Internal Milieu

I decided to buy a digital recorder today despite the fact that money is not abundant at the moment. Speaking to a few people, I realise that ideas come and go all the time and due to my terrible short term memory, I really do feel the need to record some of the things I'm thinking about. 

This morning, I couldn't wake up on time. My biology intermittently reminds me that all tasks come at a cost and any sleep deprivation I subject myself to must eventually be paid back one way or another. I slept at 2130 last night and felt that I would have enough sleep to wake up for surgical rounds at 0700. That idea went out the window when I finally was able to wake up at 1030, realising that I was very late for absolutely everything. However, I was sure that there was a surgical tutorial at 1100 and I rushed through my morning routine and power walked down to the academic unit only to find out that it started at 1000. It felt like I was still sleeping and I was wondering what I looked like on the outside.

So the only choice I had was to either join the surgical team, which I didn't want to do; or to go home and study. Being at home during the day felt very unusual - I was very picky about where things were and the fact that I had nothing in my fridge except pasta sauce, white bread and some eggs. I knew I really needed to go shopping to get some nutritious food, but then I realised, once again, that money was not abundant.

Studying surgical infections was interesting, but really was just putting a prestige element into common sense. A couple of hours later, the stomach started complaining and I felt like some Subway. There was one down by the train station not too far from where I lived and I headed down for some food. It was so beautiful, hearing absolutely nothing and walking by myself. The occasional bird chirping and car driving past, it felt comfortable not to be constantly interacting (actively at least) with the environment.

I had an appointment at 1530 with the Professor of Surgical Epidemiology regarding some research we plan on doing. After that, I had an appointment with Dr. ML, one of my role models and mentors in medicine. He was my tutor last year in the patient-doctor tutorials, but now he helps me here and there with things I ask. The afternoon certainly looked interesting.

Something else that's interesting is how one's internal milieu can be demonstrated so frankly in their facial expression, posture and gait. I was unaware of what I looked like to the by-passer, however I certainly knew my internal milieu, as one does. That's what we call consciousness.

I realised soon after I arrived at the academic unit that my colleagues were finishing up their tutorial; the one that I didn't attend because I didn't think I'd learn anything. When they saw me, they had a high degree of concern.

"Are you alright?" 
"What happened?"
"Why didn't you show up?"
"Is everything alright?"

They felt like rhetorical questions, like the ones people answer with automatic responses:

"How are you?"
"Good thanks"

It's interesting to see how little people care. My colleagues are only a few years away from being practicing clinicians and they have clinical evidence right in front of them that somebody may be really unwell. I'm not saying that I am unwell, but indeed if I was, they chose to ignore it.

My answer to their questions was universal, as it usually is: "Yes, yes I'm fine. Just tired."

The way I see it is they took a partial history, conducted a very brief physical examination in terms of assessing my appearance and come to the conclusion that something (non-specifically) was wrong. So their investigations and management were merged with the questions they asked above.

When I consistently misinformed them, they had clear evidence of conflicting information - my body language was telling them that I was unwell, and my words were telling them the opposite. So instead of caring enough to pursue what's going on, they walked away.

All those interactions that took place told me one thing: don't go to these people as a patient. They clearly hesitated to extend their hand to a friend or a colleague, let alone a patient. Now let's give them a fair chance: they could've not asked me anything right?

My response to that is this: If the question didn't change the outcome, what difference does it make if you ask it?

"How are you doing?"
"Actually, I'm not doing too well."
"Oh okay. That's not good."


You're damn right it's not good. That simply tells me that one is uncomfortable with responses other than the ones that are automatic. Then the ones that care are disappointed when you give them a programmed response. It's all sarcastic. Social interaction is sarcastic, superficial bullshit.

Yes, I have a lot of things on my mind but the only thing wrong with my today that was different to any other day was my ability to keep it suppressed. I'm sure those of us that care enough to notice the subtle hints (not that they are that subtle) that something is wrong, will pursue it; and when they don't, my heart is broken.

So, why did I buy that digital recorder? Because at least if I listen to my own problems later down the tract when I'm not expressing the same emotional instability as I was when I was dictating it, maybe then I'll come up with a solution to my own problems. Perhaps people may not accuse me of not looking after myself. Of course it's too much to ask friends for some attention, of course it's wrong to expect that people would be there for you when you both know that you're expressing yourself in a way that suggests problems, despite not wanting to express it at all.

If only we cared enough to think.

                 If only we cared enough to listen.

                                  If only we cared enough to act. 

                                                   If only we cared enough to care. 

                                                                    If only...