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06 Mar 2004

dead end
i have isolated myself from my colleagues over the past four years. I don't want to share my problems with anyone and despite being in a very comprehensive rehab program for six weeks (volutarily ) at keniworth clinic seven months ago i have no intention of going in again.
At work i feel i am being employed for sympathy reasons. Everything i do at work i feel is suboptimal and even when patients thank me for what i have done i know the gratitude is not deserved because whatever i do i have assisted rather than done myself. I am merely working to earn enough money so as not to present a financial burden when things come to an end.
I am sick and tired of saying " i don't know " when asked academic questions. Everytime this happens i see such a dissapointed look mixed with amusement in my consultants expression.
I am a registrar in my fourth year and feel even the junior registrars know and do better than i can.
The deficits i have created are now catching up with me and i have neither the strengh nor the will power to "catch up" The colleagues at my level are so "with it" and seem have such excellent results
The followup program after rehab i have attended sporadically and have relapsed once or twice over the past 4 months on pethidine. I have become a "dry addict "I do not want to tell my psychiatrist as he is obligated to send a report to the HPCSA(one of the conditions of my registration ) - this will result in me being dregistered if this happens there is really nothing else i can do.
I wish i was one of these success stories, people who jump back into life and persevere but i'm not.
I feel i have come to the end of my career and would only like to cease being a burden to anybody.
I have no family and no friends so maybe a quick exit would not be such a bad idea as there is not really anyone who will be hurt.
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Expert
CyberShrink
cybershrink

01 Jan 0001

Dear Jeff,
I'm sorry to hear that you're feeling so downhearted at present. It sounds as if you've become very highly self-critical, probably to an unrealistic degree. You're not "one of those succes stories" YET. But it's not inevitable that you become one of those failure stories.
YOu admit you've been hit and miss about attending the rehab follow-up sessions, which is a pity, as they ought to be so important and helpful. I can understand that the idea of a "quick" end which "won't hurt anyone" may at times feel attrative, but it is an illusion. Such ends ALWAYS hurt others, more than you can guess. You really ought to tell your psychiatrist about these suicidal ideas, as it's not fair to him/her to keep that information ( much more important than an occasional lapse re drugs ) from him/her ; that's like not telling one's surgeon of the awful abdominal pain one has. And that psychiatrist needs to seriously assess the degree to which you may be suffering from a Depression which could respond well to proper treatment, and relieve some of the other unpleasant feelings you have been experiencing, as well as potentially reducing or even removing a significant part of the motivation that has pushed you towards the drugs.
And unless your hospital is amazingly sloppy in dealing with controlled drugs, even the occasional lapse must surely raise serious risks of discovery, which such brief relief as they might give, cannot be worth.
I happen to believe that you can get clear of this, and find a genuinely useful niche in medicine, able to be truly helpful to others, as well as to yourself. But you would need to be frank about these feelings to your psychiatrist, and to work harder at improving this mood slump which is currently so threatening to you.
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