Post by James Noake

It's 8 months since I ‘walked’ out of hospital into bright sunshine, on crutches, apprehensive, confidence gone, unable to stand upright I’ve accepted that I have a mild form of PTSD after 6 weeks as an in-patient An abstract clinical nightmare world, heavily medicated – an environment I patrolled with confidence during my career, blissfully dissociated from the suffering of my patients Suddenly I'm on the other side of the fence, in a sterile NHS cubicle - separated from my family and close friends, battling suicidal levels of pain due to discitis and bilateral sciatica – bacteria feasting on my vertebrae, lying on the floor of the toilet crying unable to move and begging for help, the patient in the bed opposite swearing at the staff to assist me - banging my head against the radiator I went into hospital at 105kg – I left at 83kg In the MRI machine yet again today, I passed the tedious hour by doing some mental calculations: In the last 12 months - 1000 hours lying in a hospital bed slipping in and out of false sleep, picking up where I left off in familiar nightmares 20 hours of MRIs, CTs, biopsies and X-rays 42 hours of intravenous antibiotics I have days when I appear ‘normal’ to colleagues & strangers. The bilateral foot drop is subtle and, with focus, I can tame it. I still trip if I’m not paying attention - it is variably wearing and upsetting. And, so, it seems to those around me that I have recovered. But I haven’t – not fully. Physically nor mentally. I still have daily pain and it can be exhausting. My feet don't belong to me. I have a ‘silent disability’ - on the tube I cast my eye over the posters that remind commuters that not all ‘disabilities are visible’ – a rueful smile I’m an inch shorter now. I can't look at myself in the mirror. I used to play off 5 handicap in golf - now my daughters put my socks on for me in the morning Leaving hospital, the battle isn’t over – there is the task of self-directed withdrawal from the heavy-duty opioid & benzodiazepine medication The mornings are the worst – waking up to the familiar rat gnawing relentlessly on my shins. I kick and lash out at it to get it off, half asleep, imagining it to be under the duvet, but it’s not there. The constant wrestle with uncertainty grinds you down: “If it’s a struggle now, how will I cope in 20 year’s time?” “How will I support my family?” And in darker, self-pitying moments – “what did I do to deserve this?”  It sounds bleak – but there are some positives: A different perspective on life, prioritising health, family, friends, interests…. not work A different level of empathy – I can truly acknowledge a patient’s suffering based my own lived experience – I feel this has made me a more rounded, compassionate doctor And so, I push on. What other choice do I have? Perseverance.