Today

I gave my second lecture to the first year medical students this morning. Given my background in medical imaging, I am suited to the job - a job I created for myself: develop methods of education through interactivity rather than didactic methods to increase the knowledge and experience of first year medical students.

Like most tasks in my life, I put it off until the last possible moment: the night before. I slept well, waking up at 0900 for the first time in some time and got ready to go to my hospital to help a small group of first years fill out some of their assessment forms in clinical examination. They have to fill out two forms to assess their competence in examination. One form has to be signed by a doctor, the other by a senior medical student. And since we were buddied up at my hospital (i.e. the third years and first years developed professional bonds), I made a commitment to help my buddy and his friends. That took up my morning and afternoon including the 2 hours of driving to get me there and back. When I came home, it was time to give the presentation a serious go, which meant finishing it by midnight and rehearsing it least once before 0300.

Mum was happy to see me back home, but I haven't been happy to be home. There is tension in the house between my parents and when I come to visit, I seem to be stuck in the middle of it.. So these past few weeks of visiting at the end of laborious weeks in General Practice has not been pleasant. My dad looks me in the eye and lies about his drinking habits. Why do I care? It's just stuck with me.

Sitting down at my laptop finally and being able to be productive felt good. Productivity is always a form of therapy for me regardless of which context it is in. This is probably because I have been procrastinating so much this year.

The clock struck 1800 and I was confident I could be done in a couple of hours to squeeze in a coffee with my old friend from high school. All of a sudden, I got a call from a very close friend that doesn't keep in touch all that often - DV. She was sorry she hadn't been in touch but really needed my help.

I've had my migraine since Saturday and it's never been this bad. I'm not sure what to do. Can you help?


I told her I would be there in 20 minutes. By the time I got there she was already vomiting and this, to a medical student, didn't look good at all.

Pushing my feelings aside for my friend, I forced myself to be objective and not mention the terms tumour, subarachnoid haemorrhage and meningitis. I simply said it is best to be seen by a doctor in the Emergency Department. To double-check this, I called my GP and explained the history:

I've got a 23-year-old female with right parietal headache for 2 days with some paraesthesiae in the ulnar distribution of the left arm, which has resolved. She feels warm but is oriented to time and place. However she has just vomited clear fluids 10 minutes ago. She has a background of migraines, however states that this time the pain is different and is not relieved by rest or sleep. 


My GP listened to me and also pushed his feelings aside and said: since neither of us know this patient, you should consider sending her to the emergency department.


Sure, I'll take her myself.


A few hours later, we were seen by a Clinical Nurse Specialist and she triaged DV into "to be seen in 4 hours" category. After half an hour, she felt better after the panadeine forte and we left after letting the nurse know. I took her home and shared a cup of tea with her before leaving for home to finish the presentation.

It's almost 2100 and I just finished dinner. My parents are drinking and arguing about trivial bullshit at the dinner table "keeping me company." So after that I finally sit at my desk to tackle this presentation.

I'm finally finished and it's 0130. I'm supposed to be up at 0630.

---- Fast Forward ----

We're in the lecture theatre, almost 300 students and I. They're all fixated on me and I'm there to give them a talk. I break into a cold sweat thinking that I'll look like a total idiot and my presentation will be a stand-up comedy show. I was scared and finally, after delivering the talk for 90 minutes straight, it was over. I received an applause, but I could barely smile. People's feedback was great but I was struggling to be happy.

After another 45 minutes of answering questions by enthusiastic colleagues, I was finally able to get out of the theatre and breathe some fresh air. Mum was with me: I'm so proud of you. I didn't know how to feel. My girlfriend messaged me to tell me that I was great as well - she attended too. Somehow we managed to put our differences aside and keep the relationship alive. Not sure if that was the best outcome, but at the moment, "we're happy."

Mum wanted to take me to lunch and we ate well. Though during the whole time, I refused to let mum share her joy of watching her son's lecture. I can understand that I might be the only third year student to give a lecture to a first year medical cohort, but right then and still now, I just didn't care. On my way home, I called my General Practice supervisor and let him know that I wasn't coming in this afternoon because I would still be on campus for other work... I lied.

So I came home and did absolutely nothing for several hours, feeling the same. Not being able to shake this feeling of presence of absence.

I decided to go for a walk and once again, thought of so many things to write and have forgotten most. I did cry because I felt so helpless.

Today, I think I am back into a depressed state of mind. I cannot call it Depression because I don't think I meet the criteria for diagnosis. I am considering going back on the medications, but do not want to.

I want to call someone to talk about it, but it won't change anything. It won't change how I feel. In fact, I do not think I have the vocabulary to describe what it is I'm feeling, other than unwell.