Things are not getting better as the week progresses. I am starting to feel that everything is an effort and that I won't be able to deal with problems. This is a bit like how I felt when things were bad last year, though not (yet) as severe. I had to supervise a medical student this morning on behalf of the partner who is on sick leave, but they hadn't given me any extra spaces in the session for the teaching. I find it stressful having an observer when I feel inadequate, and I ended up running nearly an hour late.
Several times during the day impending problems appeared to be insurmountable, although (of course) once I started to deal with them I was able to sort them out quite well, and in a reasonable amount of time. Once of twice during the day I felt that I could not carry on doing this job. But I realised that my cognitions were false and did my best to treat myself with some CBT.
I have had some helpful support at work. The staff have been understanding. I had a little chat with our senior nurse, who is my age and has been at the practice almost as long as I have. “Don't worry” she said as she gave me my flu jab, “it's only nine years until we retire. It won't be long.” And she said that she thinks I am a good doctor and that the patients are lucky to have me. You can see why I like her. Then this evening Martha sent me a charming email: “I just wanted to say that you may well feel that you are not coping very well for one or more reasons. But finishing a heavy surgery with a new medical student an hour late is not evidence of acopia, it is quite normal. You place quite a heavy burden on yourself when you try to be a good doctor in the short time available. And you achieve it a lot of the time. The Impossible takes a little longer, as it says in the laundrette!” I like Martha, too.
The stressors are clear. Because of sick leave and another partner on holiday, my work load is considerably higher, paperwork is building up, and the study mornings which usually provide respite have had to be cancelled. It is far from clear when the ill partner will be able to return and, as Martha helpfully pointed out, responsibility for sorting things out has fallen on me - as it usually does. I can cope with being a full-time GP, but I can't cope with being more than a full-time GP.
My course of action is also clear. I must continue to think relentlessly positive thoughts, monitor my mental state, and “debrief” regularly with Martha. That, at least, is no chore!