A Marathon Journey

Anyone who's read this blog before will realise that I'm a fan of a metaphorical journey - the journey from schoolgirl to doctor, the journey from messed up adolescent to semi-functioning adult, that sort of thing.

Well, recently I made what may turn out to be one of the most ridiculous decisions of my life so far - I decided I'd make the journey from lazy so and so to... marathon runner. Yes, that's right, marathon runner. On 24th April 2016, all being well, I will complete the London marathon.

To give you an idea of quite how huge a journey this is going to be, I'll give you some details on my current fitness levels and running ability. In 2010 I completed a 10k run for charity in a not-at-all-impressive time of 1 hour 20 minutes. I say run, I did minimal training and walked most of it. I haven't really run since. I intermittently get the gym bug and start building up my fitness, but I have always avoided the treadmill like the plague. I even had a personal trainer for a while, but whilst we did a lot of work to build up my strength, we did very little to do with running. Our sessions were mostly "interval" training, so I'd do short bursts on the cross trainer or bike, followed by 5 reps of dead lifts or similar. In February, I started a job with over an hour's commute each way and was so exhausted I basically stopped all forms of exercise. I've been saying since August that I'd start getting fit again, but until this week I hadn't done much about it. I've downloaded a 16 week beginner's training plan, and have just over 23 weeks to train. My plan is to use the C25k programme to get me able to run for 25 minutes or so over the next 7 weeks, and then to move on the the training plan (which seems to suggest you can start with no running experience at all, but includes 20 minute runs in the first week). It's going to hurt.

So, why on earth am I putting myself through this? Firstly, because I had been thinking for a while that it was about time I did something mad to raise money for charity, and secondly, because whilst I know I need to get fit, I'm absolutely dire at doing things without a specific target in mind.

I mentioned charity, and I am hoping to get some sponsorship for this. I've decided to raise money for the fantastic CLIC Sargent. As a paediatric doctor with an interest in oncology, I'm aware of the brilliant advances in science and medicine that mean we can now cure more children than ever of cancer. We're lucky enough to live in a country where the NHS means that families don't have to pay for treatment. Whilst there's still a long way to go, the treatment of children's cancer now is getting better and better. What I also know as a hospital doctor is that hospitals can't do everything. The emotional impact of a cancer diagnosis on a child or young person is enormous. The disruption to family life is huge. Parents may not have to pay for their child's treatment, but there is often a financial burden - be this travel to and from a treatment centre or having to temporarily give up work to care for a sick child. We are getting better and better at treating the physical disease state, but hospitals can't do everything. This is where charities like CLIC Sargent come in. They do an amazing job of helping children and their families cope emotionally, be this through formal counselling or just providing activities allowing them to spend time together without worrying about hospitals. They provide grants to families who are struggling with the financial impact of a childhood cancer diagnosis. They provide free accommodations for families who live too far from their treatment centres to reasonably be expected to travel. They supply a range of information aimed at children of varying ages so that their diagnosis and treatment is explained in terms they understand. In short, the care provided in hospitals is excellent and gets better year on year, but we couldn't provide the fantastic support required by our patients and their families without the help of charities like CLIC Sargent.

My training might hurt, but each time it gets tough, I'll just remind myself that it's nothing compared to a childhood cancer diagnosis.

If you'd like to spur me on with sponsorship, please go to https://www.justgiving.com/amanda-friend/

Thank you.

I'm Not A Lousy Doctor - But I'm A Lousy Friend

If you've read this blog before, you'll probably be aware that I'm a prolific tweeter. In fact, I'd be surprised if you were reading and had come across this post via anything other than seeing me tweet about it. One of the things I love about Twitter is that it makes the world a smaller place. One of my favourite Tweeters is the lovely @dr_ashwitt; although she is as far from me as is basically possible (Melbourne, if you were wondering), I frequently read her tweets and think "oh my God, me too!". Recently, Ash re-posted a link to a post she wrote a couple of years ago about her experiences of depression. She urged other doctors to post their own 140 character experiences of mental health issues, and #MH4Docs got a fair number of tweets which Ash has collated here. I haven't actually tweeted yet, but I've been pretty vocal about my own issues over the years and it's good to see that people feel they can open up about these things. The thing that really made me think, though, was the sentence she used to link to her blog.

"I have depression, but that doesn't mean I'm not a good doctor."

I think a big part of the reason that a lot of health care professionals (and non-health care professionals, come to think of it) are reluctant to open up about mental health issues is the fear that their abilities at work will be called into question. I know that one of my major fears when I "admitted" to having depression was that people might think I was unable to do the job I love and have worked for for a long time. 

My mental health problems don't mean I'm not a good doctor. I have a need to be busy which means that I will crack on with as much work as I can, and I'll find non-essential tasks which just "need doing at some point" to keep me occupied. Focusing on other people means I'm not thinking about myself and my own emotions, so I'm unlikely to slip into a spiral of despair. My lack of self esteem and constant impostor syndrome mean I'm keen to please and make an extra effort to be friendly and polite. Work makes me feel better and I think my own issues mean I will always work as hard as I can. Possibly I'm at risk of burnout, but it's nothing I've ever felt close to, and the other hobbies I've developed to occupy myself and prevent negative thinking mean I have outlets outside of medicine.

No, depression doesn't mean I'm not a good doctor. It does mean I'm not a good friend, though. Being nice and polite to people can be frankly exhausting. After a whole day smiling and engaging in banal conversation and generally giving the impression that I'm a functional human being, I am absolutely worn out. I very rarely agree to after-work plans because I know I'll be too tired to be good company. If I've made arrangements, there's a good chance I'll flake out at the last minute because I just can't face being around people any more. Finally living alone rather than with flatmates is a Godsend because it means I can have meltdowns in the living room and kitchen rather than being restricted to my bedroom. On nights out, I'm renowned for disappearing without telling anyone after being consumed by an overwhelming wave of misery and wanting to get away before I spoil anyone else's night. As for relationships, I am probably one of the worst girlfriends out there. I take insecurity and anxiety to ridiculous levels, any compliment is analysed repeatedly to ensure it isn't actually a heavily veiled insult and "I love you" is not infrequently followed not with "I love you, too" but "..really? Do you actually though?".

So yeah, I have depression, and that doesn't mean I'm not a good doctor. But it does mean I'm not a good friend. If you've stuck around anyway, thank you. I may not say it with nights out or long conversations, I may cancel half of our arrangements and you might feel like you're walking on eggshells when we talk, but you are loved and appreciated.