eidolon

[Friday, March 30, 2007]

Lithium.

Over the past few weeks after having my apartment broken into and robbed (my laptop was taken!), finding out my grandmother has cancer, and deciding to visit my first psychiatrist - the following has resulted: 1) I got a new laptop and now have connectivity again! Hurrah!!! 2) the psychiatrist suggested lithium (among other things like wellbutrin) and called me hypomanic. I wanted to slap him.

Can we please make sure I actually have a problem before deciding to medicate me? When I know I only have 45 minutes for a session, obviously - I'm going to go in there and just spill my guts. Is it possible I was having a particularly bad day and perhaps this one visit isn't representative of my usual state? I didn't realize this would be viewed so pathologically. He asked me what I was hoping to gain from the session. That was a good question. At the time, I couldn't really put it into words. I told him I had been having a few problems that have been ongoing since the fall, and since they didn't blow over - I figured maybe it was time to see someone, and I'd come in and see what he had to say. I didn't expect him to be so trigger-happy with his diagnoses or with his prescription pad. Nor did I think that he'd mention something as strong as lithium after just one 45-minute session. I was stunned. Good God. Lithium can give you seizures!

Since then, I've had some time to give it some more thought. What was I really hoping to accomplish. I don't know. I guess what I wanted to hear was that how I'm feeling is normal for second-year medical students. That this is the standard second-year-blues, or the sophomore slump. And that I need to do x, y, and z to help me get out of it (exercise? meditate?). I have a suspicion this mood might be par for the course, but the only person who can really confirm it is him since he's the school psychiatrist. I also didn't expect him to be booked for the next 3 weeks when I first called for an appointment. I recognized the kid coming out of the appointment before me, and the kid who was coming in after me. Walking out of his office (sans drugs, I told him I'd hold off on those for now), I started to wonder how many of my classmates were medicated by this guy.

Since then, I've had a chance to examine myself. What can I really get from this guy that I can't get from my friends? Yes, I talk quickly and sometimes tangentially - which theoretically fits the criteria for mania, but anyone who knows me realizes that this is part of who I am. And that I don't indulge in the rest of the behavior that characterizes mania (not needing a lot of sleep, grandiose ideas, reckless uninhibited behavior, etc.). Yes, I may have cried a little in his office, but I've had a lot of stressors in my life recently. Potential cervical cancer, the loss of all my photos with the theft of my laptop, the relentless exam schedule, my parents pressuring me to get married, my grandparents' health. That and, simply being in a psychiatrist's office was stressful and upsetting. It's hard for me to ever acknowledge that maybe I can't hack it on my own. I like to think I'm a pretty capable person. Sitting in that chair and telling a completely stranger my problems made me want to cry at the situation I'd found myself in. How did things come to this?

I'd fallen off the wagon since the fall. Around October or so, my motivation to study decreased dramatically. At first, I chalked it up to simple burnout. I'm the type of person who hates studying (who doesn't?) but gets her shit done because she has to. This stopped in October. My study habits started falling apart. But when this "burnout" persisted to March, I realized that something needed to be done. I was cramming for exams 3 days prior and somehow passing, but this obviously wasn't a healthy way to be living. I had no interest in my own performance at school and lived in constant fear of failing one of my exams. I wasn't studying that much. It was only a matter of time at this rate. I'd stopped going grocery shopping and cooking meals for myself (something I used to love doing), I'd stopped eating as healthy as I used to, and I'd stopped pining away for dance classes and art classes. I even stopped watching the Simpsons. So what was I doing if I wasn't studying, eating, or doing something I normally liked? I don't know. I spent some of the time moping that I didn't have a laptop and waiting for my new one to come in. I spent the rest of the time panicking about some upcoming exam (every 3 weeks baby). Life just lost some of its color. The running narration I usually have in my head also fell silent.

So what was actually going right? Well, I was still functional. I still got up every morning and went about my day (it just didn't include studying). I still called friends I hadn't talked to in a while and caught up with them. Laughed, cracked jokes. I went to brunch with classmates. I went out for beers. I talked to my family. I made dermatologist and gynecologist appointments for myself. Got my haircut. And sometimes I laid on my bed in the middle of the day and wondered what I was doing with my life. Wondered why I was sabotaging medical school when I'd worked so hard to get here. And what was I going to do if this motivational funk I was in didn't resolve by May, when I had to start studying for the Board exams. That was what prompted the psychiatrist appointment. I wasn't about to let some pseudo-temporary funk have long term consequences on the rest of my life if this caused me to not do well on the Board exams.

I suppose I'm not anti-medication. But, in my mind, meds are a last resort. I would've liked the doctor to try other things with me first. I don't think I'm a lost cause, nor do I think I'm a serious case. I think I can be fixed in other ways. Maybe show me a different way to handle stress and pressure, since I'm obviously not doing it properly right now. It's just the sheer stamina of it. I've been plugging away at this damn thing for close to 18 months now. The endless cycle of exams. The detail. The drugs I have to memorize. How demanding it is of my life, my energy, and my time. At some point along the way, I realized that I had no control over my life. And I started to take it back in small ways with minor acts of rebellion. I stayed up till 5 AM one night, for no other reason than the fact that I could. And I wasn't going to study while I was at it. I read a magazine and surfed the web. When things were getting critical for an exam and I knew I really needed to start studying, I watched 3 hours of America's Next Top Model instead. And I started to resent med school for other things in my life that weren't falling into place. Though it's perfectly possible that I may still be single if I were still working in NY, in my mind - it became med school's fault that no one loved me, because I never had the opportunity to go out and meet new people. Everything was med school's fault. Obviously, this is not the most mature way of handling things, but for some unknown reason - this was how my brain was dealing with it. I don't know what changed between first year and second year. I could deal with it last year in a normal adult manner and get through things. Maybe this year it just became too much.

We learned about this concept called Learned Helplessness in class. Doctors put dogs into an electric cage and would shock them periodically. At first, the dogs would jump and whine and frantically try to find an area of the cage that was not electrified where they could stand. But after a certain period of time, the dog stopped responding to the electric shocks and stopped looking for an escape. It simply curled up in the corner of the cage. Tom told me that this is how they train elephants also. They tie their leg to a stick when they're little, so all they can do is walk around this stick. At that age, they don't have the strength to pull the stake out of the ground. They keep trying for a while, but eventually - they learn that they can't get out of this situation. Then when they're grown elephants, you see them tied to the same tiny little stake. Though they now have the strength to simply pull out the stake, they don't because they've learned that it's not possible. Is this what medical school is?

Sometimes I wonder - I used to be really good at rolling with the punches. Have I lost that ability? Or has there simply been too many punches, some were bound to land, and I can't help but curl up and start crying?

A lot of my friends who go to the school psychiatrist really love him. I can't say my feelings mirror theirs. I don't think I need lithium, but obviously - I'm very good at looking completely crazy when I'm in his office. Though I'm a little insulted that my natural state apparently looks like bipolarism, I do get 3 free sessions with him, so I figure I'll at the least use them up. I'll take a page out of my Equal Opportunity Dating tenet and apply it to the psychiatrist. I'll chalk it up to a bad "first date", but I'm a second-chancer. Someone with this many good personal testimonials behind him can't be all bad. I'll give it another whirl. With caution of course. And in the meantime, I'm going to force myself to start doing a few things that I think will help. I think writing is good for me. It's a way for me to talk to myself and then re-examine it later.

Besides, maybe if I am bipolar, I can sell my bipolar musings to a publisher at some point in the future and make a killing off of it. Goodbye student loan debt! Med school, which caused these problems, would then also pay for itself. What irony.

Posted by ink | 9:07 AM

[Saturday, March 10, 2007]

=(

So my apartment was burgled a few days ago. I came back from Parents' Day at 2 pm in the afternoon and went immediately to check my email (being the internet junkie that I am) and noticed that my laptop wasn't on my desk. Checked my backpack in case I packed it - funny not there either. Went downstairs to see if it was in the living room - nope. But hey - the camera that was on the kitchen table is gone. Nothing else out of place. Went back upstairs - wait a second... my docking station is missing and my desk is pulled out a bit. And my old Dell laptop isn't sitting where I normally store it. And there's this strange pile of clothes on the floor that isn't part of the mess I made last night.

The clothes were from a bag of donated items I was going to bring to Goodwill in the afternoon. My guess is that they dumped the clothes out and used the bag to carry off my two laptops and camera. Nothing else was missing. They didn't take the credit cards I had left on my desk, or my roommate's desktop computer. The DVD player was still downstairs, as was our wireless router. All that was missing was the past 5 years of my life encapsulated in a little black Thinkpad and a beat-up silver Dell. Photos; journal entries and blog entries that I never got around to posting; some experimental video journaling I was doing; all my tax returns from the past 5 years; my financial aid and student loan info; and all my notes for my upcoming exam this Friday. It's like the past 5 years never even happened. Pictures from the White Coat Ceremony with my family when I first got into medical school. My kids in Africa. China. My grad school days.

The magnitude of this emotional setback hasn't even begun to hit me. Oddly enough - I haven't cried over it. I don't think I actually believe it's gone. It's only when I'll go back to look for things that it will hit me bit by bit over time. This will be a painful long recovery. For the time being, Tad Hamilton (yes, the neighbor I dated last semester) has offered to lend me his laptop till my exam on Friday. I ran into him on the street the night it happened and told him about it. I was hesitant about re-opening the lines of communication because I feel like we're both doing really well without each other. But - I do need a laptop for my upcoming exam. For now, my friend Sonrisas lent me her brother's laptop which I'll have until Sunday, at which point I'll switch over to Tad's laptop. Why not use Tad's from the start since I'll be using it for most of the week anyway? I don't know.

Right now it sits on my desk and all I've done is stare at it.

Posted by ink | 10:20 PM

[Wednesday, March 07, 2007]

With money in my pocket and money on my brain.

So, as my debt grows, and I keep coveting things like designer jeans and plane tickets to Guatemala for spring break, I've realized that I can't go on living like this. I hate worrying about money and having to figure out what I can and can't spend money on. I receive my financial aid check twice a year, and then I suck on my that money and anxiously watch it decrease each month as I write checks for rent, groceries, utilities, and what I consider "sanity expenses" - i.e. the occasional outing and clothing purchase.

Since I have about $5000 sitting in my "backup" account (all that remains of my savings from my year working as a consultant in NY), I decided that I need to do something with that money than have it accumulate interest. I started off with a book I already have sitting on my shelf: The Wall Street Journal Complete Money and Investing Guidebook. I figure I can learn basic vocab here. Things like the difference between the NYSE and the NASDAQ. I'm hoping that the top scores I got in micro and macroecon in college speak towards some sort of natural aptitude. Though - based on what little I remember of econ, a lot of it seemed to assume "ideal conditions" that to me seemed unrealistic.

Next, I did some googling to see what was available as far as a recommended list of books to read. No fluff. I want the equivalent of the O'Reilly books for programming and comp sci. The bibles. And I'd like an updated version with useful recommendations for things like reputable online brokerage firms (as well as a listing of pros/cons of each recommended one) and money-handling software that may help me keep my investments organized.

What I found was this interesting subset of investment books that catered directly to women. "Chicks laying Nest Eggs." "Investment basics for Women: The Essential Guide to Taking Charge of your Money." These confused me. Why would investing be any different for women than men? Are these dumbed down versions of the "boy" books? What would be in a woman's book that wouldn't be in a man's? According to a description off of amazon.com, one of these books addresses women's "special needs" and is written in language "easy to understand for any woman." Give me a break!

Shooting off an email to a few med school girl friends of mine revealed that the majority of them let their dads/boyfriends invest their money, or they had their money in 'safe' places like an IRA account or a CD and were quite content with that. No one expressed an interest in reading "Complete Money and Investing Guidebook" with me or learning what a P/E ratio is.

Shooting off an email to the med school boys, on the other hand, generated a lot of interest and a suggestion that we get a group together to pool our knowledge.

Is money just inherently a boy thing?

Posted by ink | 2:23 PM