(Doctor’s) Note to Self

I have an unshakable belief in my latent abilities as a diagnostician.  My credentials include thousands of Reader’s Digest articles about people bravely battling diseases (all read before age 18; Reader’s Digest is sophisticated reading material in Ohio and I was always happy to babysit for folks classy enough to own the bound editions); lots of New Yorker science articles by Jerome Groopman and Atul Gawande and their ilk; an unhealthy relationship with daytime TV during certain periods of college; and living with two doctors during their residencies.

My best patient is myself, of course.  I can always identify my own illnesses.  ”Pretty sure this one’s just an upper respiratory infection,”  I’ll say confidently to my doctor’s receptionist. “But I’m having a really hard rime sleeping with all this coughing.” (Translation: I have a cold, Please give me the cough medicine with codeine.)  Or, “Yeah, I’ve had a low fever, lack of appetite, and a deep, productive cough that keeps me up at night. My ears hurt too.” (They don’t, but I always get ear infections when I have bronchitis, and I’m positive that when I go in for an exam he will check the little otitis media box.)  ”I think I need to come in and get some antibiotics.” (And some of that cough medicine with codeine.)

I can diagnose you, too.  ”What color is it when you blow your nose?” I ask a coworker whining about her sinuses.  ”Unless it’s green or bloody, it’s not a sinus infection. Take some of the good decongestant they keep behind the counter–the meth kind–and see if you don’t feel better soon.”  I have accurately diagnosed conjunctivitis, Fifth’s Disease, sciatica, shingles, a rotator cuff injury and a problem meniscus. “No, not Tylenol, you need NSAIDs,” I say sternly to my patients with lower back pain.  ”Take them with food so they don’t hurt your stomach, and keep taking the recommended dosage at the recommended interval for 48 hours after it stops hurting, to keep the inflammation down. But,” I lower my voice confidentially, “as long as you have some food in your stomach, go ahead and take 800 mg before bed.  It’s a hospital dosage, and you’ll sleep more comfortably.”

My home pharmacy includes everything from antibiotics and anti-malarials to Xanax and Zyrtec.  I still remember how happy I was when I saw Mucinex on the shelf at CVS; “Why, this is great! Guaifenisen used to be available only by prescription!” I chirped to the dead-eyed clerk who rang me up, back in the days when CVS had human employees.  She profoundly did not care, but a life full of thinned mucus is worth celebrating, in my opinion.

I’m a doctor, kind of, is what I’m saying.  But one place where my training has proven to be woefully inadequate is when it comes to my own psychopharmaceuticals.  I take them erratically, and at the wrong times, and decide that I’ll take one and not the other even though they are meant to work together.  Time and again, I stop taking them altogether as soon as I feel well.  ”Just a phase!” I tell myself smugly.  ”No more of that.  All better now. Totally situational, and a natural reaction to a stressor, and what I really need to do is just take a 20 minute walk every day instead and be sure to nurture my…” But before can finish the thought, let alone lace up my sneakers, I am taking days off to sleep until 5 and crying when the barista marginalizes me by giving me skim instead of 2% (I know what she’s thinking) and diagnosing friends who mention abdominal discomfort with aggressive tumors.

“The organs are the worst,” I say grimly. “It just metastasizes everywhere.” “But I think it’s just because of that latte. I’m lactose intolerant and–” “Lactose intolerance is bullshit,” I’ll hiss.  ”I suppose you think you can’t eat wheat, either.” And then I decide I hate that person and his/her neuroses, and call off work the next day to cry about how I don’t have any friends, and then my absences piss off my boss, and I have to call off work to sleep through that stress…and on and on until someone who I have snapped at but loves me anyway says, Are you taking your pills?

I am taking my pills, but I don’t think they’re working. The kind I’m taking have never worked particularly well, but they do leave me able to get out of bed AND with my mojo intact. But now…maybe last week’s crying jag wasn’t really PMS, and this week’s inability to feel pleasurable anticipation (about such things as a weekend away with the boy, which is basically the best thing ever) is not actually because the world contains no joy at all and I’m the only one who can see that clearly.

Or, you know, I might be right.

Yesterday during a staff meeting I got so angry over something infinitesimally small that my old boss had to put a restraining hand on my leg under the table. I almost hung up on my mother for voicing an opinion.  I had bad dreams all night that people were being mean to me and looking at me with a sad mix of pity and disdain, faces scrunched up like Renee Zellweger trying to portray “sympathy”.

Today I feel okay, but it’s early yet.