Hello, it’s me


Hello, it’s me. I was wondering if after all these years you’d like to meet. That’s right, folks, I’m writing a new blog entry and if that ain’t a sign that 2017 is gonna be a good ol’ blast I don’t what is. Yep, I’m still full of myself.

Anyway, a lovely reader of this blog left me a sweet message back in September, asking me to update. I confess I saw the message but I wasn’t ready to talk again. I didn’t even know where to start.

I wrote a song a few years ago about being a twenty-something (very indie and hipster, right?) that had a lyric that said “Nothing changes but nothing stays the same”. If I had to describe my life ever since I last wrote in a sentence that would be it. So much has happened even though it still looks pretty much the same from the outside. I’m now in my last year of medical school. I still wanna be a psychiatrist. I’m STILL single. My cat Mr. Queen is as nasty as eva.

So, what made me want to write again today?, you guys ask (or not, maybe you don’t give a flying fuck and I surely don’t blame you). Well, my friends, when the clock striked 12 last night this horrifying fear washed over me. You see, I haven’t told you everything about my life yet. This year, 2017, is the year I take my Medical Specialty Exam and it is a FUCKING NIGHTMARE which will decide my entire life from now on. So, I’m scared. No, that doesn’t even cover it. I’m shitting myself with fear. You see, the thing in Med School is you always think that there will be a last exam, an end to your continuous nightmare of trying to prove you are enough and capable of being this weird creature, a doctor. You naively think that getting into med school was the hardest thing you had to do and now every effort will pale in comparison. Folks, I won’t hold your hand and tell you you’re right. There is no such thing as an end. It’s continuous hard work that will make you question your decisions and wreak havoc in your (inexistent?) personal life.

To be honest, Medicine is something that demands everything of you. My life is literally on hold because of it. Of course you can say that not every medical student’s life is like mine and I’m probably just a little pussy. You’re partially right. But my life has some peculiarities worth pointing out. I have a mental illness and it demands daily care. I can’t simply ignore my mind and I surely can’t escape it; in fact, I’m obliged to live in it. And it has consequences, especially when I push myself too hard.

This October I had a breakdown. It hurt like hell. I’d been progressively lowering my Paxil until I took no medication at all and it was working. It had been working for more than 6 months and I felt great. I’d finally done it and I was proud of what I’d achieved: I could finally control my disease with my own “sick” mind. I started my last year of medical school full of hope, but the fear of failure regarding that dreaded exam was there. And it grew, and it finally imploded. Of course I’d known this might happen in such a stress filled year ahead of me, but it was still a blow to my self-confidence. I experienced the panic attacks all over again. One of them was so strong that made me momentarily lose my sight. And they raged on; all the while I was doing clerkships and seeing patients every day. I’d fall apart at the end of the day, but in the hospital you’d never guess I was hurting. I’ve become a master at hiding these things, like every anxious psychiatric patient with years of experience. I scared my parents, and I scared myself. On a car ride on a particularly stressful day after a most unexpected death of a close uncle, I broke down crying and screaming. I was a mess.

I had to make the tough choice of going back to Paxil. And Xanax. But of course that didn’t magically solve my problems. I had to work to get back together again and with the help of the Christmas holidays I’m much better.

But today, I’m afraid again. Because this is the year and a 100 question exam purely based on memory will decide my fate, if I can become a psychiatrist or not. If I can have the “dream”, which was never my dream to begin with. Don’t get me wrong, I do seriously want to be a psychiatrist, but it wasn’t my child’s wish and if I could truly choose I’d do something else. Be somebody else. But I’m me and this is my life and I’m determined to live this life.

Ironically my memory is a bit more fucked up than usual because of the meds, which do make it harder to memorise. But if I don’t take the meds, I can’t study at all, so there’s that. Fuck.

I didn’t mean to depress with this shitty talk. In truth, my life is not as bad as it might sound. I have MANY things to be thankful for and the most amazing parents I could ever ask for. It’s just there’s a lot on my plate right now, and it isn’t going away anytime soon.

As a last thought, I’d like to address those of you who want to go to med school and are reading this. I won’t discourage you, but I will ask you to consider it very carefully. This is no picnic. You won’t make that much money and you’ll work long hours. You’ll have no days off, because sick people don’t get days off. You’ll leave your family alone in many occasions and you’ll miss a lot of important events. Your best friends will marry, buy their first house, have kids… And you aren’t even a doctor yet. Your mental health will deteriorate and the suffering around you will get to you. You’ll learn to partially ignore it, but you are a human being and you’ll feel for your patients. You’ll become short-sighted because of the long hours of studying. Some people will be grateful for your dedication, but most will say you haven’t done enough. Patients will insult you. Doctors and nurses will mistreat you. You’ll feel isolated. You just want to give up and the smallest of good gestures you witness may be the only thing giving you strength to wake up again the next morning.

Your road will be long and full of rocks. So you’ll really have to want it or you won’t get there. So make sure you truly want it. If not, choose another path that may fulfill you. This is a VERY HARD life.

I’m determined to wake up tomorrow and do my best. And that’s all anyone can ask of themselves. That’s my resolution for 2017. I hope you too remember that and be forgiving in this new year, especially to yourselves. We all need love and hope to keep going on. And I’m confident that, even though the times are tough, there’s always something good on our way.

Much love to you,

Miss Smoak, MD


Merry Christmas!


Hooray! It’s Christmas! There’s only one downside: being asked if I already got a boyfriend, again. Time to put my question dodging skills into action or just answer and say ‘I’m perfectly happy the way I am’ which for the first time ever is probably true. 🙂

I recorded a cover of ‘Have Yourself a Merry Little Christmas’ to wish you guys (my amazing followers!) a magical christmas. Hope you enjoy! https://soundcloud.com/suggia/have-yourself-a-merry-little-christmas-suggia


Miss Smoak, MD

It’s been ages!


I know I haven’t written anything in ages but I’ve been so busy! Happy busy, which is good. 4th year has been amazing and I’m in love with medicine more than I ever was before. This feeling is exactly what I needed after a very complicated summer of studying, dealing with my mental health and generally feeling on edge. Actually, my diagnosis changed and I finally feel like I know exactly what I have, and I’m not ashamed of myself. I have OCD. More specifically Primarily Obsessional Obsessive-Compulsive Disorder or Pure-O, as it is afectionately called. And you know what? In these last few months I discovered that many of my colleagues suffer from mental health issues too; and we still make it work in college and in medicine. More amazing news: I’ve managed to stop taking alprazolam (it’s been 3 fucking months!) and I’m on my typical regular dose of 20 mg of paroxetine. The recommended dose to OCD patients is 40 mg but I simply don’t need it. So basically I’m feeling pretty awesome and I’m proud to say I’m one of the strongest people I know. Think I’m cocky? Deal with it.

Anyway, just wanted to let you guys know I’m still alive and really sorry for being absent but, you know, life and medicine happened. I already feel like a real doctor, especially because this wednesday I got home at 9 pm after spending five hours in the ER and in surgery (btw, it was a cholecystectomy and it was sooooo cool!). I also tried sushi for the first time; I’m still deciding if I like it.

Have you guys noticed it’s almost Christmas? And this year I have a two week vacation so I’m absolutely thrilled! God, who doesn’t love the bright lights, the food and that warm fuzzy feeling? Sigh…

Before I go, I just wanted to tell you that I’ve completed my rotations in neurosurgery (frickin’ awesome), therapeutics (terrible!), dermatology (thought I’d hate but actually enjoyed it a lot, though I’ll never get that good of a grade in the medical specialty exam to be a dermatology intern) and I’ve just started surgery (don’t get me started on this one, I cry of joy every single day).

Hope all is well and swell with you, people of the blogosphere. See you soon!


Miss Smoak, MD

Take The Leap (And The Net Will Appear)

Someone told me today that in life we must learn to take a leap of faith. I want to take the leap but in what direction? I’m still unsure, these crazy twenties are raging on and I feel as if everything is quite unpredictable. But I’m sure I’ll get my silver lining.


“My Silver Lining” – First Aid Kit

I don’t want to wait anymore I’m tired of looking for answers
Take me some place where there’s music and there’s laughter
I don’t know if I’m scared of dying but I’m scared of living too fast, too slow
Regret, remorse, hold on, oh no I’ve got to go
There’s no starting over, no new beginnings, time races on
And you’ve just gotta keep on keeping on
Gotta keep on going, looking straight out on the road
Can’t worry ’bout what’s behind you or what’s coming for you further up the road
I try not to hold on to what is gone, I try to do right what is wrong
I try to keep on keeping on
Yeah I just keep on keeping on

I hear a voice calling
Calling out for me
These shackles I’ve made in an attempt to be free
Be it for reason, be it for love
I won’t take the easy road

I’ve woken up in a hotel room, my worries as big as the moon
Having no idea who or what or where I am
Something good comes with the bad
A song’s never just sad
There’s hope, there’s a silver lining
Show me my silver lining
Show me my silver lining

I hear a voice calling
Calling out for me
These shackles I’ve made in an attempt to be free
Be it for reason, be it for love
I won’t take the easy road

I won’t take the easy road
The easy road, the easy road

Show me my silver lining, I try to keep on keeping on
Show me my silver lining, I try to keep on keeping on
Show me my silver lining, I try to keep on keeping on
Show me my silver lining, I try to keep on keeping on

The Promised Land


So, there’s this ongoing joke between medical students at my college. The 4th year of medical school is called “The Promised Land” since it marks the beginning of the clinical years and everyone, and I mean everyone, feels like they won the lottery when they get there. After three years of terrible studying pains we finally sort of get down to business. Yay! My 4th year will start on the 15th of September and I couldn’t be more excited about it. Throughout the year, classes will rotate between several medical departments and at the end of each rotation we have an exam, which sucks but let’s face: it is inevitable. My first rotation is neurology and I already have a pile of shit to read (no offense John Nolte).


Behold “The Shit” plus a new, sweet, pink office appliance

Besides neurology I’ll be doing a lot of rotations this year: Therapeutics, Dermatology (it’s fucking terrible apparently), Surgery (everybody loves it), Orthopedics, Radiology, Bioethics, Pneumology, Cardiology, Endocrinology, hematology and Otorhinolaryngology. Feeling sorry for me already? No? You fucking should! Kidding. (but seriously this is going to be a LOT of work). I’m really sad about the fact that I’ll have to wait until next year to do a psychiatry rotation but it is what it is. And you know what else I’ll be studying next year? Forensic pathology! Yes, I have the weirdest preferences. 

Well, I sincerely hope this year proves to be a new beginning in the medical world. I need this breath of fresh air. Everybody needs change once in a while. So, here’s to an awesome new year everyone! And may the odds be ever in your favour!Leo-Toast


Miss Smoak, MD

Improvement of the mind


So, I’ve been super busy studying for the exams I have on the first week of September. However (ironically) I did find the time to make a studying playlist with some of my favorite instrumentals, scores and classical music. It helps me a lot to stay focused and I hope it will be useful for you too. It’s more than 3 hours of music and you can find it here: http://8tracks.com/elsaofarendelle/improvement-of-the-mind

Good luck for those of you that already started college or school! I hope this playlist eases the pain 😉


The Cuckoo’s Nest


Last May I had to go to the emergency room because of a viral gastroenteritis. I will spare you the details about my deplorable state at the time not only because they’re gross (you get the idea) but also since they’re not relevant to the point I’m trying to make here. Anyway, I found myself at 5 am in a national holiday in my college’s hospital (oh, the irony) sitting in a bench in the ER waiting to hear my name being called. When an internist finally tended to me he started the whole typical process of gathering information, which every medical student knows very well. He was very nice and I’d seen him before since he was also a professor of Semiotics. I told him I was a student there and he said I indeed looked familiar. While conducting the routine physical examination such as assessing the heart rate, he asked me about my previous medical history and, of course, I mentioned my Generalized Anxiety Disorder (from which I presently suffer) and also Panic Disorder (for which I no longer meet the criteria. Yay!). He remarked that I seemed very anxious and that my heart rate was at 129 bpm. I replied that I was used to my high anxiety level and therefore didn’t feel particularly stressed out even though my heart was racing. The doctor then assumed a serious expression and said to me: “You need to get over this. How are you going to deal with the pressure when you actually become a doctor? You’re too young to subject yourself to such anxiety”. I nodded and he continued the examination. After that I was given NaCl via IV, tramadol, diazepam and butylscopolamine and when I left the hospital I was feeling much better. 

In the evening, my parents and I were in the living room and they remarked that I was strangely quiet. I told them there was something that had been bothering me all day and explained what the doctor had told me in the ER. The funniest thing about it was that despite all the pain and discomfort I had gone through all day, what had hurt me most was the shameful lack of understanding a trained physician and college professor had shown towards mental illness. In fact, the more I thought about it the more outraged I became, and I wished I’d had the strenght to call him out on it. You wouldn’t even dream of telling a diabetic person or a cancer patient that they need to “get over” their problem. Yet, psychiatric patients somehow must have the supernatural ability to turn off their disorders whenever they please. 

Let’s focus our attention on a very important detail. Consider the phrase “mental illness”. The definition of illness in the Merriam Webster says the following: a specific condition that prevents your body or mind from working normally. As you can see, it’s not the person that “decides” not to function normally. Instead, illness is a product of a malfunction in the body or mind. Mentally ill people are SICK people. Trust me, if I knew how to stop being anxious once and for all I would have done it years ago. So, what am I? I’m a person with a chronic condition, same as diabetes or hypertension. There’s nothing mystical about psychiatric problems; they’re the result of physiological and, who knows, even anatomical dysfunctions of the brain, its pathways and neurotransmitters like serotonin and dopamine. There’s something wrong with my brain, as simple as that. For this reason, I undergo psychological and pharmacological treatment on a daily basis such as any other patient with any other condition would. 

What is unclear to me is the reason why this is so difficult to understand. We’re in the XXI century, the age of understanding and equality, but when it comes to mentall illness we’re in the fucking Middle Ages. It’s okay to love someone the same gender as you are, but apparently it’s not okay to be sick. Right now, there are two main popular different approaches to mental health: people pretend it’s a hoax and it simply doesn’t exist or they’re so terrified of its “supernatural” power that it becames taboo. I can forgive these ignorant views in the common layman but I strongly condemn them in health care professionals that must know better and in the teaching institutions that purposedly snub mental health courses in their medical curriculums. This is a very serious matter since 1 in 4 people will experience a mental health problem in the course of their lives. This means that if you invite three friends over to your house, one of you suffers or will suffer from some form of mental disability somewhere in the future. So, if this is such a common issue, why are pretending like it doesn’t exist?

The worst of it all is the stigma. Apparently I shouldn’t even be a medical student if I have a mental problem. I’m unstable, dangerous and unable to take on responsibilities, right? Well, I’m sorry to disappoint but the medical profession has the highest rates of psychiatric problems and we STILL save a bunch of lives every year. So, you’ve been fed many lies over the years. As to being dangerous, unstable and unreliable? Ask anyone who knows me if they trust me and you’ll be happily surprised (I also never assaulted anyone just in case you were wondering except for that time in 7th grade when a boy I knew slapped my ass and I didn’t take it very well, but I’ll take a chance and say that the slap he got was well deserved). 

Waking up today and learning about the death of Robin Williams really made me realise I should have written this post sooner. It’s high time we stop ignoring this problem. And when such a beloved person is taken prematurely away from the world, probably the result of a poorly handled mental problem (bipolar disorder and depression) combined with years of substance abuse, it makes me think his death could be the start of a wave of awareness and acceptance, reminding the world that even the greatest people can be affected by disease and that mental illness is a serious problem that shouldn’t be addressed with fear but instead with an open mind, ready to discover new forms of treatment and ready to fight for the end of the stigma. In the meanwhile, we must stay strong and do what we can individually to make changes in our own small, everyday world. Believe me, I already started. I will be a psychiatrist.


Miss Smoak, MD