Well, 2016 is over. If you're to believe the mainstream media, it's been the worst year ever, and it's fairly easy to see why. With Britain voting to leave the EU and Donald Trump now President-elect of the United States, many liberal-leaning people will have found this a fairly disasterous 12 months. Even if you're a right wing Euroskeptic, there have been so many celebrity deaths that it has at times felt like a sick joke. That said, there have been many positives too. I'm not a huge sports fan, but even I think TeamGB having their most successful Olympics to date is pretty cool. Globally, carbon emissions have stalled and poverty has fallen. The tiger population has increased for the first time in a century. Hyperbole and drama may sell newspapers, but they're unlikely to reveal the full story.
For me personally, 2016 has been a pretty successful year. I (finally) passed my membership exams, started working at registrar level, graduated from my MSc and moved in with my boyfriend - can't complain at that! Of course, some things haven't gone quite so well. I didn't record my resolutions last year, but no doubt they'll have included weight loss, which hasn't happened to any significant level, and increased exercise, which has happened on occasion but hasn't really been sustained. Nonetheless, on the whole, it's not been a bad year for me.
So, will I be making resolutions this year? It's difficult not to, but it seems silly making the same ones I've made (without much success, obviously), year on year for over a decade. Whilst I'd love to be slimmer and fitter, they're relatively superficial goals. Instead, I'm going to set myself some other challenges:
- I am someone who looks after other people, both in my work as a doctor and at home when I like to feed and generally "mother" my friends and family, however I'm pretty bad at looking after myself. Therefore, I am going to try much harder with self care this year. There are lots of little things I can do, but mostly it's about remembering that I'm actually worthy of being looked after.
- I tend to be quite a negative thinker. I assume the worst in most situations, and almost always assume that I have done the wrong thing, annoyed people and am generally a terrible human. Linked in with my self care resolution, I'm going to try to think more positively, particularly about myself. There are plenty of things I'm probably good at, and believing in myself doesn't make me a dreadful person.
- I compulsively apologise for everything - sometimes I even say sorry when I'm not sure what I'm sorry for. It's silly and to be honest, probably quite annoying that I basically apologise for existing. So, I'm going to stop saying sorry unless it's actually warranted.
As I've stated on many occasions before, I've struggled with my mood for a long time, and I'm hoping that these resolutions will help with that. We live in a world where we are constantly shown how well everyone is doing. One of the lovely things about social media is that we are able the share our friends' good news and happy occasions quickly. Engagements, weddings, graduations, pregnancies, holidays and nights out are all photographed and shared within minutes. It's therefore easy to believe that everyone else is living a perfect life whilst we're barely holding it together. To borrow an excellent quote from a friend's daughter, the problem here is comparing our friends' "highlights" with our own "outtakes". So the next time I scroll through facebook and feel miserable that everyone else is partying, holidaying, succeeding and being perfect, I need to remember that my own profile looks just the same. Anyway, there's nothing wrong with watching Netflix in your onesie with a cup of tea - it just doesn't make a great photo!
Showing posts with label Mental Health. Show all posts
Showing posts with label Mental Health. Show all posts
Sunday, 1 January 2017
Thursday, 27 October 2016
You're So F*ckin' Special, I Wish I Was Special...
I once heard a friend of mine, frustrated with a mutual acquaintance, utter the words "he always has to be special!" Said acquaintance, this friend felt, was never satisfied with being "normal", he must be "special". I remember it well, because I realised when she said it how easily she could have been talking about me. I don't know this particular acquaintance well enough to know whether his reasons for needing to be "special" are the same as mine, but the comment on it made me think about myself and the way other people may perceive me.
Let me clarify. I don't like being "average". Getting a "satisfactory" rating on an assessment upsets me. It's not because I think I'm better than that - I don't. In fact, it's quite the reverse. I inexplicably consider myself to be absolutely rubbish. I feel like most people start out at neutral and I'm already minus 50. If I'm not special, above average, exceeding expectations in some areas, then I don't even out at "ok".
One of the odd things about low self esteem is that, to the casual observer, it can look remarkably like arrogance. A frustration with others not doing things I can do looks like a stuck up "why can't everyone be as good as me?!", when in reality it's more like "it can't be difficult if I can do it!", much like disappointment at an "average" rating might suggest I think of myself as better than that, rather than worse. Unfortunately, hearing yourself described as overconfident or arrogant only serves to reinforce the belief that everyone thinks you're rubbish, making you more likely to do/say the things which get you labelled as arrogant. I guess in medicine, we'd call it a positive feedback mechanism, although ironically it's fuelled by negative feedback.
Another odd thing about low self esteem is that, after a while, it becomes so ingrained that you don't even consciously think about it any more. On being asked "how did that go?", you instantly reply "dreadful", even though it may not have been that bad. You're no longer capable of seeing yourself in any way other than crap at everything. A boss of mine once told me to "stop with the self deprecation, it's boring". Naturally, this was a sign that, on top of all my other flaws, I bored people around me too. When said boss later said I was "demonstrably not crap", all I could think was "but you said I was boring". The lower your self esteem gets, the more you cling on to negative feedback as gospel and reject anything positive as either "trying to be nice" or "they don't know the *real* me" (see earlier blog on imposter syndrome).
This blog seems to go round in circles sometimes. I started off thinking I had something useful to say, and now I'm not sure I do. Perhaps just the writing is therapeutic. Either way, I'm sorry I insist on being special. I'd be delighted with normal, if only I felt it were genuinely true.
Let me clarify. I don't like being "average". Getting a "satisfactory" rating on an assessment upsets me. It's not because I think I'm better than that - I don't. In fact, it's quite the reverse. I inexplicably consider myself to be absolutely rubbish. I feel like most people start out at neutral and I'm already minus 50. If I'm not special, above average, exceeding expectations in some areas, then I don't even out at "ok".
One of the odd things about low self esteem is that, to the casual observer, it can look remarkably like arrogance. A frustration with others not doing things I can do looks like a stuck up "why can't everyone be as good as me?!", when in reality it's more like "it can't be difficult if I can do it!", much like disappointment at an "average" rating might suggest I think of myself as better than that, rather than worse. Unfortunately, hearing yourself described as overconfident or arrogant only serves to reinforce the belief that everyone thinks you're rubbish, making you more likely to do/say the things which get you labelled as arrogant. I guess in medicine, we'd call it a positive feedback mechanism, although ironically it's fuelled by negative feedback.
Another odd thing about low self esteem is that, after a while, it becomes so ingrained that you don't even consciously think about it any more. On being asked "how did that go?", you instantly reply "dreadful", even though it may not have been that bad. You're no longer capable of seeing yourself in any way other than crap at everything. A boss of mine once told me to "stop with the self deprecation, it's boring". Naturally, this was a sign that, on top of all my other flaws, I bored people around me too. When said boss later said I was "demonstrably not crap", all I could think was "but you said I was boring". The lower your self esteem gets, the more you cling on to negative feedback as gospel and reject anything positive as either "trying to be nice" or "they don't know the *real* me" (see earlier blog on imposter syndrome).
This blog seems to go round in circles sometimes. I started off thinking I had something useful to say, and now I'm not sure I do. Perhaps just the writing is therapeutic. Either way, I'm sorry I insist on being special. I'd be delighted with normal, if only I felt it were genuinely true.
Monday, 10 October 2016
World Mental Health Day
Today, 10th October, is apparently World Mental Health Day. The World Health Organisation apparently endorse this, and I guess it's one of campaigns aiming to raise awareness of mental health and illness globally.
I always find the concept of a topic as vast as mental health being squashed together in one day a little odd, but although there are a vast number of mental health issues which are lumped together under one heading, they do have something in common and I can't criticise anything aiming to improve people's awareness of such a common and yet seldom discussed group of problems.
Any regular readers of my blog will be aware that my own mental health issues are longstanding so I can't pretend I don't have a personal stake in this. For that reason, I always feel slightly guilty pushing the mental health agenda. However, it's an important issue that will affect 1 in 4 of us (I think that's probably a conservative estimate) so I won't avoid talking about it.
My first experiences with mental health problems were back when I was a teenager. The support I received was less than ideal, my parents and school didn't really understand what was happening or how best to help me and even the professionals I encountered seemed out of their depth. A lot of my experiences were covered in this pseudo-anonymous post, which I initially wrote as a presentation to give at work. It's now nearly 15 years since that first consultation in that dreadful old building and I still remember it vividly. I can't ever change that, but I hope that when I meet young people in my professional life who are struggling, they remember their encounter with healthcare in a more positive way - someone cared, someone listened.
Unfortunately, it's not just a teenage problem. Although it's pretty common for mental health difficulties to begin in adolescence, they frequently persist into adulthood. Mine certainly have. Despite my struggles, though, I'm doing ok. I'm in a stable relationship. I'm holding down a (fairly intense at times!) job. Not everyone is so lucky. Mental illness is one of the most common reasons for claiming incapacity benefit. Plenty of people struggle and suffer, and yet stigma still persists.
Once again, my blog has become a ramble with no real direction or structure. I'm not sure it says much. But, if you're reading this and you're struggling, you aren't alone. Help is out there. And remember that just because you've been unfortunate enough to get unwell, doesn't mean you aren't awesome.
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There are a number of places you can get help should you need it. The services I've listed are free to call and open 24/7. A more comprehensive list is available through the NHS choices website, but not all services are free or open at all times.
If you're struggling today, or any day, the Samaritans are there to listen for free - call 08457 90 90 90.
Children and young people can contact ChildLine on 0800 1111 whilst adults who have concerns about a child can call the NSPCC helpline on 0808 800 5000.
If you feel in danger of hurting yourself and don't have a crisis plan, please call 999 or go to your local A&E department.
If alcohol is a problem, you can call Alcoholics Anonymous on 0845 769 7555.
If you need help with drugs, you can speak to Frank on 0800 77 66 00.
Men with any difficulties can use the online chat/email service here
If you're struggling with an eating disorder, Beat can be called on 0845 634 1414 (adults) or 0345 634 7650 (for under-25s)
I always find the concept of a topic as vast as mental health being squashed together in one day a little odd, but although there are a vast number of mental health issues which are lumped together under one heading, they do have something in common and I can't criticise anything aiming to improve people's awareness of such a common and yet seldom discussed group of problems.
Any regular readers of my blog will be aware that my own mental health issues are longstanding so I can't pretend I don't have a personal stake in this. For that reason, I always feel slightly guilty pushing the mental health agenda. However, it's an important issue that will affect 1 in 4 of us (I think that's probably a conservative estimate) so I won't avoid talking about it.
My first experiences with mental health problems were back when I was a teenager. The support I received was less than ideal, my parents and school didn't really understand what was happening or how best to help me and even the professionals I encountered seemed out of their depth. A lot of my experiences were covered in this pseudo-anonymous post, which I initially wrote as a presentation to give at work. It's now nearly 15 years since that first consultation in that dreadful old building and I still remember it vividly. I can't ever change that, but I hope that when I meet young people in my professional life who are struggling, they remember their encounter with healthcare in a more positive way - someone cared, someone listened.
Unfortunately, it's not just a teenage problem. Although it's pretty common for mental health difficulties to begin in adolescence, they frequently persist into adulthood. Mine certainly have. Despite my struggles, though, I'm doing ok. I'm in a stable relationship. I'm holding down a (fairly intense at times!) job. Not everyone is so lucky. Mental illness is one of the most common reasons for claiming incapacity benefit. Plenty of people struggle and suffer, and yet stigma still persists.
Once again, my blog has become a ramble with no real direction or structure. I'm not sure it says much. But, if you're reading this and you're struggling, you aren't alone. Help is out there. And remember that just because you've been unfortunate enough to get unwell, doesn't mean you aren't awesome.
-----------------------------------------------------------------------------------------------------------------------------------------------
There are a number of places you can get help should you need it. The services I've listed are free to call and open 24/7. A more comprehensive list is available through the NHS choices website, but not all services are free or open at all times.
If you're struggling today, or any day, the Samaritans are there to listen for free - call 08457 90 90 90.
Children and young people can contact ChildLine on 0800 1111 whilst adults who have concerns about a child can call the NSPCC helpline on 0808 800 5000.
If you feel in danger of hurting yourself and don't have a crisis plan, please call 999 or go to your local A&E department.
If alcohol is a problem, you can call Alcoholics Anonymous on 0845 769 7555.
If you need help with drugs, you can speak to Frank on 0800 77 66 00.
Men with any difficulties can use the online chat/email service here
If you're struggling with an eating disorder, Beat can be called on 0845 634 1414 (adults) or 0345 634 7650 (for under-25s)
Sunday, 1 November 2015
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.
Monday, 6 July 2015
Survival Tips For Medical Students
Tonight I noticed a tweet asking for top self-care tips for medical students, and (unsurprisingly) I felt I had too much to say to fit it into 140 characters, so I thought it might be worth a blogpost. Being a medical student is an amazing experience, but it can also be incredibly difficult for lots of reasons. This post isn't supposed to be in any way comprehensive. I'm not an expert, by any stretch. This is just a collection of suggestions and ideas based upon my own experiences and those of people I know.
Work hard.
Medicine is hard work. Most of it isn't intellectually particularly stretching, but there's a vast amount of stuff to learn and the majority of people will have to do a reasonable amount of work to keep on top of it. I'm not advocating becoming a hermit, but going to most of your lectures, showing up on the wards and keeping up with reading will mean exam season is far less stressful. If you have to actually learn everything from scratch, rather than just revise it, you'll be giving yourself a far more difficult task than is necessary.
Play hard.
It's also important to make the most of being a student. Go to toga parties. Play pub golf. Go clubbing whilst dressed as a giant chocolate bar or do garlic and chili body shots from the Med Soc president. Or don't, if you'd rather not. But don't feel like doing an academically demanding degree means you have to miss out on the student experience. A boss of mine once said "you can resit an exam, but you can't resit a party". I'm not sure that's the most sensible advice, but find a balance that makes you happy. Whether it's partying, music/sports/drama societies, volunteering or just reading novels and watching trashy TV, doing fun stuff is important. Keeping up with friends and enjoying yourself is an essential way of dealing with the stress you will feel from time to time. Speaking of friends, they're really important. Make sure you keep up with those outside of your course, too. Non-medics are brilliant for allowing you to properly relax and giving you a sense of perspective (medic friends are great and can relate to a lot of what you've experienced, but have an awful habit of talking shop so you don't truly escape medicine around them).
But don't forget to sleep.
Seriously, sleep is really important. When you're trying to balance partying and studying, sleep can seem like something you don't have time for, but it's essential. Everything seems worse when you haven't been sleeping well. As a medical student, you've embarked on a pretty awesome journey, but you need to be on top of your game to make the most of it.
Eat well.
OK, so it's boring, but it's another essential. If you're spending long days in lectures and then going out drinking, it can be tempting to sustain yourself on Pot Noodles and Red Bull, but there's no way you'll be at your best if you aren't getting a decent amount of vitamins, minerals, fibre etc. Sorry guys, your Mum is right about this one.
Exercise.
Similar to the above, exercise is useful for both keeping you physically at your peak and helping beat stress. As a naturally lazy person who would rather exercise by lifting a spoon from ice cream tub to mouth than go anywhere near a gym, I totally get that this is not top of some people's agendas, but it's amazing how much more energy you have after a swim or run. Even a brisk walk around the block is better than nothing.
Cry.
Sometimes you will see things that really resonate with you and upset you. This is absolutely OK. Allow yourself to be upset. Talk to a friend. Have a cry. I still get upset about cases from years ago (such as this one), Remember that if there ever comes a time when sad things don't bother you in the slightest, you probably want to think about a change of career.
Take a break.
OK, so this might go a little against what I said earlier about working hard, but it's important. Sometimes, things will get on top of you (see previous point). You might be unwell. You will have stressors in your life outside of medicine. If you're struggling, give yourself permission to take a sick day. There's no point dragging yourself in when you aren't going to be properly concentrating. Doctors are absolutely terrible for going into work when they're unwell. It does noone any favours. Learn now to spot when you aren't well and sort it out early. Even if you're cruising along fine, don't spend more time working than you have to. If your registrar says you can leave early, do. Don't spend the holidays in the library. Having time off is vital to your emotional and physical well being.
Don't let the b*st*rds grind you down.
There are horrible people everywhere. Some of them will be in your year, some will be your seniors, some will be non-medical colleagues. Giving you a dressing down if you're rude or you really don't know your stuff is fine, but nobody should be bullying you. If they are, report it. Snide remarks, sniggering behind your back, deliberately telling you lies about teaching sessions or criticising your appearance or personality is not acceptable. People who do this are, frankly, arseholes. They're probably covering up their own insecurities by pointing out yours. They may well be jealous of how awesome you are. Either way, it's not cool. Don't let it get to you. (But if you're actually being bullied, tell someone. There is help to stop this kind of thing from happening.)
Be the best you you can, not a second-rate someone else.
This is more general life advice I suppose, but in medical school where you're surrounded by brilliant people it's easy to constantly compare yourself to other people. Try not to. The people who may seem the best at uni are not necessarily the ones who make the best doctors. Focus on your weaknesses, by all means, and work on improving them, but don't assume that anyone who really understands the kidneys or can do a super-slick neuro exam is better than you at everything. Maybe you have a really lovely manner with confused old ladies or perhaps you know intricate details of the coagulation cascade. Whatever it is, you'll have something you're awesome at too. Remember what it is you do well, feel proud of it, and work on improving other stuff so that you become the best doctor you can be, not so that you can beat someone else in an exam.
That's a very brief run-down, but those would be my top "survival" tips. Most of all, remember to enjoy it. You're on your way to doing the best job in the world, and you're going to be awesome at it.
Work hard.
Medicine is hard work. Most of it isn't intellectually particularly stretching, but there's a vast amount of stuff to learn and the majority of people will have to do a reasonable amount of work to keep on top of it. I'm not advocating becoming a hermit, but going to most of your lectures, showing up on the wards and keeping up with reading will mean exam season is far less stressful. If you have to actually learn everything from scratch, rather than just revise it, you'll be giving yourself a far more difficult task than is necessary.
Play hard.
It's also important to make the most of being a student. Go to toga parties. Play pub golf. Go clubbing whilst dressed as a giant chocolate bar or do garlic and chili body shots from the Med Soc president. Or don't, if you'd rather not. But don't feel like doing an academically demanding degree means you have to miss out on the student experience. A boss of mine once said "you can resit an exam, but you can't resit a party". I'm not sure that's the most sensible advice, but find a balance that makes you happy. Whether it's partying, music/sports/drama societies, volunteering or just reading novels and watching trashy TV, doing fun stuff is important. Keeping up with friends and enjoying yourself is an essential way of dealing with the stress you will feel from time to time. Speaking of friends, they're really important. Make sure you keep up with those outside of your course, too. Non-medics are brilliant for allowing you to properly relax and giving you a sense of perspective (medic friends are great and can relate to a lot of what you've experienced, but have an awful habit of talking shop so you don't truly escape medicine around them).
But don't forget to sleep.
Seriously, sleep is really important. When you're trying to balance partying and studying, sleep can seem like something you don't have time for, but it's essential. Everything seems worse when you haven't been sleeping well. As a medical student, you've embarked on a pretty awesome journey, but you need to be on top of your game to make the most of it.
Eat well.
OK, so it's boring, but it's another essential. If you're spending long days in lectures and then going out drinking, it can be tempting to sustain yourself on Pot Noodles and Red Bull, but there's no way you'll be at your best if you aren't getting a decent amount of vitamins, minerals, fibre etc. Sorry guys, your Mum is right about this one.
Exercise.
Similar to the above, exercise is useful for both keeping you physically at your peak and helping beat stress. As a naturally lazy person who would rather exercise by lifting a spoon from ice cream tub to mouth than go anywhere near a gym, I totally get that this is not top of some people's agendas, but it's amazing how much more energy you have after a swim or run. Even a brisk walk around the block is better than nothing.
Cry.
Sometimes you will see things that really resonate with you and upset you. This is absolutely OK. Allow yourself to be upset. Talk to a friend. Have a cry. I still get upset about cases from years ago (such as this one), Remember that if there ever comes a time when sad things don't bother you in the slightest, you probably want to think about a change of career.
Take a break.
OK, so this might go a little against what I said earlier about working hard, but it's important. Sometimes, things will get on top of you (see previous point). You might be unwell. You will have stressors in your life outside of medicine. If you're struggling, give yourself permission to take a sick day. There's no point dragging yourself in when you aren't going to be properly concentrating. Doctors are absolutely terrible for going into work when they're unwell. It does noone any favours. Learn now to spot when you aren't well and sort it out early. Even if you're cruising along fine, don't spend more time working than you have to. If your registrar says you can leave early, do. Don't spend the holidays in the library. Having time off is vital to your emotional and physical well being.
Don't let the b*st*rds grind you down.
There are horrible people everywhere. Some of them will be in your year, some will be your seniors, some will be non-medical colleagues. Giving you a dressing down if you're rude or you really don't know your stuff is fine, but nobody should be bullying you. If they are, report it. Snide remarks, sniggering behind your back, deliberately telling you lies about teaching sessions or criticising your appearance or personality is not acceptable. People who do this are, frankly, arseholes. They're probably covering up their own insecurities by pointing out yours. They may well be jealous of how awesome you are. Either way, it's not cool. Don't let it get to you. (But if you're actually being bullied, tell someone. There is help to stop this kind of thing from happening.)
Be the best you you can, not a second-rate someone else.
This is more general life advice I suppose, but in medical school where you're surrounded by brilliant people it's easy to constantly compare yourself to other people. Try not to. The people who may seem the best at uni are not necessarily the ones who make the best doctors. Focus on your weaknesses, by all means, and work on improving them, but don't assume that anyone who really understands the kidneys or can do a super-slick neuro exam is better than you at everything. Maybe you have a really lovely manner with confused old ladies or perhaps you know intricate details of the coagulation cascade. Whatever it is, you'll have something you're awesome at too. Remember what it is you do well, feel proud of it, and work on improving other stuff so that you become the best doctor you can be, not so that you can beat someone else in an exam.
That's a very brief run-down, but those would be my top "survival" tips. Most of all, remember to enjoy it. You're on your way to doing the best job in the world, and you're going to be awesome at it.
Saturday, 18 April 2015
Skinny Minnies
I've blogged in the past about eating disorders, both my own experiences and my thoughts as a doctor. I don't claim to be an expert at all, but from a combination of personal experiences, talking to friends and acquaintances who have had similar difficulties and encountering many patients with eating disorders at work, I've built up my own ideas about eating disorders and have also tried to read around the area to expand my understanding.
I make no apology for the fact that the forthcoming post may be a bit angry and ranty. I'm cross, and it was my annoyance and crossness which lead me to write. On reading it, I also appear to have used an awful lot of brackets. For that, you can have a bit of an apology I suppose (but only a bit).
A few days ago, I was casually scrolling through my timeline on a well-known social media site, when I saw a post which an acquaintance of mine had apparently showed some kind of appreciation for. The headline was "These 12 Anorexic Girls Look Stunning After Beating Their Condition". This annoys me for several reasons. Firstly, "desperately sick people look much better when they aren't ill anymore" is stating the obvious and is yet another reflection of (modern? Or has humankind always been so inclined?) society's obsession with appearance. Secondly, and more importantly, it demonstrates and perpetuates a deep and serious misunderstanding of what eating disorders are. Pictures of terribly sick, skeletally thin young women next to pictures of them looking healthier with captions like "no woman should ever be as thin as she was in the first picture, she looks much better with some weight on her" show just how flawed a perception many people have of eating disorders. I also find the use of the term "beating" to describe recovering from an illness unhelpful, but I'll elaborate on that in a separate post.
Would people write an article entitled "This Girl Who Had Cancer Looks Great Now She's Off Chemo"? How about "Man With End-Stage Liver Disease Looks Gorgeous Post Transplant"? Or "Check Out How Fit These Ladies Are Now They're No Longer In ICU With Overwhelming Sepsis"? I like to think not, unless the people in question were celebrities, in which case no doubt the first thing we're supposed to noticed when someone's been incredibly ill is whether their weight has changed or if they've got the energy to still do their hair nicely. But I digress.
What upset me most about this articles was that it perpetuates the myth that eating disorders are solely about how people look. The premise of the article appears to be "overly skinny is not hot". Now, whilst I have no problem with promoting a range of body shapes as attractive (although frankly I do wish we could all shut up about appearance), the suggestion that people (not just girls - they affect both genders and all ages) with eating disorders are driven purely by a desire to be as thin as possible is just wrong. Eating disorders are complex. Patients with eating disorders are diverse. Trying to suggest that all eating disorders occur because a person wants to be skinny is as wrong and as damaging as suggesting that all cancers are caused by excessive alcohol intake - both illnesses occur due to a variety of factors. In some cases, one of those factors may be a desire for thinness/excessive alcohol consumption, but this is only one of a number of elements which co-exist and allow the disease to develop. In some patients, this factor will be completely absent.
Now feels like a good opportunity to link to a post my lovely friend Jo wrote about her experiences of an eating disorder. Another helpful post is this one, from the website of Mind - a mental health charity. Their website has some useful information on eating disorders which may help anyone who either has an eating disorder or is supporting a friend or family member with one. As all these links stress, eating disorders are often about control and dealing with difficult situations and not just a vain desire to look thin.
This blog is explicitly about eating disorders, but more generally it's about the lack of parity of esteem between "physical" and "mental" health conditions. I use the inverted commas because personally I believe the terms create a false dichotomy. Physical conditions may well be worsened by emotions - we all know people who get more migraines when the pressure piles up, and there's now evidence that adverse events during childhood may play a role in the development of diabetes. The way our feelings and emotions affect our health is something we are only just beginning to understand. In the meantime, if we could all aim to be a bit more understanding and not jump to conclusions about people just because they have a particular diagnosis, the world may well be a brighter place. And if you're writing a headline about a "mental" illness, think about how it would look if you replaced it with a "physical" one. If it sounds voyeuristic, shocking or offensive, chances are you're best not using it.
P.S. I googled "These 12 Girls With Cancer Look Stunning After Beating Their Condition". Surprisingly, noone's written that article.
I make no apology for the fact that the forthcoming post may be a bit angry and ranty. I'm cross, and it was my annoyance and crossness which lead me to write. On reading it, I also appear to have used an awful lot of brackets. For that, you can have a bit of an apology I suppose (but only a bit).
A few days ago, I was casually scrolling through my timeline on a well-known social media site, when I saw a post which an acquaintance of mine had apparently showed some kind of appreciation for. The headline was "These 12 Anorexic Girls Look Stunning After Beating Their Condition". This annoys me for several reasons. Firstly, "desperately sick people look much better when they aren't ill anymore" is stating the obvious and is yet another reflection of (modern? Or has humankind always been so inclined?) society's obsession with appearance. Secondly, and more importantly, it demonstrates and perpetuates a deep and serious misunderstanding of what eating disorders are. Pictures of terribly sick, skeletally thin young women next to pictures of them looking healthier with captions like "no woman should ever be as thin as she was in the first picture, she looks much better with some weight on her" show just how flawed a perception many people have of eating disorders. I also find the use of the term "beating" to describe recovering from an illness unhelpful, but I'll elaborate on that in a separate post.
Would people write an article entitled "This Girl Who Had Cancer Looks Great Now She's Off Chemo"? How about "Man With End-Stage Liver Disease Looks Gorgeous Post Transplant"? Or "Check Out How Fit These Ladies Are Now They're No Longer In ICU With Overwhelming Sepsis"? I like to think not, unless the people in question were celebrities, in which case no doubt the first thing we're supposed to noticed when someone's been incredibly ill is whether their weight has changed or if they've got the energy to still do their hair nicely. But I digress.
What upset me most about this articles was that it perpetuates the myth that eating disorders are solely about how people look. The premise of the article appears to be "overly skinny is not hot". Now, whilst I have no problem with promoting a range of body shapes as attractive (although frankly I do wish we could all shut up about appearance), the suggestion that people (not just girls - they affect both genders and all ages) with eating disorders are driven purely by a desire to be as thin as possible is just wrong. Eating disorders are complex. Patients with eating disorders are diverse. Trying to suggest that all eating disorders occur because a person wants to be skinny is as wrong and as damaging as suggesting that all cancers are caused by excessive alcohol intake - both illnesses occur due to a variety of factors. In some cases, one of those factors may be a desire for thinness/excessive alcohol consumption, but this is only one of a number of elements which co-exist and allow the disease to develop. In some patients, this factor will be completely absent.
Now feels like a good opportunity to link to a post my lovely friend Jo wrote about her experiences of an eating disorder. Another helpful post is this one, from the website of Mind - a mental health charity. Their website has some useful information on eating disorders which may help anyone who either has an eating disorder or is supporting a friend or family member with one. As all these links stress, eating disorders are often about control and dealing with difficult situations and not just a vain desire to look thin.
This blog is explicitly about eating disorders, but more generally it's about the lack of parity of esteem between "physical" and "mental" health conditions. I use the inverted commas because personally I believe the terms create a false dichotomy. Physical conditions may well be worsened by emotions - we all know people who get more migraines when the pressure piles up, and there's now evidence that adverse events during childhood may play a role in the development of diabetes. The way our feelings and emotions affect our health is something we are only just beginning to understand. In the meantime, if we could all aim to be a bit more understanding and not jump to conclusions about people just because they have a particular diagnosis, the world may well be a brighter place. And if you're writing a headline about a "mental" illness, think about how it would look if you replaced it with a "physical" one. If it sounds voyeuristic, shocking or offensive, chances are you're best not using it.
P.S. I googled "These 12 Girls With Cancer Look Stunning After Beating Their Condition". Surprisingly, noone's written that article.
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