Being human

Recently I looked after a mental health patient. They were admitted to our ward after having been assessed by the out of hours mental health worker and were waiting for a formal review by the psychiatric team. This happens uncomfortably often on the paediatric ward and really highlights the rise in mental health problems in young people.

As a medical doctor, I saw this young person on the paeds ward round that morning. This was a teenager, a child who was so distressed, terrified and overwhelmed by their own thoughts. Their face was emotionless, yet their eyes full of sadness and fear. The room was silent. The curtains still drawn.

In that moment, I saw the fifteen year old me staring up from under the covers. Exhausted. Vulnerable. Hurting.

I knelt down by the side of the bed and listened. As the patient talked I moved closer. I held their hand. I stayed there.

Some would say this was not in my remit as a medic. After all, I had been told to “go in, say a quick hello and make sure they were medically fit before psych come”. But in that moment, there was no way I was leaving.

So I stayed and I did and said all the things I wish the professionals had said to me the first night I was in hospital at that age. And once the young person felt safer, only then did I leave.

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As soon as I had closed the door, the emotions were overwhelming. Tears poured down my cheeks as I ran towards the doctors’ office. The junior trainee followed me in, sensitively checking I was OK.

I have been pretty honest about my struggles at work- people know that I have had serious mental health problems and talking has helped break down the stigma. As I sat crying, the two junior trainees with me were incredible. I told them my story. I told them about my admission aged 15 to a psychiatric hospital. I told them I had been suicidal. I told them I had had anorexia… And they listened.

They listened without judging as I explained that I had wanted to open up to the patient. I had wanted to expose my vulnerability and highlight that mental illness is all around us; that they truly weren’t alone. But it seemed wrong; as though I would have been crossing an invisible line between doctor and patient; as though it was a deeply unprofessional thing to do.

My colleagues told me otherwise. They empowered me, they believed in me and they encouraged me to do what felt right.

So later that morning I popped back to the young patient’s cubicle. I knocked, went in and sat on the edge of the bed. I asked permission to tell them something personal that I had never told a patient before but I thought it was important for them to know. They looked confused but agreed.

And so I did it. I explained to the child that at the same age, I had been depressed, I had thought about ending my life and that mental illness is all around us, we just don’t know about it. They were not alone. There was hope that things could be different.

As I stood to leave, the patient whispered

“Please can I have a hug?”

That hug will be one I carry with me forever.

 

My journey back into medicine

May 2018

I sat sobbing. Unable to see through my tears, I pulled over. My body was shaking. It was early afternoon.

The ward had been exactly as I remembered, yet the familiar surroundings had failed to comfort my growing anxiety. The smiling faces of people I knew were scattered among a sea of others I didn’t recognise. And all I could notice were repetitive, circular thoughts persistently interrupting me.

What do I say? How do I justify my long absence? What words should I use? What will they think?

 

July 2018

“Come in, take a seat” I chirped, as I ushered him into the clinic room with his parents. We talked, we laughed. I examined him, formulated some kind of a plan and then sent him on his way for a few months. As he left I sighed. The smile slid from my face. Behind the closed door the exhaustion crumpled me once again. I typed my notes staring blankly at the screen.

I took a deep breath and stood to call the next patient.

“Come in, take a seat” I chirped.

Again and again.

 

August 2018

The child must have been about 7. He was a funny kid, good at football. There was nothing particularly exciting about the consultation but as he left I realised that my smile was no longer as forced. Elements of that interaction that had felt real.

There was feeling where before there had been none.

 

September 2018

There was a boy on the ward. He was sick; I mean properly sick. I had done what needed to be done from a medical point of view. But this wasn’t about medicine. This was about a poor family, whose life was about to be changed forever.

As I drove home that day, I wished I could have done more, said more. Been there.

 

November 2018

I was called urgently by one of the nurses. I followed her into the cubicle. Anxious parents hovered over a cot. The baby was listless, skin as white as the sheet upon which she lay. She was sick.

I knew what to do. I did it; almost automatically.

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A lot happens in six months.

From panic attacks at the thought of being on the ward, to leading a resus situation; yes, in many ways I have done it. I have got back to medicine from a place where I thought I could never return.

I am a different doctor now: one who knows their limits, who understands when to slow down and how to ask for help. I am a doctor who accepts their vulnerability.

That said, I still don’t know how I really feel about it all. Somehow the love and enthusiasm that I had in abundance are still not there. Instead, medicine feels somewhat unfulfilling. I leave work wanting more of the things that fall outside of my role. The care, the compassion, the psychological support, the following up and checking in. The being there.

Perhaps it is time for me to think about other options; because yes, I now realise I CAN be a doctor with mental health problems, but the question is, do I WANT to be?