Happy Belated sister day

Apparently it was National Sister Day on the 3rd August and I’m afraid to say I missed it. Coincidentally I did spend it with my adult sister drinking cider and laughing so that’s good. My littlest sister gets to have a more exciting end of August as she turns 16 on Saturday AND gets her GSCE results tomorrow. Those of you with siblings will know that, for ease, people will insist on categorising you as the “clever one” or the “funny one” in the family. Indeed I was the “clever one” for a while (along with also being the bossy one, the organising one, the stressy one etc etc) Being the eldest of five means the latter personality traits are inevitable, or so a Facebook poll told me the other day.
Anyway, given my advancing age, the holes in my brain and the intellect-eating fatigue that affects every parent of young children we can all safely say that littlest sister has, deservedly, assumed the “clever one” label. She is also beautiful, popular, kind and caring and I am blessed to have her in my life (as I am blessed by all my other siblings.) She wants to be a doctor and she will be a brilliant one I have no doubt.

And now I can tell her what being a doctor is really like because I have completed my first fortnight. I am still standing and haven’t, regardless of what the media leads you to believe about ALL new doctors, made any fatal mistakes (although I admit to lots of small ones.) And I haven’t told anyone on the ward about my MS which is a bit new for me. HR know, the car park office know (hurray for energy conserving closer parking) and my senior supervisor knows but I thought I might just not tell my new colleagues. Let them get to know the real me rather than the me seen through pity spectacles. And it’s working. They seem to like me. Apparently I am cheerful and energetic (!) I am particularly good at admin, doing as I’m told and maintaining a thick skin when being shouted at by other medics and so far that seems to be my role as a junior doctor. And I love it. Today I told a patient I would come to work even if I didn’t get paid, although I didn’t add what a relief it is to FINALLY be earning again.

Last week I almost fell back into the blabbermouth trap again – I was treating a patient who happened to have MS who was telling me all about Disease Modifiers and her typical symptoms and her day to day life with the condition. Too many times I had to stop myself from saying “me too, me too.” But it has struck me that, as a medical student I could naval gaze about my condition and tell everyone around me about it in the name of “education.” But now my role is different. None of this is about me anymore. My background, home life and medical history may make me an empathetic and holistic provider of care (I hope so) but the patients don’t need to know. They need me to be smiley, competent, kind and effective … to not hurt them when taking blood and to not nick their chips at dinner time.

Tomorrow my sister will listen to the news programmes tell her that her achievements aren’t as amazing as they will be because the exams are getting easier (nonsense). She will then probably enter medicine via the “traditional” route (as opposed to the midlife crisis route I chose.) She will do science A levels (yuck) and grab every opportunity to enhance her CV to convince someone in an office somewhere that she is a well-rounded person. She will need perfect grades, work experience, to cultivate outside interests and find time to read newspapers at the expense of slobbing in front of the TV and hanging out with her friends. She will cope with the pressure but I shall watch on, saddened, just as I was as a teacher by all the unnecessary pressure we put on our young people at a time when they should be spending time just becoming adults. I can’t imagine how I would have coped with the hell that is AS levels – the extra exams thrown in just when you thought you had earned a whole year without them. But she is energetic and driven and will compete with all the other ambitious, clever young people her age to get to pursue her dream and will go and live life as an undergraduate medic with time to study, party and meet new people. She may end up being one of those young women who now ask me “how do you do it? How did you manage studying with children and how will you do this job with children?” And I will look at her, as I do at some of them and say “you have battled to get this far. The world is still your oyster and life can be what you want it to be. Keep pushing for what you want because who says you can’t have it all.”

Happy birthday H, and whatever happens tomorrow we are all massively proud of who you are and what you will be.

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Internet nonsense and good news

My daughter gave up chocolate for Lent. She is an enthusiastic Christian but only lasted two days before she converted it to “being nice to my brother.” I haven’t seen much evidence of this but she says its because I am too busy to notice (!) A friend of mine has given up Facebook for Lent and tells me this morning that she is sleeping better, getting so much more done and feels happier (if a little out of touch.) I sometimes envy people who have a religious faith- a bedrock of certainty on which to depend on in times of difficulty and anxiety – because when I get anxious I seem to turn to the internet to find “the answer” to whatever problem I am wrestling with. And this, inevitably, draws me to internet forums (fora being correct I know but for some reason I can’t bring myself to use it seriously!) The internet was 25 years old yesterday and for many of those years I have been a big fan. And for nine of those years I have been experiencing a love-hate relationship with internet chatrooms and advice boards. For a few years it was only ones about pregnancy, childbirth and raising small people. Firstly I was an enthusiastic member of babycentre and “met” a number of lovely women who are still now my friends and who have seen me through the ups and downs many people experience at this time (poorly babies, unexplained infertility, miscarriage, PND) but the nutters and trolls outweighed the good and it was time to leave. Mumsnet is a much more fun place – you share less so people don’t “know” you – but, again, I found myself getting drawn into late night arguments and debates with strangers about the most peculiar things which would consume my brain for days. One particular question I asked about whether my son should wear a cardigan to school when he started got 765 replies, some of which accused me of child abuse! It’s a great place, but not if you let yourself get too involved (for it at its best I recommend ¬†penis cup!) I have mentioned before how I try to avoid the MS forums. I am conscious that its not really for me at this stage and that my particular brand of resolute upbeatness is irritating to those who are much less well so I don’t feel I really have anything to offer.

But the forums I have been remembering this week were the ones I used when I was applying for medical school and in the early years of my medical degree. Full of the naysayers and doom-mongers I remember clearly one person writing that “everyone who starts medical school married finishes medical school divorced.” Blimey! So it wasn’t just giving up a career I enjoyed and was good at, a pension, fantastic holidays and a decent salary – I was giving up my marriage as well. I chose not to mention this to Mr C and ploughed on regardless sharing the ups and downs of entrance exams, interviews and offers with strangers going through the same process. And I turned to many of those same strangers when, midway through my first year the combination of a poorly toddler and junior doctors telling me they “never, ever saw their children” made me march into the Dean’s office and announce I was leaving the course. Luckily for me he had seen this before, offered me a year out, and I went back much more committed but through this process the chatrooms told me that it was impossible to do well in medical school with small children, that my marriage was doomed (again), that I would never, ever again go to another sports day/school concert/parents evening etc etc. These groups, like the rest of the internet was tinged with the view that it is impossible to have a career and be a mother and partner and I trawled in vain to find people like me, who had done it.

Yet now it occurs to me that those women do exist, they just don’t have time to tell me about it on chatrooms because they are busy juggling, living life and working hard. And maybe this is why the positive stories after diagnosis of MS are not found on the internet because the people who are physically able to just get on with it are doing so and not up in the middle of the night trying to work out if the fuzzy feeling in their thumb is the start of a relapse and ending up terrified that life in a wheelchair is inevitable.

So, were the horror stories about medical school correct? It has been an intense time for many of us. Friends have lost loved ones, struggled with stress and depression and some relationships have broken down. I am not the only person to have been diagnosed with a potentially “life-limiting” condition whilst there. Personally, especially recently, life at home has been stressful as Mr C and the littlies “enjoyed” living with a wife and mum going through the rigours of final exams.

But I passed. And I made a show of myself by sobbing in a corridor when I passed. And people keep asking me if I am happy and I wonder if I am. I think I am mainly relieved. And I wonder if my lack of elation is due to five years of reading the internet about how rubbish it is to be a junior doctor. And how rubbish it is to have holes in my brain that *will* mean that the cognition I now enjoy will gradually diminish. But I am probably just tired (I am writing this just before going off to do a late shift on my elective because we don’t actually finish placements until June.) So, if anyone reading this will forgive me, I am just going to focus on the positive to give me a reboot into joy:

I passed medical school despite having very small children and having five relapses of MS in two years. I am currently well and have fantastic, loving people around me. I have done well at medical school so should, in theory, be able to choose the job I want. My children are healthy and happy and now the horror of revision is behind me I have space for books and cooking and crochet and friends again. I have a big birthday coming up and people to celebrate with. I am blessed and so will now be staying away from internet discussion boards where people may want to disavow me of my positivity and naievity (or at least until I need the Candy crush forum to tell me how to get through this tricky level…)

 

I don’t know how she does it.

Six years ago today I handed in my PhD thesis with an emotional flourish only found in those who are 38 weeks pregnant. With a toddler at home and still teaching full-time I was determined to get it done before the new baby arrived and indeed I did. As soon as I’d finished, after finishing with the weeping, I swore blind to my husband that I was done with studying … Since then I have done a specialist diploma in adult education and am almost ready to sit my medical school finals and I am WELL AND TRULY FED UP WITH STUDYING.

The library is now full of my colleagues looking wide-eyed and anxious, or anxiously reassuring each other that there is nothing to be anxious about. They arrive first thing and leave last thing at night, or they don’t leave at all as the libraries are open 24 hours. This frenzy of studying and revision will reach fever pitch over the next couple of weeks and some of them will look at me and the smattering of other parents on the course and gasp “I don’t know how you manage it … with children!”

Because of course it is different. I can’t work for hours on end, I work until the clock says I need to pick them up to take them somewhere to do something, or feed them, or just spend some time with them. This can be frustrating when there is lots of work to do and I want to finish a train of thought, but it does make you very disciplined. I work smart because I have to. I also cut corners because I have to; I hope I will be a good doctor but I won’t be a doctor with a detailed understanding of some of the more difficult scientific concepts or a memory of exactly how all these drugs work because I have to skip over them. I will cram knowledge into my head for the exams and hope I retain the important stuff for afterwards but I know some will fall out instantly, or get pushed out by the fact that I simply choose to give home more of my attention.

Because however much I want to be a doctor I want to be a good mum more. I want my children to grow up secure in their parents’ love for them and for each other, to be happy, honest and healthy and to develop into balanced, fulfilled adults. Of course I also want them to excel in all that they do and be kind to each other at all times but this is obviously a work in progress!

But I have never felt that I needed to stop working to do this. What I need to do is be very good at loving them, very good at multi-tasking and ridiculously organised. And I am. And it is exhausting. But it works, and it works because I realise that to “have it all” you have to cut corners at home as well as at work. So my house is not very tidy, and sometimes my kids don’t eat enough fruit, and my son has occasionally slipped a 12-rated film under my radar. And sometimes I am not the parent I want to be – I am the shouty, irrational woman I swore I would never be and although I always say sorry, I wish it wouldn’t happen. But it doesn’t happen often and I have an excellent “wing-man” to keep me on the straight and narrow and to remind me that the children don’t need it to be perfect, they just need it to be done with love.

There is a scene in the book “I Don’t Know How She Does It” by Allison Pearson where the main character, a working mother, is up at midnight bashing shop bought mince pies with a rolling pin to make them look homemade. She is doing this to impress upon the “schoolgate mums” that she can do “it all” – work full time and be a “proper” hands on mother. The scene makes me smile but it is not something I recognise. Don’t get me wrong, the stream of requests from school for cakes/donations for tombolas/outfits can seem relentless but frankly the children don’t seem to care if my efforts are sometimes a bit crap as long as I remember. Shop bought is often fine by them. Shop bought is the only option in their eyes if it involves a packed lunch – homemade bread is apparently a social disaster when you are eight. I have only forgotten once and luckily the lovely teacher covered my tracks. So there’s not much point knocking myself out to bake the best cake or sew the best Victorian costume, just as there is no point me missing a family dinner time to learn about the finer points of immunology.

At the moment we mostly get the balance right but of course there is the nagging doubt about the future balance. Fatigue is the biggest threat at the moment because fatigue makes me foggy and grumpy and neither of those help with the necessary hyper-drive. The fatigue of MS is overwhelming when it strikes, but a combination of Capaxone, high dose Vitamin D and Vitamin B complex seems to be helping. And anyone with small children lives life with fatigue – when I started medical school my son was still waking four or five times a night, a legacy of neonatal illness, and I still managed to go in every day and learn some stuff. So although it’s not fun, it’s doable. But what if, when, it gets worse. Reading about rehabilitation and disability this week I learnt that the average MS “patient” progresses from diagnosis to disability in 5-8 years. But that 31% are only “mildly disabled.” When I started this course, full of optimism about healing the sick, and ignoring the look of panic on my husband’s eyes about the financial implications of giving up paid work for years, I didn’t think that my hope at the end of it would be for “mild disability,” but there we go!

So, in the spirit of good parenting I have a decision to make about my children. Recent information from the MS trust http://www.mstrust.org.uk/information/opendoor/articles/1311_10_11.jsp suggests my children have a 1/40 chance of developing MS, a chance that “might” be reduced if they take high dose Vitamin D too. But there are no trials, no evidence about potential harm and no real guidance so what to do? I actually have no idea so I shall add pondering about this to my list of procrastination techniques (currently includes Candy Crush, True Blood, detective fiction and cleaning out cupboards) over the next month. Would be interesting to hear what people think…

Dizzily waiting for a diagnosis

It’s Friday evening and it seems that half the women I know locally have gone to see Jason Donovan in “Priscilla, Queen of the Desert.” I am babysitting for one of them (and glad to escape the endless talk of Middle Earth and Super Mario from my boy) which gives me the chance to write something ‘meaningful’ here.
So I thought I’d start at the beginning, of at least the year 2011 when my life took an unexpected turn.
April 2011 found me still in the midst of my own self-imposed mid-life crisis. After twelve years as a secondary school history teacher I had made the slightly rash decision to give it up to become a doctor. Many women respond to having children by wanting to work fewer hours; my response, fuelled by a fair amount of post-natal depression, was to do something even more stressful and demanding.
And stressful and demanding it turned out to be, so much so that at the end of the first year I decided to leave medical school and retrain (again) as a paramedic. My husband, as you can imagine, was delighted with all this to-ing and fro-ing! By April 2011 I was a qualified ambulance “technician” and very much enjoying driving the ambulance at high speeds and ignoring the inner voice saying “go back to med school, those doctors are wearing nicer clothes than this uniform.” What I wasn’t enjoying were the migraines and fatigue but I put this down to working twelve (sometimes fifteen!) hour shifts.
Spring Bank Holiday 2011 saw us going camping with friends to Whitby. I am not a fan of camping but Mr C (the perpetual Boy Scout) loves it and the children (then aged 3 and 6) relished the freedom so off we went! One morning I woke up with pins and needles in my arm and the pins and needles lasted all day but I assumed I had slept on it during the (uncomfortable) night. I felt flat and lifeless for most of the weekend but didn’t really think anything of it (I had often felt lifeless since the birth of the children, especially the second one who, at age 3 had never slept for longer than three hours at a stretch.) When we got home I had a nice hot bath and when I got out I fell over. I assumed the bath had been too hot and that I had fainted which was odd but not scary.
Then two days later I started feeling dizzy. Every time I moved my head the room started to spin. After a day or two I couldn’t get out of bed, nevermind drive an ambulance. I couldn’t watch TV, use the computer or even read (my own idea of hell.) A trip to the doctors got me a diagnosis of labyrinthitis and a prescription for seasickness tablets. I got out of bed and tried to function but I kept falling over in the supermarket (all those colours made my eyes roll and over I would go) and falling off chairs when I tried to talk to someone. The medication was changed and I seemed to get a little better (the vertigo was periodic rather than constant) and the googling started. I remember looking at the list of other possible causes for vertigo and seeing Multiple Sclerosis at the bottom. My best friend’s mum has MS and I remember chuckling at the very idea – I wasn’t THAT ill! With the Internet, a shelf full of medical textbooks and the wisdom of my lovely neuro-physiotherapist friend I was pretty convinced it was BPPV (Benign Paroxysmal Positional Vertigo.) Another change of medication and the GP agreed to refer me for tests. I had been ill for six weeks but it gradually got better until I was only dizzy when I moved my head too quickly and back to work I went…
Six weeks off work however is no good for someone who is going through a crisis of identity, and I had decided to go back to medical school (Mr C didn’t speak to me for four days – four days!) So in September 2011 I had an appointment with the ENT department at the hospital and a new “school” bag for starting my second year of “fast-track” medical school. I felt positive and focused but couldn’t understand why I didn’t feel energised.