Friday, March 18, 2011

The Migraine In Spain Stays Mainly In The Brain

Some of you have been wondering why I’ve been posting so regularly when my final exams are just days away - Tuesday the 22nd to Thursday the 24th of March, to be exact. Surely I should be devoting this time to revising? Fact is, I always feel more creative when there are more Grown Up Things To Do like passing exams or rites of passage. (You should have seen the bad poetry that spewed forth when I got my mortgage approved.)

I think I 'm writing so much more  because my brain is full; and full of exactly what I don’t know. I hope I’ve absorbed enough facts to regurgitate into passable answers for the nine hours that await me next week. I’m drawn to rattling off blog posts probably in an attempt to disperse some nervous energy. My family know me well – when stressed, I can run around the house talking to myself like a Looney Tunes character, so blogging is probably a more socially acceptable option.

In case you were wondering, my mental state is, I guess, like all people facing a final professional exam – suitably miserable. For non-medical peeps, the College final is essentially your professional board exam in your specialty, once you have it and your four to five years of clinical postgrad training are complete you can register as a specialist.

Having said that, I’m strangely calm this weekend. One thing about an exam like this is that you can’t cram for it, it’s months of slow slogging, a very, very long bout of attentive reading. If I have one bit of advice to anybody attempting something similar is: SLEEP IS YOUR FRIEND. I’ve had to learn the hard way. Being a bit of a night owl, used to surfing the net and watching Cartoon Network till 2 am, insomnia crept up on me insidiously during the past year and – until day Iwas  looking and acting like a zombie from The Night of the Living Dead

And bad sleep is almost worse than no sleep. My wife has had to be a sergeant-major in forcing me to adopt a strict sleep hygiene regimen of regular hours (as far as is possible when one is doing night calls at least once a week) and taking “time-outs” to meditate. Even so it’s been necessary to supplement with pharmacological help. I dislike the idea of sleeping tablets but at the moment it’s the lesser of two evils. And then there are the migraines, that zoom to a bout of insomnia like flies to carrion. It’s always amazed me how something so excruciating ends up being temporary and – from what we know – harmless to the body in general. I always think I’m about to die. Even in their milder forms, my attacks (which are fortunately usually rare) feel as if a demonic pixie is water-skiing inside my skull, pulling on my optic nerve as it slices through the choppy seas of my throbbing head.

I can really sympathise with Francisco Goya, the great Spanish artist who, it is said, also suffered from crippling migraines. Many think that his darker, fantastic visions were painted during an attack, or at least inspired by the hallucinations that can sometimes accompany a migraine’s heralding aura. I’m particularly fascinated by Goya’s wonderfully nightmarish El sueño de la razón produce monstruos (The Sleep of Reason produces Monsters). It’s one of the 80 etchings entitled Caprichos  in which Goya “[condemned] the universal follies and foolishness in the Spanish society in which he lived.” (Wikipedia). I see him taking a jib at “civilised” society and demonstrating how reason is but a thin crust on top of a seething core of dark energy. (For those of you who might have noticed, I’m borrowing the term dark energy from astrophysics deliberately  – hmmm – that seems to deserve a blog post all by itself…)

Let’s look at the etching more closely. It’s considered a self-portrait, with Goya having fallen asleep at a table. A dark army of bats and owls, supposedly representing ignorance and foolishness, swirl around him menacingly. Is this a cautionary tale about the dangers of losing one’s grip on reality? Or, is it possibly a brutal reminder of the energy of the creative process?

Certainly in my case sleep (or rather the lack of it) has raised a lot of bats and owls of their own. Perhaps I could ask them to rather hover around my blog posts while the countdown to exams continues. Just for now. They can flock right back when I’m done and produce as much bad poetry as they like.

And now off to bed. I was last looking at a paper on the Cockroft-Gault equation for predicting a patient’s kidney function and that’s already enough for a full weekend’s supply of nightmares.

I hope you all sleep better than I do! 

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