I had a moment of realisation the other day. Of how the body can separate itself from our mind when it is under intense stress. Even without us knowing it. I consider myself a relatively independent and resilient person. Often, I can control my emotions and remain focused on my task until the recent event.

It was a normal working day. Only that I had concurrent ear infection which was treated with oral antibiotics. Otherwise, the pain is bearable although I would choose to attend patients that does not require any auscultation in their physical examination since my ears hurt when using the stethoscope.

As I was seeing a patient, I felt a surge of uneasiness. I would describe it as like walking on air, the type of feeling one gets after having a bad on-call and still have to work regular hours the next day. I did not think much of it until the agitation began to get worse. My fingers were also getting extremely cold. The peripheral vasoconstriction was so bad that my hands were almost cramping, making it difficult to type and hold objects.

Amidst the agitation and restlessness, I looked for an oximeter and upon placing it on my index finger, it read a Spo2 of 98% but a heart rate of 136. I knew I had to get myself checked at our clinic’s emergency area because I was concerned about two things. It is either I would blackout suddenly or experience more debilitating symptoms that point toward a stroke or a thyroid storm.

Upon reaching the emergency, I asked a medical assistant colleague to check my vital signs. I was already feeling slightly light-headed with numbness over my fingers. My breathing seems a bit laboured with ant-like crawling sensations on my face.

The first BP reading was >200/100 with a heart rate (HR) of>100
I was advised to rest before they repeated my second measurement which is >150/110 with an HR >110

What happened next was astonishingly out of my control as a composed medical professional. I remembered curling my body into an almost fetal position in the chair with a clenched fist while letting out an agonizing groan. This then progressed into a whimper before escalating into a full wailing sound at the ER. I was crying uncontrollably for no reason I could think of.

It must have startled everyone for the doors were immediately closed shut and female medical staff were called to assist in the situation. I could hear them asking me to take deep, long breaths but as much as I want to, it was so difficult to shut down the sympathetic response in override mode. I can listen and think to myself to ‘remain calm’ but my body is acting otherwise. It was a very surreal moment.

My chest felt tight. I could not breathe. My limbs felt stiff and cold. The sympathetic response was short-lived as afterwards I was able to make a normal conversation with my superior as she explored on what happened. I was told to complete my antibiotics course diligently and given medical leave for the day.

While resting at home, I tried to make sense of what happened. I felt broken into pieces.

• Maybe I was actually under a lot of (bottled-up) stress factors. Although my mind was not acknowledging it, the physiological changes might have surpassed its threshold and become exhausted resulting in that physical breakdown.
• My father-in-law died just last week and yet I am already at work after one day of bereavement leave because I felt obliged to do my on-call duties. I may not shed tears but his absence was palpable.
• I was sleep deprived. There were a few days when I really could not sleep until 4am. I thought it was the caffeine effect from ZUS’s Jasmine Cham Latte but for it to linger until a few days was too much. although I did not feel too tired the next day, it could mess up my cortisol and other stress-related hormones.
• I had a lot of things to juggle too. I tend to be busy with my Diabetes and HIV programme towards the end of the year. I admit I have been brainstorming a lot on the types of activities I’d like to do on top of my usual workload and my report write-up for my Final Year Project.

I hope I won’t be caught up in the same situation again. That means I need to do some troubleshooting on my part.

• Take on fewer responsibilities. Stop volunteering. Stop pleasing people.
• Delegate more.
• Use my annual leave more. I get 30 days every year. I usually have a lot of leaves rolled over into the following year because I rarely use them. I do not take MC that often either. In fact, my first MC of the year is the one I just had during that meltdown. Regarding my annual leave, despite putting aside a range of 5 to 10 days leave for my GCR, I tend to have at least another 10 days to use in the new year. Even now, in October I have a remaining 28 days to use till December. So Minci, use that leave.
• Eat better
• Drink more water
• Share problems with understanding colleagues and trustable friends. Or sister.

That should do it for now.
This experience was not only a wakeup call for me but it also made me understand why hysteria happens and why some people are driven to commit suicide. Sometimes the body just takes over when your mind gets too exhausted.