Medicine, multiple sclerosis, and me

What's it like being a medical student with multiple sclerosis? Jenna Louise Duffy shares her experiences

Why is it that when sometimes your life seems to be running smoothly, and you have so many plans of how you would like your life to be, something bad happens?

"Jenna, you're not a child anymore now: you're 16 going on 17, and I think you are at the age where you can deal with certain things..." "Blah, blah, blah," I thought as my consultant droned on with the same dreary comments, and I stared out of the hospital window. These appointments were becoming a bit tedious. It was like having déjà vu. I stared out of the window. I kept thinking how excited I was about my plans for the weekend. My exams were approaching, and I just wanted to relax and have fun with my friends.

Garo/phanie/rex
Bound to this chair for life

My parents and I had come in for my routine appointment at the University of Wales College of Medicine. I had been called in for my appointment 10 minutes early, so my father was still outside parking the car. I had been unwell with "unusual symptoms" at 14 years old. Magnetic resonance imaging and lumbar puncture had confirmed lesions on my brain. The doctors suspected a virus or just a one-off illness that could not be explained. I therefore had to attend appointments every six months "to keep an eye on" me. I was never given a diagnosis.

Since then I had been free of symptoms. The initial symptoms of vertigo and optic neuritis I had had at that age had disappeared about four months after they started. That is, until two months before my routine check-up at 16 years old. I had been worried about my AS levels, and trying to complete my application form for university so that it was perfect. My dream from 14 years old was to be a doctor. I knew I would have to make a good impression.

One weekend while I was revising I began to feel tremendous throbbing pains in the soles of my feet. I put it down to wearing ill fitting shoes. Two days later, the pain had been replaced with numbness and tingling that had now risen to my knees. My parents were concerned. Each day the numbness rose up my limbs, until one morning I awoke in a panic and pool of sweat because I thought my legs had disappeared. The numbness had risen to the umbilical level. The embarrassment and anxiety of not being able to feel my feet in my shoes and feeling that my trousers had fallen down was really getting me down. It would send me into panic, frantically checking they were still there, no matter where I was, and who was watching. I continued the week as if I was in perfect health, stubbornly ignoring this problem as though it would disappear.

It took days to get even an emergency appointment, but after a while I visited my general practitioner. He referred me immediately to the paediatric consultant I have visited since age 14. Because my routine appointment with him was close anyway, the consultant felt no need for an emergency appointment. Even though everyone around me was worried, I felt as I did aged 14. I was naive, not at all concerned about what was wrong with me. I was in a daze, on a cloud where no one could touch me. It is hard to explain how you can feel totally oblivious to what is happening to you, even when you know it is serious. It is almost as if your brain switches off to all the negativity of the world and then drugs you with a happy pill to enable you to cope.

It was in this state of enlightenment that I received my shock. As I sat there looking out of the hospital window, I was still in a daze, "I cannot believe this is happening. I have got so much work to do. I could be working here one day. Got to get that application form filled. Need my references. What shall I wear on the weekend. So excited," thoughts raced as my mind wandered.

"I think you are aware how things can change ... you can deal with certain things now Jenna ..." the consultant continued, "Blah. Blah. Blah."

"We can now assume you have multiple sclerosis."

Hang on. Stop. Rewind. Was I dreaming? I think I was until I heard that last part. My mother was overwhelmed with shock. My father was oblivious as to what was going on; he was still parking the car.

"Could you repeat that, please?" I asked almost laughing in shock. "You have multiple sclerosis," the consultant explained. "Hang on a second, that only happens to people in their 40s and 50s, I nurse patients with that disease," my mum, a qualified nurse, explained in disbelief. "Yeah that's right mum." I protested. He couldn't be right. Oh my God I'm going to be in a wheelchair. My life's over.

"I am going to pass you on to the nurse next door who will answer any questions and will talk you through treatments." The consultant explained, eager to pass the buck. He apologised for my bad news and went to shake my hand, but I continued to walk as if I could not stop. Nothing could stop me. I had to escape that room. My mother followed with tears in her eyes. We sat in the waiting room and just stared at the wall.

Moments later, although it seemed an eternity of silence, we entered the nurse's room. Two minutes later my father entered, and by the look of shock on our faces he knew something terrible had happened and burst into tears. My mother explained to him what had happened while the nurse made us a cup of tea. The first thing that I said was, "Oh no, I can't do medicine can I?" I panicked so much I thought I would hyperventilate. The nurse calmed me and replied, "Yes, you can do medicine. I know many patients who have gone on to do amazing things. It can make you stronger."

That was five years ago. Today I am a third year medical student about to embark on the important clinical practice I have been longing for. When I look back at my journey so far, I feel overwhelmed. Since that day I have experienced the emotions and struggles that some people face over a lifetime. Acceptance of disease is like grief. I experienced denial for so long after that day I cannot even put a time to it. In that period I hit an all time low, something I would never wish on anyone. The darkness, the dread, the anxiety, the insecurities, the gloom, the loss of confidence, the loss of self assurance, and ultimately the death of who I was, and what I wanted to be.

Doctors prescribed antidepressants that seemed to worsen my fragile state of mind. I never sent in my university application form, and I just about achieved my AS levels. They were not the grades I wanted. Now I was convinced that I could not do medicine. I thought I was incapable and unworthy of the title of "doctor." I could not confide in anyone. I tried to confide in my friends but felt it was too much for my mind to cope with let alone theirs. My rages of anger and frustration were taken out on my family and friends. I did not feel wanted and hated myself. I even ignored my nurse when she visited my house. That was it. I had given in to the darkness.

Then my mother brought home a nursing application form. She thought the experience would give me a boost, and I would have a different environment and patients to distract me from my own problems. I flew the application process and started working about four months later. Then I received a postcard from St George's Medical School in the West Indies asking me to do medicine. I must have filled out a form at a career's fair or something. It was my saviour, along with the nursing experience I had gained. It made me realise what I wanted and where my heart was. I visited my tutor at school to rearrange sitting two of my A levels, and I finally got the grades I wanted. The nursing experience went in my favour too.

Soon I was in my interview at Brighton and Sussex Medical School. I knew I was where I wanted to be. Since then I have developed so much, and I do not regret a single thing. Everything that has happened to me has happened for a reason, and it has indeed made me stronger. I have had two more relapses, which I have found difficult to cope with. Multiple sclerosis prevents me from driving, cooking, and basically caring for myself, until I recover and return to remission. This was a danger I knew I would have to face, especially since I attend university in Brighton, which is a long three hour drive from home in south Wales. I am lucky to have good friends in Brighton, who have cared for me when I have become unwell. Once I could not attend an objective structured clinical exam, so I had to sit it in the summer. The medical school was supportive. I know that although multiple sclerosis may hold me back for a little while it will never stop me doing the things I want.

I look at patients today: some accept their illness; some are in shock; some have denial, anger, or frustration; and I remember exactly how I felt. I know that nothing I could say would really make a difference and would not be professional of me; however, all I know is that explaining the bad news is an important part of this enduring process. This process of acceptance is inevitable, but it can be made easier when the patient does not look back with blurred images, or frustrated and angered feelings of the consultation that changed their life. The lessons I have been taught about breaking bad news are very important and should not be taken lightly. They could make a difference to someone's life, and you will be sincerely thanked for your kindness and understanding.

   

           

	LIFE       Jenna Louise Duffy (January 2007)
	Jessica D'Souza (January 16th, 2007)       Lecturer, microbiology, MMMC Manipal EMAIL
	Dear editor This article really touched me I feel more people should read it as it clearly indicates how strong we can be even in times when we feel let down. I have known several individuals whose approach to similar situations has inspired me .Jenna has shown amazing strength to not just accept her condition but also to stick on to her dream of becoming a doctor. I believe that each one of us is capable of following our dreams.yet so many times we give up or we do not want to take the chance,perhaps we should think of jenna and others who have achieved inspite of their difficulties .Hats of to you jenna . Im sure you will become a good doctor not just as a professional but also one who cares and understands her patients.Another interesting part was of her doctor who told her that she was sick, and just passed the buck to someone else why can't the health proffessionals be more human .It might seem like a routine for them but for the patient its like his/her life is falling apart.Perhaps doctors and health professionals should be made to realise how important a role they play in the lives of so many people,some workshops or training is called for.