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I'm a writer. I write about life with bipolar disorder - also known as manic depression - so my eponymous alter ego is MaNic Grant.

I've written more than 1 million words: it's the world's longest suicide note.

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Treatment

10 min read

This is a story about making people better...

Ward

I remember the days when I thought that there were magic buildings full of magic people with magic potions who could make magical things happen. I remember the days when I was naïvely optimistic about the abilities of people, institutions and organisations who make highly alluring claims: we can cure you!

If I had ruptured a major blood vessel, or my body was losing its battle against a bacterial infection, you can be damn sure that I'd want somebody to stop the bleeding or give me some antibiotics. If I had an operable cancer, you can be sure that I'd want somebody to cut it out of my body.

Some areas of medicine are comparatively new. Some areas of medicine don't have a great deal of success - the data doesn't show significantly better outcomes for patients who are treated, versus those who are untreated. Medicine is actively losing its battle to save lives in some areas, such as suicide and opioid addiction. Mental health problems and addiction have been declared medical emergencies; epidemics.

Sometimes I wonder if it's useful to think of myself as having a chronic illness, and to expect that problems are just around the corner. I can have a good day, a good week, a good month... maybe even a good year. However, it's probably dangerous to start thinking of myself as "cured" or "recovered" and begin to consider myself "normal". Complacency will no doubt lead to repetition of past mistakes, which can result in an incredibly fast chain of disastrous events, destroying every semblance of a normal life, which was so convincing that I and other people were completely convinced that I'm just another ordinary bloke... not some ticking time bomb.

I fought very hard to get treatment. There was a great deal of reluctance to diagnose me as bipolar, and there was further reluctance to treat me. I seemed very functional. My problems seemed acute. Everybody hoped that I'd go away and get better without intervention.

wanted treatment. I knew I was getting sicker. I knew that my situation was deteriorating. I could see the car crash that was about to happen.

I believed that treatment was effective.

I just had to find the right treatment.

I tried so many medicines. I also believed in the "magical healing powers" of hospitals and doctors. I was indoctrinated by the medical establishment's dogma: "we are the experts and we are the only ones who can cure you".

Of course, I'm not such a fool that I believe in alternative medicine. I critically examine all the claims of all charlatans, quacks, healers and others who promote themselves as miracle-workers. Desperate people are suckers. People are also lazy and gullible. Many of us will be scammed in our lifetimes, because we are so desperate to believe in the existence of things that are too good to be true.

It would have been good I could have avoided that period of my life when I was desperately searching to find the right specialist, hoping that a stay in hospital would be my salvation, or trying a heap of different medications in the hope that I would stumble upon the right one, but it was a necessary education. I needed to learn what was possible, and what was not possible. I needed to see with my own eyes and experience those things first-hand, to learn the limitations of psychiatric medicine.

Psychiatry is young. Mainstream psychiatry - the prescribing of psychiatric medications on a massive scale - is an experiment that's barely a few decades old, which is no time at all, when we consider that anatomical studies of the human body and surgery are parts of medicine which are hundreds of years old. The present-day situation, where at least half of us will take a pill for depression or anxiety at some point in our lives, and so many of us have been taking psychiatric medications for years and years... this would have been unthinkable before Prozac successfully normalised the practice of dispensing mind-altering drugs to tens of millions of people across the USA and Europe. Nobody really knew what the long-term consequences and long-term outcomes would be.

I've lost interest in having any contact with doctors now. I've lost interest in any new developments in the field of psychiatry. I've lost interest in the idea that there will ever be a miracle pill to cure depression, anxiety or to stabilise moods. The brain has proven a far more complex organ than the blunt instruments of psychoactive substances are able to have any precise effect on. Pills are useful for curing a bacterial infection, but they are of no use in an organ which has been evolved to specifically resist attempts to alter it - the brain's ability to maintain homeostasis is incredible, and all psychiatric medications are fundamentally flawed, because they affect a plastic organ, which can simply adapt itself and return to its original state.

Hospitals can offer welcome respite - sanctuary - from the unreasonable demands of the world. Hospitals have their place as a controlled, safe environment, full of caring people. However, psychiatric care has changed radically in the short time that we have been practicing it as a branch of medicine. Those who are ill-equipped to cope with life outside institutions cannot expect to live in an asylum forever, which might sound like a good thing for those who believe that people can be cured and rehabilitated. However, in my experience, it is the horror of the "real world" which is the very reason for the epidemic of mental health problems, and it's often infinitely preferable to protected with the safe confines of an institution than to be fending for oneself in the big wide world. The idea of losing your freedom might sound terrifying and unpleasant, but for those who are struggling to cope - struggling to be functional - freedom is a small price to pay, for the comforting reassurance of life inside an institution.

When you are a child and you hurt yourself, you run to your parents to "kiss it better" but often the injury remains painful for sometime and there is nothing that can be done to alleviate your discomfort. We learn that sticking plasters, stitches and plaster casts can help our bodies mend themselves, but there is nothing to be done to speed up the healing process. There is little that can be done to take away our pain. There is little that can be done when we are suffering mental anguish.

Although my life was very badly damaged, I'm now part of a large organisation where I'm known to a lot of people, and they'd be concerned if I went AWOL. My home city is still very new to me - and I know very few people locally - but I also think that somebody would ring my doorbell and check on me if I went AWOL. I have a routine. I have put things around myself that are structured and stable, even if that rebuilding process is very far from complete.

I've been here before... so very close to a fresh start; a complete life. About a year ago, in the blink of an eye I lost most of my new friends, my new girlfriend and my new job. The year before I nearly died, and I regained consciousness to find I'd lost my girlfriend, my home and my job. I'm aware that my life is very fragile. I'm aware that my existence is precarious.

I wrote positively yesterday about my life and how far I've come since the very deepest depths I sank to, but I know that I have a difficult job trying to stabilise myself and find a way of living my life that's sustainable, and tolerable... pleasant even, one hopes.

It's strange that I've been so much and ultimately reached the conclusion that I was doing a reasonably good job of looking after myself, but I simply had some very stressful life events to deal with. I thought that I could turn to doctors and hospitals to make me better - and indeed my life was certainly saved when my physical health was severely damaged - but now I feel much happier doing everything on my own: I prescribe my own medications, adjust my own dosages... but mainly I just try as best as I can to create a tolerable set of circumstances to allow myself to thrive; I've come to recognise that my family don't care about me and have abandoned me. I've been incredibly lucky to have very loyal, generous, kind, caring friends and wonderful girlfriends, who've believed in me, and looked after me, and stuck by me through the difficult times.

When you see the finished product - a functional man - then we might assume either that he never had any major difficulties in his life, or that treatment was a success. I'm grateful for the hard work, effort and dedication of those who work in psychiatry, but my ultimate conclusion is that it's a flawed branch of medicine. Things could have ended very badly, but those friends who bothered to come and visit me in hospital, check on me when I went AWOL, look after me when I was sick, believe in me, support me... that's the thing that was the key to giving me a chance at getting my life back. Those who've read my blog and are kind enough to reach out to me - to be in contact - have helped me to feel like I have some value, and to feel some self-esteem.

My colleagues don't know how sick I've been, and they don't know how much it means that I'm able to be treated like a normal person at work. My colleagues don't know how important it is that I have the structure and routine of office life. My colleagues don't know how great it is for my mental health to have the social interaction that we have, even if it's just office chit-chat.

We might conclude that the doctors I saw 11 years ago were right - I'm not really very sick and I'm quite capable of living a fully functional normal life - but they're also wrong, because everything had to get smashed to smithereens and rebuilt from nothing, before I could reach this point. I nearly died so many times. Was it avoidable though? Probably not.

That's my conclusion: I've learned a hell of a lot, but it would be wrong of me to start telling people that I have the answers, because what I discovered was that I had to learn everything first-hand. If I had a time machine and went back to tell myself everything I've learned up until now, I don't think I'd believe myself and I'd end up making exactly the same decisions, much like children have to make mistakes even though their parents warn them about everything and try to protect them.

Does this mean that I forgive my parents for abandoning me? Nope. If your kid is sick in hospital, you go and visit them. Period. No ifs. No buts. You don't abandon your children, no matter how old they are.

 

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I Love My Job

6 min read

This is a story about having a métier...

Hospital bed

It feels strange to be writing this, but I'm really loving my job at the moment. I've always been a bit of a workaholic, but I often get depressed and demotivated when I'm not empowered to do my job effectively. I have often complained about being bored and unchallenged - a common consequence of working for very large organisations - but after a difficult 'bedding in' period I usually find myself in a role where I'm adding a lot of value, which I find very rewarding.

I've written so often in the past 15+ months about how much I detest the rat race and the coercion of capitalism, forcing me to work when I'm very sick. Not long ago, my kidneys failed on more-or-less the day I was supposed to start a new job. My life hung in the balance, as the amount of toxins in my bloodstream put me at continuous risk of cardiac arrest. Whether my kidneys would ever function again was doubtable and I had weeks of emergency dialysis, lasting several hours a day.

I discharged myself from hospital against medical advice, because of the coercion of capitalism. I need to work. I can't afford not to work.

That period in hospital was a major setback. I exhausted myself, persuading the company I was about to start working for to wait for me to leave hospital, which they did... but I had to leave hospital at least a week before it was safe to do so. My recovery from such a traumatic medical emergency was not straightforward - my left leg was not working properly due to nerve and muscle damage and I was in immense pain. It took months before I was able to walk very far without it causing me a great deal of agony. Work was impossible.

A company asked me to build an app for them, with a very tight deadline, which I did, but my financial situation was precarious and I was still very unwell. The pressure was too much and I tried to end my life.

A friend recommended me to the company he was working for, to build an application for them, which I did. I had a tight deadline, which I easily met. Strangely, the company decided to extend my contract, but the work was finished so I was incredibly bored. My colleagues worked in Warsaw and I was in London, so I had nobody to talk to - I was very isolated. I was still recovering from the suicide attempt.

Another friend recommended me to another organisation. Again, there was a project with a deadline, which I completed early. I enjoyed that project, but I'd had to move house and I was rebuilding my life in a new city. The preceding events had left me in a very financially precarious situation, as well as isolated from friends. I finished the project, but my life was unstable - I got sick, broke up with a girlfriend and my personal life fell apart, although I managed to minimise the impact at work.

I started work with the current organisation. I did so out of desperation, because I was in danger of losing all the progress I'd made to getting back to health, wealth and happiness.

I lived in a hotel for months. It was awful.

It was quickly apparent that there were people I enjoyed working with, and there were plenty of challenges to keep me busy, but my personal life was very badly broken. The work was good at times, but my brain chemistry was not healthy, and some days were very torturous. I struggled to find pieces of work which would keep me entertained and motivated. My mental health was a hit-and-miss affair.

I struggled onwards, setting myself some major milestones: I wanted to take a holiday in October, to beat the winter blues. I wanted to take a holiday during Christmas and New Year, to get some more winter sun and because my relationship with my family is irreparably broken. I wanted to come back from holiday and carry on working, to cement my gains. I knew that I had to move house and settle somewhere - to have some security and put down roots.

I suppose I always manage to make myself useful in any organisation, given enough time to get my bearings and manoeuvre myself into a role where I'm empowered to make a difference. The place where I currently work seems to have gleefully put my skills to good use, and I feel like I'm in the right place at the right time. I do stuff that I think will be useful and I'm rewarded for it, even though I'm rarely doing what I'm 'supposed' to be doing.

I worry that disaster will strike. I worry that my big mouth will get me in trouble. I worry that the personal risks that I take - staking my reputation on my decisions - will backfire one day, if I make a mistake. I know that my employment is precarious; temporary. I'll be kicked out as soon as I've served my useful function.

I have a great deal of extra pressure on me now that I've made a commitment to a new city. My financial security would quickly collapse if I lost my source of income. My mental health would be likely to deteriorate very badly, with a major setback.

I'm not sure why I'd lose my job when I am enjoying it, being very productive, doing useful work and being seemingly well received - well liked - by my colleagues, but I do have a propensity for getting carried away and doing stupid stuff. The springtime has often proven difficult for me in the past. I need to work very hard to keep my mood as calm and regulated as I possibly can.

On a Sunday night when I'm usually dreading Monday morning, I'm actually feeling very happy to be starting a new working week. I feel motivated. I feel like I have a purpose. I feel empowered to do a good job.

 

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Tinnitus

5 min read

This is a story about hurting myself...

Ear

There's an insufferable noise inside my head. It's a bit like a hissing, whining, wailing, screaming roar. I can't actually hear anything per se, but there's something that's far noisier than everything else that I can perceive. The world seems very loud and invasive to me - every tiny sound is amplified to neve-jolting volume - but the noise inside my head is louder, even though it's silent.

I know this doesn't make any sense.

At its most basic, the noise is like the shrill notes of a horror movie, which indicate that something bad is about to happen. The noise is deeply unsettling; disturbing. I feel on edge.

Then, after a while, because the noise doesn't go away, it seems to become more urgent: Pain, injury and death feel as if they're about to happen. I'm in a constant state of 'flinching' from the anticipated blows to my body.

The feared pain never seems to quite arrive, but instead there's a dread that this feeling will never go away. This is my life now: Living in a constant state of anxiety; living with perpetual sustained threat.

How can I go on living like this?

How can I live with this noise?

There is no noise.

My rational brain knows that there isn't any noise. My rational brain knows there isn't any threat. My rational brain knows there isn't anything to be anxious about.

Further, I know why this anxiety is so bad: Because I've been through an incredibly stressful life event, and I'm not using my usual coping mechanisms, such as drinking alcohol.

In fact, I'm effectively putting myself through alcohol detox, tranquilliser withdrawal and sleeping tablet comedown, whilst simultaneously doing one of the most stressful things that ever happens in our lives - moving house.

If I don't learn to cope without alcohol then it will destroy my health and send me to an early grave. If I don't learn to cope without tablets, then I will be forever trapped by addiction.

The unfortunate short-term consequence is very unpleasant to live through.

In fact, it's so unpleasant I've started to think I would very much like to not be alive.

That's the noise.

The noise continuously tells me to hurt myself; to end the pain.

If there was a sound that existed which told you you're better off dead, then it rings at full volume in my ears. Its sustained pitch and relentlessness tells my brain it's never going to go away, things are never going to get better, and this unbearableness is a permanent state of affairs... and the only escape is death.

I've been through enough anxiety and depression to know that things don't get any worse than this, and eventually things do get better. I have unfortunately experienced enough prolonged panic attacks to know that this is just another one, and although seemingly interminable, it will eventually pass.

Given a little more freedom - a few more options - I would stay at home in bed, and sleep. To make matters worse, however, I feel compelled to be in the office, which is just about the worst place in the world, because I have to pretend like everything's OK when it's not. I have to sit in my office chair for 7 or 8 hours, when every single bit of my body and mind screams to be doing something distracting or relaxing.

Driving in heavy traffic is a mild improvement over sitting at my desk. In fact, sticking sharp objects into myself would be a mild improvement over sitting at my desk. Jumping out of my office window and falling to my death seems like a vast improvement over sitting at my desk.

It's a pretty disturbing state of affairs and I'd be yelling for help, except that I know there's no comfort that anyone's going to offer me. Nobody's going to pay for me to be sick in bed. Nobody has anything they can say or do to ease the situation. I'm just going to have to suck it up.

It's not like I've run out of pills or the shops have run out of alcohol. It's not like I couldn't go into debt while I get better. There are temporary solutions, but they all delay the inevitable.

I suppose I'm ripping off the sticking plaster, as opposed to peeling it off gently little by little. This is a short sharp shock. This is the fastest route between two points, but also the rockiest road, with thorny bushes, biting insects, choking dust and a whole host of other things that don't mean it's necessarily the easiest path.

Now... I need to go and find distractions until it's time for bed. Today has been an incredibly long day, and I wish I hadn't woken up.

 

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The First Cut Won't Hurt At All

7 min read

This is a story about deferred gratification...

White rose

Let's do two analyses of the last year of my life. In the first analysis, we'll be harsh and attempt to form a negative opinion of everything. In the second analysis, we'll consider things in their proper context and circumstances, and arrive at a radically different conclusion.

Everybody has to work, right? Everybody should have a job, because nobody's entitled to be a burden; a lazy layabout. It's my responsibility to earn money to pay rent, bills and buy food.

A year ago I was living rent-free, not paying bills and having my meals bought and cooked by somebody else. I was not working. I was not earning money.

Everybody should look after their health, right? It's our personal responsibility to practice self-care and to ensure that we maintain our physical and mental fitness.

About 11 months ago, I went back to work. The job required me to travel internationally and to regularly travel across the country. The job required me to return to the overcrowded capital and live out of a suitcase in less-than-ideal temporary accommodation. I worked alone.

Everybody should make sure they take breaks; holidays, right? We all need to make sure we don't over-work ourselves and burn out. We are personally responsible for managing our own stress levels.

About 8 months ago, I finished one project and immediately started another one. I left one large organisation, where I had established myself over the course of a few months, and had to repeat the rigmarole of impressing a new boss and a new set of colleagues.

Everybody needs to work hard to maintain good relationships, right? Nobody should ever abuse drink, drugs or medications. We are all personally responsible for our bad decisions and their consequences, and as such we should never argue, break-up, or use mind-altering substances.

About 5 months ago, I relapsed back into drug addiction. My physical and mental health suffered horrendously from my self-inflicted substance abuse. I broke up with my girlfriend. I nearly lost my job.

Everybody needs to pick themselves up again and cope with the unexpected, if unfortunate events befall us. We are personally responsible for being resilient in the face of adversity.

About 3 months ago, my project finished unexpectedly early and I found myself without work again. Instead of immediately trying to get another contract, I took loads of drugs and wasted a whole month doing absolutely nothing.

Everybody needs to protect their money and their hard-won gains, right? We are all personally responsible for ensuring that we only move in a forwards direction, and never slip backwards.

About a month ago, I lapsed back into drug abuse, which caused me fail to tell my colleagues I was unwell until 1:34pm, because I had no idea what time it was. I had no idea what time it was, because I'd papered over my own bedroom windows, in order to hide myself from the prying eyes that my mind would create, in a state of drug-fuelled paranoia.

Everybody needs to pay of their debts, save money and economise, right? We should be careful with our cash.

In the last month, I've written-off a top-of-the-range Apple Macbook Pro for the second time this year. I bought a brand new Macbook and iPhone XS. I drunk-booked a luxury holiday to a theme-park family hotel. I dine on my own in fine restaurants. I drink fine wine like it's water. I stay in hotels which are rated number one on TripAdvisor. I'm doing the very polar opposite of economising and saving money.

Why?

I've got daddy issues, I think.

Conventional dad wisdom would tell us that my actions are deplorable; my attitude contemptible. There are many obvious faults and flaws in my character which are apparent in my description of my crimes and misdemeanours from the past year. It's pretty obvious that I'm a massive fuck-up waste-of-space loser who deserves to be disowned, from my description of a single solitary year of my pathetic useless life. It's no wonder I don't get no respect from my daddy: my bad behaviour is plain for all to see.

I document everything with candour, so that all may judge me as I have been judged since my birth. I want you to see what my dad sees. In fact, he sees nothing, because he has sworn to never read a word I write.

I promised you a second analysis, right?

I lied.

It's up to you to arrive at your own analyses from the same set of facts.

I could have spent time defending myself and telling the story in a way that portrays myself in a favourable light, more likely to receive sympathy.

I can hear voices in my head. The voices say: "fuck off and die you navel-gazing self-absorbed self-pitying manipulative maudlin faux-tragic melodramatic tear-jerking little shit".

The voices don't come from the TV or the radio. The voices don't belong to demons and devils. The voices don't belong to manifestations of madness. Those voices are the real voices of real people. Those words are real too. I don't hallucinate - I can picture exactly where I was when those words were spoken. I don't choose to replay those unhappy moments, but those unpleasant words are so numerous that when I drive one unpleasant memory from my mind another one immediately intrudes.

I'm fortunate enough to have obtained the written verbatim transcript of my dad's interview with a social worker, just over a year ago. My dad says that I'm faking having a mental illness as an excuse for my bad behaviour. Then he says that I should be kept in hospital and chemically sedated. Then he says the best that can be hoped for me is that I should be confined to a bedsit at the opposite end of the country, heavily medicated. He says that he's protecting the family from me and that I'm forbidden from contacting my sister or visting the family home.

All of this - especially the part about being forbidden from visiting the family home or contacting my sister - was the first time I've seen or heard these views of his.

It strikes me that I'm posed with the same challenge I just set you, dear reader. I could view the evidence with conventional son wisdom, and judge the behaviour to be abhorrant. Or, I could invoke the generic and rather pathetic "parent" defence. "I'm sure it's just because he cares" goes the oft-repeated BS. "Parents are doing the best they know. They're not perfect" etc. etc.

My mind should be dull; blunted. However, instead it's sharp and slices through things. To say it's scalpel-like is the wrong analogy. Instead, it's like broken glass which is hard to pick up without causing an injury.

High on drugs, my dad always imagined himself intelligent; a philosopher.

Where did my predisposition to slice to the heart of the matter come from? Why do I dissect everything, exposing the absurdity of existence? Why am I afflicted with an agonising yearning for meaning in a godless universe with no afterlife?

How did I ever arrive at the notion that taking drugs and philosophising about the meaning of life is within the grasp of my intellect?

It's a mystery, for sure.

 

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Life Is Better In Flip Flops

6 min read

This is a story about nerve damage...

Tied on flip flop

As you can see from the picture above, I had a very bad injury to my left leg. What you might not know is that the massive lesion to my leg healed perfectly. Some nerves were severed when a piece of mirror glass guillotined its way through my shin, but the nerves managed to regrow. The severed tendons and muscle was sewn back together and my leg had completely recovered.

Then I got DVT (deep-vein thrombosis).

The first I knew about the DVT was that my ankle looked a bit swollen and my foot went numb. It was the fact I hadn't needed to urinate for several days which prompted me to go to hospital. On the day I decided to go to hospital, my foot, ankle, leg and knee were swelling at an alarming rate. By the time I was examined in Accident & Emergency, my left leg was almost fully twice as large as the right leg.

My weight soared from around 80kg (176 pounds or 12½ stone) to 95kg (209 pounds or 15 stone) which is a heck of a lot of weight gain for 5 or 6 days. It took many many sessions of dialysis to get that fluid out of me, while the hospital anxiously waited for my kidneys to start working again.

Unfortunately, the blood clot/thrombosis and other complications caused nerve damage. Presumably the blood vessels which had been surgically repaired and the nerves which had managed to re-grow and re-attach themselves, were quite fragile versus normal physiology. My foot went numb.

To be more accurate, my foot was left numb after many months of excruciating pain.

I had a nerve condition study and an MRI scan, but there was still a lot of swelling and other damage, making it unclear whether a surgical intervention might ever return the feeling to my foot. My main concern at the time was pain management, because it was too painful to walk any great distance, and pain kept me awake at night very badly. I was taking the maximum dose of tramadol AND codeine, plus supplementing prescribed painkillers with dihyrocodiene and other opiate medications, which I bought on the black market. I was briefly a very heavily dependent opioid painkiller user.

Opiates have weird side-effects. I couldn't tell whether the nausea, itching, constipation, cramps, sweating, diarrhoea, and intense anxiousness about maintaining my supply of opiate painkilllers, was a result of their effects or the effect of withdrawal. All I knew was that I would have periods where I felt incredibly rubbish, and then periods where things were more bearable, despite dosing myself regularly throughout the day.

The thing which made the greatest difference - other than a loving, caring, attentive and wonderful girlfriend - was a topical ointment containing diclofenac, which is a NSAID (non-steroidal anti-inflamatory drug). Because of the earlier complications with my kidneys, many medications were contraindicated. Perhaps I shouldn't have used the diclofenac gel, because it's not very kidney-friendly, but it was the only thing which gave me any reliable relief.

It's possible that most of my pain was related to opiate withdrawal and strange interactions between the tramadol, codeine and dhydrocodeine, which I should not have been combining, but I did so out of desperation for pain relief. It's possible that in my desperation for pain relief, I actually made things worse. Perhaps tramadol alone would have been more effective.

Eventually, I decided that I hated all the effects of the opiates, so I decided to go cold turkey. I had been heavily opiate dependent, for a period of several months, so I was expecting to experience pure hell quitting the opiates. Certainly a lot of noise has been made about the addictiveness of OxyContin, Vicodin and other painkillers which have been implicated in the opiod addiction epidemic sweeping the United States, declared a nationwide public health emergency by President Obama on October 26th 2017.

Back in July 2017, I tried to walk from my apartment to my local Chinese takeaway in flip flops - a distance of about 500 metres. I could not walk more than ten paces without the flip flop coming off my left foot, because it was so numb and my toes were somewhat 'clawed' such that I couldn't hold the flip flop on my foot or tell when it was slipping off.

For almost all of 2017 I was taking a neuropathic painkiller called pregabalin - marketed as Lyrica - which I found to be quite effective. However, it occurred to me that this painkiller might have been preventing the natural nerve re-growth which had successfully healed my severed nerves once before. After 9 months with no improvement to the numbness in my foot, I was becoming quite depressed about the prospect of never regaining any feeling in my foot, and consequently never being able to wear flip-flops again, without tying them onto my foot as pictured above.

I like wearing flip flops. They're an important part of my beach bum seaside-dwelling kitesurfer identity.

I decided to stop taking pregabalin.

If anybody tells you that pregabalin is not addictive, they're just plain wrong.

Pregabalin quite recently became a scheduled drug in the UK, making it illegal to possess without a prescription. Pregabalin affects the GABA system of the brain, just like alcohol, Valium, Xanax and GHB/GBL, which are all considered to have a high abuse potential, so naturally pregabalin is no different.

Of all the drugs I've quit and medications I've withdrawn from, pregabalin is one of the worst. Because of its tranquilising and sedating effects, the rebound when withdrawing creates a state of insomnia, anxiety and induces the general sensation that the world is about to end, which lasts for months.

I quit pregabalin under the supervision of doctors, tapering the dosage down gradually, but it was a pretty aggressive schedule, which was chosen by me. I wanted to quit pregabalin as quickly as possible, because I wanted to find out if it would help my nerves re-grow and allow me to wear flip flops again, or indeed be able to feel a kitesurf board underneath my feet.

Pleasingly, I can report that I put on a pair of newly-purchased flip flops tonight, and I was able to walk around without the left one falling off.

My left foot feels different from the right one, but I do have some sensation restored and I don't have the aches and pains which troubled me during a lot of 2017.

It might seem like a minor point, but it's actually something that has disproportionate imporance in my life: To be able to wear flip flops again is a big deal.

Life is better in flip flops.

 

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Proper Preparation Prevents Paranoia about Privacy

7 min read

This is a story about shame...

Battle scars

The holes in my wall tell a story. I picked up a massive wardrobe and moved it to block the entrance to my bedroom in an attempt to barricade myself in, because I wanted privacy so badly; I so desperately wanted the certainty of knowing that nobody would barge in on me unexpectedly. In fact, I spent the best part of two days and nights without sleep, attempting to secure my bedroom against would-be perverts hoping to barge in and catch a glimpse of me in my nest of shame.

Obviously, it's somewhat of a self-fulfilling prophecy. When somebody spends a couple of days dismantling beds, bookcases, chests of drawers and heaving heavy pieces of furniture into their barricade, it's pretty noisy and the work is exhausting. As a person gets more physically tired and sleep deprived, they gey clumsy and they make mistakes, such as toppling a massive heavy thing with sharp corners into a wall, gouging out plaster and leaving an ugly hole.

My body is covered with battle scars from my efforts to keep my shame private. I have an enormous scar on my left calf and another one on my right thigh. I have a broken nose from where I was balancing a piece of furniture above my head in an attempt to cover a window.

My paranoia stems from my childhood, when I was constantly bullied, at home and at school. Nobody respected my privacy or my right to live a dignified life. My paranoia stems from an abusive relationship, where I was punched in the face, screamed at and generally verbally abused, and regularly had to put a door in-between my ex and I, which she would spend hours aggressively kicking while I was trapped in a room with no toilet, food drink, or exit other than to face the violent abusive woman on the other side of the door. My paranoia stems from not having a space of my own where I can lock the door and feel confident that I'm the only one with the key; feeling like I have no right to privacy and that I can expect somebody to barge in at any moment. Being a guest in somebody's home is not the same as having your own safe space. Being a prisoner in your own home is truly traumatic.

I built myself a summerhouse in 2009 and then insulated and carpeted it in 2013. I finally had my own miniature house with a front door I could lock, although it had no running water or toilet. I improvised a water supply using the garden hose and locked myself in there until my ex-wife moved out. I would have starved to death if she hadn't, but I didn't care... I wanted to escape from that abusive relationship.

I could have had a clean break, but my ex-wife put me through hell with the divorce. I arranged a quick and easy house sale, which would have allowed us both to get on with our lives, but she sabotaged me at every opportunity. She ruined my chance of escape and recovery. She sabotaged my efforts to rebuild my life.

London is not a good place to be sick and poor.

London is not a good place to be paranoid.

London is not private.

However, at least London is anonymous. I completely lost my mind on the streets of London and nobody paid me the blindest bit of attention. Nobody would remember my face. I'm never going to see anybody who remembers me when I was insane, penniless, homeless, destitute and in a very shameful sorry state indeed. London was the perfect place to recover from the trauma, without getting paranoid about my neighbours witnessing what should be a private affair.

Privacy is important when you're struggling. Privacy is important when your life is filled with shame.

Invasion of privacy sows the seeds of paranoia, leading to psychosis and schizophrenia. Human interest is a powerful force, which is the reason why fly-on-the wall documentaries and reality TV shows are so enthralling, and why we love to read people's blogs, diaries and journals. It's impossible to tear your eyes away from the spectacle of somebody struggling. People will line up like it's a fucking spectator sport, watching somebody suffer and not doing the slightest thing to intervene or otherwise fucking off and minding their own business. People know when they're being watched. Knowing that you're being watched makes everything a million times worse. "Why don't they do something or just fuck off?" you think to yourself, and soon it's all you can think about; the audience is spellbound and they'll literally spend hours watching and talking amongst themselves: "ooh it's awful isn't it?" and "yes I know. it's been going on for ages" ... but they never get bored.

I've recovered a remarkable amount since those dark days of 2013/4. In fact, I've made a miraculous recovery, but it's very far from complete.

I've gone from owning my own home and a summerhouse, to now renting an apartment. I've gone from financial security to mountainous debts. I've gone from having every right to privacy, to the situation where I have to show my bank statements to letting agents and allow my landlord to come into my home. Instead of being my own boss, I have to submit myself to security vetting and allow people to pore over the details of my private life. I've been poked, prodded and generally put into a goldfish bowl to be gawped at by numerous doctors, consultants, psychiatrists, social workers and a whole heap of wannabe amateur psychiatrists, who think they've got me all figured out, but who fail to recognise that it's grossly insulting and patronising for them to take a lazy glance and think they know me.

Things are very difficult.

I've had so many years and months of shame and swallowing my pride, and it fucking sucks.

I've had so many people judge me who I really didn't invite to pass judgement, and who really have no place, prying into my private affairs. I'm doing a good job of living a normal life within society's rules. I don't deserve to have people sitting in judgement of who I am, what I am, and whether my thoughts, feelings, actions, intentions, character and other attributes of me and my personality, are somehow acceptable to the self-appointed nosy busybodies.

Where is my space where I can feel safe? Where can I be free from the tyranny of the judgement of puffed-up pompous twats who think they know best and they have a right to barge in on me in my private shame; to embarrass me.

That's why I work so damn hard. I'm trying to earn enough to buy a place which is mine and nobody has the right to come barging into. I'm trying to get my little slice of privacy and free myself of the tyranny of having to kowtow to other people's judgement... most often other people's inferior judgement.

Please, give me some space. Have I not always used it wisely? Have I not proven myself to be very capable of doing amazing things, when given the space; the trust?

I have my shame, which I'm attempting to de-fuse by making everything about myself as public as possible, but it's a slow process. I feel like I'm only halfway there.

I have my flaws. I have things I want to keep private.

I need dignity.

 

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Penblwydd Hapus i Mi

7 min read

This is a story about early retirement...

Birthday cake

I was pretty pleased with my life's achievements by the time I hit the age of 30. I'd earned a lot of money and been able to enjoy a lavish lifestyle, and I had plenty of material possessions as status symbols to attest to my accomplishments. My income vastly exceeded my expenditure and I'd amassed enough savings and assets to be able to support myself without a job for many years, without having to tighten my belt or live frugally.

I decided to quit the rat race and be my own boss. I retrained as an electrician and set myself up in business as a one-man operation: just me and my van... and my customers. Turns out that you always have a boss, whether you're a salaried employee or the founder and CEO of your own company. There's always somebody who you're dependent on for your money, like investors and customers who have to be kept happy. Perhaps only trust fund brats are truly free from the tyranny of having to kowtow to anybody, but even they have to kiss the ass of the trustees if they want to get their hands on more cash than their already more-than-ample unearned lifelong income.

My subsequent attempt to use my software smarts to earn money while I slept didn't turn out much better than my attempt to become a traditional tradesman. Realising that customers were harder to extract money from than I'd anticipated, and that I was going to end up giving away a substantial amount of equity and control to investors, I burned out and became very depressed about life.

I tend to win more than I lose when software's involved and my most recent attempt at earning money in my sleep was quite successful, when I bought Bitcoin miners which I kept in my summer house. I also ploughed every pound and penny that I could beg, borrow or steal and I bought Bitcoins, which then appreciated in value a hundredfold or more. Sadly, I needed to liquidate my assets to settle an acrimonious divorce, hence why I'm not [yet] a multimillionaire... well, and also to be honest I didn't think the value of Bitcoin was going to go much beyond $5,000 but that's another story.

To be fully retired and spend my days wandering around National Trust stately homes - or whatever it is that retired folk do - I think would be quite torturous and tedious. I was dragged around enough stately homes as a child, with my pushy parents mistakenly believing that educational leisure experiences would be somehow beneficial to me and my future.

Software is the gift that keeps on giving and I've worked an average of 3 months per year, during the last 4 or 5 years. That's pretty close to semi-retired. The remaining 9 months of each year have been spent sleeping rough, living in hostel dorms, in and out of hospital, locked up on psych wards or otherwise generally living a life which most people would not consider to contain much rest and relaxation.

I'm pretty exhausted to be honest.

I'm 39 years old and I'm knackered.

During the last 9 years I've done all the things which my parents told me not to. I've followed my dreams and I've ended up in a few nightmares too, but I've finally been able to experience life. I was a very well-behaved boy and young man: I was the well-mannered sensible child who did all the right things and was achieving all the things that grannies and aunties like to hear about when your parents phone or write to brag. There's a lot of snobbery in my family and I felt duty-bound to comply with very boring, rigid and old-fashioned ideas of success. I'd spent my life up to the age of 30 living somebody else's idea of how I should live my life. Then, I rebelled.

I really rebelled.

It took me a while, but I caught up. At the age of 32 I had been a straight-laced boring conformist who'd never stepped out of line and had never experienced life, in all its its horror as well as its beauty. By the time I reached my 35th birthday I was pretty much ready to start gently pressing the brake pedal. Now I'm only a year away from turning 40 I've got both feet on the brakes and I've pulled the handbrake too.

I don't think you can really say you've lived until you've been arrested, thrown in the back of a paddy waggon, locked in a police cell, sectioned, locked up on a psych ward, been hospitalised, been in critical care / intensive care, been on a high dependency ward, had organ failure, had dialysis, had a horrific injury requiring general anaesthetic and major surgery, become homeless, slept rough, lived in a hostel dorm, run out of money, been physically addicted to drugs and all the other things which came about when I decided to abandon all caution and just do whatever the f**k I wanted for a few years.

I really made up for lost time, but I don't regret any of it. If I have any regrets, it's only that I listened to my parents and I behaved myself and I was sensible. I wish I followed my dreams earlier. I wish I did what I wanted sooner, rather than attempting to please my parents and gain their approval, which turned out to be impossible anyway.

To continue my life in the way I had been living it until a year ago would be quite disgraceful. There's no dignity in being 40+ years old and doing the kind of crazy s**t that I've been doing during a lot of my thirties... in fact I think it's a real shame to see people who haven't been able to stop the madness when they've reached an age where they should supposedly know better.

In light of the fact that I only have a year until my 40th birthday, I am now semi-retired. I have almost fully retired from my life of crime, drugs and insanity. Now, my life consists of a cushy government job which requires very little thought or effort and gives me a lot of disposable income and leisure time. Life is a lot less exhausting without the police cells and the hospital beds.

Over the coming months I'm going to complete my 1-million word writing project, pay off all my debts, replenish my savings and write a new chapter in my life: the comfortable semi-retired existence of a highly paid consultant doing government work; the return of some of the lavishness of the lifestyle I used to enjoy when I was a much younger man.

I am a little sad to say goodbye to the version of me who could say and do whatever he wanted, but the consequences almost killed me on numerous occasions and my luck was going to run out sooner rather than later.

39 isn't the usual age where people start a laid-back life of semi-retirement, but I think it's appropriate in my case to dial back the insanity from 11 to a much more reasonable 3 or 4.

I hope the previous 12 months I'm writing about this time next year are much more becoming of a gentleman celebrating his 40th birthday. I'm pleased that I've got a year to get things sorted in my life, so I don't feel like a total failure.

Happy birthday to me. 39 today.

 

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What's Missing from this Picture?

4 min read

This is a story about unnecessary packaging...

Holiday essentials

I've had a stressful morning. I had to package my Macbook carefully so that it could be safely sent away to be repaired. I had to locate the original packaging for my Virgin broadband router and box it up so it could be sent back to them, even though it's defective junk. I then had to find a UPS parcel drop-off point and a Collect+ drop off point to drop off the respective parcels. This required a trip to purchase bubble wrap, a suitable sized box and packing tape, as well as two more trips to two different drop-off places.

While I was out dealing with those chores, I also had to purchase a piece of carry-on luggage and some flip-flops. The flip flops were sold to me in a box. I don't know why flip flops need a box - just a simple cardboard clip to keep the left and the right flip-flop together is more than sufficient.

Anyway, I'm home now. I have located my passport. I have located some leftover Euros I had from the last holiday I took... 22 months ago. I opened the box containing my new flip-flops and lo and behold, there was a discrepancy in the number of flip flops present in the box - 50% of the required number of flip-flops were missing.

Do I drive back into town, park my car, walk to the shop and explain the situation in the hope that they admit their mistake and remedy it without quibble? Do I just purchase a second pair of flip-flops and then open and check inside the box before i leave the store? Do I just abandon the whole ill-fated exercise, and buy a pair at the tiny departure airport, where the shops will probably be closed? Do I take time out from the one single whole day I get to spend with my friend, without either of us having to worry about airport arrivals/departures, hotel check ins/out and all the rest of that crap, just to go looking for some suitable summer footwear?

I don't know why this is making me upset, because I don't even know if the nerve damage to my left foot/ankle is so bad that I can even wear a flip-flop on that foot. The last time I tried, I didn't have enough sensation and motor control to keep a flip-flop on my foot.

Also, my flight's delayed - French air traffic controllers on strike or something. My flight barely enters French airspace, but whatever... everyone should have the right to go on strike for better pay and conditions.

My 'holiday' is really just a day spent with a friend who I hardly ever get to see, then we both fly home on Monday. I have another week to go before my current gig comes to an end, so I need to make sure I take the money while it's there on offer.

"Have you got any holidays planned?" asked a person I spoke to on Friday, which is code for "we want you to work solidly until you drop dead". We'll have to see how badly they want me, because I really need a holiday - a proper holiday.

It seems churlish to complain, but I've had a month of hell. Breakup, losing my local job, getting sick, holiday plans pretty much cancelled, the stress of finding a new gig, the prospect of going back to London, the never-ending pressure to generate vast sums of cash to dig myself out of the hole... the hole I can never quite escape from. FML.

What was supposed to be a romantic beach holiday with my [ex]girlfriend has now turned into a very brief weekend meetup of two old friends. It'd have been far easier for us to meet in London, as he was there yesterday. He's travelled London -> Prague -> Lisbon -> Faro -> Lisbon -> Prague, and I'm travelling Wales -> Bristol -> Faro -> Bristol -> Wales. Our carbon footprint is criminal.

Hopefully I'll be in a better mood when I wake up in Faro tomorrow and I can hang out with my old friend for the whole day, free from commitments and responsibilities... I can put up with sweaty feet.

 

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It's Psychological

5 min read

This is a story about it being all in your mind...

Splattered toilet

Uncontrollable shaking, jaw chattering, nausea, insomnia, restlessness, chest pains, elevated body temperature and sweatiness, breathlessness, diarrhoea and stomach cramps - it sounds like I'm physically sick, but I'm not. I genuinely believe that there's no physical reason why I'm experiencing all these symptoms. It's all in my head.

My symptoms are not due to disease, medication, drugs, alcohol, injury or any tangible physical thing. A medical examination - purely physical - would conclude that I'm in good health.

Why do I feel so damn awful then?

It's been months since I stopped taking the addictive sleeping tablets. It's been months since I stopped taking the addictive painkillers. It's been well over 6 months since I stopped taking the addictive sedatives and tranquillisers. It's been about a year since I stopped taking the stimulant I was addicted to. It's been over a year since I stopped taking opiates for the pain in my ankle. I'm completely clean and I recently had 5 days of sobriety, to prove that I hadn't become alcohol dependent and give my liver a break from the booze.

From what we understand of addiction, there are physical addictions, which we treat with substitute prescribing because the physical symptoms are too awful for addicts to withstand, and there are psychological addictions, which are just a lack of willpower and an indication of moral deficiency and bad character. We understand that psychological addictions are easy to deal with - just quit cold turkey and get over it.

It upsets me that I've done all the hard work of getting off at least 8 addictive substances, with 7 of them considered to be physically addictive, but the 8th still has a psychological hold on me, somehow... 1 year later. That's not supposed to happen. In the textbook, once you quit drugs your life becomes amazing and brilliant and perfect and you never look back. Certainly, the textbook will tell you that physical addictions are real addictions, and psychological addictions are not real addictions at all - they're all in the mind.

So why is it that I'm so sick?

If it's all in my head, why do I feel so nauseous?

If it's all in my head, why is my body shaking uncontrollably?

If it's all in my head, why are my symptoms so manifestly physical that other people can notice them?

Addicts are taught to hate themselves. We're told that we're bad people; that our problems are all our own fault. We're told that we have bad character; we're weak; we lack the moral fibre to buck our ideas up and behave properly. We're told that we're worthless scum... worse than worthless, in fact - a menace to society and death's too good for us.

How can it be then, that I've done all the right things and proven my worth to society; I've proven that I can white-knuckle my way through cold turkey and get clean from not just 1 addictive substance but 8. I've done all the right things, but there's still very a real and tangible physical manifestation of my addiction, which isn't supposed to exist because any residual addiction that I still have is psychological apparently.

It upsets me that I've done all the hard work and proven that I've got incredible willpower, yet this psychological problem with physical manifestation still plagues me.

With my bipolar disorder, I have to be very careful to manage my stress levels, make sure I get enough sleep, have a good routine, eat well and generally look after myself, but I still suffer bouts of depression and episodes of mania. I have to be very careful to not get carried away when the early warning signs of mania and the triggers are present. I have to struggle an incredible amount to hide the fact that I regularly have debilitating depression and suicidal thoughts.

With addiction, we're told that there aren't any tablets to treat it, unless it's a physical addiction. My kind of addiction has supposedly been cured, because I've used the only treatment option that's available: willpower. For over a year, I've managed to control my addiction to my substance of choice, by simply willing my addiction to go away.

It seems a little remarkable to me that I've managed to rebuild a lot of my life and I appear to be a very functional fine upstanding member of society, but yet I'm sick enough to cause concern to my nearest and dearest. How can I be so sick when I've been doing all the right things? How can I be so sick when I haven't done anything wrong? I've followed the textbook to the letter, but reality does not correlate with the wishful thinking you find in the textbooks.

In a perfect world, I'd disappear for a month and go lie a beach in a hot country. In a perfect world, my income would be secure. In a perfect world, I wouldn't have Damocles' sword dangling over me all the time. In a perfect world, I'd put my health first and society's expectations and the unbearable pressures on me second.

This is not a perfect world. I'm trying to build a glider while falling off a cliff.

 

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First, Do No Harm

6 min read

This is a story about primary care...

Your GP Cares

Primum non nocere is in and of itself a non sequitur because the use of Latin and other languages of classical antiquity is primarily intended to deter the hoi polloi from becoming educated. The number of doctors who are able to train, qualify and practice, is something that is tightly controlled in order to maintain high salaries - artificial scarcity - as opposed to allowing the unrestricted proliferation of medical knowledge which might improve the health of the nation.

Those who profess the Hippocratic Oath might be able to stay true to the vow they have sworn if they practice the treatment of acute illness in a hospital - dealing with curable disease and injury - but in the treatment of chronic illness in the community, as General Practitioners (GPs), can we say the same?

If we look at a few obvious statistics, we can see that medicine is failing. Average life expectancies have started to fall and chronic illness has seen a dramatic rise. There is an epidemic of mental health problems, and suicide is the biggest killer of men under the age of 45.

Of course, one might say that the root causes of these conditions are non-medical.

It occurred to me that a significant piece of the NHS has already been privatised, in that many general practice surgeries are owned and operated as private profit-making enterprises. This seemed to present a significant conflict of interest, so I decided to conduct an experiment.

I asked a GP a simple question: when you're treating a patient, do you think about their healthcare needs, or do you think about other things? The reply was shocking.

"It's not about [the patient] it's about everybody else"

I'd had my suspicions for a while - gathering plenty of evidence - that those who profess to do no harm might actually have been corrupted into serving other purposes; into betraying their profession and failing in their duty of care. This was the final confirmation that my worst fears were realised, and there are powerful actors within the healthcare system who place other things above the health of their patients.

By co-opting doctors into the capitalist profit-driven sector of the economy, and by co-opting them into the welfare system, we are asking doctors to choose between their luxury cars, the private school fees for their children, and other trimmings associated with their high social status, versus increased taxes to pay for the welfare state. By placing the most vulnerable people in society in front of the doctors, when seeking incapacity benefit, the government is pitting one group against another.

If the study of economics has taught us anything, it's that people respond to financial incentives. While a GP might argue that they're saving valuable taxpayer money, which might be spent on the NHS, by denying incapacity benefit to a vulnerable member of society, one must also admit that the GP acts in rational self-interest. Less money spent supporting society's most vulnerable means a lower tax burden and more money in the pockets of the profiteers, which include GPs who are partners in their practice.

The first principle of do no harm forbids a doctor from weeding out malingerers based on their best guess. To cut off somebody's incapacity benefit is definitely harmful, and there is no diagnostic test which could decide with a high degree of accuracy who is the malingerer and who is genuinely unable to work. If the doctor in question truly cares about their patients, they would have no option but to choose the option which gives most benefit and inflicts least harm.

We see so many suicides because patients are fobbed off with inferior treatment options, because it's a cheaper alternative to give somebody pills than to give them psychological therapy. While I understand that being cost-conscious might be seen as being pragmatic, it again violates the principle of do no harm. To fob a desperate and vulnerable person off with ineffective medication, when better treatment options are available, is tantamount to negligence. If a doctor has a consultation with a man under the age of 45, they must surely be well aware that suicide is the thing that is most likely to cause their death, and they should therefore treat it as a serious threat to their life. To call people's bluff and knowingly prescribe ineffective treatment is obviously the reason why suicide rates are so scandalously high.

I imagine that some doctors - although egotistical and in love with themselves - have a tiny piece of them that wants to make a difference and save lives. I think that exhaustion and the pressures that are felt by ordinary people are imposing themselves on doctors now, who are struggling to send their children to the best private schools (boo hoo) and are feeling compassion fatigued because of burnout. If we can relieve the pressure on GPs, they may become more willing and able to work in support of their patients' needs, as opposed to "everybody else" (read: being the government's job police).

I strongly believe that we have an urgent need to change primary care, so that it becomes not-for-profit, and patient healthcare can become the primary objective. Perhaps profits are not the primary motivator, but money has a corrupting influence which can be clearly seen when you speak to a GP who is/was a partner of a practice. Co-opting healthcare professionals into the job of coercing vulnerable people into bullshit McJobs, where they are exploited by the capitalists, has absolutely nothing to do with healthcare and is most certainly harmful.

I've witnessed first-hand how this care for "everybody else" - instead of patients - has become shorthand for the compassionless, sympathy-lacking, bullying, hectoring and suicide-inducing grotesquely twisted vision of so-called medicine, inflicted on society's most vulnerable people.

If you want to be the job police, and you think that suicides are an acceptable price to pay, so you can feel superior and send your kids to private school, perhaps medicine is not for you.

 

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