I can't sleep and...

i am wishing that i didn't have to live life in chronological order. imagine if you woke up every day not knowing what part of your life that day would come from. i could wake up with butterflies in my stomach and think "fantastic - i must be just falling in love with mr me - there will be some perfect kissing today." one day i might have lost the use of my legs, and the next day discover i was 9 again, and spend the whole day running and dancing around. i might spend a day caring for baby blue through the chicken pox and be up all night with him, and the next day be 15 again and i could give my mum a big hug of appreciation for all the time she spent caring for me instead of wishing she wouldn't embarrass me. i might work a 12 hour shift in A+E and the next day wake up to find i had retired, and spend the whole day resting, reading, walking by a lake. i might be one day a widow, and the next be back with mr me, and greet him as if we'd been separated by death for years. any day i woke up and baby blue was still a baby i would be so thrilled to hold him in my arms as he was my tiny baby again, and no matter how hard the day and night were i would treasure every second.

I suppose this idea is a little like the concept behind "The Time Traveller's Wife" - and shows the sheer joy and privilege of a single day with our loved ones. Somehow it is very hard to live in that joy when you know that tomorrow will be "just the same". But it never is exactly the same. Living in time is the enemy of valuing the moment. Anybody else fancy my idea of a mixed up life? i suppose it might be a little bit hard to ever get anything done...

Warning: sentimental post coming up

I think I've finally understood one of the mysteries of being a mother. It's the trait that young people can't understand as they grow up and become independent - why their mother can't let go, can't let their babies grow up. "Time has moved on," the child reasons, "I've changed, why can't she accept that?"

It's because she's still caught in the magic of this fleeting time, the time I'm living through now. It's a time when tiny hands come up around your neck and cling to you, when huge clear blue eyes gaze up at yours with total trust, when a tiny warm body snuggles into yours, sucking nutrition, growth, life from you, when a wave or a pincer grip can make you so proud you can hardly speak, and when a little face splits into a smile of pure delight at the sight of your face in the morning. It's such an unspeakably precious time, and it's over so fast, no wonder mothers say, "But s/he's still my baby..." I suppose the only way to learn to let go is to remember that they never were ours, they were only lent to us for a short time.

negative voices

It all started this morning when a friend dropped by to lend me a baby door bouncer... My elderly next door neighbour said hello to her and her 1 year old daughter, and she mentioned that it was a lovely day for gardening. He then said pointedly to me, "Yes, did you hear that? it is a lovely day for gardening."

Now our next door neighbour is a retired man (normally really lovely), and obsessed with his garden. As far as I can tell, he spends most of every day out there, despite his fairly advanced lung disease, and it is always pristine and beautiful in every season. Our garden, on the other hand, is a little rough around the edges. It has a wild unmown section at the bottom, which is a deliberate choice to give bees etc some habitat, but I sense he's not too keen on that feature, since some weeds grow there. The beds mostly have easy care perrenials in, because that's all I had time for at the best of pre-baby times. And ok the lawns haven't been mown yet this year, and things have gone a bit "to seed" since the pelvic pain kicked in halfway through pregnancy. But in my opinion it looks presentable. Compared to two and a half years ago when we bought the house and the plot was half rubble, half bed full of weeds, it's practically an oasis.

What was really disturbing was what that simple jokey comment, (which I may have totally read too much into), did to the rest of my day. I was instantly torn between paranoia (oh no he thinks I'm a terrible neighbour and inadequate housewife, gallivanting off to baby groups all week without attending to my own back garden) and anger (doesn't he understand what it's like having a new baby to take care of and how difficult it is to even keep the house clean?). I became unable to focus on the conversation with my friend after she came into the house, even though she dismissed him as a cheeky old man, and then I began to feel bad that I was coming across as scatty and absent and not in control. We talked a little about it at the end, and she said to me as she left "You're doing a great job. Hear that." But sadly this was no use. The negative comment had sunk into my brain somehow and was blocking all positivity out.

By the time I set off for my breastfeeding support group, my brain was a storm of negative voices. I spent the pleasurable sunny walk across the park thinking about my choices as a mother, and spiralling down into self-doubt. I began thinking about what will happen when I go back to work. Currently I'm planning to complete my training working half time, and then get a permanent job with even less sessions than that, if possible. I started hearing the (mostly male) voices of my colleagues at my current practice, who already feel that a year of maternity leave is an extended holiday and that I won't remember anything when I get back. Soft option they were saying to me, don't you care about your career? don't you want your son to go to private school like our children? don't you want to be a partner? Then my paranoid version of my parents voices started, You need to give your time to your child, they grow up so fast... and Christians I have read books by if you have the means you should give up work, God intended mums to look after their children. I began to feel that I will be giving both baby blue and my work less than my best. Next I began to worry what mr me was feeling about me, and projected onto him the view that I spend all week having fun and coffee with my friends, while he slaves away at work. Then I started wondering what other mums think of me, and whether they see me as a failure because baby blue is still in disposables and still has to be cuddled to sleep for his daytime naps. Then my childless friends - do they think I've turned into an antisocial baby bore? Then my own judgements on me - I forgot to clean his tooth again this morning, maybe he'll grow up with tooth decay... I didn't realise he was hungry for half an hour of grumpiness, maybe he's not growing as well as he should be because I don't feed him enough.... You get the general idea.

Fortunately the thought bog was stopped when I got to baby cafe by an hour of chatting to fellow mums, venting my frustrations re the next door neighbour, and feeling a little more that everyone's in the same boat i.e. we're all doing our best. This evening has cheered me up even more, with some affirmation from mr me, and an 8pm decaf vanilla latte at Borders, accompanied by some Marie Claire reading while he kindly manned the baby monitor at home. However, just typing out these frustrations and insecurities and (mostly unfairly attributed) opinions of others has already put a bit of a weight back into my chest.

What really annoys me is that I am still this vulnerable and weak. I was chatting with some church friends last week and bitching about the fact that most church seminars and days for women seem to keep reinforcing the same point - that you are accepted and valued by God, you are His daughter, His princess, you don't have to worry what others think of you. I implied that I'd got that by now, I'd heard it enough times, couldn't they move on to something meatier? Not all women were seething masses of insecurity, I said. Well maybe they're not, but sadly, and mortifyingly, it seems that I still am. I still need this message to sink from my head to my heart. I know this needs more prayer. I know I also need practically to learn to let little comments bounce off me, especially as society seems to judge mums for every choice that they make. I'll never be able to do everything and please everybody. I need to learn to be happy and confident in our family choices and in doing my best. But how? Does anyone have any more tips on how to beat the guilt, insecurity and self doubt that being a mum seems to exponentially increase?

brief pause on a Sunday evening

...to feel sad about nothing...

...sad that another busy week has just sped past and another is on its way...

...to think about my friends, who seem to be going through some hard things recently...

...to ponder how I'll feel if I fail this exam on Wednesday, which I really think I might...I'm not good at doing failure...

...to hope that mr me is really ok, and not pretending to be ok because he knows I'm only just coping with myself, as usual...

...to wish it was the summer time and I was escaping to a cottage somewhere...

...to wish I spent less time wishing my life away...

...to think about the sermon today, and ask God to give me a servant heart...

...to count my blessings, which are many, including a husband who loves and supports me, a career that fulfils and stimulates me, friends and family who care about me, and all I need materially...

...to decide it really is time for bed, actually...

A year of blogging

Today is my first blog birthday - a year since I sat down and made myself a new secret identity. (It's not very secret now - when I visited my parents' church in Liverpool at Christmas, a man I had never met before asked me if I was doctor/woman - think my mum must have been spreading the address about!) I have mostly really enjoyed blogging - it can be a bit of a self-absorbed occupation, but I am someone who naturally needs a lot of introspection and self-reflection. If I don't get time to think through and come to terms with what's going on in my life I tend to get stressed and emotional. I had got a bit that way this time last year, and I think that writing this has really helped me to get a bit unblocked and to get back in touch with my more creative, wondering, thoughtful side.

One advantage of a blog over a diary is that the fact that some other people read it makes you feel some obligation to keep it up, even if you don't feel much like it. Since living away from home I've never really successfully managed to keep up a diary without leaving very long gaps in it when I just got too busy to write. Another advantage, as I wrote in my first ever post, is that "if I ever manage to write something clever, someone might actually read it."

If you are somebody who keeps up with my blog, thanks for your interest in such mundane subjects as me being stressed at work (all the time) or what I did on my holidays. I hope that sometimes it gives you space to reflect and think too.

In other news, I am on nights again this week, and am just developing a cold, so I won't write more as I shall end up moaning. Roll on 4th Feb, when paeds will be over, I'll have done my exam, and I'll be heading away from shift work forever!!

The Pedestal

I have had one of those periods of my life where my insecurities surface more than usual recently, for various reasons, and one of them reared its ugly head the other night when stressing to mr me at about 1am when we were in bed. This insecurity is one of the worst things about being a doctor.

Rightly or wrongly, when you tell people you are a doctor, they have a certain reaction. Normally it involves the word "wow!", and there is instantly a certain mystique about you that wasn't there before. You have seen babies born, you have seen people die, you have (hopefully) stopped a few people dying, and most people place their trust in the integrity and competence of their doctors. So they suddenly look at you in a slightly different way. Being me, I normally say "I'm a doctor," in a slightly apologetic way, as if to say, "please don't look at me differently" (although I notice I have recently started introducing myself as a doctor, instead of a junior doctor. So maybe I am getting slightly less self-deprecating)

I am getting more able to live with the pedestal that people put me on. Perhaps too much so - sometimes I try to imagine how I would feel if I wasn't a doctor any more, and I realise that I am slowly depending more and more on my career for my sense of self. I am well aware that pride lies that way, and I attempt to "consider everything a loss compared to the surpassing greatness of knowing Christ Jesus my Lord." (Phillipians 3:8) I know that I need to work more with God on finding my sense of identity in Him and not in the things I have or am here in this world.What I still find very hard to live with is the nagging fear that one day I am going to fall off the pedestal.

Medicine is a lot about the way you present your knowledge. E.g. you have a young female patient with a chest pain which sometimes occurs at rest, on breathing in, then goes away again after a few minutes. You ask a few questions and it sounds like a chest pain related to anxiety. That is your diagnosis. You know that there is probably a tiny percentage chance that it is something else. But the risk calculator instilled into your brain by practice is telling you that this tiny risk is not worth investigating for. Do you tell the patient all this? No. She is already anxious, you don't want to make her more anxious. So you tell her in your best reassuring manner to try a few simple measures to reduce her stress and that the pain is nothing serious. To safety net you maybe ask her to come back if things don't improve. For the patient to go away happy and to get better, you need to come accross confident. This "bedside manner" that doctors have to have can sometimes feel like an act. You are taking on the anxiety, so that the patient can stop thinking she is ill. But the general public often seem not to understand that the art of diagnosis is, by it's very nature, a sophisticated type of educated guessing. In many cases there will be some uncertainty. But if your educated guess later proves to be wrong, the patient may forever think you are a bad doctor, even if 9 out of 10 colleagues would have done the same thing.

Then there is the question of knowledge. The volume of medical knowledge is vast. It covers all diseases from prematurity to senility, and from every system of the human body. It is almost impossible for one person to know it all. Especially with some of the questions I get asked in my day to day life, eg "why does my tongue hurt when I drink pineapple juice?" or "is it usual for one twin to be left handed and one twin to be right handed?" But if a patient, or worse, an aquaintance who is asking you medical questions, suddenly finds that you don't know the answer, sometimes they look at you like their world is tumbling around their ears. Because doctors know everything.

Maybe some doctors know everything. Gregory House, for example - he knows everything, and that is very lucky, because he has the most statistically improbable caseload of conditions I've ever seen. I have met a few who seem to remember every footnote from medical school. But the vast majority of doctors know about the conditions we see every day in our chosen field, and for the rest we depend on remembering some of the information, knowing where to find the rest of it, and recognising when to refer to somebody else.

I find it very hard to be under the constant pressure of being expected to be some higher form of human being, who never gets things wrong or doesn't know the answer. It doesn't help that I am naturally rather ditsy, and tend to bump into things a lot. Sometimes I can see people looking at me thinking "well, at least she's not a surgeon!" after I have done something particularly dyspraxic. I am getting better at coming across confident and all-knowing at work, but in my day-to-day life, it's just not me. I'm too honest to pretend I know all the answers all the time. Sometimes I love to be somewhere where nobody knows what I do, and I'm just a girl, just another person on the street. I also regularly fantasise about being a housewife, and not bearing this responsibility that sometimes seems so heavy.

I am well aware that I tend to live my life far too much through other people's eyes, and worry constantly about what others think of me. I think for this reason I feel these pressures more than many of my colleagues. I am also aware that a lot of what I'm describing may well be me projecting my own insecurities onto others, and imagining they are mentally criticising me when in fact they are doing nothing of the kind. I don't think it helped that in my first few years of medical school, my housemates were constantly commenting "I can't believe you are going to be a doctor, you're so dozy/clumsy/I can't believe you're going to skip a lecture!" etc. I know that I am a bit scatty, always have been, and this is something I have to fight daily in order to make sure I practice safely by staying organised. I never go beyond the reach of my competence, and I am honest with patients about this. Maybe if I can deal with my inner critic, I can start to let the rest of the world think what it likes about me.

misc

ok, so last night was not good. i had a bit of a brain mist and all the ward patients decided to get sick, mostly struggling to breathe, which tends to scare me. tonight so far is going a bit better following a shaky start.

at the moment i feel stressed. there are various reasons, but the most significant is that the GP training scheme i am on and have been for the last 2 years, has introduced a new system which involves jumping through a lot more hoops, most of them electronic assessments. i was managing to cope i thought, but discovered 2 days ago that i have to jump through a whole load of them before next Friday. which is not so easy to do when you're on nights. think this saturday might be devoted to studying and preparing for meetings, which is a bit sad. maybe i will manage some gardening or shopping as well.

in the morning i am going with mr me to pick up a van and then we are driving (or rather he is driving, i am sleeping in the passenger seat) to my parents' house in liverpool to pick up some furniture. it's an antique walnut veneer dressing table and mini wardrobe that i used to have in my bedroom throughout my childhood, and loved. we will put them in our (finally) redecorated bedroom and when we buy a new bed, we can move in there. i am so looking forward to having a dressing table again - at the moment my unnecessarily large collection of toiletries lives on top of a chest of drawers in the fitted wardrobe, and gets knocked around by the clothes hanging above it. i am temporarily obsessed by curtains bedding and lamps for the new room.

i miss my church. due to work, new york and visiting home, i've only been able to go one out of the last five sundays. it definitely has an impact on my state of mind. i start to feel isolated from friends, and more importantly, it affects my prayer life and relationship with God, which has a knock on effect on my general mental wellbeing.

i am looking forward to christmas, as i always do - i am a total child about loving christmas, but am slightly sad that i will need to revise for professional exams in january over the holidays. i have been quite efficient with my christmas shopping this year and have most of it done already.

i feel my brain needs a good clear out and i need some focus and organisation in my life. i feel like i'm writing myself a horoscope here. anyway, i shall go and attempt to tidy my brain.

sorry about the lack of capital letters. i'm not in the mood for them tonight.

Exciting things about Autumn

Here is a cheery post to distract myself from the fact that I'm on nights again with a nasty cold. I love autumn. I was going to say it was my favourite season, which I think every autumn, but then every spring I think that is my favourite season as well, so it's hard to say.

• Autumn is a season of anticipation. There's a certain tang in the air, of bonfire smoke and crispy leaves, and frost to come that makes me think, "Bonfire night is coming/ cosy evenings are coming/ Christmas is coming!"

• Strictly come dancing is back on! I am deeply and worryingly obsessed with this. Generally I don't go in for celebrity/reality TV programmes, but I think this is the perfect Saturday night TV show. Of course, I've always loved dancing, so that's most of the attraction, but I also love the dresses, the drama, the glamour and watching someone fall in love with dancing. It seems to have slightly more value for me than things like "I'm a Celebrity", because the contestants are genuinely learning a skill that is difficult and rewarding, rather than just solely trying to revive their faltering careers (although a lot of them are doing that too.) Me and my sister are both into it, so get together and watch it at the weekend. Good excuse for a night in with a glass of wine.

• I'm going to New York at the end of the month. Another thing to anticipate this year. Am planning to morph miraculously into a glamourous Carrie-Bradshaw type person and wander the streets of Manhattan in high heels which will not hurt me at all, looking wistful and thinking profound thoughts. Or at least I am planning to do lots of shopping, sightseeing and have lots of fun.

• Winter coats! I love the day when I decide I need my winter coat out for the first time. It makes me feel dressed up, but wrapped up.

• Bright, frosty, clear blue mornings when the trees are golden, and the air bites. Preferably on a day when I can go for a long walk followed by a hot chocolate somewhere warm.

Pale and Interesting

As someone born with naturally fair and easily burnt skin, I have always tried to be careful not to burn (except for a brief and foolish teenage flirtation with sunbathing). When my dad, who is originally from Ireland, and has the same skin type as me, was diagnosed with the most aggressive form of skin cancer (thankfully at an early stage), three and a half years ago, I became even more careful, and tried to stay out of the sun and protect myself properly.

I had an interesting conversation with a friend last week. Her father-in-law has recently been diagnosed with the same type of cancer, melanoma, but unfortunately his had already spread. Her mother in law told her to, "promise me you'll celebrate your fair skin, and give up on trying to have a tan." These words struck me, and made me think of the strange change in Western attitudes towards skin shade that happened some time during the last century. I have achieved a state of being comfortable in my own skin, at least the colour of it, in recent years, but I remember being bitterly humiliated as a teenager, when people would call me "milk-bottle legs".

According to Wikipedia, the trend for tanning in the 20th century was originally started by Coco Chanel in the South of France in the 1920s, when she accidentally tanned. Prior to this, having fair, pale skin was a sign of beauty and status, because it meant you were rich enough that you didn't have to do manual labour. After this, having a tan became a sign of beauty and status, because it meant you were rich enough to afford expensive holidays abroad. Interestingly, melanoma is the only cancer where rates are higher in social class I than social class V. In many cultures today, particularly in India, fair is still considered beautiful and skin lightening creams sell like fake tan does in England.

Anyway, I thought for the sake of my friend, and anyone else still struggling to come to terms with pale skin, I would create a small celebration of beautiful pale complexions. And these women are not just beautiful, they are interesting. They have something to say for themselves.

"I prefer a man who leaves and gives expensive jewels." Satine, Moulin Rouge














"Perhaps I didn't always love him as well as I do now. But in such cases as these, a good memory is unpardonable." Elizabeth Bennet, Pride and Prejudice






"I will cleave to you Dunadan, and turn from the twilight. But there lies the land of my people and the long home of my kin." Arwen, Lord of the Rings






Don't tan! Wear sunscreen!

Disconnected things

I have a sore throat. I hope I am not getting ill.
My in-laws have been over today and we had a nice time. My mother-in-law was unable to stay out of the garden, so between us we got it tidied up quite a lot.
I am a bit worried about starting paediatrics on Wed. Haven't done any acute hospital medicine since this time last year.
I am currently on call, but haven't been called all day.
I was grumpy with mr me today for no particular reason.
My colleague who has become my friend is leaving Yorkshire tomorrow to take up a new post in the South. I will miss her lots.
The blind at the window is making my eyes go funny with its stripes.
Seeing pictures of myself on facebook keeps making me realise how much weight I have gained over the last couple of years.
Last weekend the friend that I secretly slightly idolise because of her willowy blonde-haired classic beauty got married to a soldier in uniform. It was a picture perfect wedding.
I have really enjoyed the friendships I have made in psychiatry. Felt that the people there were less driven, competitive, materialistic than a lot of doctors are.
I miss my mum a bit.
I am looking forward to the autumn. I hope it is a proper autumn and doesn't just continue to be wet.
I really have to go to bed.

if i can

It's been another one of those days. Those days when I go through the whole of my time at work without once remembering my true motivations for actually being there. (I'm being very honest with myself here). I seem to spend so much of my time working for my pay-cheque, for my career, for the goal of going part-time, to get the nurses or the managers or the patient's family off my back, for the prestige of being a doctor, to impress my consultant or help my colleagues, to learn, or on my worst days, just to get to the end of the day.

In fact, none of these reasons are enough to do the job I do. My primary reasons for working are - corny as it sounds - to help people who are ill, and to work to the best of my ability to give glory to God. The moments that I love my job are the ones when I suddenly feel that I am really connecting with a patient, whether that's because somehow the advice or medication or treatment that I am giving is helping, or, more often, because they feel someone is listening and understanding their pain.

On days when I am in danger of forgetting all about the real reason I am there because I am bogged down with all the other rubbish that comes with working in the NHS, sometimes this poem helps me.

If I can stop one heart from breaking,
I shall not live in vain;
If I can ease one life the aching,
Or cool one pain,
Or help one fainting robin
Unto his nest again,
I shall not live in vain.

Emily Dickinson

Ok, so maybe the end is more appropriate for an RSPB worker, but the rest of it fits for me. I hope maybe it helps you too.

oh, that kind of an evening!

It's the kind of a warm hazy summer evening where it seems almost a desecration not to be in the countryside. The kind of an evening where I long to be lying under a hedgerow by a river, watching the first stars come out and hearing the silence behind the splashing of the water and the gentle song of the birds. It's the kind of an evening when my eyes get misty and I think about a long time ago.

When I was 25...

Most years around the time of my birthday, I like to record all the new experiences I've had that year. There are normally more than you expect there to be. Well it was my birthday on Saturday, so here goes.

This year I...

...bought my first house

...had my first sick note

...lived in someone's spare room for the first time

...found my first white hairs

...called my first ambulance

...broke my first bone

...started to love gardening

...ran my first GP surgery

...made my first really close friend from another culture

...bought my first wedding hat

...started my first blog!

Green and pleasant land?

Working with mostly non-English colleagues for the last 3 months has given me lots of opportunities to look at things from other points of view. The chat in the junior doctors' room ranges from ways to control the world population, to where is best to go on holiday, to council tax and religion. What has struck me most I think is getting a glimpse of what it's like to live in England as a foreigner. This came across particularly forcefully a couple of weeks ago when I went to a barbeque at a colleague's house, and was the only British person there. I had a fun time and people were friendly and chatted to me, but what came across from almost everyone I spoke to was how difficult they found it to live in England. Almost all made some reference, either implicitly or explicitly, to the discrimination they face in getting a job. This is particularly an issue for doctors at the moment. People see this country as a difficult place to survive and a very hard place to get ahead. People have said in my prescence recently, all of these things... "you have to be disciplined to work here", "you have to pay for everything here, everything is taxed", "some are more equal than others", "I have to prove my worth twice as much as an English graduate" etc. A lot of internationals also seem to find it difficult to see the classes of society who see benefits as a way of life. I suppose if you come from a country where the poor starve on the streets to a country where you have to prove your worth at every turn, and then see people living for free, it is difficult.

Certainly all this has made me think a lot more about the country that we live in. Why do our media cover human interest stories obsessively for days? Why do we have to pay a licence fee and a fee on almost everything else that happens on a piece of paper? Why do we pride ourselves on being an inclusive society, when the BNP got 11% of the vote in my local council elections? Why do we enable people who have no desire to work to live in a comfortable house with enough money to run a car as long as they have enough children? Some of these thoughts are not comfortable to me. I admit to normally being a woolly liberal when it comes to benefits, and a little islander when it comes to thinking the British way of doing things must be the best. Of course there are great things about our country and things we should be very proud of. Corruption is minimal compared to a lot of countries, we have freedom of speech and religion and a lot of history behind us. I just hope we don't lose the freedoms and traditions that we have. The thing that struck me most at the barbeque was when a young Nigerian man said to me "The reason that this country is losing its power and greatness is that it has turned its back on faith, which was the source of its strength."

Easter

Feel a bit short of ideas and inspiration at the moment so can't quite think what to write. Thought would jot down a few random thoughts that occurred to me over Easter. Easter can be a funny holiday sometimes because I feel it's the most important celebration in the Christian calendar, but sometimes it passes by and I hardly seem to notice it, especially if I'm working. Because our church doesn't own its own building and there are a lot of young people in the congregation who tend to go home for the Easter break, there are not normally any extra services at our church for Good Friday or anything. Due to much messing around of my rota at work by HR department, I was at some stages during the week supposed to be working on the Saturday, so we decided to go back to Liverpool (where both our parents live) for the Sunday and Monday, and stuck to the decision even when I wasn't working at the weekend any more.

...On Good Friday I watched a programme on BBC called "Who do you say I am?" which was a meditation and a telling of the Passion story based around works of modern art using the image of the cross by Christian and non-Christian artists. I thought it was a refreshingly good piece of religious programming - not so preachy that it was only watchable by Christians, not deliberately critical for the sake of having a new and controversial approach, but open and asking questions. I found parts of it very moving...

...Decided to go to the local Anglican church for the 2pm service on Good Friday as well with a friend who lives locally and it was refreshing to be in a different church tradition than my own for a while - more meditative and symbolic than what I'm used to perhaps. Not many people there really, but the vicar was very sweet and made a special effort to speak to us...

...Also enjoyed Easter Sunday morning at the church my parents-in-law attend - they had us all write down what Easter Sunday meant to us on little pieces of paper, and stick it to the wall at the front, after listening to a passage being read from Matthew 28:1-10 The thing that struck me most at the time was the phrase "Suddenly Jesus met them." Became newly aware that the Resurrection meant that not only could they meet Jesus again, but that anyone can meet Him, ever since then, if they want to. It is why I can still know Him today. I know this is pretty obvious, but it just reminded me in a new way, OK?...

...I fasted alcohol for Lent, because although I hardly ever drink more than 2 glasses of wine at a sitting, I feel I sometimes use it if I'm particularly stressed and wanting to let go of any worries from the day's events. I don't think that's very healthy. I can see why lots of doctors become alcoholics. So I think it was a success giving it up. At the beginning I thought I would be desperate to have some on Easter Sunday, but as it turns out, I wasn't all that fussed. My first glass of wine did turn my head quite dizzy though...

Hearing the voice of God

Here is a quote from "Psyciatric Interviewing and Assessment" (Rob Poole and Robert Higgo, Cambridge 2006) about pseudohallucinations.

"there is a heterogenous group of experiences that is very similar to hallucinations. They are almost invariably associated with underlying severe emotional distress. The only major exception is a small group of individuals in the general population, neither evidently mentally disordered nor distressed, who have a strong religious faith and who hear the voice of God in their everyday lives. We recognise that they may be right about the origin of the experience, but we prefer to believe that it is due to some other, as yet poorly understood psychological process."

I first ran up against this issue in medical school - the issue that may cause other doctors to think I have an "as yet poorly understood psychological process," and normal people to think I am a bit loopy - the fact that I believe that I hear God speak to me. A hallucination is defined as a sensory perception experienced in the absence of an external stimulus. However, beliefs or perceptions which can be accounted for by the patient's religious or cultural background are not considered true delusions or hallucinations. Also, for it to be a true hallucination, you must be convinced that what you can see or hear is real, and perceptible to anyone close by. We had some examples to work through in small groups to force home these points, and had to say whether they represent hallucinations or not, eg "you are walking home alone late at night, and you are feeling anxious about being followed. you see a shadow in the trees and become convinced it is a person" - that kind of thing. (not a true hallucination by the way) One of the examples was "you have a friend who is devoutly religious. He tells you that he talks to God and God talks back to him." The group started to debate it, but I said "no - that's normal." They knew I was a Christian, so looked at me weirdly and left it at that. A Muslim girl in the group said that this would not be normal for a Muslim, as God spoke only to the prophet, not to other people. (Not sure whether this is the mainstream Muslim view or not, by the way.) Came away from this session feeling slightly uneasy, as I normally do when people think I'm mad.

Now I have never heard God speak with an audible voice that I can hear with my ears. I know of people who have, but for me it's a lot harder to explain than that. It kind of comes like the internal monologue that most of us have all the time. I think I may have this inner voice more than most, because whenever mr me asks me what I am thinking about I can tell him the 2 worries, one random wondering thought and the plan for the curtains in the back bedroom that were chasing each other around my head. When I ask him what he was thinking about, he normally says "dunno - football I think." Anyway...when God speaks, the internal monologue suddenly seems to turn into a conversation - i.e. an answer comes back at you different and faster than what you would have thought for yourself. That is my experience sometimes. I can normally tell it's God by what He says - it is in line with the Bible and what I know about His character, it's frequently something uncomfortable or out of left field, but when I try to follow it or pray into it or whatever action is required, I get a peace about it, which is again difficult to explain.

It's not always like that, and particularly if I am praying for guidance about a specific thing and waiting for God to talk to me like that I can become very confused between my own thoughts and His voice. Sometimes God speaks through reading the Bible - I can be reading and suddenly something jumps out of the page at me and applys itself to my life - I think a lot of Christians have that experience. Sometimes God speaks more through feelings and emotions - normally to let me feel His love or a sense of peace at leaving things in His hands. This happens mostly when I'm worshipping and open to Him. Sometimes God speaks through circumstances in my life, and I know some of the times when I've been closest to Him have been when I'm going through a really hard time and having to depend on Him completely. I'm not one of these Christians who prays about what colour socks to put on in the morning etc - I believe God gave me a brain to decide that kind of thing with, and sometimes I think even the bigger decisions can be taken with some common sense, a background of what kind of things God wants for you and a willingness to hear Him if you're going the wrong way. I think sometimes the decisions which are most significant to us (eg which job should I take?) can be different to the ones which are significant to God (eg He might want us to forgive somebody because otherwise we will do something which hurts them or us and will somehow affect the rest of our lives.)

So anyway - this is my confession. I hear God talking to me. Do you think I'm mentally unwell, or subject to a poorly understood psychological process? (feel free to say so) If you're a Christian, do you hear God's voice and if so how?



"The watchman opens the gate for him, and the sheep listen to his voice. He calls his own sheep by name and leads them out. When he has brought out all his own, he goes on ahead of them, and his sheep follow him because they know his voice." John 10:3-4

A Friend

Having moaned excessively here about having difficulty making proper friends at work due to all the moving around different jobs, I have now managed to make a friend after 9 days in my new job, and I feel that she will be a good one. She's the only other female SHO, she grew up in India, she is married with a little daughter, but lives apart from her husband during the week, so is effectively a single parent doing a full-time medical job in terms of her workload. Somehow we seemed to like each other straight away - kind of had to, being the only 2 girls, but today it well and truly leapfrogged the colleague-friend barrier due to a discussion about faith. I won't go into our whole discussion here, as it was a private one. Briefly, she is a Muslim, but with a lot of interest in Christianity and we found lots of things in common to talk about. Also chatted about recipes and skincare (which overlap each other a lot more in Indian culture than in ours - think I would like to try the crushed almonds and milk face treatment) and other girly issues. Am invited to go to her house soon and meet her daughter etc. Feel hugely encouraged about this - I know I sound a bit pathetic being so excited to make a friend, but it did feel special. Maybe partly because it wasn't some diffident British affair where we both gradually come to understand we are friends by little gestures and invitations and understandings. She just came right out and said she was happy to have met me and she has been praying for someone at work to talk to about her faith. After my general whining previously about friendships not ever going beyond the end of the six-month job, I propose to make sure that this one is different.

Being a wife

On Sunday at church, one of my friends asked me whether I would be interested in a Bible study course for some married girls in the church about marriage and how we are all getting on with it. She asked me to bring the benefit of my experience, as I will be the longest married in the group. (It will be our 5th wedding anniversary this year.) Probably sounds like a bit of a cheesy idea, but I think it's a good idea to reasess these things from time to time and look at the foundations of a good marriage over again with some supportive friends. I agreed that I would like to be involved, but just thinking about it has set me off wondering how good I am at being a wife. The best book I read about marriage on our wedding preparation course was "The Mystery of Marriage" by Mike Mason. Bit highbrow, but a lot of interesting and good stuff about learning to put another person before yourself etc - can't remember all the details now - should probably buy the book and read it again. Just started thinking that I spend so much of the time at the moment being tired and a bit needy that I probably don't very often put mr me's needs first. Not helped by the fact that he is normally fairly undemanding himself. But surely I could be more creative in making him feel loved and special. To be completely honest, I normally spend more of the time thinking and daydreaming about what he might do for me, what he has and hasn't done recently to show me he loves me, rather than considering what his needs might be. We are both good at some stuff in marriage - we always have a date night once a week, we don't argue much and mostly in a non-destructive way, we are good at regular hugs and stuff. Think that this group will be good and helpful, but how much of a good example I am as a wife... I'm not sure at all.

nonsense

want to escape
into the blue
out of the hurly
and hullabaloo

away from the ceaseless
kerfuffle and blare;
the bustle and burly
and tearing of hair

want to be idle
want to be free
to leisurely languidly
lie by the sea

with nothing to do
for a year and a day
oh why can't my dreaming
vacate me away?

An average day in General Practice

Today I felt good. I saw a patient today with a problem which has been present for a couple of weeks and has been referred non-urgently. The problem has been getting worse since then, and is now significantly affecting his functioning. He and his family are very worried and asked if they could get the appointment any quicker. So I rang the (very helpful) phoneline for the speciality involved, and they arranged me an appointment for tomorrow morning. One of the rare occasions when you feel really proud of the NHS. So now the patient thinks I'm wonderful, and more importantly, his problems and his anxiety will soon be resolved.

Today I also felt bad. In my one hour tutorial with one of the GPs at my practice we did an in depth analysis of a case I saw on call just over a weekend and handled pretty badly. Basically I allowed myself to be pressurised into calling an ambulance for a patient when that wasn't the most appropriate thing to do. Going through your mistakes in detail for an hour is a very good learning experience. It doesn't make you feel very good about yourself though.

I saw 17 patients today and they all made me feel different things. Some made me feel sad for them, some made me feel uncomfortable, some made me want to bang my head against a wall, some made me confused, some made me feel like I'd done something good, some like I could have handled things better. Some made me feel I wished I could have got to know them better. Most of these things I now wouldn't remember feeling if I wasn't deliberately trying to remember. The general effect of all this is to send me home feeling a bit drained and with occasional moodswings. The ones I remember most are the ones I was a bit worried about for whatever reason. Sometimes if I try to remember all I've done in a day my head feels like it's in a fog. I expect this will only get worse when I go to 10 minute appointments instead of 15.

Anyway, why am I sitting at work at ten past seven typing this when I've only just finished my paperwork? I am going home to my lovely husband who is making me tea. Then I have to see whether the floor in the back bedroom is ready to be sanded at the weekend. Hey-ho!