Week of March 8th 2019- Chronic Disease Prevention (Wow. This was Worse Than the Renal Rotation.)

Monday, March 8th- Waiting for the Pain and Getting Bananas Instead

Woah! I’m being responsible and writing for my daily blog post on a daily basis instead of at the end of the week or worse yet, more than a week later…. Wrong! I mean, it is Monday, March 8th as I write this, but the only reason I’m here is because I don’t want to work on other responsibilities of mine. Woo hoo! Welp, this week I’m in a rotation with a name something along the lines of prevention of chronic diseases. Really, it’s not that big of a deal. It’s just a super work heavy rotation. Ah, and it’s individual. Gia is at the food bank while I’m here. (I was at the food bank when she was here about a month ago. I’d much rather be at the food bank since that was all manual labor and no homework, but eh, I had my time.

People complain that this is the worst rotation. That the preceptors are super rude and crush any and all self esteem you may have. As of yet, it’s not that bad. Hopefully they’re just drama kings. Yes, the guys have been the most complain-y. Maybe us girls are just more used to constant criticism to our character and self worth. …that was a super stereotypical joke. That I do not apologize for because from my experience (I am female) it rings some truth. It doesn’t matter anyway. Suffering is relative. There is no greater or lesser suffering. It’s all just suffering.

Not much for me in this rotation yet. The director of my internship gifted me about 15 bananas. That one isn’t a joke. She just asked if I wanted to make banana bread and gave me a bag full of bananas! Not a bad day…

 

Tuesday, March 9th- Wow. That was quick.

So, it’s bad. I spent the day in the Department of Health working on assignments again. At this point it wasn’t so much the word she said, which weren’t rude, so much as the tone she chose to say those words in. I’ve never been a very self motivated person. So I arrived on Monday with the minimum amount of work done and the next day I arrived with a bit less than the minimum. I got home and procrastinated then set to work late and didn’t sleep much. Not much sleep=even less energy.

At this point I was sure the preceptor thought I was a lazy slacker, which… eh, partially true. Her tone just reinforced my negative thoughts and this was the fateful beginning of a downhill snowball week. :/ Gosh. I know if I thought better of myself and didn’t let my fragile self confidence snap at the ugly gaze of an uncaring stranger this week it wouldn’t have been bad. Maybe it is just me. Maybe it’s just in my head. Maybe there’s no such thing as depression. Or maybe there is, but that’s not my main problem. Maybe I’m just a “self indulgent little girl” and that’s the cause of my problems. That’s a quote from my favorite movie (Girl, Interrupted).

I don’t know what to think. The facts are these. I spent the day re-working and re-doing two powerpoint presentations I was responsible for presenting to high schoolers and middle schoolers the next day. I also turned in the radio skit I’d been slaving over the previous day. When I’m sad, stressed, self loathing, depressed, whatever you want to call it those feelings will manifest in different ways. I feel like they are inevitable. That I can’t fight them, so I don’t. But maybe I can… I don’t know. Two big ones now are that I’ll be extremely tired. I was falling asleep as I worked. Also, I hadn’t slept much, which didn’t help. Another is that I’ll work/move much slower than normal. I wonder if it is all in my head…

 

Wednesday, March 10th- Presentations at a High School and a Middle School

My dream is not to be a dietitian. I studied for that career path for my Bachelor’s degree and am currently in an internship to become a dietitian. But this isn’t my dream. My dream is to be a teacher. Specifically a high school teacher. When I tell people that’s my dream job they look at me like I’m crazy. They don’t understand that I want to teach high school because I feel like that’s a deciding time for people. That’s when a supportive teacher who believes in students could change lives. It’s when students are still kids in the sense that they are still growing up, but are close enough to adulthood that they don’t have to be babied. That’s the way I see it.

Under any other circumstances, I would have been stoked to present an educational topic to a library full of high schoolers. But not this day. This day I had to present a topic I didn’t even know anymore after so many revisions. I looked for so many sources and between working on this presentation and the other one and the radio outline plus my heavy feelings of self pity… well I couldn’t even explain the things on the slides well. Much less make them entertaining for an audience of blank faced Puerto Rican high schoolers. It was completely embarrassing and a waste of a morning assembly. But I was comforted by the fact that I’d likely never ever run into any of these island dwelling teens after I completed my internship and moved back to good ol’ Texas.

The dietitian supervising me gave a short presentation to make up the rest of the hour I was supposed to fill when my presentation ended too soon. For my presentation she chidingly told me to make it more engaging and take up the whole hour. This one had only been corrected once and honestly, I didn’t know it in much detail. It was about the different food groups. How was I supposed to talk about why you should eat your fruits and vegetables and stuff to middle schoolers for a whole hour?! I just nodded my head and jumped into it blind. It went a million times better than expected. The kids were interacting and (expect for the usual lulls in teenage attention spans) they paid attention. It was amazing! The first presentation broke my heart and began cracking at my dreams of being a teacher, but this presentation, it renewed my convictions.

 

Thursday, March 11th- Yesterday, I Spent the Afternoon in the Emergency Room (not the patient) and Today I was on the Radio.

Yes, so yesterday after the school presentations I was working on assignments at the Department of Health when the director got a call from Axyl. It was a medical issue and one that he should be in the emergency department for. The director dismissed me from the last hour of my day to go with him. If you guys have read my older weekly blogs, you’d know that most of us interns from abroad do not have family here in Puerto Rico. You would also know that Axyl had a falling out with a couple of other interns too, namely Robin and Karen. So…that left me. I’m the closest thing to family he has here and the director knows that. I met up with him then headed to an ER (emergency room) where we stayed until around midnight when they dismissed him, saying his abdominal pain wasn’t anything serious. Oh well. Good news, I guess.

At the rotation I was supposed to be on the radio in the morning and then do a supermarket tour in the afternoon. Well, I didn’t get to work on the supermarket outline of what I was going to say because other than being sad and unmotivated, I was in an ER the whole afternoon. I bumped into the dietitian I am with this week when I arrived at the Department of Health. She greeted me and asked how I was. I was visibly tired and replied “So-so, something happened.”, then proceeded to explained how I’d come to spend the previous day in the ER keeping my friend company. You know what this grown, insensitive woman’s reaction to that was? She asked me “but did you get to finish the assignments for today?”.

I’m not going to get into it here, but I know that dietitian and Axyl have bad blood. Regardless, that’s just cold. Okay, moving on. This is making me mad all over again. We went to another town to do the radio show with her and her (slightly nicer) dietitian co-worker. The radio bit was fun. It was probably the thing I was least nervous about this week and I’d be delighted to do another radio show someday (with different co-hosts, of course!). In the afternoon the heartless dietitian I’m with told me I was lucky she and her co-worker were free the next morning so that I could do the supermarket tour then. Of course, (“this is important!”, she said) I would get points off for it being late, so I’d have to do a great job tomorrow or the points wouldn’t add up and I would not be able to pass the rotation. It’s not the first time she “hinted” at my not passing the rotation, so eh, it didn’t faze me.

 

Friday, March 12th- Shopping Tour Disaster

As you may gather from the title of today. The tour didn’t go well. I didn’t dilly-dally. After the radio show it was as if all my self doubt was magically lifted. I didn’t feel the heavy pull of sadness and self loathing on my limbs. I felt light and able! I felt awake and up for the challenge! I read through material convinced that it’d be better if I knew the material than simply taking notes to read aloud. Seems I was wrong. But it doesn’t matter. Anyway I prepared for this, I know it would have been a disaster. I had notes for the first section. I supposedly had knowledge for the second.

I was her face. Both dietitians came, but it was my preceptor’s face that disturbed me. From the first fruit I discussed (a wretched pineapple [one cup of contains about 133% of the vitamin C you need in a day, by the way]) she had this concerned face. If it had been disgust or doubt maybe I could have pushed through, but it was concern. Like she was watching a train wreck and just couldn’t look away. It was awful. From then, I stumbled over my facts and promptly forgot what I’d studied and not written down convinced I’d remember. It felt like I was being dragged around the grocery store being poked and prodded for facts and knowledge nuggets I did not have. *sigh*

“Well, I failed this rotation.” Those were the first words I spoke to the director when I returned to the Department of Health after that pitiful supermarket tour. She told me not to worry about it, probably thinking it couldn’t have gone as bad as it did. I didn’t argue. I had had enough. I’ve been through so much criticism throughout this internship. From preceptors (dietitians that are supposed to take us under their wing and teach us, a new one each week), fellow interns, even the director of the program herself.

Preceptors have told me I have no initiative because I’m quiet. My internship partner has told me I’m a bad human being and a terrible partner. The director assured me three times in the course of 20 minutes that if I wanted to leave the program that she would understand and support my decision as if she were urging me to get out of her internship. Those things hurt, but I thrived. I proved them wrong. I’m still here. My partner has since told me I’m a good partner and thanked me for helping her in anything I can. The director has since had a change of heart after seeing my renewed spirit when I didn’t let her bully me out of her internship.

But this dietitian with her concerned face by the rack of pineapples broke me. I spent the afternoon holding back tears and gulping down the lump in my throat as I worked to finish the last few assignments for this nightmare rotation. I wonder if self confidence would have made as much of a difference as I suspect. Maybe. The mind is a powerful thing… but mine’s a weakling.

 

Saturday, March 13th- Brooding

Another Saturday that I spent laying in bed amongst my filth of granola bar wrappers, mounds of clean unfolded clothes and random papers piling up in the crevices.

 

Sunday, March 14th- Delayed Dad

My dad was supposed to arrive this afternoon. He’s coming to visit me for Easter. Why Easter? Well, we got the week off. No rotations! So I have time to show him around the island that has been my home for (almost!) the past year. However, the corrections for my assignments from hell week are due next Monday, so I have to work on that this coming week while he’s here. :/

Not sure how, but he missed his flight and instead of arriving around 3pm, he’d arrive at 3am on Monday. Surprise 12 hour change of plans. :/ It’s fine because that gave me time to laze around in the morning, pick up the key to the Airbnb we’ll be staying at until Wednesday, and clean. Yes. I finally cleaned! It’d been at least a month of stressful living in the mess of my creation. But I know the mess bothers Axyl, so before leaving for the week I made sure to clean everything. I tidied my bed area, dresser, mini fridge, and desk. The only thing I didn’t do (it was 2am by this point) was wash the remainder of my dishes. I’d swing by the next day to do so.

At 2am I left for the Airbnb and waited for my dad’s taxi from the airport to arrive. When it did at 3am, I began to excitedly plan out the week’s events before falling asleep, satisfied and at peace for the first time this week.

 

Coming up Next Week!

  • Easter week off!! Hooray!! My dad is here to keep me company. 🙂 I’m so glad to have him here. I want to show him everything, but he’s getting old and can’t keep up like he used to. Let’s see where all I can take him. 😀
  • Working on assignment corrections from this week’s hellish rotation. Ugh. :/
  • Maybe getting volunteer hours at the food bank with my dad? Maybe? heeheehee…. I’m too lazy for my own good…

Social Anxiety – Personal Poetry Collection

I wrote this during the last nutrition conference I went to. I felt incredibly awkward and disconnected with the room of dietitians. My fellow interns were socializing and networking with dietitians they’d gone to rotations with while I avoided everyone. It was just me stuck in my head. Instead of socializing, I wrote this.

March 22, 2019

Social Anxiety

The taste of mint

making me sick

It makes me tick

having to pick

yet still getting a kick.

 

Color a bluish tint

I begin to sink.

down I go, plink

thinking I was mink

when I’m not even in the rink.

 

No longer a hint

goes down like buttermilk

thick but smooth like silk

My truth, myself I bilk

as do my ilk

 

Even so, alone I tilt

and quietly I wilt.

Week of January 21st 2019-Food Service Week 2 (Mostly Ranting About Anxiety… Then Coping by Joining a Dating App)

Monday, January 21st- Learning to Make Menus and Exploring Puerto Rican Cuisine

Nothing fun today. Just went to the rotation where the preceptor told Gia and I we were “failing in even the most basic of things” in regards to the two week menu we turned in. So, she spent the morning explaining how to properly write a menu, the structure and whatnot and even the types of culturally appropriate foods in Puerto Rico. Man, I was wrong. There are a lot of different foods in Puerto Rico. I’m still not on the starchy vegetable bandwagon though! We got to try a few and one downright tasted like chalk! (Yautia, featured image above)

Tuesday, January 22nd- Anxiety Hurts Me and Those Around Me

My day was tainted by Gia snapping at me. I hate how I let my anxiety prevent me from doing so many things. I’ve gotten good at working around it. I enable my own anxiety by finding ways to work with it instead of defying it., but I’ve gotten too good at it to the point that it’s just natural to me. Today I didn’t want to get up to ask the preceptor a question. Gia had a question on her part of the partnered assignment due today. I dreaded it. So, I didn’t jump on that band wagon. Instead I was beginning to suggest a way to do the assignment without asking the preceptor. I was in the middle of telling Gia we could print it the way it was and if the preceptor said something still needed to be fixed, I would print the page with the changes.

I didn’t get through my sentence before Gia snapped at me, blaming me for not letting her ask the preceptor. It was my anxiety! Mine! didn’t want to ask the preceptor. Of course, I didn’t enthusiastically jump up and run with her to ask! I never prohibited her from asking!! I simply didn’t encourage it. Ugh. I hate myself. This topic has come up before. You’ll get to read about a big dramatic thing that happened when I post about Thanksgiving break from last year (I think that should be up by Friday). Basically, Gia has brought up me holding her back because I, in her words, “get annoyed” or otherwise make her feel bad for asking questions. get in my way of that. have anxiety. am not in control of it at the moment. I don’t mean for that to affect her. The effect it has on me already drives me crazy. Ugh. I hate myself.

So I bought ice cream, a little fast food strawberry pie and other random junk. I don’t have time to cope in a healthy way. Gosh. Don’t be like me. Please.

Wednesday, January 23rd- Sorry, Just Ranting about Anxiety. Feel Free to Skip

You know, I annoy myself. I do. I don’t like the person I am. At least other people can get away from me. They can snap at me or cast me out. Believe me, I can do that to myself too, but what I can’t do is get away from myself. Which stinks, because a lot of the time, I wish I could. Today, I apologized to Gia for suggesting some complicated, unnecessary way to complete the assignment yesterday without asking the preceptor because I was too anxious for that to even be an option for me.

I told her I am frustrated at myself and I hate that anxiety keeps me from doing even normal type things in my life. I told her it’s even worse when it affects other people and that I am not in control of it right now. That I know I’m always apologizing for the same things, but that I do genuinely feel bad every time and it’s not something I can fix over night, but that I would work on it to at least not affect any group work we have to do.

She didn’t respond well to it. She told me she’s sick of getting counted off for things that are my flaws not hers because I’m her partner. Specifically, she mentioned the Spanish language difficulty some of our preceptors have put on our evaluations. (I grew up speaking Spanish, but not reading or writing it like she did.) She also said it does bother her when I prevent her from doing things. (I did not! I didn’t want to ask, but I did not tell her not to go ask! But I guess that’s how she perceives it.) She concluded by saying that I’ll never understand her, and she’ll never understand me, but she wasn’t going to argue when I didn’t agree to something she wanted to do since that would avoid problems.

Really? And this isn’t a problem? Getting upset every other day and apologizing for it to be thrown back in my face? That’s better than just telling me, “hey, I understand you don’t want to go ask do you mind if I go ask?”? That would have been the end of it. But I didn’t say that. I just said softly and sincerely, “and you think this is better?”. She looked me straight on and said, “Yes.” in this hard, determined voice. I said, “okay.”.

Then I got home and was okay, until Axyl brought up my anxiety. He said I have to be more outgoing and ask questions and that he can’t understand why that’s so hard for me. That it would help the preceptors get to know me a bit and blah, blah, blah. I tried to explain, just as I’d tried to explain to Gia this morning how I understand intellectually that talking and asking questions is the solution. I see all the benefits it would bring versus being shy and quiet. However, emotionally it doesn’t even seem like an option. He stared at me with blank eyes and no understanding. That triggered me into a sad state, and I spent the next hour or so hiding out in the kitchen singing songs softly.

Thursday, January 24th- Last Time at my Old Apartment!

First day I didn’t have to go to a print shop before my food service rotation. That was nice. We actually had stuff to do today which was even better. The preceptor had a meeting this morning but left us to do some accounting invoices. I liked that. Instead of some other times where we kind of just waited around. I guess we could have gone to the kitchen and observed or something, but read above (Anxiety!). Yeah, I like accounting work. Later Gia and I scampered over to the nearby McDonald’s since the kitchen at the hospital is super cold and full. We bought a pie and sat inside. It was super awkward to eat my lunch there. A hot dog. Clearly not on the menu… XD haha!

Afterwards I walked back with Gia to my old apartment complex. There I got to meet Uuie’s dog (a fellow intern’s and one of Gia’s roommates). I also went to my old apartment to clean up the left over trash I’d left in my room when I moved out in a rush. I returned the keys to a terse Robin who didn’t even want to look at me and I knocked and knocked and knocked on Karen’s door to settle some money matter (to finish that topic and tell her I don’t even want her money anymore). She didn’t open the door. Even so, it felt SO GOOD to leave that apartment. I never have to go back!!!!

Friday, January 25th- Hiding in the Broom Closet Drinking Coffee with Gia XD

The preceptor was busy all morning. She was doing some paperwork until about 11:30 am. So, Gia and I hung out in the kitchen for the most part. We were given a cup of coffee by one of the kitchen workers, but we didn’t want to get told off by our preceptor for lollygagging, so what did we do? We (I’m completely serious about this) hid in the supply closet while we sipped our coffee. Ha! It was hilarious. We were giggling over our cups half the time. I wonder if the other interns get themselves into comic situations like we do.

Once the preceptor was finished, she assigned us more projects to do. One is to find a recipe and adapt it for 100+ people. Some sort of rice or pasta or starchy vegetable which Puerto Ricans group into what’s called “farinaceos”.  It’s a whole separate food group here which also includes bread. It’s like the U.S. carbohydrate food group but including starchy vegetables. Anyway, there’s that plus a proposal for a recycling program and a proposal for an outpatient clinic. We are just her little monkeys, aren’t we? All the work we do either helps her get ahead (like the accounting stuff we did the other day) or she uses to present to her bosses. Isn’t that convenient? I mean, if I have free labor (the internship doesn’t pay us interns), I’d use it too, but come on!

After lunch we went around the department and observed the preceptor give a meeting to her kitchen staff about areas to improve and what health inspectors look for. When it ended (two hours later!!), Gia and I got to help fill up cups of juice and package the snacks for that night. 🙂 That was fun! I’d work doing that. It’s calming to do a repetitive task. When I got home, I took a shower then chit chatted a bit with Axyl before he fell asleep. At 7pm! So I watched a movie and called it a day myself.

Saturday, January 26th- I Got on a Dating App…

What did I do Friday night after watching the movie? I decided my life isn’t busy enough, so I finally caved and got on a dating app. Epp! I’ve never been on one and I’m not what you would call a promiscuous person. So, I was pretty hesitant since as far as I know, most dating apps are known for hook up culture. (Maybe that’s not the case, but it’s what I’ve heard.) Well, I gave it a shot on a whim and after setting up my profile, promptly fell asleep. I woke up late. I know I have a ton of assignments to do, but ugh… it’s overwhelming.

I spent the day chatting with a match I got on the dating app and with Richard. Haha, I got Richard and Axyl to talk with each other. That was funny. They are my two best guy friends, so it was cool that they hit it off. Both are these super direct, I-Don’t-Care-If-It-Hurts-Your-Feelings-It’s-The-Truth kind of people.

As for the guy from the dating app, he was alright. Made me laugh right off the bat, but the conversation didn’t completely flow. By the end of the day, I asked to meet up with him. I have a date with him next Friday.

Sunday, January 27th- Someone Send me Motivation, Please

I don’t know what I’ve done all day. Procrastinate and stuff mainly. I’m not motivated and can’t find the energy to work without motivation. *sigh* I’m so tired.

 

Notes:
Photo Credit to Lovesx-70 on Flikr

Health Doesn’t Just Come From Your Doctor: The Importance of a Team Approach to Health.

I’m easily triggered. Just because someone isn’t diagnosed doesn’t mean they aren’t struggling. Do you know how many people have medical diagnoses that either aren’t discovered until years after the onset or at all? It’s not uncommon. And often times medical diagnoses have physical symptoms. Can you imagine how difficult it is to go about life with constant or extreme pain, inflammation, fever, cough, whatever it may be, and all the doctors, specialists, and medical professionals tell you nothing is wrong, when you clearly know it is? How can everyone- professionals especially- doubt what you feel so strongly every day?!

Now imagine that same negation, doubt, and being brushed off but no physical symptoms. Or the ones you do have aren’t even considered. I’m talking about undiagnosed mental disorders. I’ve gone to the doctor. Other than being overweight and having a twinge of high LDL cholesterol, I’m fine. You know, the last time I went to the doctor, the nurse asked about any signs of depression or anxiety. It’s a complicated, but simple question. I mean, the whole concept of mental illnesses are things most lay people (in my experience at least) don’t seem to understand. It was nice to be asked. I replied, “yeah, some anxiety”. I was too anxious to mention my depressive tendencies.

 My Experiences at the Doctor’s

I’ve been going to therapists/ support groups on and off for the last four years now and I can say that it’s really helped me. However, all of that was when I was in university. It was either free or really cheap, super close to where I lived, and on my own account. I remember the doctor I went to a couple years ago didn’t say a word to me about mental illness. But she sure did waive the mood screening she supposedly did. Just because I wasn’t bawling my eyes out or trembling as I spoke, I’m ruled out for anxiety and depression, not to mention all the other known disorders? I didn’t know the DSM had changed their criteria!

Mental health isn’t that easy. You can’t just look at someone and know they are mentally okay. Sometimes you can. I would argue that when I went to the doctor this winter, I was a stereotypical depressed person. I looked tired even through most of what I did during the day was sleep, I hadn’t showered in several days. I know the doctor and everyone else could tell by my greasy hair that fell slick over one side of my face. Maybe I looked better than I remember feeling, but the not having showered thing was evident.

Despite that and the fact that the nurse seemed to have written down something about my anxiety comment, the doctor didn’t mention a word about mental health. I understand doctors are much more physiologically inclined, but health is multifaceted! You couldn’t run a hospital with just cardiologists. What would people with diabetes do? Or burn patients? How about a hospital filled with dentists? No! Each medical professional has a role.

Collaborating with other Medical Professionals as a Dietetic Intern

As you guys may know if you read my weekly blogs, I am doing a nutrition internship at the moment with the end goal to become a licensed dietitian. My first rotations were mostly clinical which meant I was evaluating patients at hospitals. One thing that I got harped at for? Not referring patients to other medical professionals. At first, I assumed, well they called a nutrition specialist so I should focus on the nutrition aspect. Makes sense, right?

Yeah, well it isn’t that simple. Some patients were sedated, others had a tube down their throat, and yet others just didn’t understand their disease. I couldn’t just waltz into their hospital rooms and focus solely on nutrition. Everything was entwined. From the patient’s medical diagnosis (doctor), their ability to move (physical and/or occupational therapists), ability to swallow (speech pathologist), will to live and eat (psychologists), any damage/ deformity that could alter nutrition intake or absorption (surgeons), to when blood sugar was checked (nurses) and how much family support/ financial stability they had (social workers), it is all intertwined. If I had a patient who was hungry but was in too much pain to eat, I couldn’t do my job. Or, more like, it wouldn’t matter if I did my job because the patient still wouldn’t eat. That was doctor territory. I wasn’t about to tell a doctor what to do.

The Intertwined World of Medicine

Health is a complicated thing. It even goes beyond medical professions to each individual. It includes, yeah, any diseases, dental caries, and so on, but also diet, physical activity, sleep, stress management, and emotional balance. I knew that when I was doing nutrition evaluations at hospitals, but I didn’t want to overstep my boundaries. I didn’t want to boss around professionals with more studies than me. But that wasn’t what I was supposed to be doing. This is what I mean when I say health is simple and complex.

I don’t have to know all the inner workings of the body or mind or even that patient’s life. All I have to know is that if I see something not quite right, it’s okay to consult someone. It’s okay to take a couple minutes of someone’s time if I believe it would help. I am not a dentist, but if I have a patient who can’t eat because their dentures don’t fit right, it is my responsibility to call one. Otherwise, I’m being negligent. It’s wrong to recognize a problem (worse if you also recognize a solution and even worse if it’s a relatively simple solution) and then do nothing about it.

A medical professional shouldn’t leave a patient to figure things out if they have already figured it out. The least they can do is mention the observed problem to a patient and suggest they seek help from a specialist. Better yet would be to call in a referral. That being said, it is all health care worker’s responsibilities to be observant and help where they can. I know every profession is busy with their own work, but if you see something that’s not quite right, no matter your line of work, say something!

If Only my Doctors Read my Blog…

I’m getting better at it. I wish my doctors were better at it. I know I need some sort of mental health specialist to get out of this rut I’m falling into again. I’ve never experienced such extreme symptoms as I am right now. Yet, my doctor didn’t mention a word about mental health. She asked if I’d gone to the dentist though, so I guess that’s some positive points there.

I don’t know if I am certifiably insane. I don’t blame my doctors for the fact that I haven’t gotten up the courage to set up an appointment with a psychologist. I’m not saying people’s health is solely a doctor’s responsibility. In the end, you are in responsible for your health. What I’m saying is doctors are the gatekeepers that connect most other health professionals and a quick referral can change someone’s life for the better in a matter of weeks versus the months or years it may take that person to figure it out on their own or, as is my case, build up the courage to do something for themselves.

Oh, well, I guess that’s what natural selection is about, right? Hooray for not knowing what, if anything, is wrong with my mind!! Maybe I’ll feel like making an appointment with a psychologist next year…

Why am I not enough? (Remembering to put on a fake face to survive in the “real” world)

I’ve had problems with depression and anxiety …also probably paranoia and anger management at least since 8th grade. Everyone has traumas. Mine happened when I was 10 years old. It was no one’s fault. Who was I to be angry at then? I think humans need to blame someone or something or else all that anger gets internalized. At least that’s what happened to me.

 

Brief Overview of my Life Growing Up

I’m not ready to write about what happened. I don’t want pity. What I want is to explore its effects. At 10 years old, I learned that loved ones aren’t a given. They can be there one day and not the next. (No one passed away, if you’re wondering.) But I learned no one is a sure thing. Not even my parents. However, through this turbulent time I still had my teachers and classmates. I learned that was my constant.

Middle school years

That’s all that I carried with me: my school friends and academic success. (More so my friends, but at the end of the day I chose academics and switched schools.) 8th grade. New school. I don’t know why since I’d always been the kid who had a friend by the end of the first day of school, but I didn’t make any friends that year. I didn’t feel the need. I wasn’t interested in talking to other people. So I didn’t. Academics. That’s all I had.

High school

I tried, but by now it wasn’t just a lack of desire. It was full-blown anxiety. I couldn’t bring myself to talk to anyone. I’d only talk when teachers called on me in class. Even then my heart worked overtime from the stress of being called on. Academics. That’s all I had. Not having friends, I dreaded school breaks. Winter break, spring break. The worst was summer break. My mind would over think. I’d get into existential crises. At 15 years old, I knew I needed a distraction. I needed a purpose. Without school, my life, I feared death. Or maybe I feared not living.

I lived (arguable choice of words) like this for 3 years. By senior year of high school, I began to wonder. What if I didn’t treat academics as my life. What if I did poorly? I felt my parents weren’t proud of me with all A’s. (My dad praised anything and everything, while my mom questioned my A+’s for not being 100’s.) Would they freak if I got C’s? So, I stopped trying. I tanked my GPA in the last year. Began failing tests. (I’d never failed an exam before then.) And. Nothing. Happened. They were disappointed, but they didn’t lecture me. Just told me to try harder.

Or maybe they did care. I don’t even know how I felt. I’d say I didn’t care, but I did because I was worried that they didn’t care. I was nervous watching my grades drop and them not bat an eye. I wanted them to care. I wanted to matter to my parents. Not that I didn’t. I knew, intellectually, that they cared about me, but at the time I needed to proof to believe it. My dad’s praise was so frequent it meant nothing and my mom’s was nonexistent. Positive wasn’t happening, so I sought negative attention.

But I didn’t get it.

Then I went to university

I’d made a friend during those last two years in high school. I’d stopped trying so hard to keep my grades up and still passed. My priorities shifted. I learned the wonders of human connection. School didn’t matter. I had friends! Maybe it was my depression or paranoia or broken trust in family stability (no one got divorced either, in case you guys are wondering). Whatever it was, I could not feel or believe that my parents loved me. I knew that as a fact. Not as a feeling.

But I knew my friends liked me! And that feeling was indescribable! A feeling! That itself was surprising! I was numb all throughout high school. The only time I felt anything was during that short-lived flirty time with the boy I snuck off to the library with (blog post on that here). Often I remember anger. But that was it. Anger or nothing. It was like I wasn’t alive. Emotionally, at least.

But in university, I made friends and felt emotions. The most important of which was happiness. I’d had that spark of nervous flirty happiness with the boy in high school, but not like this. Not from friends, and later happiness all to myself, from myself. I found freedom in university. I wasn’t always at school or at home surrounded by people. Being watched all the time. Or not, but that’s what the paranoia told me. I had my own space. It was scary at first. I still struggle to do things by myself. I don’t think I was ever allowed to be alone growing up (bedroom doors were not allowed to be closed in my household and I didn’t go out with friends, much less on my own). University was life changing.

I learned what happiness is. I learned what friends are. I learned who I am. When no one was watching, I knew who I was and amazingly, I liked myself.

What did books matter when I was learning all of this?! They didn’t. And while I was learning who I was, I had to decide on a career. (Blog post about how I came to that decision here.) And now I’m here. In Puerto Rico. A place I knew nothing about when I decided to move out here for a year. Much less did I know anyone here. All the interns in my program were strangers. Now, I wish some of them still were.

I’ve learned that people can be mean and care only about themselves. I’ve learned people can be indifferent or too interested. I’ve learned people can be angry. They can be distracted. They can be cruel. And they are hypocrites.

I knew these things as fact before. But now I know them as feeling. …It makes me wish I didn’t have emotions again. It’s an empty wish and a common one of mine, to go back to the numb high school days. But in those moments with friends, some with romantic interests, and others through my own personal accomplishments,  I’ve learned what positive emotions are and I believe they are what makes life life. Only being able to feel anger, which later morphed to sadness, is not life.

When I was in high school, it was a numb, unfeeling depression. In university, with happiness, I learned sadness. Harsh, deep sadness. The peak of which occurred in my senior year of university. This year I lived with a great friend of mine. And I hurt her. Before her, I always had a facade up. An act. It wasn’t to be cruel. It was to be kind. I didn’t want to expose others to my sadness. But with her…

Life Changing Friendship- Learning to Trust and that it’s Okay to be Myself. Flaws and All!

To Mariah I gave all of my trust. I let go completely. I let her in as far as she wanted to go. And she went far. She saw me at my worst. I’ve never been that depressed since. Even though she’ll deny it, I know I ruined (or at the very least) inconvenienced many of her days. We spent Thanksgiving (2017) angry with each other and that weekend trying to drag me out of bed, literally. I made her suffer. It wasn’t on purpose; it just goes with depression. With depression and anxiety and paranoia and anger issues and what ever other labels exist for all the not positive aspects of my personality.

But she refused to give up on me. We’re still friends. I know that woman would do almost anything for me. And I don’t know what I did to deserve her. I don’t feel like I deserve her. It’s rare, someone like that. So loyal (against their own good even). And I was spoiled.

Post Graduate Nutrition Internship- Learning to Distrust and that it’s NOT Okay to be Myself. Flaws Should be Well Hidden.

Now, I’m here in Puerto Rico working on a dietetic internship (when I doubt I want to work as a dietitian for the rest of my life) almost attached to the hip with my internship partner. I go from rotations where I’m supervised and evaluated. Hello, paranoia and anxiety! Oh, there you are anger! To an apartment where everyone has beef with at least one other person. The environment is toxic. Doesn’t help my depressive tendencies.

Sorry I can’t be positive and supportive 24/7. I still try. It hurts, but I try. Thing is, I can’t give what I don’t have. Every day I feel more paranoid, more anxious, angry, and sad. Or then I’m manically happy! But one misplaced comment and I’m underground again trying to dig myself out. Or not. Sometimes I don’t ever want to surface. (Related blog post here.)

I let myself believe, due to my experience with Mariah, that people can be trusted 100%. I can let go and be my completely flawed self and not worry about the repercussions. But I now know how truly lucky I am to have someone in my life like that, because that’s not the case with anyone else. I already had trust issues. Maybe everyone does. However, I was healing. I was learning to trust again.

But now, I feel as if there is nothing to learn. From my experiences here, no one wants the real me. No one wants my flaws. I am, as I always feared, an inconvenience. I have to pretend to be only the best parts of myself, because that’s the only parts people care to get to know. That’s understandable to me with the preceptors who supervise and evaluate us, but I mistakenly thought it wouldn’t be the case with my fellow interns. I was hopelessly optimistic. And I was wrong.

I have to learn how to fake it. Something I wasn’t 100% successful at during my customer service-y job as a cashier during university breaks (2015 to 2018). I could do it, but only for so many hours a day. Here, I share a room, I go to rotations where I am supervised and evaluated 5 days a week with my internship partner plus travel to the site and work on assignments outside of those 8 hours with her and I come home to an apartment where people aren’t happy to see each other.

 

Constant People, Constant Need to Fake It (to fake sanity/happiness)

The only saving grace is that I feel that genuine care and friendship from my roommate. But, he’s still another person I am around every day. In university, I had space. I had freedom. Now, it’s back to how it was when I lived at home. Constant people! But higher stakes! The only time I’m alone is when I go out by myself. Remember my friend anxiety? Don’t forget depression! To motivate myself to go anywhere is difficult enough. To not change my mind is another thing. Depression tells me it’s not worth it. Anxiety tells me it’s all going to go wrong anyway, so why try?

I don’t wish to blame my hard times on these mental health issues, but I know they are a big factor. And I feel like I have to keep them to myself now. My struggles and thoughts should remain my own to not affect others. Even then, there’s nothing I can do about my energy or aura. If I’m that depressed and empty inside, it doesn’t matter how big I fake smile. I’ve lost my ability to act believable. Thank you Mariah, for making that ability obsolete in me and damn you.

I’m truly going to have to fake it and hope I make it. Seven more months until the end of this internship. Wish me luck, please.

 

 

Note:

Featured image is of me last Halloween (2017). I’ve always loved goth fashion, so I enjoyed expressing myself that day through dress, hair, and makeup. I use it as the image for this post because it represents how I feel at the moment. I am in no way saying goth culture equates to sadness or anything like that, but that’s how most people seem to take it. And I feel like this is how I come off to people without make up and even when I do put on non-goth makeup. I feel like no matter what I do outwardly, all people see is my obvious sadness or negative aspects of my personality. And what can I do about that?! (Nothing overnight!) Why am I being punished for that?! Isn’t the depression, anxiety, paranoia, distrust, anger, and self loathing punishment enough??

Best and Worst Experiences during Clinical Rotations in High School: Why I’m Not a Doctor Part 1

I wanted to be a doctor when I was younger, but I gave it up because I didn’t want to lose my humanity. In high school I, essentially, took a year long, intensive, crash course in anatomy and (more so) physiology. I was a sponge. I absorbed everything. (Except vitamins and minerals. Those were not interesting to me at all.) It’s amazing how knowledgeable I became from that one year. I remember sketching anatomically correct hearts and coloring them for fun.

I also remember going into clinical rotations the following year (11th grade) and feeling incredibly awkward about it. I was wicked book smart, but catastrophically inept when it came to people skills. (Still not great at it…) Which means 90% of my clinical rotations went like this:

 

Dr.:

“…and that’s what we do in [insert area of hospital here].”

Catastrophically Inept at Social Skills 17 Year Old Me:

*nods*

Both of us:

*AWKWARD SILENCE*

 

It was almost worst if the medical professional I was shadowing tried to converse with me. Most of my answers were short and direct. Example:

Dr.: 

“…and that’s what we do in [insert area of hospital here]. What area do you want to go into or what are you interested in besides medicine?”

Me:

I’m not sure yet. Um, I like to read.

Dr.:

Oh, that’s okay. It takes time to figure that out. What kind of books do you like to read?

Me:

Uh, really anything as long as it’s fiction.

Dr.*Sees I am most definitely not the conversational type*:

…that’s nice. Yeah, when I was younger [insert personal story here to fill up my silence]

 

The worst example is when I made a conscious attempt to be more conversational because I had read somewhere that it’s good to take interest and ask questions. That gets people talking according to some self help text I read. So, I mustered up some anxiety ridden courage and asked the cardiologist I was with that day a question (who, to make things worse, happened to be the father of one of the girls in my clinicals class). It went like this:

 

Dr.:

So, we evaluate patients using a stress test.

Me.: *Thinking: Don’t let the silence hang. Say something! Ask a question! Show him you are interested in the topic and want to know more!*

So… what does a stress test consist of? (…yes… I actually spoke this very formal way back then. Even around friends. It was sometime this year that I began simplifying [read: dumbing down] my speech.)

Dr.: *Stares at me for a second* *Responds in a this is completely obvious, I don’t know why you asked that question tone*

It’s a stress test. We put the patient on a treadmill and stress the patient.

Me:

*feels stupid* *silent for the rest of the day*

 

…But I digress.

Before the flood of vile flashbacks, I planned to recount my best rotation. For that, let’s backtrack a bit. In high school, I didn’t study. I just learned in class. And retained all of the information. When it came time for a test I simply reviewed (read: quickly read through) my notes from class and presto! high A’s. Here’s the best rotation I had:

 

Nuclear Medicine Dr.:

See here?

*points to a patient scan with some mass or other abnormality*

This patient had [insert some diagnosis that I’ve long since forgotten]. Do you know what [insert some medical term related to the patient’s case] is?

Me: *Enthused this isn’t a personal question and is something I can answer with much more ease*

Yeah, that’s [insert correct answer].

Dr.: *Intrigued I got it right*

Right!

*Continues discussing case* *Brings up new scan*

Now this patient had [insert some other diagnosis that I’ve long since forgotten]. Do you know what [insert some medical term related to the patient’s case] is?

Me: *Glad for another question I can answer*

Yeah, that’s [insert correct answer].

Dr.: *Very intrigued now*

What’s [some medical thing]?

Me: 

[insert correct answer]

Dr.: 

What’s [some medical thing]?

Me: 

[insert correct answer]

He was rapid fire quizzing me now and I was gaining confidence with every correct answer. A couple questions later:

Dr.:

Where are the thyroid glands?

Me: *Nervous because thyroid glands were only briefly mentioned in class. Once.*

*Hesitates then uses both index fingers to point to my throat on a fuzzy educated guess*

Dr.: *Satisfied at last, asks with genuine interest*

What area do you want to go into?

Me: *Still buzzing because I got the last question right* *Confidently answers*

I want to be a nurse.

Dr.:

A NURSE?! You have to aim higher! It’s better to struggle at something difficult than to excel at something easy. Don’t you think?

Me: *Thinking about doing very well in my regular level classes and just well in my AP and IB classes, but learning things on a much deeper level*

*Thinking about the fact that I took those higher level courses because I truly believe it’s better to challenge yourself and do okay than not to and breeze by.*

*Tentatively* Yeah, I think you’re right.

Dr.: *Gives me an encouraging look and a hint of a smile*

Don’t conform with being a nurse. Be a doctor.

 

Then he gave me his business card and urged me to contact him if I ever had any questions. I assure you no other doctor gave me their business card. Nor did I ever impress another doctor. Not surprising, since I probably said as many words to the Nuclear Medicine doctor as to all the other doctors the rest of the year combined. And no, I am not omitting his name for privacy reasons. (I’d give him a pseudo name, if that was the case.)

I actually lost his card sometime after that school year. I was not able to remember his name, let alone call him when I began doubting the whole doctor thing when I began university. Not that I would have called him anyway, because… you know… severe anxiety. I did go over to the nuclear medicine department at that hospital sometime before going off to university though. I had hoped to run into him, but I didn’t see him and I didn’t even know his name to leave a message. :/

 

If you’ve read the My Life Now section of my blog, you know that I’m here in Puerto Rico as part of a dietetic internship instead of in med school.

I’m sorry, Nuclear Medicine Doctor, high school clinicals teacher Ms. Dee, all of my clinicals classmates who expected medical greatness of me, all of my teachers that swore up and down I’d go on to excel as a doctor, my AVID teacher Ms. Dar, my parents, and myself. I’m sorry.

~*~*~

My next deterrent from medical school wasn’t the crushing fear of losing my humanity. (Though that was always present.) It was a wrong click when I enrolled to university. Come back for part two next week to read about fateful click!

Note:

Picture is of my physiology class material sophomore year in university.

 

 

 

The Mock Interview

Originally Published February 18, 2018

Look! Another old blog draft. You’ll probably be able to tell where the draft ended and where I added the ending, but I hope it’s still entertaining. Here it is:

Let me tell y’all a story…

Today, I went to my university’s career center to do a mock interview. It’s for a class and not a big deal. So, I wake up early. I think, “Yeah, two hours before my interview is enough time to shower and get ready for this thing”. Fast forward to 7:00 in the morning. Snooze. Snooze. Snooze. I didn’t get up until 8:15 am. My interview was set for 9:00 am. Yep. I got dressed, lazily printed out a couple of resumes and searched my whole apartment for a belt and decent jacket. Finding neither, I start walking to the door. I have approximately twenty minutes to get to my interview which is, conveniently, a mile away. Now, I live relatively close to my university, but a mile is a mile.

I shyly slide into my roommate’s side of the apartment hoping not to catch her as she’s brushing her teeth or (like a couple weeks ago) watching YouTube videos au naturel. Luckily she was doing neither of those things. She was just going through her closet like a normal human being when I asked her about the parking situation for the building I was heading to. Upon discovering that this would not be an option for me I start to walk away. Like the good human being that she is though, she scolds me about not taking a jacket and goes ahead and gives me one. She also gives me a belt for bonus points.

Quick side note about my roommate. Let’s call her Mariah. She is one of the sweetest most caring person I have ever met. But she believes in tough love. You’ll hear more about this in coming blogs, I’m sure. Alright, back to the story.

So, with borrowed jacket and belt donned, I take off. 17 minutes. That’s okay. I planned to ride my bike anyway. One mile has nothing on my Huffy Cruiser! I cross the street and go to grab my bike, but it’s not there. That’s when I remember I moved it closer to my college. It’d be more convenient I had said at the time. Great. Just great. 15 minutes now and still .8 miles to go. I could sidetrack and get my bike but that’d be about a quarter of the journey I already had. No! I decided. I will walk! I will walk, and I will make it on time!

Somehow, I do arrive exactly at 9 am. But, what’s this? This isn’t the career center! It’s hospitality services. A few paces ahead: student housing. Oh gosh. I’m late.

After this whole ordeal to make it to my mock interview I end up flying through it and getting multiple compliments and a few pointers for the real thing. It was extremely surprising to hear that I have nothing to worry about in a real interview. The mock interviewer said I seemed relaxed and natural. I’ve never thought people skills come naturally to me, but it’s moments like these that make me pause and think, “hey, maybe anything is possible…”.