I was feeling pretty anxious about my doctors appointment. I'd only seen Doctor Keyser once before, in the same situation granted, and he'd been nothing but kind and understanding. But he's a hard little man. He speaks with an almost flawless British accent, yet he is so bluntly German. His eyes are like little hard rocks behind his perfectly round, gold framed glasses. If he wasn't so tiny, standing at no more than five foot one, one could easily mistake him for Nick Robinson going grey. Whereas my usual GP is a younger, softer, charmismatic and personable young woman, Dr Keyser invokes memories of being dragged to the doctor by mother and being scrutinised from every angle by someone who to your feeble childs mind is like a cross between your headmaster, and God.
The buzzer called me in. Don't worry, I calm myself, it's just a quick in and out, he can read your notes after all. He greets me as he's leaving his room.
"Ah, Miss Myatt!" he exclaims. I don't know why the surgery never changed my title along with my name when I got married, "if you could just come in, has the receptionist told you about the student doctor today? Good good! Well he will examine you and take down your notes, and then I will come and check to see that everything is ok. Good? Good!"
The student doctor in question was a young south eastern asian man. At first I groaned inwardly; all other times I've been told there was a student doctor in, it was whilst they observed, never unsupervised. He had a kindly enough face, but he seemed so fresh and, well, undoctorly, I wondered what it was he would say.
"I came here just under a month ago," I explained, "I have a history of depression and I had been suffering with some of the symptoms for a couple of months so I came back before they could get any worse, and the doctor prescribed me my usual...now I'm nearly out and I need some more..."
He looked at me strangely. I wondered what his experience with mental health issues was. I was soon to find out.
He asked how I was feeling. On top of the world, I told him, for about a week or so I've been feeling just brilliant. Whether that is the pills or Christmas and the promise of seeing my whole family and the wonderful new years celebrations that are planned I don't know. Perhaps those months of feeling blue were just a minor blip.
He asked if I wanted to come off the pills...I asked if this was advisable...after years of being on and off them in one form or another I know the standard course is 6 months. He said it was just strange; usually with anti depressants they take weeks if not months to kick in, he explains. I say yes, indeed, I know this, this is all an old game to me, but today I am feeling on top of the world, on bad days I'm inconsolable.
He goes through my symptoms, past and present, and he seems perplexed. We've been in for a good five or ten minutes and he mumbles something about being unable to write me a prescription; we'll have to wait for Doctor Keyser. I presume he will be back soon.
Then the extraordinarily unprofessional happens. He tells me he just doesn't understand depression. I ask, what exactly do you mean by that. He says he cannot comprehend. He asks what I mean by "when I'm down I just can't face the world". He says that to him he wakes up on a morning, and then he wants to get out of bed and get on with his day. He doesn't say this in an accusatory way, more in an inquisitive way. I explain that, for me, all logical thought goes out of the window. When you feel like everything is against you, why bother to do anything? Why fight a loosing battle when you may as well just curl up and die?
He asks if I've had thoughts of dieing. I explain that, yes, I did when I came to see the doctor a month ago, and thats what triggered me to seek help, before I let it go to far. He asks if I've harmed myself. I say no. What about in the past? It's difficult to talk about, so I just show him the scars on my arm instead. He seems repulsed.
Then the conversation takes an even stranger turn. He asks "what about religion? Does that help?"
I'm perplexed. He seems to be reading from my notes, but I do not recall ever disclosing anything to do with faith to any doctor here. I tell him that whilst I'm Catholic, on down days God is far from my mind. Indeed, on really bad days one begins to doubt His existence at all.
He begins to explain that he's from a Christian family himself, but it's so difficult. He believes in God but he's not sure about religion. He wants to live life his own way, not prescribed by the church. He wishes to be the master of his own destiny, but he cannot deny that he knows God is there.
"I believe we'll never really know what God wants," I say. He confides that when doing devotionals, sometimes he will read a passage in the Bible which is spot on, and relates to exactly how he is feeling that day. He confides that his friends think he is mad for this, that he must be twisting the words to mean what he wants it to mean, and I suggest that as a trainee doctor he must be surrounded by many scientifically minded folk. He says yeah, and then says, "but it can't just be coincidence, can it?" I say "There's much wisdom in the word. It may be written by God or it may be written by man, but it didn't just appear from no where." He sits in silence for a while, nodding, in deep thought.
"I'm so sorry...I have no idea why I'm telling you all this..."
I get that a lot from people. That's why I'm pursuing counseling as a career.
He realises that he's really crossed the line by this point, but I assure him I don't mind, and besides, religion and theology are passions of mine. He goes back to my notes and asks what I mean about having a history of depression. I go through the whole sorry tale from the first time I harmed myself in sixth form college to the day I quit university. He was suprised to find Id studied a science subject. I wonder if I really come accross as that dumb these days. He asks is there anything I do to try and help myself, and asks if it's possible to try and make yourself "snap out of it".
I tell him no, it really isn't, sometimes you can try and get on with things, sometimes you can't. He reaffirms that he finds it so difficult to relate to mental health issues because he's never had any experience aside from in the classroom. By this point he's perusing my medical notes. Why did you have an ultrasound on your liver? How is your asthma these days? Why aren't you on medication for your PCOS?
The PCOS strikes up a whole new area of discussion. I explain I'm not on any medication because I'm trying for a family so I'm trying to lose weight. He asks how it's going and I explain it's been difficult the past couple of weeks, but Im still going to the gym and I'm loving it. As it turns out he's a real gym enthusiast and we get to talking about our work out routines. He's suprised to know I love the weights. He confides that he never used to do weights, but today he turned 25 and he's determined to get a six pack before he's 30. I wish him a happy birthday, he says thanks, he wishes he was at home in Malaysia with his family. He says I should visit Malaysia, it would do me good as it's always sunny and my depression is obviously seasonal.
By this point we've been sat talking about everything and nothing for almost an hour. Doctor Keyser, it would seem, is seeing another patient, and said patient has taken up all this time. I'm a little irked about this, as my appointment was at such and such a time. The student doctor is appologetic, and suggests I wait back in the waiting room, but just as I'm about to leave Doctor Keyser walks in.
The student gives him the lowdown...she feels fine right now but was not a few weeks ago...no majorly terrible symptoms right now. Dr Keyser asks about my sleeping and appetite and gives me a standardised questionnaire. to track my progress
"Yes, you've very much improved, however there is a good chance you will go back if we take you off the anti depressants again so we will follow through with the usual six month course. However, I need you to make some lifestyle changes, because that is really the only thing that will help you in the long run."
I'm puzzled as to what he means. My life is really pretty good right now, and I couldn't ask for much more to be happy that is otherwise out of my control. I ask what he would suggest.
"Well, you need a decent social life, get that social support so when you are in crisis you aren't left on your own..."
I mentally check this off. My friends are ace, my family supportive, my husband gentle and understanding, my social calendar currently packed.
"...you really need to do some exercise, get those endorphins flowing..."
The student doctor and I exchange glances, we know full well this isn't a problem for me.
"...And if you find that you are getting anxious and irritable make sure you get at least an hour a day to yourself that nobody else is allowed to intrude upon and do whatever you like to relax. Go window shopping or something."
He prints off my prescription and says he'll see me in a month. After my hour long consultation with the student doctor I'm really quite perplexed and am unsure whether I should be peeved or not. I probably should, the student certainly crossed the lines of professionalism there, and Dr Keyser seemed only to be interested in signing off my pills for me, after keeping me waiting for over an hour.
So I'm taking my hour to myself to relate the story here. It's the weirdest doctors appointment I've ever had, and it would be a shame to loose it!
One of the things about Laila's annual Christmas adventure to Liverpool that I REALLY love, however, and I hope you don't mind me saying this dear, but it is the annual Christmas gift from Laila. I have many lovely and generous friends who get me lovely and thoughtful gifts that I treasure, but Laila is an expert in the art of packaging. This year it meant that to get to the goodies within the gift bag I ended up covering the cafe we were sat in with angel and snow flake shaped confetti as I pulled out reams of silver and blue tinsel! The only problem I had afterwards was wondering what to do with it, as it always seems a shame to put such thought to waste. Well, Laila, last night I put your tinsel to good use and made a tinsel wreath!
