I hate to admit it, but I still suffer from post-traumatic symptoms. As someone who had never had a history of mental health until last June, I’ve found living with a mental illness a very confronting experience. I have no obligation to share anything private about myself, but I feel it’s important to de-stigmatise mental illnesses, particularly in the medical profession.
Today felt like the right day to talk about trauma. I was on the train this morning and shared a carriage with several returned servicemen heading towards the city for Anzac Day events. It made me feel emotional looking at them in their smart blazers decorated in medals. Post-traumatic stress disorder (PTSD) can be a debilitating condition that affects many people, including soldiers and ex-soldiers. I technically do not have PTSD. I have many symptoms of PTSD but by definition I did not have a life-threatening event, so I cannot be diagnosed with it, but I have been managed by my doctors as though I do.
Initially I refused to accept that I had anything wrong with me. I considered myself simply exhausted, and thought that all I needed was a good rest. Eleven months on, I am still not back to my baseline health. I still take medications, and still receive therapy. Many doctors don’t seek help for mental health because there is a fear of mandatory reporting to the medical board if you are deemed impaired from your condition, and there is still a general taboo surrounding mental health. We know that 1 in 5 doctors have been diagnosed with, or treated for, depression. Despite how common it is, we still don’t talk about it because we perceive it as a weakness and we worry that it may affect others’ perception of our abilities as a doctor.
Let’s be real. We all have problems. We all have shit going on in our lives that others don’t know about. What we see on each other’s social media are highlight reels – including mine. I was still posting things on Instagram from my hospital bed as though I was living a normal life, because being a psychiatric inpatient was my shameful secret. The reality is, we all go through lows. In medicine, we witness incredibly sad things – a diagnosis of cancer, neuro-degenerative diseases with no cure, deaths, tragic accidents… the list goes on. We also cope with aggression, abuse, bullying and harassment. It’s a tough gig.
I didn’t want to say that I was traumatised from my experience as a Plastic & Reconstructive surgery registrar last year. To admit to that felt like I was exposing a weakness in my character, but that was my own prejudice speaking. When I was in hospital last year, my treating psychiatrist recognised that trauma was a major part of my presentation and strongly suggested I see a psychologist. I didn’t accept it at first. I questioned him, and asked whether he believed in adrenal fatigue, and whether there was a possibility that I had that instead?
I recently started speaking to audiences about my experience, which is something I’m now able to do. However, I discovered that there are still things I can’t do. When I went to Ballarat Hospital to give a talk on burnout and mental health, I also offered to give a hand injuries tutorial whilst I was there. This is something I used to love doing. I was sent some teaching material from the clinical school, but as I was going through the slides, I couldn’t keep going. I started getting flashbacks and felt nauseated by the images of hand injuries that were on the slides. I almost felt paralysed and felt like I wouldn’t be able to do this tutorial, so apologetically I withdrew my offer to teach.
Once I got back to Melbourne from Ballarat, I took the tram to my friend’s place. The tram stopped at the corner of Commercial and St Kilda Roads. It was my old stop outside The Alfred Hospital. Overall I had a good experience at the Alfred, but I can’t deal with anything hospital-related right now. I felt silly, but I couldn’t look up. I stared at my lap… C’mon Yumiko, just look up, it’ll be fine, I told myself. I quickly lifted my head to see the Chevron apartments and The Alfred logo through the window… but after a split-second I had to look back down. I couldn’t deal with it.
So, I guess I’m still not okay. Currently I am still going through dialectical behavioural therapy (DBT) and other therapies. DBT was first developed to treat borderline personality disorder, but it now has a much broader application; it is used to treat depression, anxiety, eating disorders, as well as PTSD. Some of the features of DBT include teaching patients self-soothing techniques, so that when unpleasant feelings arise in your body you are able to calm them down rather than letting them escalate and consume you.
I wrote this post to say this: It’s okay to not be okay. I am not ashamed that I have a mental illness. I am not ashamed that I am receiving therapy. I am not ashamed that I need help. I accept that I developed a mental illness as a result of what happened at work last year. It is not a reflection of my personal qualities. I am strong, resilient, and proactive. I accepted therapy because I am proactive and taking responsibility for – and ownership of – my own recovery. For that I am proud, and that’s the reason I’m getting better – because I asked for help when I needed it. To keep on going when you’re suffering is not brave, it’s irresponsible. To admit you have a problem is the braver thing to do.
Mental illness is common. If you need help, ask for it. Your mind and heart will thank you for it when you’re in a better place. Trust me – I’m a doctor.
Take care,
Miko xx
Thank you for this article. It’s so powerful, honest & encouraging.
Hi Miko, thank you for reading! Much love, your namesake xx
Thank you for sharing this Miko. Your honesty and vulnerability are inspirational.
Thank you for reading and for your kind words. Much love.
that was very brave Miko to share that.
i remember from the pharmacology lectures at university the lecturer explaining the animal models of depression. I remember the associate professor describing one model where they would use mice (or rats – I forget) and put them in cages. then they would give the animals random shocks. after a while, the animals would feel helpless and would just lie down on the bottom of the cage and not move. this was the helplessness model of depression.
in humans, there is this theory of “locus of control”. it can either be external or internal. now those with an internal locus of control rarely get depression since they feel empowered. those with an external locus of control feel helpless and are depression prone. The path that you and others have walked means that you end up with an external locus of control since you are NOT in control of your destiny. it is up to the opinions of others who may or may not like you. Compare that situation with say being an accountant where (if you are bullied) you quit one company and join another (or even start your own). there is only one company in this surgical game so you are too afraid to be assertive even if you are being abused.
now, if I may share with you my reaction when I pulled the plug… it was completely different to yours. I hope that you can benefit from my perspective…. when I was turned down for less qualified candidates initially I felt ill. That passed. Say 2 weeks. Then I felt great. I felt empowered. I felt like my “normal” self. I was not afraid to stand up for myself if I was treated unfairly. A great weight had been lifted off my shoulder because I did not want or need to play anyone’s game except my own.
now moving forward, I want to give you some tough love. You sacrificed a lot to get your medical degree. Don’t throw it away. you need to do a fellowship. Any fellowship. doesnt matter. and believe it or not, you are luckier than others since some of your skills are more transferable. you could be an awesome dermatologist. or a GP with interest in skin cancers or cosmetics.
what worries me is that you are not getting back on the horse. and you need to. dont make this hiatus too long.
let me tell you life is AWESOME after you become a fellow (of any college). you set your hours, you dont have to put up with garbage. you could work part time, start a medical business or start a non medical business (?a yoga empire). you can do anything. but begin soon. you need something to take your focus away. you need to silence your left brain and get a new passion.
these are 3 books that you might be interested in reading
viktor frankl – this is a philosopher who was imprisoned by the nazis. he said that despite the atrocities they were doing, they could NOT control his internal state. only he can control that. that applies to you too
the power of now – in this book, the author talks about the pain body. the more you think about past hurts, the more you relieve them. this is about being now oriented.
the law of attraction – you get what you think about.
I hope to see you posting about your new career in the future. and happy stuff. like yoga.
trust me, life is AWESOME once you get a fellowship. you will be back in control. you will be able to control your schedule, your social life, how much money you make. I can’t describe how awesome it feels to be in control.
when I think back to my experience, i dont feel depressed. I feel angry at how many years they took and how I let myself be treated like that. but that angry feeling doesnt last long – i bring myself back to the present. and the future looks friggin awesome. so does yours. you just need to see it.
Thank you for your thoughts. I have read Power of Now and it has definitely shaped me a lot and helped me in the past year. It’s a book I will read every year. You’re right, there are thoughts of going back to train, but for now I’m sick of studying and training. I need time off at the moment to get better, but don’t worry, I have a lot of things happening behind the scenes, including a move forward in my career, and I can’t wait to write about that soon! I am also engaged in a big project that I will hopefully announce in the next few weeks. Sorry to be vague but these things are under wraps at the moment until it becomes a bit more official (paperwork and things!)
Thanks for the “tough love”. I appreciate your support and the clear passion you have in staying strong and moving forward. I’m glad to hear that you are in a great place right now despite past injustices.
HI Miko. Thanks so much for sharing your story. It is so important for others to hear the stories of people who have been on journey’s like yours. Look forward to meeting you later this year.
Hi Sophie,
Thanks for reading! I look forward to meeting you too.
Lots of love,
Miko
Thanks Miko for sharing your experiences. It is excellent material for all of us to reflect upon. I hope you also gained some benefit from the telling of your story.
I unfortunately have been at the other end of experiences with the mental health teams. I was set up by a very vindictive wife and was actually made an involuntary patient. When the Monash Health team realised they had made a mistake they did not apologise but labelled me with a fictitious diagnosis that justified their actions. The diagnosis has since been shown to be false but I now have a form of PTSD and have lost faith in humanity. I have been irreparably harmed by the intervention of Monash Health to the point where I attempted to take my own life.
I hope you and others can use this story as a focus of reflection as well. I feel better for sharing it.
Hi Stewart,
What a horrifying thing for you to have gone through – I’m so sorry to hear that. It must have been a nightmare to be made involuntary and forced to go to a public psychiatric unit against your will when you weren’t mentally unwell. I hope you are getting better. I can’t even imagine what it’s like to recover from something like that.
My best wishes to you.
It’s great to hear you are gradually improving. Its interesting that you don’t fit the formal definition for PTSD. About a month after you went public, @ZoggMD published an interesting video https://t.co/bvCsToW5WM suggesting we call it Moral Injury rather than burnout. “Burnout” is too suggestive of it being your fault or weakness – and way too close to victim blaming. It wasn’t your weakness. You were brutalised at Bankstown Hospital and you probably weren’t part of a particular Boys Club…. you didn’t burn out, they set you on fire. I hope you can continue to rehab your injuries and eventually make full use of your abilities.
Dear Kevin, thanks for your message. That is a powerful video. I hope to see more institutions taking responsibility for the welfare of their employees and not putting the onus on individuals being more “resilient”. I am a bit sick of hearing the word “resilience” because so many of us who experience burnout are actually very resilient people. Thank you for your empathy – I really appreciate your comment!
There are no traumatic events, only traumatic experiences.
Good point, Michael. I appreciate that
Mourning. I left surgery as a resident. The failure, the death of that career, felt like someone i knew had died. I used to be fond of all things related to abdominal procedures, everything from the details of preparations/drapping, anesthesia, surgical material and choices. After the event, i couldnt bear it, it was not because it seemed ugly or terrible, but it reminded me of that failure. Some people tell me what doesnt kill me makes me stronger, but i have to give myself a fair evaluation. Being a surgeon will not be something i do in this life, in part because i couldnt make terms with the drawbacks, that were accentuated by specific cirumstances.
I will always be fond of surgery.
I am sorry english is not my first language.
Hello,
Thank you for sharing your story. I can relate to you. I still think Plastic Surgery is fascinating and such beautiful, intricate surgery… but reminders of it can be painful because of what happened. You are right to think of it like a ‘death’ because it is a loss of a career, and we go through the same grief process. I hope you are happier now and I wish you all the best.
Miko
My family always supported me. One thing they can’t do, they cant sympathize on why i left because it is something very unique to that experience. That is something heavy to bear. I am sure your family must support you no matter what, they understand you were exhausted and treated unfairly. But only you can forgive yourself.