A unique perspective from a paediatric trainee diagnosed at 32 years of age with attention deficit disorder. A disorder which some believe to be over diagnosed in the paediatric population, yet it is barely thought about in adults. “Procrastinates, struggling with exams, can be abrupt, needs more confidence” – some phrases used to describe the trainee in the workplace. “Good communication skills, excellent team player, well-liked, brings a fresh and logical approach to paediatrics, good clinical skills” – the positive characteristics which the trainee found increasingly hard to believe after repeated failure of postgraduate exams and diminishing self-confidence.
“On waking up I realise I have a presentation to give, it has not been written. I arrive at work to discover I have left my stethoscope at home, why can't I ever manage to leave home with everything I need? Handover is difficult today, people aren't speaking quickly enough and I struggle to stay in the moment. My mind drifts easily – what new career shall I choose if I lose my training number? It's my last chance to pass my exam this time. Through the day I am asked questions, I know the answers but cannot present them logically. I am frustrated with myself. Consultants are trying to teach me but are visibly irritated when I can't recall the facts they have imparted. Does everybody have to concentrate this hard to make their brain work? In bed I just want to rest, my brain won't let me. I have to get up tomorrow and do this all over again”.
After a year of cognitive behavioural therapy, a formal diagnosis was made – together with methylphenidate the trainee described “the noise in my head disappeared, I hear every word people say now rather than one in three and I finally enjoy my job. Most importantly I feel, for the first time since I was eight years old, that it's okay to be me”.
An interesting case illustrating how a physician with an undiagnosed paediatric disorder persisting to adulthood overcame the “noise”.