Biggest meltdown of 2014

I have spent most of boxing day today enjoying the Korean TV series “You Who Came From the Stars.” It is a great show, and I am now hooked after an online marathon of the last 12 episodes.

However, about 20 minutes ago, I found myself sobbing my eyes out in the middle of the show. It was not so much due to the drama’s plot, but rather because I was suddenly overwhelmed with a sense of overwhelming loneliness and helplessness. Out of the blue, I started feeling intensely sorry for myself.

December has been a particularly rough month for me. While I am thankful for the Christmas break this weekend, my mind continues to replay all the little things that have been taking it in turns to nibble away at the facade of strength I wear everyday:

The work-study-sleep life cycle that ushered in this last month of 2014.

The times at viva practice and at the revision courses when I felt like everyone else just did not like me and wanted to work in a different group from me.

The dirtiest look Liz has ever thrown at me when I could not describe to her the anatomy of the Larynx during one of our practice viva sessions.

Sitting the exam with such confidence that I will pass (because I have worked so so hard), only to scan the list of successful candidates over and over and over again but fail to find my candidate number over and over and over again.

The shame of having to tell everyone that I have FAILED and let them down, especially after all the efforts that some people have gone to help me out.

Being on lists with consultants who repeatedly tell me that what I am doing is wrong. In fact, A Jones went as far as not even letting me touch his patient or the anaesthetic machine when we were on an eye list the other day.

I am a crappy anaesthetist. I was 2nd on-call 2 days ago- I could not do a sciatic nerve block, could not get the damned CVC line into this renal patient (granted, she has had LOTS of IV access issues in the past), did not notice that the patient had been slowly oozing out a fifth of her circulating volume in the last 4 hours…

Went on holiday with JX and had her antagonising me and throw scathing remarks for all my inappropriate jokes, my vulgarness, my inattentiveness, my general stupidity… all whilst willing myself to swallow down my pride and not say or do anything that will ruin a friendship that I actually still do treasure.

Attended the Christmas day church service yesterday morning, only to be surrounded by families with babies and lots of people that I do not know (mind, I have been in this church for 7 years). Even a family that I did know chose to sit a seat away from me to keep their distance, and said very little to me. I ended up being seated by my lonesome self in the corner of the room most of the morning.

Spent Christmas with the W family yesterday, which was lovely, other than the fact that the invitation came so late that inviting me almost seemed like an afterthought. Their oldest little boy, whom I love, also treated me like he did not care that I was there- no requests for me to read him a storybook like he always did… in fact, no interaction at all!

I am lonely and pining for some love and affection.

So yes, for all of the above reasons, I wailed and whimpered for a good 10 minutes. I had thought that my lacrimal glands do not work anymore… especially when I simply could not summon tears when I had wanted to vent my exam-related frustrations earlier in the month. Well, that is definitely not true because the tears came on fast and furious today. My “walls” broke down during that time, and for 10 minutes, I stopped lying to myself that everything is ok. I know that all is not fine. I am miserable, insecure and lonely.

Obviously, the sobbing had to stop when I finally managed to tire myself out. It almost seems ludicrous but I also patted myself on the shoulder for a good 5 minutes in consolation that “everything will be alright,” “things will get better.” I really needed a touch, a hug, a hand to hold, but that was all I could offer myself…

Now that the tears have been wiped off, time to pick yourself up again J.

Gambatte ne!

One mark nightmare

So, I received my exam score breakdown today.

I scored good marks for my clinical viva.

Then went on to fail the entire exam by one miserable mark.

This is like the primary viva one mark nightmare replayed all over again for me.

But you know what, maybe it is somehow a blessing in disguise.

Maybe God knew that it would not be satisfactory enough for me to have a knowledge base and foundation worth only 31/40.

I am determined to work diligently and consistently in the coming 6 months, not madly and self-neglectingly like I have done for the last 3.

I am determined to go back to Red Lion Square next summer & show them that I am worthy of the FRCA.

Go girl.

Praise the Lord.

Failed the fucker

Pardon my language. At Stage 2 of my usual coping strategy at present (see Coping Strategies)

I thought I had it in the bag after sailing through a really straightforward clinical anaesthesia viva in the morning.

The afternoon was a lot less pleasant, and I almost certainly fell down on my clinical sciences. I also realised by the end of the afternoon that I had taken a completely wrong route for revising for the science viva. They never wanted me to know stuff down to the detail of the primary exam, but really wanted to focus in on clinical application of the sciences instead.

What a shitty day. After all that nausea, breathlessness, palpitations and queasiness, the FRCA is still not mine to enjoy. The suffering is prolonged yet again, and will no doubt involve more sacrifices of precious time and my mental health.

Been feeling ashamed all evening as I texted all the people who have helped me along hitherto with my bad news. Took the train of shame back home and am now strategising on how to hold my head up high at work tomorrow.

Pissed off as heck at the moment, though I’m sure a moment of thoughtful reflection will strike later on.

Words cannot even begin to describe….

The mental anguish

The physical exhaustion

The constant worry and anxiety

The niggling guilt whenever I am away from my revision

The dreaded final exam is in 7 days time. I feel like there is still so much more ground that needs to be covered, though I doubt anyone can ever be completely prepared for it. After all, I am “only” expected to learn not just anaesthesia, but also medicine, surgery, paediatrics, obsterics & gynaecology, neurosurgery, cardiothoracics, ITU, A&E, anatomy, physiology, physics, pharmacology, and the art of talking. You would think that “surely they only expect you to know the basic principles,” until you get quizzed on the pKa of cocaine, or the exact angle of the right main bronchus compared to the left.

I do hate being viva-ed. I hate being asked all these difficult questions by my consultants and colleagues. I dread the possibility of coming across as “thick” and ineloquent whenever we go through the long and short cases. Yet, despite how much I really dread asking a consultant to viva me, I force myself to do so. I go asking for trouble. I put myself out there in a vulnerable and very uncomfortable position. All for the sake of practice & perfection.

These last few weeks have gone by in yet another exam-induced blur (It is concerning that there have been so many “missing”/ blank periods in the memory of my life these last 4 years). I have completely sacrificed my evenings, my weekends, my sleep, my social life. Heck, I even sacrificed my birthday and spent it doing 12 hours worth of magic roundabouts at the viva revision weekend. It just sucks so bad when you spend the minutes before going off to sleep thinking about the Budapest criteria for complex regional pain syndrome, then find yourself waking up in the middle of the night with your brain racing away trying to describe the anatomy of the larynx.

Sometimes, I look at the patients smoking at the hospital’s main entrance and wonder if they can or ever will appreciate this torture we are going through just so we can look after them. I don’t think they ever will, especially when so many of them do not even realise that Anaesthetists are doctors too…

Some of my friends have pointed fingers at me accusing me of managing a terrible work-life balance. People shake their heads when they hear how life has now been reduced to the work-study-sleep cycle yet again. I don’t think they understand. This is literally the last hurdle. The Royal College will unshackle my freedom and return it to me the moment I pass this exam. My sanity will be returned to its rightful owner, and perhaps there will finally be time to vacuum the floor, scrub up the bathroom, or change the bedsheets. For now though, I need to work and plan diligently for the day I go to “war” fighting for my freedom.

I do need to manage this stress though, and realise that taking an exam is not a truly stressful situation. As DG always says, true stress is when you knock a kid down in your car on your way to work, when a loved one is diagnosed with a terminal illness, or when you are cold & hungry with no knowledge of when or where your next meal will come from. These are truly stressful situations. An exam? That is nothing in comparison. So what if I fail this test? I get to sit it again, that is all. Yes, it will be a pain in the bottom, but that is not the end of the world.

J, please remember this.

Keep going, keep praying. God will sustain you through it all. He already knows if you are going to nail it or fail it. Note this, and have peace.