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At the heart of general practice since 1960

How virus nearly sank my career

One of the bleakest times of his life has left Dr Robert Hollingworth with an altered perception of illness and depression ­ he explains why

planned to hit the ground running when I was offered a place to read medicine as a mature student. I would work as hard and as consistently as I could from the outset, aware this was a second chance and a third might not be forthcoming.

But the best-laid plans can soon be cast asunder by the unforeseen and it was only a couple of weeks into the first term of the first year when I began to feel increasingly tired. It was not the pleasant tiredness felt at the end of a busy day, but a real muscle-aching bone tiredness that went on and on.

I was having strange symptoms that I could not account for. I was bathed in perspiration at the slightest exertion. I had started to play rugby again and was spending more time sitting down at the pitch side than on the field playing because I was so breathless. If I entered a warm room I would feel instantly nauseated and light-headed.

Initially, I put these symptoms down to being unfortunate enough to have had chickenpox earlier in the year, an altogether unpleasant experience that resulted in three weeks off work and a beard. I thought the symptoms were a legacy of this and I was slow in recovering.

Matters came to a head one morning when I fainted twice in the medical sciences building. The first time was in the toilets where I was found lying on the floor, much to the consternation of my friend.

The second and (most embarrassing) was in the lecture theatre. The room was too warm and I felt light-headed, sweaty and all the other unwelcome sensations of a forthcoming faint.

My GP ordered bloods, which came back as positive for glandular fever. I was both surprised and relieved by the diagnosis. Surprised as I had not had a sore throat at any time, just this terrible tiredness; relieved, as many pessimistic thoughts had been in running through my mind ­ leukaemia, Hodgkin's ­ the list was as long as my paranoia. To have a simple virus was good news.

Relief was shortlived as I grew increasingly tired to the point where I had difficulty in getting up and then staying up. Sleep no longer restful, I became depressed.

My vision of a medical career seemed to be receding before my eyes, which compounded my worsening depression.

As end-of-term exams approached I felt so ill the pre-clinical dean effectively ordered me home saying I was not even to take the exams, but to do the resits in January.

Five lonely weeks. Most of Christmas I was on my own because my wife was at work. I just stagnated, my depression so bad I remember vividly when I hit rock bottom. I had carried the vacuum cleaner upstairs; it seemed so heavy and the stairs so steep that I lay on the landing and cried with frustration, bitterness, anger and despair.

I felt I would never be well. After this catharsis things began to improve and gradually, day by day, my mood and health got better.

I returned to medical school in January and passed the resit papers. Thoughts of a medical career, at one time so elusive, became a reality. My depression lifted but recovery was agonisingly slow.

I had been fit and well all my life and never experienced this degree of illness or depression. All in all it took me around 12 months from beginning university to feeling well again. For more than a year afterwards every time I felt unwell or had a sore throat I would rush to my GP who would indulge me with a Paul Bunnel test, which of course came back negative.

My health remains ­ touch wood ­ excellent and I rarely think of this time. However, it has altered my perception of illness and depression. Many people have far worse, but for me it was one of the bleakest times of my life.

What my illness has taught me

 · Glandular fever can present atypically with no sore throat. In younger patients with persisting tiredness, I screen for glandular fever.

 · I warn patients with glandular fever the course may well be protracted and last many months.

 · I am very aware of the attendant problem of depression and believe in treating early.

 · While I believe ME and chronic fatigue syndrome are 'sin-bin' diagnoses, I am convinced they exist in one form or another and to dismiss them because of lack of evidence does the patient a great disservice.

 · Blood tests for patient reassurance are perfectly justifiable and an important tool that doctors possess.

Has the way you practise been influenced by a condition affecting you or a close relative?

Pulse wants to hear from GPs with a story to tell and advice to offer.

For details contact

Amanda Elliot, Pulse,

CMP Information Ltd,

Ludgate House

245 Blackfriars Road,

London SE1 9UY

aelliot@cmpinformation.com

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