I know I’ve been terrible. A months long absence. I’m sorry. Will you forgive me?

This place feels almost foreign to me. Even the name. “Borderline Med”?

But then I ended up cutting my wrist in a 20mg Ambien-induced state after becoming devastated this past Sunday night and I realized more than ever that the struggle will always be there and I will always have to keep fighting this crap. “This crap” right now mainly being the eating disorder. I hadn’t cut in more than a year I think, wtf.

My mood is fine. Although last week was effed up and it was a wake up call. I have to take care of myself. Which is why this week was better, putting more effort into putting myself back on track.

I’m halfway done with intern year, first year, of residency. That’s pretty insane. But I feel pretty lost and still can’t find my footing in this place, much less this world. I’m in a rut. And it’s my fault. I’ve let myself go.

But mainly I just wanted to update you and ask: if I come back, can we start over?

I’m gonna try my best. I promise.

Much love.

 

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Eh.

Took a hiatus. I’m sorry. But hopefully I’m back. Making no promises with my crappy schedule. But here I am. As I told one of my patients yesterday: let’s take it day by day, ok?

So. I did 2 months of psychiatry. I loved it, the hospital, the patients (mostly), the staff, everything. I felt stupid at first, then got the hang of it. Then on my last day I did an impromptu half hour teaching session about psychopharmacology with the medical students and I thought: well, I actually know more than I do. And that was awesome obviously.

But then I started medicine. A month of it. It’s been a week. Let’s just say I’ve found myself teary eyed in the bathroom or when I’m alone in the work room at random times. Yeah, it’s that bad.

And it’s not the team I’m working with. The team is great (except the attending, more on that below). It’s the fucking schedule. Minimum 12 hour shifts (that mostly turn to 13 or 14), 6 days a week. I bet you can guess which day of the week I have off, judging by the date on this post….and how frequent my potential posts will be.

The attending I started off with was good. He was chill and relaxed. The attending I have now is an overachiever. And I don’t bode well with that. I’m the chill type of person, by doctor standards, that is. No wonder I ended up in psychiatry, it’s the chill people specialty. I did enough overachieving during my teens. Ain’t nobody got time for that.

I feel stupid 24/7 and it’s taking a toll on me. Last time I did medicine was a year ago. “Rusty” is an understatement for my current status. It’s like I never went to med school and need a refresher course on everything. At least during my 2 months of psychiatry I felt marginally stupid but knew some things. Here it’s just straight up embarrassing every time I have to round on patients in front of the team, especially the attending.

My attending gave me feedback yesterday. He said nothing I didn’t know already, about my performance anxiety apparently having no reason to be as I seem more sure of myself, about how I should brush up on what my patients have to refresh my memory….but what really hit me was him saying “study on those topics even if it’s 2 minutes”.

Haha! Dude. SERIOUSLY?! I have no time to take my trash out in a whole week and my apartment stinks, let alone study. And let’s be honest, I don’t care about the topics. As terrible as that sounds. I just want to be done with these four weeks and marginally pass, setting the bar as low as possible so that the next psychiatry cointern that comes around doesn’t get treated like shit. I just want to know the basics so I’ll know when to recognize a medical problem in my psychiatry patients in the future.

Dude: just tell me what to do. And I’ll do it. Don’t expect me to be interested, though.

He did, however, reiterate something my program director has told me a few times before and something I’m proud of: that it shows I have good rapport with my patients. And really, as long as I know the basics and have good rapport with my patients, I’ll be set. No need for me to overachieve. It’s not like I have the time for it, either way. I’ll worry about studying for real when I get back to psychiatry and neurology rotations (and I’ll have the time for it).

So, medicine…it sucks and I would rather do 10 batches of laundry in a single day than do this for a prolonged amount of time (and trust me, I HATE doing laundry).

Yesterday I couldn’t take it anymore. A patient started masturbating as I was interviewing him. Yes, you read that right. Hello, trigger! Hello, feeling disgusted and used! And of course, nobody in the team gave a shit except the females. Then another patient’s family was driving me nuts with wanting special treatment for the patient.

And already my head had gone over to dark places because another patient was irritated with me when I went to talk to her. I found myself thinking about suicide, yes, solidly for the first time in a while.

I was able to manage the thoughts. But yesterday I couldn’t take it anymore. I got to my apartment at 9:30pm and just started bawling. How can anyone live through this? Why is this necessary? I just want to help people and lead a balanced life. Is that too hard to ask for?

I texted the Russian. And he got worried. He came over. Cuddled and held me while I cried like a baby and just let everything out of my chest. Everything including our current crappy relationship situation, or whatever it is, because both of us have shitty schedules and barely interact. Started crying even harder after I told him I didn’t want to get depressed again (he knows I’ve been depressed, although not in detail….I’ll get around to that when things are more stable between us).

And I guess I just needed a good cry and a day off, because today I feel better. I was able to finally clean my apartment.

I’m not depressed. Not yet. And I hope not ever again. But I know myself better than anyone else, and I know that if I don’t get enough sleep or enough balance in my life, I will fall down that slippery slope quick. And medicine is exactly the type of environment that depression festers in.

No wonder there’s so much physician suicide. But that’s nothing new to me, really. It’s just more tangible when you’re no longer a student and are actually in the front lines. I honestly think it’s unnecessary for one to work 14 hours straight, 6 days a week, and expect to be ON all those hours…sometimes having to skip breakfast or lunch. Nobody gets a sticker for toughing it out. What’s the point, then? My attending went so far as to make the medical students rotating with us come to hospital tomorrow, on a holiday. His reason? “Well, in my day, when I was a medical student…” Seriously dude? Times a-change. Get over it. I have to go because it’s my work, but the med students? Come on.

And…I’ve gotten more shit from my medicine patients in one week than I did from my psychiatry patients in 2 months. Oh the irony. Especially since people think psychiatry patients are “the difficult patients”. Pfffffft. Sure.

I try my best. I really do. And my intentions are good. But it’s difficult not to have your morale eroded quickly with so much crap going on.

And that, my friends, is my current “life”, for lack of a better word. Everyone keeps telling me it will be over soon, but soon isn’t soon enough. I want it to be over now.

And because I like to finish things on a lighter note: it seems things with the Russian are turning more solid/stable every day. His schedule is going to be better now, apparently. Can’t say the same for me, unfortunately. We’ll see what happens.

I’ve had a good two weeks working at hospital. Well, actually, this week was much better than the first, but you get the gist of it. I’m finally starting to get the hang of it again.

I’m working at a psychiatric inpatient unit. So far I like it a lot. My attending has given me good feedback, at least for having been only my first two weeks. We’ll see if I can keep it up.

I had three patients thank me this week, which felt great. Then I had a patient get significantly better. He said his symptoms were the mildest they had ever been for the past 3 to 4 years. And he thanked me profusely, even said his mood was “excellent”. And guess who changed his medications? Me (with my attending’s approval of course).

I still don’t feel quite like a doctor, but I’ll get there. My attending keeps reminding me to present myself as DOCTOR Dana. I keep forgetting the doctor part, haha.

And I still feel like an idiot frequently, but less so this week at least.

I have a lot in my head regarding my work so far. My feelings and thoughts are very convoluted. I’ll post more about that this weekend.

As for my own mental health… I’m in a very good place right now. Been able to keep it up. No extreme homesickness so far. However, I’ve been terribly crappy at taking my Prozac. I forget every other day, practically. And then I go to hospital and make sure my patients take their medications so they get better and reach some stability. Geez, can’t even do that for myself.

But I’m OK…right now. I’m just worried about this becoming a slippery slope. I don’t have a psychiatrist or therapist yet in the city that I adore, and I’m starting to get worried. It’s not that I need one right now (although I am running out of meds…shit), it’s that I don’t want to fall in the hole and then be forced to look for one. I’d rather prevent all that from even beginning to happen.

But I’m so lazy you guys! Right now I have time to see a psychiatrist or therapist, but I’m so friggin’ lazy to go and do it. I’m so tired by the end of the workday (and my workday really isn’t that long, to be honest), I have no energy for doctors’ appointments. My work in the unit seems simple, but the truth is I’m always moving and always doing something.

There’s never a dull moment or no work to do. I didn’t think I’d get physically tired so easily at first, but oh how wrong I was…

 

So…I have a license to practice medicine as a resident physician in my state.

That was a huge relief off my shoulders. However, the experience was incredibly unpleasant and I wouldn’t wish it on anyone. The licensing board holds doctors to such ridiculous superhuman standards. And they’re incredibly rude, to top it all off.

Annnnnyway….now that’s over…well, the day after I got the wonderful news, actually….I had my first day of psychiatry residency: July 1st.

It was quite the overwhelming experience. Nothing bad happened, I was just an overall anxious clutz who didn’t know the ropes at the hospital and didn’t know what to do with herself. But I’m pretty sure everyone feels like that the first day of residency.

Except when your attending asks you to present a patient in front of the whole team and you pipe up “Sorry doctor, I didn’t see that patient with you”, and she says “really? I was sure you did…” and you insist, “No, I didn’t, sorry”. So, then, she presents the patient and 30 seconds in you try to not morph your facial expression into one of horror as you realize you did indeed see that patient with her.

Yeah. I did that.

First day as a doctor and I can’t even remember my patients. Shit.

But that was the biggest blunder. I think. There were also a bunch of I don’t know’s answering her questions. Simple questions to top it all off. She was probably thinking I was an idiot. And she wasn’t far from the truth if that was the case. It was my first day. Right?

I still can’t get used to being called “doctor” and that it’s actually true. Was kinda mindblown when I read my name next to the words Faculty/resident. Transitioning from the role of medical student to that of resident was harder than I thought. I told my attending. And I also told her that I was sorry for being nervous and awkward. It was my first day.

And at the end of the day, she said “You did a great job.”

I think she was just trying to be nice. But that’s fine. I’ll get the hang of this.

Eventually.

 

Ah, this week has been an emotional roller coaster. But I’m glad to say I feel great right now. Currently. At this moment.

The licensing issues had me freaking out and horribly anxious about 2 days ago. However, my program directors dissuaded that fear after having a meeting with me. They’ve been super supportive at my program and it makes me happy that I chose them. They’re confident things will resolve and that definitely calmed me down a lot. So, we’ll see what happens this coming week.

Really, all I want is to be a psychiatrist and help people. Is that too much?

So after all that mess, I decided to try and calm down. Been laying low the weekend, just adulting and doing chores in my apartment. Basically, nesting. Also, feeling slightly better about my appearance since my previous post. Just trying to be patient with my face and the time it will take to heal…trying to not pick, etc.

I recently received my long white coat *eek!*. That’s quite the milestone. It means you’re a doctor. It means you made it after so much work and sacrifice. Funny enough, I have a love-hate relationship with the white coat. I like how it’s a sort of uniform and gives an official tone to things. However, I’m not a fan of it because it creates distance with patients in a field like psychiatry. It’s one thing to talk to someone with a white coat about your infectious diarrhea, it’s another to talk about your past trauma and hallucinations. One doesn’t require the patient to feel *that* comfortable, the other requires as much comfort as possible.

Annnnnyway…none of that will happen if I don’t have a license to practice medicine. But we’ll see. I have faith in whatever that this will resolve.

Patience. I need lots of it right now.

And a bit of luck and good wishes wouldn’t hurt either.

 

I feel so fugly.

I feel so fugly I don’t want to go out. And I haven’t during the whole day.

My skin is breaking out like crazy and of course I haven’t made it any better by constantly picking. I don’t remember when was the last time I felt so consistently ugly for so many weeks in a row. 2016 is a good year so far…except beauty-wise.

I feel so ugly it makes me anxious. I don’t want to go out unless I wear truckloads of makeup and even if I do I’m constantly self-conscious about people looking at me and thinking my face is too caked over.

Thoughts like “He’s probably thinking I’m a ‘butterface'” cross my mind constantly. And the worst part is: right now I wholeheartedly believe I’m a “butterface”.

I’m even afraid of the Russian thinking I look nasty or something, or that whenever he looks at me or kisses me he can see the amount of cake I have on.

My skin was moderately bad as a teenager, then I got some respite during medical school, and now I’m back to being a spotty fugly-ball. What the hell happened?

I just want it to be over already. For someone who was badly scarred by bullying there’s nothing worse than having the cause of your bullying turn on you a second time around. What did I do to deserve this?

Why can’t I just be pretty? Why can’t my face just be…normal?

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