Realistically whilst it was evident from an early age that all was not always well my run-ins with the medical establishment didn’t really begin until I sought help in 2006. It is difficult to put myself back in the mindset in which I was then but it was sufficiently serious that I agreed to trial antidepressant medication. I was assured that this was not something to be anxious about etc. in this instance they did at least put me at my ease on that score. What they failed to instruct me on was what to do if something went wrong, which it did, on the first set of meds they put me on, a very common SSRI called citalopram. No one could have foreseen such effects, I recognise this, I do not blame anyone, shit of this nature happens all the time to people struggling everywhere, you take the chance that the meds might help and if they do, happy days, if they don’t then you can console yourself that you are in the minority. Of course that consolation is a little hollow at the point you are standing in the queue at a supermarket with a full trolley of shopping and the whole place starts to close in on you such that your only thought is to get the f*** out as quickly as possible.

That was the beginning of the process of sampling all the medical profession were prepared to offer me, the only thing that had any realistically positive effect were the diazepam which were helpful for relaxing before sleep but they were reluctant to give me any repeat prescription for those, assuming perhaps that I might have friends for whom I could become a black market supplier. Other than that I had experiences that ranged from the utterly nondescript to the physically disassociating from my body and wondering if I were to jump under a bus whether I would feel the sensation or be immunised from it as an out of body onlooker! Thankfully I had foreseen the somewhat more turbulent nature of that medication and had taken myself off to a friends some days before for ‘observation.’ I was able then to order a lockdown of the premises on the instruction that I was not to be allowed out until I could describe why throwing oneself under the bus was a bad idea.

It’s fair to say that my medication experience was one I felt I had put behind me until 4 years later when a combination of 2 medical professionals taking the time to do no more really than what they were there for but doing so properly and for reasons of care, which made a huge difference. (The arbitrary nature of how this happens still makes me wince as it shows how random genuine support can be and this is just so wrong). I had changed Dr when I had moved house, I was muddling along in some form or another, just about getting by sometimes, occasionally enjoying things too but often still struggling. I moved to a nicer house to clear the head and the heart a bit and thought to try to make a slightly better fist of things elsewhere. I saw a GP at the new practice and started to explain things to him. He stopped me after around 25 minutes and said that officially we only had 10 minutes for an appointment and he was really sorry but given that there were other people waiting to see him he would have to cut me off there. He asked if I was free the following day, which I was, so he proposed booking me in for the last session of the day when we could take the time we needed without fear of eating into someone else’s. This gesture alone gave me what was and remains a fairly rare feeling of someone caring, I think the following day we talked for about another 45 minutes and he resolved several referrals for me and some other bits of go to and advice. Whilst this on its own would not have been enough to solve matters it started a process of renewed trust and meant I went into those referrals with my mind a little more open than I might otherwise have done.

One of the referrals was the next step in the coincidence list. I attended a clinic designed for psychological assessments and saw a clinician who seemed both friendly and knowledgeable. We spoke at considerable length and he made copious notes. He then proceeded to tell me that much of what I had thought previously about the normal state of things was not, it wasn’t patronising it was insightful, it showed that he had listened to what I had said carefully but had knowledge I did not. He explained things in a way that made a lot more sense about why I had not been understanding how most people lived up to now and provided a better structure for me to assess my own situation. I found it interesting and useful, he told me why in some detail the medications I had been on would not work for me and that there was a very different sort which might, were I minded to try it. I trusted him enough that I decided to give it a go and if it were an issue could come back. He explained how the dose would need looking at and over time and how I was to come back for a review in some weeks to look at the dose. He had explained he was a locum, so I’m pretty sure I had no expectation of seeing him personally again, I did look him up though and found that he was a somewhat highly-regarded Harley St clinician.

When I returned to the centre I was kept waiting nearly 45 minutes beyond my appointment time, with no apology offered when I was called in. The clinician asked me what medication I was on and when I replied said that this medication was usually used for epilepsy wasn’t it (which was indeed the main use for it) which puzzled me since I knew that the previous session had pages of accompanying notes that would have explained everything about the discussions that had been had and why. It became clear over the course of the session that this clinician had not read any of the notes and was expecting me to start again but was also much more of the ‘traditional’ mindset that I had previously encountered. So much so that I recall cutting the session short, ordering him to up the dose I was on to the that recommended for the second stage by the previous clinician and I would be on my way. The only useful thing he did was to do so without arguing and I left. I remained on that medication for 7 years. The diagnosis the first clinician supplied was as personal to me as it was comprehensive and remained the only diagnosis on file until 2017 and, ironically, is now being revisited due to suspicion that the updated diagnosis I received in 2017 may not be as accurate!

I leave that little diary part more as an indication of how arbitrary service provision is, how difficult it can be to get to see someone and then when you finally do how much of a lottery it is that you get someone who is even any good. For me it was the coincidental collation of a GP who cared enough to book a second session followed by a referral he made coinciding with the visit of a locum practitioner who took the time to listen to what I was saying. Those 2 individuals accomplished more in the 2 hours of their time that they gave me than all other professionals put together over more than 30 years, not because they were better clinically per se, though one might argue that fact on their behalf given the results they achieved, at least for me, but because they took the time, they bothered to do more than just tick the box.

It shouldn’t be the case that this is the exception to the rule, it angers me how random this makes healthcare provision, how people are subject to the most arbitrary of circumstances and competence of certain individuals to get the help they need. Would that I were a trailblazer, a campaigner passionate and motivated to further the cause but I’m neither diligent enough nor perhaps physically uncomfortable enough to be so. It is the path of least resistance to just keep going in some way ticking along, marking the days off and survival on that basis has in itself been at times challenging enough. All that’s missing is the date of release really, along with no sense that release brings anything, freedom or otherwise. It sounds nihilistic and sometimes it is though most of the time it lacks the buy-in even to be that, yet according to the medical profession, or at least certain parts of it the fact that I am still here, still holding down a job and relationship and family life means I am a success story and should take pleasure in the fact. I’m afraid their failure to understand the fact that taking pleasure from anything is simply not on the menu is as offensive as it is ironic.

Song Of The Day ~ Shame – One Rizla