I have written a fair few blog posts about my experiences of Mental Illness at Medical School. What I have never written, however, is a diary type entry of what actually happens in a typical week of Medical School. Many prospective applicants seem to like things like this, so I thought I’d do one myself. This is not just aimed at perspective applicants, however – it is aimed at anyone who hopes to gain a bit of an insight into Mental Illness. I have to warn you that this will probably be quite a depressing blog post. But I think posts like that are necessary too to show the cruel reality of Mental Health.
I’m not going to lie either – part of why I’m doing this is because my mood is absolutely rubbish at time of writing. It’s funny, but I find writing to be strangely therapeutic. Perhaps others going through something similar and not knowing how to cope could give it a go too. Maybe it will be helpful.
My alarm wakes me up at 7am. Well, no, it doesn’t. Truth is, I’ve been awake for hours, not been able to go back to sleep because of all sorts of anxious thoughts running through my mind. What will today be like? Will I have a better day? Why are my friends taking their frustrations out on me? So no, my alarm doesn’t wake me up – it just rings as some sort of courtesy call.
I groan and feel like bursting into tears. Another week. A whole other week to get through. I’m exhausted and tired – please can someone just have a bit of mercy on me? The voices also slowly start speaking up, incomprehensible at this time of day but enough to scare me and further deepen my worries.
After what feels like forever, I finally get up. Checking to make sure no one is outside my room because I can’t face to see anyone, I tiptoe to the toilet, get showered, brush my teeth, get changed and quickly walk back to my room. Head slowly beginning to hurt and feeling like vomiting, I contemplate getting some breakfast. Nah, I decide, I feel like I’ll be sick if I try to breathe air down my throat, let alone try to get any food down (Medics will be telling me that this doesn’t make much sense, for the trachea and oesophagus are different tubes but role with it).
After getting the tube to Medical School (during which I just put my head down, keeping myself to myself like most Londoners), I go to my Problem Based Learning (PBL) session. PBL is a fairly new teaching technique at Medical School where we all basically get into groups and discuss a case. Personally, I find it a complete waste of time but I know of others who like it. I’m thankful it’s not the main teaching technique at our Medical School, so we only have it once a week.
I meet up with my group and put on a smile. None of them know about all the voices that are currently running through my head, the pain inside and the feeling of emptiness. I’m surrounded by them and am making some lighthearted comments which they all seem to be enjoying, but I feel extremely isolated despite this. “They’re laughing at you, not with you” a mean voice says loudly. I realise it’s not real, bring back the smile to my face and pretend nothing has happened to my group. Thankfully they’ve not realised anything.
The PBL Session starts. A patient comes in with what we decide is pneumothorax – what do we do? I give my opinion on it all, it’s discussed, we come up with learning objectives, research objectives and head our own way. Why did I say this? Why did I smile when he said that? I swear his smile fell by a millimetre when I was speaking, am I really that unimportant? Anxious questions like that are running through my mind about that session. Unreasonable questions, of course, but my anxiety doesn’t see that.
Got a few hours of lectures now. But the voices are getting worse. My mood is plummeting. I feel like I’m unable to breathe, trapped in the midst of some dangerous battle which cannot be won. I run home (literally – I’m too scared to take the tube), get myself into bed and cry myself to sleep. I stay in bed until the next day – eating a few peanuts or something from time to time but too scared to go downstairs to get myself any water.
My day starts at 3am. As I’ve had no water to drink since about midday yesterday, I decide that now will be a good time to go and get some for everyone else will be asleep. Despite this, my heart beats rapidly as I go to the kitchen, fill up my water bottle and run back to my room. I can’t sleep anymore, so I decide to try to get some anatomy of the abdomen revision done.
After a few hours of revision where nothing goes in, I go to shower, once again making sure no one bumps into me. I wear a suit today for I am meant to be going to see a patient as part of my training. I briefly admire myself in my suit, pretend to be James Bond in front of the mirror, laugh it off and make my way to a taxi to get to the hospital. I don’t take the tube because I’m always scared someone may ruin my suit and make me look unprofessional in front of my patient. Another irrational fear of mine.
I arrive at the hospital and almost immediately spot my patient. I go up to her, smile, and begin talking to her about what’s different since I last saw her a few months ago. For the first time in a long time, I feel normal. I feel like I’m actually making a difference to someone’s life. I am only a Medical Student at this stage – I’m doing nothing but just talking to her. She tells me lots of inspiring stories about her life, and I find myself feeling much more positive about them myself. “Thank you,” she tells me at the end of our mini-consultation. “You have great sensitivity – I know you’ll make a great doctor.” I am slightly dumbstruck by her comment. It’s funny – people say patients are often inspired and helped by their doctors. I think this is definitely true, having been a patient myself now, but I would say that we also learn and can be inspired just as much by our patients.
Today, I decide to go to lectures. I feel very positive after my consultation. Now we have a lecture on the regulation of appetite. It turns out to be way more interesting than I expected.
For once, I manage to get a good nights sleep. You’re probably assuming it was because of the positivity of the day before. Actually, it was because I took my sleeping pills last night. I avoid taking these on a regular basis because of how addictive they are, but last night I thought I’d decide to take them.
I have lectures in the morning, which means all my year group will all have the same thing. I shower and get changed in the same manner as before and text my friend in the same halls to ask her if she wants to walk to lectures with me. She obliges, and we both set off. This friend once moaned about my negativity, so I just stay quiet for most of the walk, scared to accidentally offend her again. I feel uncomfortable as I do so – just a few months ago, I would have been talking my tongue off but now I just don’t know what to do or say. This ends up making me feel miserable.
We arrive to our lecture theatre but I change my mind. I decide to go to the overflow room because the lecture theatre has too many people for my liking. No one seems to want to come with me when I mention it, so I feel a bit more unwanted and useless and slowly walk there myself. The whole lecture is just me contemplating my frustration at everything, with the voices back trying to put me down.
Wednesday’s are a half day so as soon as the lecture is over, I go to wind down a little – or at least, try to – and play cricket in the nets for a while. One of my friends also accompanies me there. Most of my time is spent playing almost blankly – it’s a hard feeling to explain. I am enjoying it but everything negative seems to be at the back of my mind. Not enjoying it as much as I used to is the way the psychiatrist put it to me a few months ago, but I’m not sure if that’s the feeling. My friend understands this, however, and we both go to Nandos after playing. He tries to get me to eat a bit more. My appetite still isn’t there, however.
I don’t know what it is about Thursday’s but I have never like them, and today is no exception. I won’t talk about how I wake up or get changed again, because I think you’ve got the point. I have Anatomy today and the day is rubbish. Basically, I will have a lecture in the morning which is one hour long, followed by a break for four hours, followed by dissection and living anatomy (the latter being where we practise physical examinations).
Appropriately, it’s raining today. I decide to sit with my friends at lectures but am disappointed when they all quickly leave me alone at the end, all hanging out together but seeming to forget me in the background. I sigh, wish I didn’t tell them about my mental illness again and head to the library to get some work done. I get to the library, feel restless and decide to go for a walk instead to clear my mind.
After a good four hour walk, I feel exhausted but I need to go to dissection. Usually I had some sort of weird excitement for dissection – now I just don’t care, I seem to treat it like it’s some sort of chore. Today we are dissecting part of the abdomen, while focusing on the intestines. I let my group take a lead role today which is quite unlike me – usually I like to be in on the action. For the whole dissection session, I just stand behind and watch, my mind elsewhere once again. Oh, and the voices are there of course. Eventually, I start to feel light-headed and I ask to be excused. I’ve never felt light-headed before in dissection. As heartless as it makes me sound, I never was squeamish or worried about seeing dead bodies. I feel like I’m losing myself slowly.
Last but not least, living anatomy. After feeling rubbish during dissection, I feel even more worthless. I volunteer to be the subject during the session – the ‘model’ that the rest of my group will practise on. It requires me to take off my shirt. “Ooooh, you’re nice and skinny so it’s easy for us to see your clavicle and your anterior superior iliac spine!” my group and the demonstrators say to me. I smile, but decide not to tell them the reason for my substantial weight loss.
Today, I have a GP placement. I have the morning off but I need to go and see my mental health home treatment team so I get up on time (i.e. at about five in the morning, and wait for another three hours being bored). The clinical team meant to see me haven’t arrived yet, but I don’t mind – they’re human too and everyone is late from time to time. When they do eventually arrive, they ask me how my week has been and I tell them about the voices. They listen empathetically as I also tell them about my friendship group seeming to treat me differently compared to how they used to. They gently suggest I find new friends when I tell them everything, but this makes me worry a little and get on the defensive towards my friends.
My appointment ends up running late, so I turn out to be late for my GP placement too. No matter, I told them that this might be the case so nobody seems to mind. My task today is to find a patient, talk to them before their consultation, sit in during their consultation and then talk to them after. Seems easy enough but my confidence is low – I feel too afraid to approach anyone right now. Instead, I go outside, take a few deep breaths and decide to tell myself I can do this. I find a patient who is in for a cough. We talk, and it seems to go well. Instantly, I once again forget about all my mental health issues and the voices seem to be inaudible. He is grateful again even though I do nothing but talk, and again I feel happy that I’ve helped make someone’s day. Perhaps being in a state of depression myself makes me so eager to try my level best to make others happy, not wanting them to ever feel the same way as I feel most of the time. Whatever it is, I’m glad that I seem to be half decent at something at least.
I get back to University Halls, wondering what to do for the weekend and suddenly feel lonely. After the high of being surrounded by patients, I suddenly feel bored and worthless again like I should be doing something to help others. This feeling quickly translates to loneliness, and I ask my friend if she wants to meet up for a bit. She’s busy, she says, but that I can come down but just not expect to talk much. I decide it’s just a polite way of her telling me to leave her alone, so I phone my crisis team instead who I have a cry to over the phone.
Then, at their suggestion, I pack my bags and decide to go home for the weekend. At least I’ll have my Mum there to look after me.
Although it may not seem like it, I am genuinely grateful to be studying Medicine currently. I have discovered that by helping other patients, even if it is just being a reassuring presence for them, I feel less worthless and as though I am actually making a difference to people. This positivity is what keeps me going. I do wish sometimes that my ex-friends were there for me as much as they seemed to be there for everyone else, but perhaps that’s why we’re no longer friends anymore. It’s funny – I now have no friends, but I feel much less lonely. Angry and frustrated, yes, but lonely? Definitely not.