One I prepared earlier

I've been neglecting this blog. 

I write a column in a medical newspaper every couple of months, and that absorbs my writing energy. So I am going to double-job, and post my most recent column here, to keep you distracted until I get some time to write something else.

(First published in the Medical Independent on 20th May 2021)

Today I “attended” the IMO AGM, by which I mean it was transmitting from my laptop while I pottered about tidying up after breakfast, reorganising the knives in the dishwasher, and putting on the fifth load of laundry. I glanced at the screen occasionally to watch the wonderful new President Dr Ina Kelly and her colleagues deliver their speeches. The CEO, Susan Clyne, began to present the findings from a recent survey about doctor’s wellbeing. She told us that 70% of the doctors who took the time to participate in the survey showed signs of burnout. I stopped moving the plastic plates from the bottom shelf to the top one, and looked up. 66% of GPs had been unable to take time off due to difficulty finding locums. 85% of doctors had 9+ hours added to their working week during covid times. 87% had to cover out-of-hours shifts on top of that.

What the actual fork.  

I abandoned the Weetabix-encrusted bowls and sat in front of the screen, head in hands. Of course I knew all of this to be true. Of course. But I thought about my friends and colleagues, my daily contacts and the faceless names on the hospital letters, and I thought about the pain and hurt in each of their hearts. 

Later on in the day, a panel discussed the mental health issues that covid has triggered in the general population, and in doctors. I asked what is the main barrier which prevents doctors from seeking help for mental distress, and the answer from Dr Íde Delargy was “stigma”. We are too ashamed to say we are struggling. 

I have suffered from anxiety since I was a teenager. My first panic attack happened on the way home from Mór Disco one night in First Med. I lost my shit, as they say, but put it down to the €2 Tequila Sunrises. In fact I was scared, and worried and uncertain, and it manifested in physical symptoms of dyspnoea, tachycardia and headrush. I had subsequent panic attacks in my sleep which frightened the bejaysis out of me. 

It wasn’t until I had a miscarriage in my late 20s that I decided to proactively seek some help for my anxiety symptoms. I looked up the Health in Practice Programme page on the ICGP website and found a therapist who worked nearby. Her house had a red door. I sat on the chair and cried. Occasionally I sobbed, and the breathlessness and heart pounding was exactly the same sensation I had felt during the panic attacks. 

I had another miscarriage and it happened again. I went back to the Red Door. 

When I was diagnosed with advanced cancer it was easier. You’re supposed to lose the nut then. I went to ARC House and sat on the couch, and sobbed. A huge lump of fear gathered at my throat and stopped my words from coming out. The kind lady didn’t mind. She waited. And then the words came. 

There was a Milligan-esque relief in these counselling sessions – “I told you I was ill”. It was as if my once-silly fears were now legitimised and I had Real Problems to talk about. And yet it wasn’t the imminent death that worried me. It was still the niggling doubts about my social interactions, the internal struggles with my personality foibles, the guilt and doubt about previous behaviours. The desire to be a better person in my dying years, clashing with the fundamental truth that sometimes I am simply mean. 

I had a month or two of very low mood after I completed a shedload of chemotherapy. I have developed a number of tricks for combatting anxiety, but I was totally caught short when it came to dealing with depression. It was terrifying, but thankfully it lifted. I attended a Mindfulness-Based Stress Reduction course for people with advanced cancer, which helped. I needed to move away from cancer, though, so I haven’t gone back to ARC House for therapy. The Red Door has been painted blue by its new owners. My wonderful GP has died, but I am building a relationship with my new one. I try to cultivate my self-awareness, and keep track of the ups and downs of my mental wellbeing. 

I am never ashamed to say that I don’t feel mentally well, or that I am having an off day. I make myself do the right thing when it comes to going to my GP for bloods and prescriptions (a massive 40% of doctors who completed the IMO survey said they had no GP). I try to talk to other doctors about looking after themselves. What I really want though is for us all to be able to say, without shame, “I don’t feel well”. 

Challenges

The theme for this year’s International Women’s Day is #ChooseToChallenge. The idea is that you stand in a commitment pose, holding your right hand up like you are taking a pledge (or acting in a low-rate courtroom drama) and vow to stand up for or against something that will enhance gender equity in our society. You could Choose to Challenge domestic violence, for example, or the kidnapping of girls, or the trafficking of female children for sex work. 

Here are some of mine.

I choose to challenge the pile of laundry, that is my task to tackle simply because it has always been. 

I choose to challenge the paradox of me hating the stupid laundry, and yet feeling better and happier when it is done. 

I choose to challenge the vicious-circle-ness of me not letting anyone else do the laundry, because they will do it wrong, or late, or messily, or put the powder in the wrong slot and leave a trail of white sickly-smelling particles all over the countertop. 

I choose to challenge the goddamn pink and purple full-page advertising spread for Mothers’ Day, that suggests that a bunch of flowers and a poxy cake are exactly what every woman with children craves. Or the patronising offer of fizzy wine or branded cream liqueur, with an amusing meme of a woman hiding the drink in her teacup while homeschooling some screaming brats. Oh how we laughed at this woman who has been driven to despair and addiction! So funny!

I choose to challenge the patronising tones of the men forced to discuss women’s rights for the few days leading up to International Women’s Day, using phrases like “Just to play devil’s advocate here” so that they can rehash the same old what-about-the-menz tropes and expose their own male fragility. 

I choose to challenge the belief that women would prefer to be at home minding their children and scraping the hair out of plugholes. That they are truly blessed with part-time working and flexible hours, because it allows them to Have It All. That the ideal life balance includes repeatedly breaking up roaring matches between siblings and slicing your thumb-end off with a potato peeler. There is a much-used saying that a person on their deathbed never says “I wish I had spent more time in the office.” Well, if the alternative is days and days and days on end of vacuuming the same stupid carpet and washing the same stupid towels and putting away the same stupid plates into the same stupid drawer, then 40 hours a week in a comfy office chair with a fancy coffee machine and the ability to go to the toilet on your own sounds pretty attractive to me. 

Children are fine, like. I love them and all. Hanging out together when everyone is happy and giggling and getting on is truly lovely. Reading a story while snuggled up in bed, smelling their heads and feeling their love; that is wonderful. But let’s face it, the work involved in growing them and cleaning them and educating them is dull at best, soul-destroying at worst. And the implication that women are somehow innately better at this drudgery seems, well, convenient for the other parent.

I choose to challenge any suggestion that I am just a big whingey feminist who is ugly and smelly and who no man would want to marry anyway. 

I choose to challenge myself to stand up and say that yes, I DO prefer paid work than unpaid servitude. 

I choose to challenge the relegation of childcare and maternity leave issues to the very bottom of any political agenda. 

I choose to challenge the baffled look on society’s face when I suggest that women are treated unfairly. “But sure you’re a doctor, what are you complaining about?”

I choose to challenge clothes without pockets. 

I choose to challenge myself to calm down now and go and drink fizzy wine and eat poxy pink cake, because we all know that is really all I need. 

Treacle

Harrumph.

Sigh.

Really?

Oh right. 

It's just the same. Every day. Punxsutawney Phil and all that goes with him. 

But it's not the same, because actually each day the heart sinks a little bit lower, the brain slows down a little bit more, the shoulders slump closer to the ground. 

Eeyore would be in his element. 

Wading through treacle, as my wise colleague Gabrielle has said. Or a slurry pit, with equally risky consequences. 

The first time around we had adrenaline, claps, free chocolate bars, free live music streamed to our couches. We had warm evenings. Food delivery was a novelty. Zoom was like something out of Star Wars, for those of us who grew up in a house where the phone was locked with an actual key. We dressed up for pretend nights out. We camped in the garden for our holidays. Oh What Fun we had! It was like something out of Enid Blyton, without the weird colonial overtones and god-knows-what undertones. 

The "second lockdown" was a pathetically understated affair. My life changed not a single iota, except that we missed our chance to go to a fancy restaurant. Then came the great escape of the December opening up. What a bloody omnishambles that was. We went to the local (not fancy) restaurant and I hated every minute of it. All I could see was those goddamn spiky-ball virus particles swirling around our heads, swarming towards our mouths and noses. I ran out of there and scrubbed myself clean when we got home. Oh What Fun. 

And then the deluge of phonecalls at work. Cough. Sore throat. Headache. Sore body. Feel funny. Partner positive. Mother positive. Aunty positive. Granny positive. All 24 guests at my wedding positive. And the waiting staff. And the receptionist in the hotel. And the priest. And the lead mourner at the funeral the priest did the next day. And so on, and so on, and so on....

The covid calls began to calm down, just trickling in every other day or so. There were more of the "my heart is beating really fast in my chest and I don't know why" calls, and the "I have panic attacks on my way to work" calls, and the "my son with special needs is desperately in need of routine and support" calls.

And the homeschooling. Emergency education, someone called it, and that makes so much more sense. Teaching phonetics with dopey rhymes that I can't remember. Arguing about whether a semi-circle has corners. Having a mental awareness at all times of how lucky we are to have enough devices, enough broadband, enough heat and food in the house. Getting irritated at not being the kind of person who allows themselves to wallow in self-pity. 

And then there are the ups. Driving into my workplace with tears in my eyes because the sun is shining, there are helpful happy guards outside directing hopeful happy older people and their helpful happy relatives inside to get their first shot of the vaccine. The practice is full of chatter and laughter. The sun is streaming in. It is a beautiful day. 

They are almost no phonecalls about coughs or temperatures now. I am able to ask the person with the sore knee, or funny thing on their face, or a pain in their side, if they would like to come in to see me. They are relieved, and so am I.

Some things that I have been planning for a while are coming to fruition. Some things require fizzy bubbles to celebrate. There is hope. 

But it is still All. Quite. Hard.