Friday, February 28, 2014

Depression is...

As salaam alaikum,

I cannot survive without writing. Writing has become such a big part of my life, that even though I'm going to have to get up in less than 7 hours to finish clinic notes from today, darnit, I'm going to write! If I don't write before I go to sleep tonight, I'm going to explode!

And sometimes, that's what self-care during residency means. Exchanging sleep for doing something that will make your soul make sense.

Speaking of one's soul making sense...I, just a few seconds ago, over the course of several hours, whipped myself into a frenzy of sorts. I've done a lot of reflection about my place in religion, my place in Islam, my place with God, all of these things. This, in addition to facing a patient today who recently had suicidal ideation and a plan, got me feeling pretty depressed.

Soon, everything around me was depressing.

The fact that I had a patient who was 25 and a parent already while I'm 29 and single was depressing.

The fact that my best friend from med school is pregnant with her first child and I'm 29 and single, perhaps indefinitely, was depressing.

The fact that my younger cousin is enjoying the first few weeks of motherhood whereas I remember her being the age of her daughter and I feel no closer to motherhood than I was when I was her age was depressing.

The fact that over half of my friends from medical school are married and have already had their first child and I may never get married and or by the time I do I may be infertile was depressing.

The fact that I am overweight and currently hairy was depressing. No one would ever want me, and my SO would realize that and leave me, and that was also depressing.

Then I talked to my SO about God, a topic he shies away from with me because I usually have heavy thoughts. I talked to him with how my patient rationalized her severe reaction to the death in her family with God's plan and about how I realized that I've never been comfortable with God's plan. Not God's plan itself but the term, the simplified concept. I realized that it's always depressed me when it's suppose to be a source of comfort. He was not ready for this conversation at nearly 10pm at night, so I hung up the phone and brooded on my own.

And then I had an epiphany that brought me up from the depths of my self-constructed depressive episode.

For me, depression is believing that God has no plan for you, or that God's plan is for you to fail. In Qur'anic terms, that you are one of the ones who God is hardening your heart to prepare you for hellfire, and there is nothing you can do about it, because it's God's will.

This was the source of my depression when I was a teenager, and I hadn't felt that way in a long time. I don't believe it now, but I got a whiff of it as I found myself sinking deeper into my self-made funk.

That is the root of depression for me. Those times when I feel so remote from God that I begin to doubt the purpose of my existence...those are hard times.

And that is how my patient felt when she wanted to shoot herself.

And that is how I felt as an adolescent.

And that's how I would continue to feel if I didn't take a break from sleeping this evening and keep vigil by my laptop and write things out.

Depression for me is doubt in my purposeful existence. My only remedy, then, is belief.

Wednesday, February 19, 2014

The Business of Being Born


I'm following along with my cousin's induction at a distance. She was excited to go into the hospital yesterday, but I knew all too well what a nightmare inductions from 0 dilation can be. I've been following along, step by step, and now, more than 24 hours into her induction, she is finally getting into a more active labor pattern (wouldn't call her being in active labor yet!).

When she and her mother began to get discouraged when she was 1cm after 12 hours of misoprostol, I assured her that I had managed some women who were inducing over the course of 4 days (I didn't include that some of these women were so tired by the end that they opted for c-section).

To which her mother, my cousin, said, "They were in labor for 4 days?"

To which I answered, "Yes and no." Putting misoprostol in the cervix is not the start of labor. The start of labor is regular, painful contractions and cervical change. So some of those women were not even in latent labor for more than 24 hours after the first cervical maturing agents were given.

My poor cousin, who did a lot of talk on Facebook and elsewhere about her moment, how no one was going to ruin it or force her to take medications...asked for an epidural after the first hour of contractions at 2cm dilated.

Can't say I didn't see that coming...but anyway.

When my time comes in the next 5 years insha'Allah, I will not turn my nose up at an epidural, I'll say that right now! It'll be nice to try natural, but I'm for safe delivery of babies first, and I'm not sure I'd tolerate a foley balloon, either.

Anyway, all of this bustle around the third great-great-grandbaby of my grandparents (my cousin's first granddaughter, my newest first cousin twice removed, hehe) has gotten me excited about my own childbearing prospects.

So I'm just going to say it, categorically, once and for all.

I love babies. I love babies, always have, always have wanted more than I'll perhaps be able to handle, and always looked forward to the day of being a mommy. And ever since the first time that I witnessed childbirth, I've wanted to experience that as well. Yes, the moment that make most women cringe as they watch the head pop out of the introitus, sometimes destroying the perineum in its wake and gushing forth with blood and poop made me say...I want to do that!

I'm continuously bitten by the bug of seeing women around me pregnant and birthing babies. From one of my attendings, one of the former residents of my program, who had glamor shots after she had a successful vaginal delivery of her 6 pound beauty, to my co-resident who recently went to c-section to deliver her surprisingly plump 12-pounder. From the plans of one of my attendings to conceive in the next year to the current 21 week pregnancy of one of my classmate's wives. Not to mention the oodles and oodles of babies my med school classmates have been having.

I can wait my turn!

That is not a typo, haha. I certainly can wait my turn, but it doesn't make me any less excited! I don't feel any less privileged to take part in the birthing process for all of the families that I've delivered, even as that number builds up. Every time I get to deliver a baby is still exciting, though in different ways than it was initially as I build up experience. But I've seen enough people on the other side of things to know that starting a family is no joke in a way I cannot appreciate until I'm there.

So I'll just keep training for now, work on getting married first, and then will make an actual five-year plan...

In the meantime, my cousin just dilated to 5. I have to go to work in an hour in which I will be managing our maternal child service in the afternoon. So I'll be surrounded by all things baby soon enough. For now, this morning, I have to focus on my medicine patients.

But, rest assured, I've been excited about having my own children for years now. I think about having my own children seriously every day, from what they'll look like (with my current SO as the combination) to what I'll name...the girls. Boys names are tough for me.

And having experienced, through friends and patients, the joys and traumas of the conception process, from miscarriages in the second trimester, fetal demises in the third trimester, preterm deliveries, complications, and infertility...I'm ready for parenthood in any form, whether they are my own children or whether I am adopting. Insha'Allah, I'm ready... wait!

Sunday, February 16, 2014

Hypomanic Birthday


Last week, I worked for 76 hours. I haven't worked that much since I was an intern (God bless R2 year!). Yesterday alone, I worked from 6:30am to nearly 11pm. I had a video to make for my former boss (long story short) and I had to fry chicken for our weekly Friday potluck, so I got up yesterday at 4:30am. I went to bed yesterday just before midnight, I think. And then I woke up at 4am and couldn't go back to sleep and began digging into old projects.

For example, my dream would be to do a rotation in Family Medicine of some sort in Brazil, São Paulo or in Salvador if possible. I reopened my A Capella project in which I'm producing an arrangement of "What You Won't Do For Love." I was up, scrambling around my apartment looking for the notebook in which I sketched out the bass line and was immediately intimidated by the amount of work I put into this project months ago and realized that it wasn't the best project to resume at 5am.

And I don't know where I would start in trying to find contacts in Brazil in Family Medicine. Actually, I do know...I emailed a physician who I was connected with who worked in public health in São Paulo who I hadn't spoken with in almost 6 years.

Happy 29th birthday to me! Feburary 15!

That was my yesterday. I think I've finally chilled out.

I usually look at my birthday as a new year of sorts. Actually, my birthday feels more like new years than the actual advent of the new year on the Gregorian calendar does. I think my call day sent me into a temporary hypomania from which I came down slowly.

This year also totally did not feel like the beginning of a new year. I think I was too busy to have an intention-filled, mindful birthday. But that doesn't mean I don't have goals for my 29th year.

Realizations I've made in the last year, being 28 years old:

(1) I never got used to being 28. It was the most I've worked in my life and I rarely thought of how old I was. I had to think when people asked me how old I was. It seems like I was 27 longer than I was 28.

(2) 28 was a challenging year but I think it's the happiest year I've had in a while. Residency surely gave me enough stress but I think I was the healthiest I've been in a while from a mental health standpoint this past year.

(3) Prayer changes things. Immediately, sometimes! I shall never abandon it, as God has never abandoned me, even when I consider myself worthy of abandoning.

So, with that, goals for my 29th year:

-- To eat more mindfully.
-- To make more space in my life for gratitude, in prayer and in my relationships.
-- To move forward in my own personal Islam that has been in the making for the last few years.
-- To dance samba!
-- To get in the shape of my life.
-- To up my running game!
-- To write with abandon like I used to, now that I have more to write about.
-- To read more, because there's so many things I've always wanted to know more about.
-- To spend more time with friends.
-- To be more honest with myself and others about my personal values and goals.

I think that'll do it. That's a hefty enough list to tackle in one year's time.