Tuesday, December 10, 2013

The Blues

Lately I have been feeling very unmotivated. I don't much feel like going windsurfing, and the job is drudgery. I am wondering whether my depression is rearing its ugly head again.

The thing is, I have been sick of my job for much longer than this mood has been upon me, so I don't believe my cynical views about the value of my work to be a symptom of depression. I don't just prescribe pills, I spend my days capacity building and problem solving these barriers patients have, yet it makes little dent in people's ability to self manage their chronic diseases. Objectively questioning whether the traditional doctor patient relationship is an effective antidote to the barrage of fast food advertising and temptations out there in the real world is a pretty valid argument I think, particularly when our outcome statistics aren't improving. Feeling good about yourself because you are doing something, well that's just self gratification if the clinical outcomes aren't there to prove what you are doing makes a difference.

I am not saying what I and my colleagues do doesn't make a difference. I believe it is valuable work, but I do question how much my medical school knowledge and the traditional doctor-patient consultation can have an impact. I think that model is totally broken when it comes to chronic disease, when it comes to teaching people what being healthy feels like, why sugar addiction is the most pervasive and dangerous addiction in our world today, and how the hell they can change that all around. Writing a script for a pill, an exercise program, or a dietitian review is not the answer when the stores tempt people with rubbish food or when parents push the sugar drug on their kids by pouring soft drink in their bottles. We need environmental change, we need fast food advertising to be banned from children's television time slots and we need high taxes on fast food. I and my colleagues can't compete with the golden arches!!

I know that the new crop of young doctors coming through training are completely unprepared or skilled to manage these issues. There remains a continuing view from the ivory towers of tertiary hospitals and medical specialists that doctors actually have control over whether patients take their medication, or go for a walk, or binge eat on lollies and cakes. Of course hospitalised patients are totally at the mercy of their doctors in an artificially controlled environment. No wonder their diabetes is well controlled when they have no access to junk food. Do these specialists have any idea how many patients stop smoking in hospital and then immediately restart at discharge? And that's my fault???

As you can see, I am very passionate about my work, but there comes a point where continually doing what I am doing becomes soul destroying. I'd like to do even more capacity building with patients, sort of life coaching, but the fee structure doesn't allow this, so I can't. And there's limited alternative options due to only five allied health visits a year being covered by medicare. Certainly not enough to turn a person's life around. Without support from society, I see it as a losing battle. Does that mean I'm depressed??

So back to the mood. I am a little blue, but I'm pretty comfortable with blaming most of that on Hazel's recent passing. It marks a big change in my life, from obligation and commitment to free agent. What was keeping me grounded is no longer present, and that is causing me some anguish. I want to just get the fuck outta here, but I can't.

I can't because I'm still working towards my financial goals. I can't because I commited to working next year mainly for succession planning. I need to pass on my corporate knowledge of the last 13 years to my colleagues. I may be tired of being the go to girl, but I don't want to destroy the great gains we've achieved. I believe in working towards self redundancy. That's my job for 2014.

I'm not getting the anxiety attacks I got last time. I don't not want to go to work any more now than a few months ago, even a year ago. I do know that something changed when I returned to work in October, that I understood that I needed to plan my exit because long breaks were no longer cutting it. When I got back in October I looked younger and happier and people commented on it. I now look older and grumpier...

I'm a bit inclined to think that some of my mood is also part of letting go. That if I enjoyed my job I'd be inclined to continue a bit longer, save a bit more money.... I kind of like that this mood motivates me to plan my future.

Which is why this isn't depression. All I can think about is my future. I am planning, researching, purchasing, researching, organising, decluttering, budgetting.......all for my future non doctor life. It's what I get up in the morning for, it's why I look at a 35knot wind day and go "meh". It's why I no longer veg out in front of the TV but read books and research on line. Yet on the weekend I went down to Coros anyway, just because I wanted to catch up with windsurfing friends I hadn't seen since last year. I didn't care to sail, but I enjoyed chatting with my friends.

I think that this excessive planning may be screwing with me a bit though, so I have begun meditating again, and have restarted a running program. Minor mishap though when my heart rate monitor battery died... easily sorted.

I have been quite busy in the garden, having started on the rendering of the second tyre wall, as well as tending the vege patch with great love and care. I have some great updates on those projects coming soon.

So I'm a little blue, I'm a lot cynical, and I'm ready to move on. Just I've friggin' gotta be patient.... AArrgh!!

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