Tell me about it: I’m beginning to wonder if I will ever feel it is safe to practise medicine
PROBLEM: My life has never gone the way I planned. In fact, things have generally turned out better than expected. After leaving school I completed a science degree, but by the time I graduated I was expecting my first child. This was unplanned, but I loved my then boyfriend. We got married and had two more children. I spent my twenties and thirties at home rearing them and am now in my early forties and our brood have grown with the youngest due to complete the Leaving Cert next year.
The older two are in university, as am I. Over the years I admired the work of doctors and felt it was something that I could aspire to and I had no difficulties getting into medical school as a graduate. My husband and family have been really supportive. I love the academic challenge and thus far, I have been doing really well in my exams.
My friends joke that I am probably going to save money by becoming a doctor as I have spent so much over the years going to GP and private medical clinics, for my own ailments and my children’s.
Some time ago one doctor suggested that I might be a hypochondriac; I ignored her and found a new more sympathetic clinician. Since the onset of Covid-19 I have become very conscious of my own health and my family’s and where possible have tried to ensure that we only leave the house when it is absolutely essential. We have been lucky that we were all in a position to study or work from home. My husband is now back in his office and the kids are trying to lead as normal a life as possible.
I, on the other hand, am making as many excuses as possible to remain at home. I am terrified of catching Covid-19 and spreading it to others. My real problem is that I have a medical placement coming up in the next few months in an area where there is likely to be a high risk of viral infection. I do not want to raise these concerns with my course leader as I do not want him to think that I am unsuited to the profession.
On entering medicine, I never gave much thought to the associated risk of viral infection or transmission, but I am now beginning to doubt if I will ever feel it is safe to practise.
ADVICE: What you are experiencing is a more intense version of what many are going through right now – a heightening and intensifying of anxiety that may or may not have been pre-existing. When you learn to handle this experience, it will equip you to help the many patients you will meet who have symptoms linked to anxiety and fear.
Very often the cause of anxiety is fear of the unknown, or of what we think will happen
For some time now, your friends and those close to you have been pointing out a possibility of hypochondria, a fear of illness that can, and now has become chronic. There is something about a crisis that really puts what we need to face in front of us and there is a huge opportunity here for you to address this. Your motivation is that you want to continue your studies and be useful to patients on your clinical placement.
Very often the cause of anxiety is fear of the unknown, or of what we think will happen, and at the moment your fear is of coronavirus and this has a medical and factual base. What we need to do is get you to focus on the reality of the situation. Put your faith in the public health advice and try to limit your interest in the topic to responsible sources only.
As you know, we have the best medical minds and researchers working on this issue and trusting their knowledge and advice is a rational thing to do.
It might help to limit your perusal of news and social media on the virus to two sessions of 15 minutes each per day – this advice comes from Dr Brendan Kelly, in his book ‘Coping with Coronavirus, a Psychological Toolkit’. This excellent book will give you practical and well researched advice on how to start tackling your anxiety.
Overcoming this fear is something to do daily, starting with one small fear per day: acknowledge the feeling you are having and express it honestly to someone
What you can begin to get some control over is your thoughts. Most of your anxiety arrives in the form of ritual and negative thoughts and with some practice of self-awareness you can begin to spot the train of thoughts that accompany the rise in anxiety. These will mostly be in the form of fear: fear of what might happen, fear of illness of self and others and fear of future regret. We all know that fear has a shutting-down effect on us: it makes us hyper protective of those we love, it blocks our capacity for rationality and good decision making and it physically causes tension all over the body.
Overcoming this fear is something to do daily, starting with one small fear per day: acknowledge the feeling you are having and express it honestly to someone. You will find that speaking about it allows you some distance and good judgement of what you are saying. With the practice of learning to quieten your mind (e.g. yoga, mindfulness, meditation) you will gain an understanding that what goes on in your mind can be let go of and with a calm mind you get access to your innate intelligence.
This journey may take some time, but now is your chance to get some freedom from your fears – start with reading and mindfulness and if this is not working fast enough, go and see a psychotherapist who will work with your GP to support you to continue your career as a doctor.