#hopefully some day I manage to just kill my personality and become an automaton doing the tasks I want done

[medicinemane]

Anyway, kind of don't want want my house decorated in old lady kitsch or to be dressed in nouveau riche pensioner chic

May shock you, but I find that kind of insulting and want to fill my house with my own shit and figuring out making my own clothes so I can wear something nice that I like that isn't just overpriced plastic that falls apart instantly

[lk-mitogen]

mental health rant

A friend of mine had an explosive breakdown at work today, and he got into a lot of trouble for it (he yelled at an R4 and an external doctor, both of which are...wayyyyyy higher up in rank than we are lmao, we’re at the bottom rung or lower). Talking to him and his girlfriend and another friend individually, I got the gist of why he did it -- his parents are divorcing, he has financial issues because of it, he’s lost faith in becoming a pediatrician and now has no idea who he wants to be, we work under insane pressure every day and no one gives a shit except when we fuck up, etc etc -- and I remembered me in my first year and a bit of med school, how I was just like that, because my own parents were divocing and it was hellish, and people came to know me as “that person who’s always fighting with the teachers” because I didn’t give a shit who you were, if you were wrong I told you and gave you twenty citations to back up my opinion, and it was just disruptive and offensive and it absolutely made me no allies.

He wasn’t wrong to get angry, to get irritated, but there are ways of expressing it that are better and more productive, but the reason I can tell that is because I’m in a better place now.

And like, he’s not the only one. My best medical school friend had a prolonged breakdown from last year until very recently, and it manifested as panic attacks and fainting spells and she would literally tell me “I have to get fresh air” and leave me alone in the emergency room with 20 patients because she just couldn’t handle it anymore, and I hated her a little bit for it, not gonna lie, she abandoned me when I really fucking needed someone to help me over and over and over, even in the middle of a goddamn surgery once, but I understood, I got it, and she got help and she’s better now, and she’s an impeccable doctor, whipsmart and attentive, I’d consult her anyday.

And like, this guy’s girlfriend has lately been complaining about nonspecific abdominal symptoms, and she keeps wanting to find a medical explanation for it, but I know it’s psychological, because she’s dealing with the same stress we’re all under PLUS her boyfriend is going absolutely nuts and in a violent way, it’s not the first time he yells at people when he’s frustrated, it’s just the first time he did it to people high enough and emotionally alien enough to him to report the shit out of him for it, and she’s his onlly emotional support, he’s the kind of boyfriend who would say “if you leave me I’ll kill myself”, so good luck with that sort of insane pressure, even if you have enough money to pay for your own transportation and food without difficulties like some other people have.

Another friend keeps sleeping in, she just can’t get up, I keep telling her put!! an alarm!! earlier!!! and she swears she does, but she says she can’t help herself from turning it off, because she “self-sabotages”, and it’s so!! fucking!!! frustrating!!!! because again, she leaves me to handle the 6:45 am handoff alone every. single. day. because she can’t get up and she arrives at 7:20 am with coffee and an apology and I gotta grit my teeth and bear it, because I GET IT, i really really do, she’s under a lot of stress and it manifests as self-sabotage, like, boy do I get it, I’ve been there, so I try to be kind and understanding and patient but. My god. I legit tune her out now whenever she starts apologizing because I’m 99.999% sick of it. And like! She’s a great doctor! Her bedside manner is A++ I admire her so much for it, and she genuinely cares for our patients, even the worst of the lot, I really wish I had her empathy (only not really because that’s where her self-destructive tendencies come from, I think). Basically, she’s a great person, just. Man. Wake the fuck up on time, PLEASE.

And this other guy, another part of our team, is a total flake, he keeps manifesting nonspecific symptoms like MY JAW HURTS I GOTTA GET MY WISDOM TEETH PULLED OUT!! one day and MY ABDOMEN HURTS I CANT COME TO WORK I THINK I HAVE APENDICITIS!!! and fucking shit like this every goddamn week it’s something new, and he’s on so many different medications for depression and anxiety and sleeping and staying awake and he’s gained easily 20 kilograms this year and I feel for him, I really do, his life is spiraling out of control and he’s clawing the walls all the way down to rock bottom, and I can see it, everyone can see it, but he’s too flakey to ever get anyone on his side, and part of me wants to tell him, buddy, take a sabbatical, but the problem is, he already took one so he can’t take another, and he’s burned me too many times and not reciprocated emotionally enough for me to reach out and help him, because I will drown right alongside him at the rate he’s going.

And then my other friend!! Whom I care about! A lot!! she’s also super empathic and kind but. SHE IS. SO GODDAMN SLOW. AT EVERYTHING. In the time it takes me to see 6 patients and write their SOAP notes she’s done one, and she’s not the sharpest tool in the box, she sometimes suggests treatments that are...not the correct ones, and so I gotta go and help her out, talk it through with her so she doesn’t heck it up, and she’s super cool about it! But!!! SO GODDAMN SLOW!!!!! PLEASE! LEARN TO BE MORE EFFICIENT!!! Even though I know it’s all a symptom of burnout, too, even I’m not cold-hearted enough to not realize it.

We’re all just. Shambling through this year, trying our best, and our best manifests in different ways when under stress, sometimes it’s just showing up to work. Sometimes it’s just managing to write the note, even if it takes you hours. Sometimes it’s asking your buddy if they can cover you so you can go cry in the bathroom for five minutes and then come back. We’re all doing our absolute best to be here and attentive and empathic, and I am really proud of everyone, but I’m also really sick of being the most sane person on the team. A selfish childish part of me is like, I WANNA HAVE MY BREAKDOWN TOO DAMNIT!! But I’m too old for it, and I’ve trained myself quite well to handle my meltdowns in efficient ways, productive ways, so I can get back on the horse quickly and in a stable manner. I’m proud of me for that too, but it does get tiring, having all parts of my team leaking anxiety and depression and stress in psychosomatic ways.

So I’m going to give in to my desire right now and have a very condensed breakdown rant and hopefully get all my high octane frustration out in one go, and then parse it out once it’s text.

For the past 10 months I’ve lived through the best and worst of people. I’ve given folks CPR to the point where their ribs break under my hands, I’ve had to fist a lady’s inverted uterus back into place in the most body horror moment of my life, I legit feared for my life when this dude going through withdrawal physically threatened me, I’ve delivered an extremely deformed baby with gastroschisis manually and their guts were spilling over my hands and though it didn’t die in my arms it died about ten minutes later in mom’s and it was sad as FUCK, I’ve had 13 12 11 and 10 year old girls delivering babies because their brother cousin uncle foster dad abused them and abortion is illegal in my stupid fucking hyper catholic state and this is a never ending cycle cause mom was 14 when they had them and on and on and on, and this other time I was the only fucking doctor at a public hospital once during an overnight shift and I had to suture this guy’s toes back on having 0 prior experience suturing ANYTHING and they fell right off the next day because I didn’t know what the FUCK I was doing and I still feel fucking awful about that, and at that same fucking hospital some IDIOT put formaldehyde in a saline solution bottle and this poor surgical nurse accidentally poured it into some poor patient’s open abdominal cavity IN FRONT OF ME and the fucking suction didn’t work because that public hospital is a piece of SHIT and that patient totally died and the resident told the family it had been something else and I WAS THERE and it was BULLSHIT, and COUNTLESS other horrible, truly horrible, absolutely horrible things, and I’ve tried to take all of that shit and learn something from it, make something good come out of so much, so much, SO MUCH awful, and I’ve patiently, patiently, patiently tried to tolerate my collegue’s breakdowns, and their eternal lateness, and the residents yelling at me, and the external doctors telling us we’re never going to be anything worthy, and I think I’ve been doing a good job of it, to be honest, at this point I feel like I’ve become this politely smiling shell of myself to survive it, because a part of me feels like I’m living in an alternate dimension where morality and ethics and laws no longer exist, because they simply do not apply anymore, someone has just taken all of that important stuff and dismissed it to be kindergarden stuff, and I gotta nod and go with it or else I’m going to be my friend saying “i need air” and leaving, or “i self sabotage like this” and sleeping in, or “i think my wisdom tooth is aching” and taking the day off or just, simply, EXPLODING at everyone until they kick me out, and like

a big part of me is MOURNING the fact that I’ve become like this, that THIS is what becoming a doctor means in my country, that THIS is the type of formation they require of us. This horrible automaton of a person, that is a symbol of so much goodness but underneath it it’s all lawless shit, it’s all under the water shit, it’s all cover everyone’s fuck ups type shit. I hate it. I hate what I’m becoming. This person that can talk about all this and kind of go “yeah, I guess it’s objectively awful, but have I told you about [this even more awful event]?” because if you play that game there’s always a worse story, there’s always lower, and lower, and LOWER.

I’ll always be glad I chose to study this career, for all it’s morphed me into something I never wished to be. Because I can wade in these muddy rotten waters and help my friends and my family navigate it, I can help strangers and underprivileged people navigate it, I can help all of them from my insider privileges, to make their experience better than it would have been without me, more efficient, more smooth, more right, correct, lawful. I can’t help everyone, and I’m human and I’ll fuck up now and again too, because I’m learning, but I know, firm in my heart, that wherever I go it will be better that I was there than if I wasn’t.

Even if it’s just because the bar is so fucking low it’s difficult not to do better, believe you me, a lot of my colleagues are so fucking burnt out that they somehow still do it worse, and I’ve seen it in external doctors as well.

I’ll take all of these horrible awful no good experiences and I’m going to do better, I’m already better, I will make people have a better experience when they are going through the worst parts of their lives. Even if I had to mess myself up a lot to survive it, I think it’s worth it to spend this one life of mine doing this. I really really do.