I just feel like ranting a bit... I am a helper. It is my calling, my profession, my job... I'm sure those of you who are EMTs or police officers or firefighters can relate. The funny thing is, I'm not really sure how helping I can be when I am so often not even "there". I started off in medical school with real problems doing intimate exams of others. I would see in my head someone else instead. Genital exams threw my head into spins. Then I realised if I just completely detached I could view my hands as simply tools, machines. Just forget that there is a heart or soul attached to the hands. I spend my days doing things to people I would not allow done to myself. Paps, rectal exams. Looking at hernias, butts, penises, vaginas. Like a sick privilege. Seeing people in the emergency department, working the pediatric shift listening to young kids who have been abused. Most of the time I just detach. The cool clinician. How good a doctor can that be? When I am on call I don't sleep because I have to work. When I'm not on call I still can't sleep because of the nightmares and the dreams. In the daytime I am eternally exhausted. Sometimes I even fall asleep in surgery while retracting. And the dreams are crazy. So real and yet I don't remember most of them ever happening in my life. Then again I don't recall a lot of things ever happening in my life. My life is like a jigsaw puzzle: all separate pieces. They may fit together to form a collective picture but I prefer not to see the picture because it isn't pretty. At least if I can look only at fragmented parts I can pretend it makes something else as a whole. I can't even call what happened "abuse" because "abuse" to me has become such an overused word. I hate the idea of labels. "Abuse". "PTSD". "Survivor". Maybe I am in denial. I still think to myself that what happened in my life was nothing and I am simply overreacting. How bad can it be, I ask myself? Sometimes I think I would love to drink myself into oblivion but because I fear throwing my career away over substance abuse I don't. My career has become who I am because outside of it I feel I am nothing. Reading self-help books, I end up thinking oh well that is all such pop psychology crap. I know the theories, the medications, etc. All part and parcel of becoming a doctor, the head leanring. But that's all it is. Head learning nothing more. PTSD and CBT, exposure therapy, EMDR... Zoloft and SSRIs and MAOIs and adjuvant therapies... makes no difference to me and my life. I am walking through life seeing people, treating them, medicating them. Such sincerity. I think many days when I look in the mirror all I am is a huge fake.