The Breakdown Chronicles

The Breakdown Chronicles Pt 5: Perception

11pm.

It’s quiet in the house but for the entanglement of voices from Billy’s shower music crooning through the bathroom walls. I got home a few hours ago. The heating has been on for an hour to melt the evening’s gentle spring chill and my bedroom smells of vanilla, orchids and a pleasant hint of worn perfume. I’m sitting alone in bed, exhausted, nursing a hot chocolate, lingering over the sensation of sheer presence. Tomorrow, I sit my medical school finals.

Paradoxically, this is also, quite honestly, the most underprepared I have ever felt for an exam in my entire life. Normally, I would be in a state of total panic stricken anxiety. But not tonight.

I can hardly believe that a few weeks ago, I didn’t even know if I would be able to sit these exams. My confidence was at such an all time low, hanging itself on morsels of papers, dictated entirely by the results of exams long gone. The girl who wrote reams of notes, studied each them at least three times over and learned every detail with admirable thoroughness seems to be a shadow of the person I feel as though I am now.

I have never been more grateful for this change in perception.

The way my thoughts spiralled out of control in that fortnight from hell felt terrifying.  I realised then that I couldn’t let them become bigger than me, control me or dictate the way I felt about myself. Every day since the weekend where I went home and decided to get better, not only have I been channelled my efforts into revision; I have also pushed myself to change the way I think and behave. Each day I’ve stuck to a tight, grounding routine involving self-care, praying regularly and phoning my parents daily. With each relapse into catastrophic thinking, I have broken down thoughts, emotions and feelings, tracking them back to where they originated and rationalising them to created healthier automated responses. I have gone from feeling worthless and as if there is simply no point in life- to focusing on small tasks and rediscovering purpose. I have gone from letting depressive thoughts eat me up, to recovering in hours, to recovering in minutes.

I’ve reconnected with my faith and understood myself in deeper ways than I thought possible. I have learnt that to pray to God with intent is to access a part of me that is infinite love and wisdom and devoid of ego.

I have found happy places in my mind. I have found sources of strength in moments of crisis.

All whilst revising for my finals.

The headspace I am mentally occupying now is totally different. I look around me and I know that other people have worked harder than me, for longer than me and are more prepared for tomorrow’s exam than me. I don’t know all the facts in my files the way I would have known them if this was any other year. But the thing is… none of it matters.

See, what I have learnt the most over these past few weeks is that I am on my own personal journey. This journey is completely different to that of those around me. We may be sitting the same exam tomorrow, but we are all on different life paths, so comparing where I am to where the girl in the exam hall next to me is is futile. This is something that pre-breakdown Gowri would never have understood.

How far I have come mentally and emotionally in this months is immeasurable on paper. I’m in a better place. And meanwhile, the crazy hours I have put in over the last few weeks will somehow channel their way into my thought processes tomorrow as I look at the paper in front of me, mentally walking through each question. And ultimately, whatever the outcome may be from this set of exams, at the end of the day… they are just exams. If I pass, that’ll be wonderful. If I don’t… I’ll just be even better rehearsed for a resit.

That journey, the personal journey that I have been living through has opened my eyes to a world where my own self-worth is completely separate to my exam performance. So tonight I’m not panicking. Tonight, I am contemplating that my re-established faith in God, the universe and myself will manifest in ways that will only ever be beneficial to me.

Let’s see what happens tomorrow.

 

The Breakdown Chronicles

The Breakdown Chronicles Pt 4: Returning

What incredible goons my family must look like waiting for the train to depart as they animatedly talk to one another, wide grins plastered across their faces as the bright March sunshine generously pours through the station’s crevices and dances across Platform 6.
I watch them from behind the dirty glass in half admiration, half anticipation of the fact that within minutes, this carriage will glide into the distance, taking me to the place where I need to be. As it happens, it’s a place away from them. I brace myself. On this occasion, more than ever before, I know I have to take a part of them with me. The deep strength and unconditional love is the cement that glues me to the gorgeous scene on the platform before me, no matter where I go. I feel it like a warm bath of liquid light.
Days ago, I thought I was at rock bottom. Like a storm that started inside me collected winds bigger than me and attacked me with such force that I didn’t know if I could get back up.

“Was there a trigger that you can think of?” said the kind faced, slightly unconvinced doctor as he sat before me, confronted by my messy, anxious and poorly articulated attempt at conveying years’ worth of feelings that had spiralled out of control in the last week, leaving me in a place of such incorrigible darkness. Could it be that the storm was so forceful that I couldn’t even remember the trigger anymore?
I walked out with a green prescription clutched between my fingers wondering how on earth it could have possibly reached this point. How was it that so quickly I went from being in control… to losing ALL control? I closed my eyes and a loud voice screeched in my ears… “I don’t want to be on antidepressants”.

‘You wouldn’t think twice about taking antibiotics if you had pneumonia’.
‘Gowri… Depression is not a weakness. It’s an illness’.
‘I think you should submit extenuating circumstances. Your exams are in a month’.
‘Gowri… come home’.

People have previously commented on my inner strength. That very strength I was in utter desperation to find called out to me in the shape of my dad’s calm voice, filtering through my phone speakers in the form of that last sentence.
So I came home.

That night, I sat before my dad, cocooned by the comfort of my living room, hot drink in my hand and told him everything. The darkness, the storm… the doctor. How many people can say that their parents can sit before them and hear their child say that they might be depressed without an inkling of judgement?
My dad is also a GP. And I’m lucky to say that not only did he take me seriously, he talked me step by step through what got me here, what options I have, management-wise both short term and long term.

What I appear to be going through is a period of reactive depression mixed with anxiety. The cause was years’ worth of accumulated self esteem issues whereby the hard work I put in did not translate to good results, reinforcing this idea that I’m somehow a failure, in an already competitive environment. The trigger was not getting into the hospital trust that I wanted to for my foundation years, instead, starting work in a place so close to home that it felt like a digression. The anxiety has stemmed from these experiences and blown up to a level where I felt as though I couldn’t face anything anymore.

After much deliberation, I’m able to say the following:

1. I will not be taking antidepressants. That’s not because I’m in any way against them but because I feel that this is not endogenous depression, but reactive and that I do have the strength to overcome it without medication so far. I was also alerted to the fact that antidepressants are not a solution but an adjunct. They readjust chemicals in your brain that up your mood… but the actual work has to come from within anyway. I would rather not resort to them until I’ve tried other options… however, I feel no pride or ego and if I find I need to take them, I will.

2. My family came together in the most beautiful way this weekend to pull me right out of this funk. And in a 24 hour period… I had only one relapse; compared to this week, that is an incredible transformation.

3. I will be relying heavily on my mum, my dad, my boyfriend and my friends for support. And I’m not ashamed of that because when the storm knocks me over, these wonderful people are the people who have this unbelievable faith in me to pull through this.

4. The trigger was medschool. Paradoxically… I have a mere 3 weeks of medschool left. This weekend, my dad took me to WHSmith, bought me a calendar and two marker pens so I can cross off every day that goes by. Another day closer to the beginning of my new life.

5. The hardest part. The moments of darkness. The unexpected triggers. The tearful mornings. In these moments… I need something. An anchor. A light. I need my faith back. And as a devotee of Lord Krishna from the moment I was conscious of my own existence, I have decided to push aside all the philosophising, the rationalising, the logic and the confines of human understanding. I will be calling upon him every day because he is the ultimate strength inside me and he has not once let go of my hand when I’ve needed him.

Yes, my finals are in a month. And you know what? I’m going to pass them. And more importantly, I’m going to pass this. I’m facing the storm, each time it tries to knock me over and it’s going to pass. And I’m going to emerge from it with greater strength, greater perspective and a drive to continue working on myself to such a degree that dare a storm return into my life… it will feel like a breeze.

The Breakdown Chronicles

The Breakdown Chronicles Pt 3: Not Gowri

Deep breath. Kettle on. It’s fine. Just write like no one is reading.

I lost my diary. My black diary, with the pages thick as a sketchbook. I’ve got three volumes that are full of snapshot moments of brain shards but I can’t find my latest one. That’s a little annoying because I usually spew all over it… probably one of the reasons I’ve maintained any level of sanity over the last few years. It’s not helpful that I can’t find it.

Having any real belief in the ability of a positive mindset to attract greater positivity into one’s life is unhelpful when that mindset has fucked off to a headspace far, far away.

Every day for the last two weeks, I’ve been suffering from the extreme ill effects of low self esteem but recently, it has become worse. I’m crying for up to two hours a day. I feel very alone. My appetite has diminished. I don’t feel as though this problem is ‘real’, somehow which means I’ve struggled, thus far, to seek any real help over it. I feel like an absolute failure.

What brought it on? Well, I have outlined in previous posts that I’ve always been an over achiever and that mentality can manifest as unhealthy thought patterns when taken out of context. Throughout medical school, I’ve worked exceptionally hard in an attempt to overcompensate for what I thought was a lack of intelligence (but also a lack of strategy) but unfortunately I’ve never done well in my exams. Years’ worth of conditioning has caused me to equate my self-worth to my performance. My poor performance has, therefore, created and reinforced this feeling of poor self worth. However, it has never affected me to this degree.

I’ve generally been good. I have always had fantastic support networks and a deep interest in spirituality which means that I never spiralled into any real mental health problems. What I am going through now, more likely than not… is transient. However, what I am realising is that it doesn’t make this period any less real.

Things took a particularly bad turn a couple of days ago when I found out that I would be spending the next two years of my life working as a doctor in pretty much the same place I grew up. I have been so disappointed in myself. In my inability to get a good enough score in my rankings to go somewhere I actually wanted to go, when it feels like everyone around me is going somewhere better.

My mother works in the hospital I’ll be working at. I worked there, as a lab assistant, for two whole summers. I already have an ID card for the place. The entire purpose of me putting down the deanery that I did was so that I could be closer to home… but the place I have wound up is a little too close.

There is a pressure, isn’t there? For our twenties to be the best years of our lives with a high turnover of friendships and relationships and prosperity in shiny new careers and instagram accounts plastered with success. I too, I suppose have succumbed to this very pressure. I wanted to go somewhere different, somewhere totally new, complete with its own challenges.That’s why I took the risk of applying outside of Birmingham but now it’s backfired. Every time I think of where I’ll end up for the next two years, I picture the hospital car park under the sheets of grey, north-west-England clouds and my chest feels heavy and hopeless. I feel hopeless. I feel trapped. I feel like nothing has turned out how it was ‘supposed to’.

My final exams are only a month away and I am genuinely struggling to find any motivation to get up in the morning, let alone get myself to study. I don’t want people to think I’m weak so I put on a front and then I go home and let it all loose and cry in bed for half an hour to two hours at a time. I’ve had some scary thoughts. I have enough insight to recognise how irrational this is but also to understand that this is more than just the usual ‘exam stress’.

I am not myself. I’m not Gowri. 

But my strength lies in that somewhere deep down inside me, I am determined to get back to where I was before life knocked me over like this. I’ve taken some steps in the right direction.

  • Today, I spoke to student support. They were not hugely useful, but I have an upcoming appointment with part of my university welfare team, although I am not in any way relying on it.
  • Tonight, I’m going to have an honest discussion with an incredibly supportive figure in my life who I’ve finally reached out to, which I hope to be the start of a productive plan to get me out of this rut.
  • Tomorrow, at some point, even if I have to drag myself there, I will lace up my trainers, walk into the gym and push through a workout because my brain is screaming for endorphins.
  • Beneath all the sadness, there is a ray of hope and that hope is the fact that I still want to be a good doctor. The fact this very hope merely exists means that I know I will find my way out of this destructive mindset.

I started a blog because I can’t find my goddamn black diary. I’m calling it ‘The Breakdown Chronicles’, renaming parts 1 and 2 that I’ve already written because the chronicles began a while back and I will be blogging my way through the journey back to Gowri.

Watch this space.

 

 

Medicine, The Breakdown Chronicles

The Breakdown Chronicles Pt 2: Dear Medschool

Dear Medschool,

I am writing to you to let you know that I am absolutely done. I only have a few more weeks left and I’m towing that incredibly fine line between giving up because I cannot be bothered to even care and fighting until the end and I promise you that you’re not going to get the better of me. I plan on seeing you through, seeing this through and shooting down every demon of mine that you’ve fed for the last five years. I am better than you.

It’s a damn shame that my perfectionist personality fell right into your arms, like so many of us, such that you’ve let me be entirely consumed by feelings of low lying inadequacy that loiter in the background of every teaching session, manifesting as hesitancy to answer a question, whilst someone else comes out with the answer I was thinking of. That same inadequacy rises to the surface every single time I know I have to sit another fucking exam to get through the next loophole.

Your value system does not favour me despite the sweat, blood and tears that I’ve poured into you. I don’t have a fucking photographic memory, okay? I’m not a fact absorbing sponge that an OSCE examiner can squeeze in order to regurgitate everything he/she wants to hear. I’m not a walking-talking-Oxford Handbook. And don’t shit all over me and say it’s my ‘exam technique’, because that’s like saying my mind is reduced to something that is less than intelligent because it cannot distinguish between b and c on a multiple choice paper.

As far as this relationship goes between us, the thing I will take away from you is a scroll of paper that puts a ‘Dr’ in front of my name. Other than that I’m just another anonymous, insecure student, spewing away every single time her results have rocked up with another scrape through. Because according to your value system, all I am ever capable of is a scrape.

Let me present to you the saddest part of it all. Every time I actually sit down to learn something, I realise that I am utterly fascinated by Medicine. Any time I feel part of a team, any time I’m able to care for someone even a little, I’m filled with the utmost satisfaction. Sadly, those experiences have been so few and far between, although they are the ones that have pushed me through this course. The reason I get so nervous before the tired examiner in front of me is because I care so much and I get tongue tied, my brain feels like it’s wired differently. You might have forced me to read my way through textbooks and papers so that I know enough in theory but on a practical level, I’m still shit scared of being an FY1. I don’t even feel vaguely ready and I have no clue what I’m doing. I’m sick of ‘seeking learning opportunities’ because the reality is that when you’re a medical student, you’re not part of a team and no one really cares about you being there so you spend 3 years learning how to professionally not-get-in-the-way and that’s just so demotivating.

And the purpose of this letter is as follows. This feud between you and me is so close to being over. There are only a few more loopholes for me to get through and once it’s over… it’s over. I’m no longer going to be brought down by the toxicity of this environment. It won’t matter how much I know because by then I’ll know enough and I’ll learn the rest. I’m not stupid, Medschool, contrary to what you’ve often led me to believe. I realise that it isn’t you that has done this to me, but me. That these were pre-existing insecurities that have only grown because of my surroundings. You were merely the surroundings. The fertile soil that created a breeding ground to grow what was already there. I’m so over seeking approval and validation from exam results and consultant’s comments. I’m so over feeling a certain way about myself that’s dictated too much by you and not me. I’m so over this power struggle.

So let’s end with this thought. I might’ve scraped through, but I still fucking passed every time. I still did everything else I wanted to do outside of this degree. I’m leaving with new skills, new experiences, challenges that have shaped me and friends who have morphed into family. And as hard as you’ve made it for me to convince myself that I’m good enough, the final push is no longer about that. On Monday, I will find out where I’m going to be a doctor for the next two years (which is terrifying enough as it is). And then, for a few weeks only, I will go into focused hibernation and then all I have to do is pass. Exactly like I’ve done for the last four years and if I’ve done it before… I can absolutely 100% do it again. I’m not going to let you make me feel like I’m your little bitch anymore and I’m not going to lose motivation now.

It’s the final fucking hurdle. Watch me jump it.

Yours for not much longer,

Gowri

The Breakdown Chronicles

The Breakdown Chronicles Pt 1: I am good enough.

In most domains, I think I come across as confident, bubbly, positive and enthusiastic. And for the large part… I am. But it’s no secret that very few people are truly consistent with exactly what they showcase on the outside and like everyone else, I too fall into that category.

Eight weeks away from my final exams of medical school and I am fully aware that this is the time where those insecurities eat into me more than ever. Why? Because it happens every year. Medical students are, by nature, often intelligent, high achieving and highly driven with a gift of working smart or a curse of working hard.

For several years of my life, I have needed to seek external validation in order to feel good about myself. That isn’t unusual either. Fortunately, as my own self awareness grew, so did my ability to recognise where this was happening and I learnt to force myself out of it. As a result, I’ve become a little less anxious, a little more daring and kinder to myself. But there are a couple of areas of my life where that has been a real struggle. It’s as if a feud is taking place between the person I feel like I am and the person I would like to be.

All those years as a child where I was the new girl at every school and at the receiving end of other girls’ bitchiness… the one thing I was able to turn to was the fact that I was smart-ish. That, coupled with the indian mentality of my parents where nothing below 95% was good enough had me burying myself in books so that I could prove to everyone around me how good I actually was. It’s only now, several years down the line that I realise that I wasn’t proving anything to anyone. I behaved that way to prove to myself that I was,  good enough. That’s why I studied for every minor class test. That’s why I sailed through my GCSEs with a straight set of A*s. That’s why I submitted extra papers to my teachers until I hit the top scores. That’s one of the reasons I applied to medical school… to prove to myself that I could get in. That’s why I worked so hard throughout my A-levels to exceed my required grades for entry. That’s why I myself would never feel satisfied with anything less than 95%. That’s why, for my pre-clinical years, I have eight files’ worth of immaculate lecture notes, written mostly in the early hours of the morning where I wasn’t otherwise occupied with everything else I was also piling on my plate to prove to  myself that I was fucking good enough.

The issue with this vicious cycle of proving something to yourself is that you never actually get there. The more you look for something outside of you to tell you that you’re good enough, that you deserve to be where you are and that you’re ready for the challenges that lie ahead, the less likely you are to find it. That deep, fulfilling security is only something that you can generate internally. No grades will ever give you that. That’s why the highest achievers are often the most insecure people.

Since coming to medical school, the sad truth is that my mentality has taken a turn for the worst. I never expected to be at the top. What I expected was to be average. And in an environment that values exam technique, memory recall and the ability to deliver a wealth of knowledge coherently to an examiner in a room with a five minute timer… I have fallen to a place that is well below average and that has bruised my ego.

I’ve also learnt a hard truth: working hard does not often equate to doing well. This is a bittersweet lesson that the universe has taught me time and time again. What equates to doing well is a high degree of self confidence. Knowing you’re good enough gives you more grounds on which to stay totally calm. Why would you panic? You know you’ve got this. A calm mind is the most fertile place for the right facts to come to you, exactly when you need them. It all begins with self confidence. The one thing I could really use a bucketful of right now.

So today, I’m writing this post to remind myself of some long forgotten facts.

I am good enough to be here. I am intelligent enough to be here. I am enthusiastic enough, bright enough, smart enough, conscientious enough, dedicated enough, resourceful enough, kind enough and lucky enough to be here. And in three months time I will leave here having consciously chipped away at these insecurities because it is not what I have done that makes me worthy of this, it is who I am. And at 2 in the morning as I run around the wards with a stethoscope around my neck, a bleep going off on my belt, loose papers with scribbles of jobs tucked into my pockets,  and a body full of weary caffeine receptors, I will look back on all it took to get me there and maybe I’ll smile, maybe I’ll cry, maybe I’ll love it or maybe I won’t but because of who I am… I will draw as much happiness out of that moment as physically possible.

I am good enough.