitating that they hinder one from fulfilling his dreams and attaining his full potentials.
It’s very easy to ridicule or make sarcastic remarks about something that’s not readily understood. Textbook descriptions may be accurate but they come nowhere close to the real experience of the illness. When the community tries to downplay the symptoms, reducing them to the trivial ones commonly popularized in mainstream media, or to dismiss the reality of the internal struggles and relative disability, daily living can become incredibly difficult.