Ready, Set, Type...

Most people go to their doctor and see a 'doctor'.  For many people in the population, their doctor is a bank of knowledge who can do things to fix sick people.  A lot of people miss the obvious fact that doctors can get sick too.  Yes, even the profession who know all about curing illness still suffer from it.

Most doctors are close to retirement when they face significant illness.  This is also true of the general population.  Why is this?  There are so many reasons...  Consider this; most people go through medical school in their early 20s.  A medical degree is a substantial amount of work, and one that requires a time commitment.  If you have significant illness during those years, the odds of getting through even just your initial training are stacked against you in a pretty big way.

I got through medical school with those odds.  For the first 5 years of my medical degree I battled infection after infection.  This was raised with  more doctors than I can count using my fingers and toes.  By 2007, the 5th year of my degree, I understood that pushing for treatment and investigation into this problem would only strengthen the widely held viewpoint that I was a hypochondriac, or trying to manipulate people for attention.  I had settled for simply asking for medical certificates under that guise when I was too sick to attend my placements. 

In the middle of winter, my usual GP was away.  I was on a paediatric rotation and it seemed children were the most germ generous population I had ever come across.  While fighting off one of the many bugs passed onto me from my patients I approached a local medical practice for a certificate.  All I wanted to do was sleep. 

The doctor at the surgery greeted me cheerfully, with energy, and with no apparent judgement.  I was in no mood for his good humour and joyful approach to his work.  As blunt as I could be I stated I was there for a medical certificate and is he could please just write the piece of paper and sign it I would be gone quickly.  Then this doctor did the strangest thing; he took a history.  Much to my dismay he said he would be happy to give me the certificate, but only after he actually made further enquiry into my medical history.  It may sound as though I am being sarcastic when I say this particular doctor did something strange by taking the time to ask me questions and consider the answers, but in terms of my experience of the medical profession up until that point in time, I understood that medical students were taught to take histories, exam people and do investigations, but that the majority of practitioners simply dismissed coughs and colds without much consideration at all.  So for me, it was strange. 

I was livid about having more sleep time taken from me for the purposes of what I assumed would be a medical history that yet another doctors would conclude could only belong to an attention seeking hypochondriac.  But, this doctor surprised me again...

"You've been sick this long, and this many times, and no-one has taken the time to find out why?"  I wasn't sure how to respond given my mind had already settled for the fact that I was unlikley to ever have someone give consideration to the facts.  After I confirmed this statement he called a respiratory doctor who had been responsible for admitting me to hospital on numerous occasions.  He spoke to this God-like specialist in rather forceful and demanding, yet still polite, tones.  That evening I was admitted to hospital for investigation. 

24 hours after being admitted we had a blood test result.  "You have low IgG!".  Ok.  I understood what IgG was, but I hadn't learnt what causes it to be low, how you treat it, and what it means to not have enough.  "You will need an infusion". 

GREAT!  I thought to myself.  How fantastic.  Once I have had this infusion I will be healthy and able to enjoy life.  I was mistaken:  I did not need "an infusion", what he meant to say was "you will need infusions" (for the rest of your life).  Ah.  A slightly different story.

Of course we sent off more blood samples for further testing etc, but it was essentially that day in July 2007 that I was diagnosed with the most frequently occuring primary immunodeficiency; Common Variable Immunodeficiency. 

I started treatment, infusions of IVIG, shortly after this diagnosis was made.  Every month I would present to the hospital for a day admission to infuse what I nick-named "vegetarian blood".  In November of that year I finally opted for an indwelling port-a-cath to be inserted after faceing mutiple jabs for IV canulas every day for a one week period.  The port, named "Oscar" by my classmate Mital, was inserted in the study break immediately before my final medical school examinations. 

Soon I would discover the joy of independent needling of the port.  I pushed for home infusions, which eventually began in January of 2009. 

Finding out the diagnosis, CVID, was a journey,  Living with it and trying to maintain maximum health with this condition is a journey that I'm still on.  I've tried so many extra treatments and had so many investigations. 

Someone calles my condition a "disease" while introducing me to a rotation supervisor.  I remember immediately feeling disgusted at this description, while full well knowing that is technically what it is.  For me, the word disease conjures up images of lepers and those afflicted by purulent infectious conditions.  But in reality, this disorder is a disease:  My B-cells don't form functional plasma cells...  Part of me doesn't work properly because of a disease... 

Has it been easy being a patient who is part of the medical profession?
Has it been easy being a doctor with a significant physical illness?
Have I found the solution to all of my problems?
What have I found solutions to?
Have I learnt things through being a patient that every doctor should learn?

I have a perspective on illness that few patients get; I see the other side of the fence a well.  I have a perspective on medical practise that most doctor will not get until they are much older.  These different perspectives deserve to be explored.