Thursday, March 15, 2007

A little adjustment disorder

Over the last few weeks I've been struggling hard to find a rhythm and a routine for reading and writing. My dear visitors have gone home; my teaching has mercifully been reduced to about eight lectures over the course of the semester; and I have few regular meetings or commitments. I'm feeling stronger, physically, than I have for ages, and have established a good routine of walking along the creek for about 45 minutes each morning.

These would seem to be ideal conditions in which to catch up on some reading and writing, after the last five months since my diagnosis; and also, it must be said, after the few months last year when I was flinging myself from pillar to post, hardly ever sitting still long enough to read or to put a sentence together. Yet it has been almost impossibly difficult to work. I can barely sit at my desk, and check email, blogs, news and weather sites to a ridiculous degree, yet I'm unable to take myself off to the cinema or break the cycle. If I sit down to read, I fall asleep within minutes. I can feel physically strong when on the creek path in the morning, or on my bike, or even on the tennis court (had a great workout last Sunday, though I still can't serve), but when I go in to work I come over all feeble, and have to hold onto the stair rail, or the back of a chair, or sit down, when I used to dash about, and sometimes even literally run along the narrow corridor between the two halves of my building. And when I think about going back to full duties in second semester, I am liable to start panicking, start crying and feel anxious. This has been very distressing to me, as I have always loved my job, and loved going in to my office and seeing folk. I've revelled in the busy-ness of trying to balance my teaching and my research; and if I've moaned about committees, I've also enjoyed my share of knowing what's going on and how things work, and my part in making good decisions. All this seems to have changed.

It's taken me a while to work at untangling the threads making this particular knot. I don't think I'm over the worst of this (I had a cheerful and interesting appointment with Tash and a stand-in oncologist, Craig, on Tuesday but sobbed all the way home and for most of the rest of the day), but things look a little clearer than they did a few weeks ago, so let me try.

Some of the anxiety and fatigue might be attributable to the after-effects and side-effects of treatment and the effects of menopause; but I suspect this is more psychological than physical. At a party a few weeks ago, I was talking about some of this to Sandra, who named a psychological condition "adjustment disorder" which I looked up. It seems to appear within about three months of a shock such as illness or bereavement, and can be accompanied by depression, anxiety or other such things. It is to be distinguished from post-traumatic shock disorder ... but I'm far from trying to make an accurate self-diagnosis. I took great comfort in the idea that there might be a recognisable pattern to the way I feel. Someone else likened having cancer to traumatic shock, and I took comfort in that, too. I don't want to overdramatise the problem, but I don't think I have ever experienced anxiety of this kind before, and it was helpful to see that there might be a shape — a beginning and an end — to it. So I made an appointment with one of the counsellors through the breast clinic, but my appointment isn't till May (I'm in London for most of April).

I was so desperate the other night I let my partner sit me down and pretend to be my counsellor, and we came up with some concrete suggestions for how to manage the time at my desk, and I'm pleased to report that for the last two days I haven't opened email till after lunch. Mornings are for research; I don't have to accomplish any number of words or tasks; but all the reading and writing I do in those hours has to be on the project I've set myself. And I think I will get close, finally, to finishing this little essay on Piers Plowman soon. Ironically, I'm writing about Langland and the nature of work. Here's a sentence I wrote today: "Langland knew that writing was hard work, but seems unable to say this directly; and so in this regard, as in many others, the poem proceeds by indirection and dialectic." That's pretty funny, really: I wonder if that sentence will still be there in the final version!

So I'm trying to untangle the small-scale problem of how to read and write, while also tackling the larger issue of facing up to returning to work. It's certainly not made any easier in that the University is still in the throes of a major shake-up; my Faculty is suddenly deep in debt; my department has vanished; and my new school is facing staff redundancies as we all write new subject outlines for 2008 and beyond. I even found myself experiencing a sense of grief, and loss: I have spent my entire adult life at the university, and suddenly feel strangely detached from it. It's possible this is a good thing. This was Manfred's view, when we spoke about this at another party, that a little adjustment disorder might be beneficial, if it loosens the ties of duty and obligation in which I have bound myself so tightly. When I was talking with Suzanne in the meetings before my surgery, she said, "cancer changes your life." I am starting to see what this might mean.

3 comments:

Meredith said...

Thanks for this and for your entire blog Stephanie, it's always the first I read from my blogroll when you have something new. Something I've been working through with my psycho-oncologist (isn't that a great title?) is simply being able to accept that everything's different now. I thought that once treatment was over, and I'd passed the 1-year no-recurrence mark, old routines & ways of thinking/working would naturally drop back into place. Instead, I have to start from scratch. "Adjustment disorder" seems a very good way to describe it.

Meredith said...

hi me again, hehehe, I just read this, and thought of this post again - very similar theme.

http://spinningtumor.blogspot.com/2007/03/in-pursuit-of-elusive-normal.html

Stephanie Trigg said...

Yes, it's odd; I actually *don't* want things to be normal again. I want so much to have learned something from this enforced stillness.

The lymphopo blog tells one hell of a story. But yes, I agree with a comment you've made elsewhere: we are so much better off with a reasonably good national healthcare system.