internship and depression
It started so insidiously. I was in the middle of a general medical term, not enough hands to balance patient files with observation charts and patient lists. Medication charts that were never perfect, discharge summaries piling up, the never-ending beeps of my pager. Cover shifts that extended beyond finishing time and the post-take days, afraid to come in to work because the patient load would have doubled overnight, the ward round bound to take twice as long.
That was why I was tired all the time. If I finished early, it was to go home and sleep. If I had a rare moment of silence on the wards, I went to the doctor’s lounge and slept. Eight pm was my preferred bed time, and even then, I struggled to wake with my alarm. Breakfast was sacrificed for five, ten, fifteen minutes more sleep. I didn’t want to leave the house to buy groceries or visit friends. I didn’t have the energy to call or text friends. I had no energy so I stopped cooking. It was easier to eat pizza and curries that arrived on my doorstep.
I wasn’t depressed. I was just tired. I was overworked. I made excuses for my fatigue and my amotivation and my anergia. I made excuses for the low mood and anergia. I ignored the voice in my head that suggested reaching out as an option. Everyone else was coping. Everyone else was working harder and better. You’re attention seeking, narcissistic, nothing more.
That rotation ended. I moved to a different ward. Three days in, I was in theatre watching a case. My registrar asked me to chart antibiotics. I stepped to close to the anaesthetist and was promptly reprimanded. In hindsight, he wasn’t mean or rude or nasty. But tears sprung up in my eyes and I couldn’t make them go away. I tried mindfulness. I tried thinking about happy things. But five minutes later, I was out of the operating room, hiding in the women’s bathroom, trying to get myself together. I couldn’t think of a reason to cry, but I couldn’t stop crying.
I escaped the hospital and forced myself to see a family doctor for a medical certificate. She said the word depressed. She talked about medication and reviews and time off. That’s what happened. I took a week off. I slept most of it away. I told a colleague and a friend and they helped with food and driving and appointments and covering my shifts. I started being awake more, more motivated. Things gradually got better. I survived nine more weeks of theatre.
I’m in a much better place now.
Intern year is difficult, there is no doubt about that. It is exhausting at times. But please know that when bad days turn into weeks, there is help available. Know your warning signs. Know that when you start feeling like your symptoms match the DSM, that you are allowed to reach out. Know that you are not weak or attention seeking or a failure. Don’t assume that everyone else is coping and that you should simply harden up.
You are not supposed to be infallible. You are human first, doctor second – there is no shame in asking for help.
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