Travel Pathology

Ok, it is time to get back into the swing of things.

Sitting at the kitchen table this morning with my Princess Diana teapot holding warm earl grey tea and my journal which articulates a growing “to do” list, I find myself resisting intrusive invites from my brain to quit writing this post and return to bed to continue reading my faerie smut while feeding myself more bread drizzled with honey. But I must resist, the holidays must come to an end. With the arrival of the new year and a new term, it’s time to establish a sense of order.

It has been over a month since I have had the discipline to sit down and type. Since last term ended with the submission of the most daunting paper of my life and a swift visit to the ER (or what is called “A&E” here on this side of the pond), I thought it wise to take an intentional hiatus from anything that resembled a computer screen.

Allow me to explain.

I first noticed heart palpitations while preparing for bed a week before my course research paper was due. It felt as though a butterfly was stuck in my throat. At first, I assessed with a radial pulse, then grabbed my stethoscope for further inspection. I remember thinking, am I really hearing this? It sounded as though my heart would skip every other beat, then undergo a rapid fire of ten-plus beats at a time, causing a fluttering sensation in my chest and throat. Despite my years as a cardiac nurse, self-assessment made it challenging to determine whether these sensations were real or a product of my imagination. I conducted a series of assessments, counting my rhythm at rest and quickly standing up to check if the palpitations were triggered by a change in position or exercise. After several rounds of my heartbeat remaining steady with position adjustments, I concluded that the palpitations were random. My brain began catastrophizing  my situation, recalling every traumatic story I was exposed to over my career.

So I cut out caffeine from my diet for the proceeding five days, ensured at least nine hours of sleep and went on brisk daily walks around the park. And yet the heart palpitations persisted.

“Are you just really stressed about the paper?” my flatmate Kylie inquired as I shared everything with her during our festive movie night featuring “The Holiday.” I took her question seriously and checked my body for any symptoms and sensations that I have over the years learned to identify as stress-related or stress-induced. Truthfully, no. My gut, which usually feels tied in a knot during stressful seasons, felt normal. My skin had no breakouts, and I genuinely felt that I was making great strides on the paper. I believed I would be able to complete it in time to jump into the holiday season that I had been anticipating all year.

The heart palpitations, however, persisted for days, forcing me to weigh out the possibility of seeking medical care. I remember just wishing I had a home electrocardiogram machine. All I needed was a quick ECG and maybe some blood tests, and I could make a clear differential (self) diagnosis.

Here in Scotland, residents have a friendly non-emergent hotline service provided by the NHS where you can simply dial 111 and receive professional medical advice. After a week of persistent symptoms and no answers, I started to feel that my perfectly planned holiday was in jeopardy, so I phoned 111 and spoke to a nurse, describing my symptoms. Without her being aware of my medical credentials, she echoed my thoughts exactly – an ECG was in order, and thus, she sent me to the ER. I immediately felt guilty, knowing that my case might not be severe enough to warrant a visit to the emergency department. However, I was stuck on a long waitlist for a general practitioner, with no guarantee of being assigned one by the time the holidays rolled around. Furthermore, as the nurse explained, a typical clinic wouldn’t have an ECG machine, so they would probably refer me to cardiac services anyway. I’ll go… as soon as I turn in this paper. I thought to myself.

So, I visited the library one last time, tidied up my citations, ensured I was within the word count, and bid farewell to all control over my final grade as I hit the submit button for the assignment.

And I haven’t had a heart palpitation since.

To my embarrassment, it seems that the only cure I needed, was to be rid of that research paper. Of course, I had to see it through. The nurse I had spoken with over the phone already sent my information to the Royal Infirmary assuring me that “they were expecting me”. With this self-imposed social obligation in response to the kind nurse’s efforts, I subjected myself to hospital life on the other side of the coin; wearing casual clothes instead of scrubs, and not getting paid for each hour I spent in the waiting room. Overall, it was an enlightening and educational experience. Accustomed to long layovers in airports, I know how to make time pass. I read more faerie smut, people-watched, and reflected on how important genuinely kind interactions can soothe a very uncomfortable and non-enjoyable experience such as a trip to the ER.

After six hours in the waiting room, I was finally called back. The physician glanced at my record and declared, “You need an ECG.” Fueled by embarrassment, as a cardiac nurse self-presenting to the emergency department with no current symptoms of any kind, I played dumb and went to great lengths to conceal my profession. I am creating more work for people on their long shift for an issue that seems to have miraculously resolved 7 hours ago.

After my ECG printed, I asked the tech whether I could see it. “You know how to read it?” She asked. “No” I lied, “Just curious what those things look like.” She handed my results over to me through squinting eyes. I glanced at the sheet holding a facade of facial expressions that conveyed “non-understanding”.

Perfect sinus rhythm. Actually, it was rather impressive. P for every QRS complex, perfectly spaced, if not slightly sinus-brady at a 58 bpm pace. My heart, was healthy. I would live.

Returning home at 11pm that night, I cherished the new insight into the healthcare system. And unlike my courses, this educational experience was free of charge. With this new understanding of how stress manifests in my body, I thought it wise to close my laptop for the entirety of the holiday season.

The stress of the final weeks of first term propelled me into weeks of holiday celebrations and cheer. I woke up when I wanted, indulged in a diet of bread, cheese, and wine, slept as long as the sun allowed, and enjoyed days free from my laptop.

I moved into a new flat.

Celebrated New Years eve hopping between pubs, sipping scotch and observed fireworks on the Royal mile.

Capped the holiday season with a road trip to the Isle of Skye.

And now, classes have officially begun.

It has become time to summon my will, and reconstruct my routine. Which can be quite fun in theory but executing is a different story. As my former science teacher once put it, “I am a victim of inertia”.

Even though my alarm has been set to 7:30am every single day for the last week, it seems I am overruled by my circadian rhythm who fears the dark and holds me hostage to my bed until the sun makes its way to this part of the world, which happens around 8:30 these days.

When I grow hungry, my taste buds have grown accustomed to breads and pastries and beer. The spoiled gut now resists me every time I offer nutrition in the form of the rare vegetable, and demands precious sugary carbs.

My warm up routines at the gym have felt closer to an actual workout, as I struggle to complete my typical one minute plank.

The lingering momentum of the past month holds me hostage, resisting the change necessary to navigate the upcoming term. However, crafting this blog post marks the start in the right direction. Graduate school predominantly demands students to engage in extensive reading and writing. This blog serves a valuable purpose, lubricating the gears in my hands needed for typing and reacquainting me with the routine of days spent immersed in the written word.

Here, we mark the beginning of second term.