Stuff and nonsense

I was riding along the river today (fairly languidly, as anyone who has rode with me will testify) enjoying Perth’s soothing scenery of water and sky, breathing deep lungfuls of air, and having a thoughtful tailwind carrying me toward my (enforced) choice of destination. If only some similar external force could give me the extra propulsion I require during the day!

I wonder how much more time I spend pining rather than dreaming. The two may seem slightly interchangeable but one represents the impossibility of recapturing the past, whereas the other represents a possibility waiting to happen. How often is it that I try and describe or articulate an intense happy memory, only to find that the descriptive details are lost and all I can recall is the thought and the emotion. So many sweet, encapsulated moments of life – beach fishing against a pink-hued sky; biting into a deliciously delicate choux pastry chocolate eclair; a warm, salty embrace; the set of gloriously house-shaking piano chords – enough to make my heart sing, but at the expense of me forever chasing the experience, and with a bitterness if the moment cannot be replicated.

How often we wish for a tailwind, only to get stuck in a headwind.

Well didn’t psychiatry turn out to be a blessing in disguise. What other specialty will allow me free weekends, 8:30 – 9am starts, weekly half-days and the occasional unscheduled 1/4 day off? Surely only general practice, where I am destined to remain as slack and unambitious as one can be in such a career.

However, when all is said and done, there is still a deep and profound frustration at myself for not being more motivated, more fearless, well, just more. I can say with a certain amount of certainty that I will always be a suboptimal doctor. That I will for most of the time, if not all, feel like a fraud.

In psych, it is becoming so plainly obvious in how I let myself project and countertransfer onto my patients. If at best I am going to be a passable healthcare provider, I should at least be passable to all the patients consistently, and not just to the ones I deem fit. The ones that suffer most in my care are the antisocials (I see them as having an inability to empathise; threatening), those ambivalent about staying on the ward (dependent), those with a distasteful forensic history eg. rapists/assaulters/paedophiles (lack of respect for fellow humans), thought-disordered (incomprehensible, suspected fraud) and the somatisers (just creating a whole lot of work). Whereas I put in the extra yard to advocate for the pleasant non-threatening ones. It’s a large mouthful of pride and prejudice (haha) to swallow when I have to, under the blanket of duty of care, put my hands on someone’s belly to gently palpate their organs when my core self screams in disgust and revulsion.

On a different note, Happy V Day to you all – I trust you all enjoyed this little paganistic ritual, and hope that no-one’s day was overshadowed by disappointment, as seems to be the default emotion, haha. Good luck in your search for true love, in whatever person or form you should happen to discover it in!

I think I can summarise the shittiness of my job in 2 succinct words:

Ward Cover.

Every week-and-a-half the monkeys at HR put me down to cover the licorice all-sorts of geriatrics, psych, haematology, oncology and medical outliers. That day happens to fall on today, the entire Sunday. I must be getting paid double time or something, but afterwards I’m sure I’ll be drinking twice as much.

I’ve been treating my pager like the evil diseased harbinger of doom that it is. Every time it buzzes, my instinctive reaction is either to look down at my hip where it rests and yell “Fuck off, fuck OFF” or to stop myself from picking it up and hurling it at the nearest hard surface. They totally BS-ed us: “oh don’t worry, there’s always help around, everyone’s supportive” but no-one has a clue, most of all me, about what the hell is going on. This isn’t normal. It’s not comforting to feel like every next pager call is going to ruin your life (or someone else’s). I’m so sick of being scared sick. It’s just pure, nauseating, heart-hammering terror.

The protective factors against insanity I’ve identified (man, too much time on the psych ward) are the following:

• Taking the bike on my shift. Who the hell thinks it’s reasonable to walk from E block to C block for a medication write-up?
• I made some laksa. O bowlful of happiness.
• My Isabelle Carmody book – I don’t care if she is the Lit Queen of juvenile teenage private school girls.

I need help. And something stronger than paracetamol.