Bad news for patients...

So my union has decided to go on strike...

Two weeks ago when the BMA asked if I would be willing to take part in industrial action over threats to my pension I firmly said “no”. Today I found out I am in a minority. An overwhelming 92% of the junior doctors who responded to the ballot favoured taking part in a strike over this issue.

Now all routine GP appointments, hospital clinics and operations will be cancelled on 21st June. Supposedly this won't harm patients. What the hell? What about the elderly woman living off a state pension – a fraction of the pension her consultant will eventually live off – who has to endure another week or so of pain because her hip replacement is cancelled? Or the patient with worsening COPD whose chest clinic appointment (and subsequent clinical intervention) is postponed? Will their lungs appreciate that? Not to mention hundreds of psychiatric patients who won't get to see their psychiatrists that day...

There's no way around it – this strike will affect patients. 

My view remains that if doctors are so unhappy about their NHS pension they don't have to take up the offer of one; they can pay in to a private pension instead. But they know that private pensions are crap by comparison. Most of my friends outside of medicine work in the private sector. I currently have a fairer salary and fairer pension than any of them, even if proposed public sector pension reforms go ahead. Sure, unlike them my job involves sticking fingers up peoples arses, but we all have to make sacrifices in life...

On an entirely different note, it's my birthday this week. I have already opened my presents from my mother – a cheque for £125 (much appreciated) and two books on bipolar disorder, one entitled “The Bipolar Disorder Survival Guide”... Gee mum, thanks. Thanks for rubbing it in.

Having got over my initial annoyance I reflected on the fact that she's only buying these books out of love (and perhaps a little desperation). Both books look fairly good. I just wish my illness weren't the main topic of conversation between myself and my family members at the moment.

Depressingly I didn't have time to make carrot cake last weekend (the heat made it unbearable to turn the oven on), so I bought one from M&S instead. Not a patch on what mine would have been. But then I didn't exactly get a birthday cake this year, so it was nice to have something sweet and manufactured in the fridge to comfort myself with.  

So much for the European Working Time Directive...

I'm now back at work, albeit without any on-call duties. My main worry about going back was how my friends and colleagues would respond to my absence. Fortunately that hasn't been too bad. My own team are quite understanding and don't ask too many questions. When other people have asked where I've been I've just said I've been unwell and they haven't probed any further. I can't say I'm quite back to my normal social self. I used to enjoy having lunch and chatting to my friends in the doctors' mess. Now it feels noisy to me. I want to escape to the hospital chapel instead.

The thing I am struggling with most is tiredness. Although Occupational Health stipulated that I am not to do any out-of-hours work, the reality is that in medicine or surgery there are no fixed hours. I am supposed to work 8-5pm (which trust me, after a month doing nothing is exhausting enough), but on Monday we finished at 6pm, Tuesday at 6.30pm and yesterday I wasn't done until 7.15pm. That's 4 hours and 45 minutes I've already worked for free this week. I used to joke that I was a full-time doctor, part-time NHS volunteer. I would guess that the extra hours I have worked this year amount to days. So much for the European Working Time Directive!

The long and short of it is that yesterday afternoon I became quite distressed again mentally. I had worked largely on my own in the morning and hadn't had much in terms of a lunch break. My mind drifted to suicidal ideation, as it frequently does when I am unwell and under pressure. I could hear voices telling each other I had jumped under a train. I saw vivid images of myself jumping under a train. I had a strange sensation of being knocked over by a train. Obviously I didn't fall, but the sensation of being hit was there. I rested against the wall, took a few deep breaths and got on with the day with my friends. When I got home I cried. I cried before dinner. After dinner I cried for an hour before bed. I woke up twice in the night, crying. The bedroom is now littered with the toilet paper I was using to mop up my tears.

I loathed myself for doing so, but I decided to text one of my colleagues and say that I wouldn't be in until mid-morning today, rather than 8am. I needed a few hours rest in the morning to collect my thoughts and do some writing. I figured this is the only way I can continue to work – by admitting that I am still unwell and taking small breaks here and there.

That is such a hard admission. I feel weak and pathetic – pathetic because I can see everyone around me “coping” with the hard work and hours, able to come back to work early in the morning after a tough day. But to my knowledge they are not plagued by suicidal thoughts, persistent crying, sleep disturbance or crashing mood swings. Yes I am at work, yes I am now able to work. But my illness is still very much present, and I'll just have to keep judging my ability to function on a daily basis.

On a more positive note, I'm planning to try a new carrot cake recipe on Saturday. Just a day and a half to go...

Lucky number seven

Number seven showed up in the waiting room yesterday and greeted me with a firm handshake. “I used your first name just there and not your title because I didn't want to give the game away,” he said, with a grin. Give the game away. I am a doctor, a mentally ill doctor sitting in a waiting room of mere patients.

Number seven seems quite fierce, very direct in his questioning technique. Who do you live with? How long have you been with him? (Blimey, eight years? That suggests you're good at maintaining relationships). The man is smart. Not the type of psychiatrist who is easily conned or manipulated. Reminds me of number two...

Number one (my favourite so far) referred me to number two when I was too self-destructive to be managed in the community. Number two wasn't having any of that shit. One week I hoarded the antidepressants the nurses dished out each night and landed myself in hospital on a cardiac monitor after an overdose. Number two went mental. You don't bloody harm yourself with a drug that I prescribed to make you better. Do it again and I'll refuse to see you! So I didn't do it again. Not until I was back under the care of number one.

Number three picked me up at medical school. The man couldn't stand tears. Rang my social worker in a panic when I started crying during his clinic. Number three told me that it wasn't Prozac that was killing my libido, it was the fact that I was a woman. I can see why the man might think that. It's hard to imagine any woman he's ever slept with enjoying herself. Of course, that's not to say I've never fantasised about sleeping with psychiatrists. Just not him.

Number four was private. Cost £100 an hour. It's true – turns out money really doesn't buy you happiness.

Number five just told me to take my medication and stop bloody drinking. So I did. And I got better. Not exactly rocket science is it?

Number six seems okay. So far.

I have both loved, respected and at times loathed, hated and feared my psychiatrists. Funnily enough I often think about becoming a psychiatrist - all I need do is get myself onto a training programme next year and somehow survive within the profession. I can't decide how suitable psychiatry would be for a person like me though. In some respects I think my experiences would make a damn good psychiatrist. But could it end up breaking me? Number six told me to choose which speciality I go into very carefully in light of my illness. Avoid night shifts. Avoid too much hard work... But I want to follow my passions! I can't turn down a speciality for fear of becoming unwell. What if this truly is my last episode? Some people would call that denial. I call it optimism.

Dreaming of aubergines...

I'm beginning to think that being a doctor could be a bonus when it comes to accessing treatment for bipolar disorder (once you are able to get over the trauma of temporarily being a patient, not a doctor). On this occasion I seem to have been fast-tracked through the system. Appointment slots have miraculously appeared for me. My GP made it very clear that I was a doctor during the whole referral process... As a result I got myself onto a CBT programme within a fortnight. Whether it will help God knows, but I've never known the NHS to act so quickly in response to mental illness. I'm being treated almost as well as a cancer patient!

In other news, I've just woken from an extremely vivid dream about giving a presentation at the UK's “National Aubergine Conference”. Nice. An hour before I was lying in bed weeping. I haven't been able to leave the house all day. I checked my email and made myself a fantastic lunch (surprise, surprise), but then froze and started to cry endlessly, mainly worrying about my career. Checking out the aubergines at this conference was a real mood booster though. When I woke up I had all but forgotten my woes and had set my mind to thinking about what I could next cook with an aubergine (when I've thought of something I'll let you know). Is that the sort of experience I need to be talking to my psychiatrist about?

When the other half gets home we've planned to cook another recipe from the Kitchen Shrink - grilled trout and toasted sunflower seeds with leeks. Supposedly the fish oils will do me no end of good. Don't get me wrong, I love fish, but sometimes the thought of deliberately cooking something healthy just makes me crave pizza. And not thin, upmarket pizza. Thick, greasy, cheap, pan-friend pizza of the Pizza Hut variety. With lots of meat. Meat and aubergines.  

Mission accomplished

So I finally got around to doing some baking this afternoon...

Not exactly how I thought they'd look, but pretty delicious nonetheless. Once again the recipe can be found here.

Feeling slightly down because I am desperate to go back to work but have been advised not to for at least another week. It feels so isolating being at home all of the time with only mental health professionals for company.

I thought I could at least use my brain by doing some studying, but it is still a nightmare concentrating. Perhaps they are right. Perhaps attempting to treat patients when I am in this state would be plain stupid. But I could happily sit at a computer and do desk work. This experience has made me realise that nearly all of my friends are doctors. My social life stems entirely from my work life. Surely the longer I stay off work the more isolated and depressed I will become?

Cupcakes pending

I'm now at the mercy of my local Home Treatment Team. The psychiatrist I saw said this would be a short-term approach, but I can't see my mental health improving with this set up. I managed to have my shower this morning and planned to walk to the corner shop to buy cream cheese for my cupcakes. But now I have to wait for the nurse to visit to reassure her that I am okay today. That I'm not going to harm myself. That I've taken my medication.

How long is it going to take to make these cupcakes? Yesterday was impossible. I took sleeping pills in the morning to slow my mind down which left me drowsy all day. The trip to the psychiatrist felt like a disaster. Now I've got nurses visiting I feel like a prisoner in my own flat. The nurse who rang this morning called me “miss”. I'm a fucking doctor! And yet I'm having to do what nurses tell me to. This is not the natural order of things. I know that must make me sound arrogant. But it is so hard being a patient. I feel so angry.