Were you already a physician when you started to experience your own forms of pain?
I was. I had just graduated from my internal medicine and general psychiatry residency, and I had started my first job.
What kind of symptoms were you experiencing?
Well, it started off with what was billed as a computer injury - a repetitive strain injury. I was at work one day, I had just started this job, and I was under tremendous amounts of stress. I also didn’t like the job. As I was typing one day, I experienced very acute, sharp pain in my left elbow. That persisted, and turned into numbness, tingling, paresthesias, subjective weakness. About a month later, the exact same symptom occurred in the other elbow.
The problem with this symptom was that my department in outpatient internal medicine had just piloted the electronic medical records program for this medical center, and there was a tremendous amount of typing that I had to do … this prevented me from using the computer, which meant that I couldn’t do my job.
Were you trying to self-diagnose at all during this time?
Absolutely, and especially as the pain progressed to other parts of my body because I had been trained in both internal medicine and psychiatry, I was double boarded at the time, so I should have been perfectly suited to diagnose myself and figure out what was wrong.
Were you stumped, or did you have an inkling that this had something to do with stress?
That is really an important part of my experience… despite being highly trained to understand both the mind and the body, I had no idea for the 10 years of my chronic pain that my mind was causing these symptoms. That had never been suggested to me in medical school or residency, or even in my recovery. Some people had said “well stress can worsen your pain symptoms” and I wasn’t even sure of that, but I was willing to accept it. But that still wasn’t an adequate solution for me. I wanted to know what was causing my pain, I didn’t care what was worsening it. I wanted my life back, and I wanted the pain to go away. The whole time, I was completely perplexed. I was searching for some genetic muscle disorder, or something unknown because no one could give me an answer.
This went on for 10 years… tell me about that progression.
It started out with the bilateral forearm pain and subjective weakness, and then it spread over months and years to neck pain, shoulder pain, jaw pain, hyperacousis - sound sensitivity where the slightest noises became painful to my ear, I had multiple cracked teeth, headaches, muscle spasms, all kinds of musculoskeltal pains and strains, rectal muscle spasm (which had earlier been diagnosed as endometriosis), skin rashes, multiple food sensitivities, hand tremors. By about the 8th or 9th year, I developed severe anxiety and panic attacks which were truly terrifying and disabling. Even though I was a psychiatrist, I really did not have an appreciation for how terrifying severe anxiety and panic attacks are until I developed them myself.
[This was an excerpt. Listen to the full podcast above]