Choosing A New Path By Natalie Dale - The Bipolar Battle, Inc.

By Natalie Dale, MD

“I long ago abandoned the notion of a life without storms, or a world without dry and killing seasons. Life is too complicated, too constantly changing, to be anything but what it is.”– Kay Redfield Jamison, An Unquiet Mind: A Memoir of Moods and Madness

Unstable Resident

I was diagnosed with Bipolar II Disorder less than a week before the NBME Match Day. I was still hypomanic when I, along with every other graduating medical student in the country, opened the envelope that would determine my future. I’d matched into my first-choice residency – a neurology program at Oregon Health Sciences University. All of my hard work and perseverance finally paid off.

Fast-forward four months to the beginning of the intern year. My hypomania transitioned to a mixed episode and increased in magnitude. I spent a lot of time crying—or dancing—in deserted hallways, trying to hide the severity of my symptoms from my superiors. My test scores plummeted from the 93^rd percentile to the 3^rd. I started having trouble reading.

In medical school, I was always one of the top students, but in residency, I consistently made mistakes so severe that my senior residents capped my patient load and personally reviewed my work. Unsurprisingly, I only worked as a resident physician for nine weeks before my symptoms became so severe that I was hospitalized and required to take time off.

I returned to work as quickly as possible, but again, I lasted less than two months. I was plunged into a dangerous cycle of hypomania, depression, and mixed episodes that would relent with time off and medication changes, only to reappear shortly after restarting my rotations. After eighteen months of residency, I’d spent less than six months on the job.

When I decided to leave residency, it felt like the end of the world. I’d wanted to be a physician since I was a little girl, delivering baby alpacas on my family farm. I spent most of my adult life pursuing this goal, devoting nine years of schooling, countless sleepless nights, and hundreds of thousands of dollars to the cause. But when I’d finally earned that MD, it all came crashing down.

A New Interest

But during this struggle, I started doing something new. I started writing. It began as a way to journal about my complex storm of emotions, but then I started developing some new ideas. Plotlines and character arcs. And before I knew it, I’d written a novel. By the time I decided to quit residency, I’d written two novels and several short stories.

Writing became more than a pastime. It was a lifeline. I used writing to explore new characters and ideas, moral quandaries I’d struggled with, and my feelings of failure.

With virtually no experience in creative writing, I approached it with an open mind. I didn’t feel like I needed to know all the answers, so I started asking questions. I listened to podcasts, took online classes, and joined a writer’s critique group, then another, and started attending writing workshops and masterclasses. All the while, I kept writing.

Revelation On An Airplane

Sometime during this period, I flew out to Chicago for a friend’s wedding. I was stuck in the middle seat when the overly chatty man next to me asked what I did for a living. I didn’t know how to answer.

Before leaving residency, I always said I was a doctor. Even when I was on leave, I was proud of how hard I’d worked to get my degree, and I wasn’t quite ready to give up on that jolt of surprise people get when I tell them that I—a blond female in her early thirties—am a physician. But by the time I was flying out to Chicago, I’d left residency with the understanding that I could probably never go back. So, what could I say?

“I’m a writer.”

It was the first time I’d ever spoken those words aloud, but they felt true. And as I said it, I realized I needed to work to make those words a reality.

Forging a New Path

The decision to leave residency was the most difficult thing I’ve ever done. Like so many working professionals, I had sacrificed my health, my friendships, and my time with my family to achieve my ambitions. Yet when I was forced to step back and evaluate my priorities, I realized that a career in medicine did not fit with the person I wanted to become. I decided to quit residency and commit to writing full time.

Once I started calling myself a writer, I started acting like one. I treated it like a job, working on it from 9 to 5 every weekday. I took classes and started networking. The more I worked as a writer, the more I realized that I’d made the right choice. And while my disease certainly didn’t disappear with my career change, I became both happier and healthier.

Unexpected Benefits

As a physician, especially a resident, my hours were both demanding and written in stone. I never got enough sleep, and I was constantly stressed. It’s no wonder that I kept having episodes in that environment.

As a writer, I am not episode-free. My medication regimen constantly needs tweaking, and I struggle to go more than a couple of months without a ‘blip.’ But as a writer, I can handle those ‘blips.’ My job is simply so much more flexible. If I’m too depressed to write, I can edit. If I’m too hypomanic to be trusted with an important project, I can start something new. I’ve written some darn good short stories while hypomanic (including Akathisia, published by Breath & Shadow). And if my symptoms are too severe to do anything, I can take the day off. No one is going to die if I don’t show up.

Hindsight

I would not be where I am today if not for my Bipolar Disorder. I discovered my passion for writing while taking time off to recover. Much of my inspiration comes from the disorder as well—from the discomfort of akathisia to the complex social dynamics and stigma that accompany mental illness. But most importantly, Bipolar Disorder forced my hand.

By forcing me to detour from my expected trajectory, Bipolar Disorder made me re-evaluate my priorities. It gave me the courage to throw all my training and education out the window and try something new. To choose my health and well-being over my ambition. It was downright terrifying. I don’t think I would ever have been brave enough to do it without the impetus of my disease. And I don’t think that I am alone.

An Unexpected Opportunity

For so many of us, our diagnosis of Bipolar Disorder is like a flash of lightning out of a clear blue sky. It is an invisible disability that can impact every aspect of our lives. When it hits, we have hopes and dreams, ambitions, and plans that are suddenly, and sometimes irrevocably, altered. And while many can eventually return to their original trajectory, others are forced to forge a new path.

For those of us whose careers and life trajectories have been forever altered, it can feel like our world is falling apart. Our friends and family will comment on how much time and money we’ve wasted, our resumes will wither, and the identity we’ve spent so much of our lives cultivating will fade away. But the very disease that has taken so much from us has also provided us with a gift.

Last Thoughts

How many people get the chance to step back and re-evaluate what is really important to them? To take a close look at their priorities and re-align their life to fit? By forcing us to take a step back, Bipolar Disorder allows us to forge a new path, one that balances our health with our dreams.

Bipolar Disorder is a debilitating disease. But for me, it has also led to wonderful and positive changes that I would never have expected. I would not go so far as to say that I am glad to have bipolar, but without it, I know I would not be where I am today. I never would have gotten to this place if I hadn’t gone through a very dark, scary period when I had no idea who I was or what I wanted to become. It took my whole life falling apart before I could start building something new.

Natalie Dale graduated Alpha-Omega-Alpha from the Chicago Medical School in 2016 and began her residency in Neurology at Oregon Health Sciences University. After struggling with Bipolar II Disorder, she decided to leave medicine and focus on her long-time passion: writing. Since then, she has written three novels and several short stories exploring the deeply personal experience of physical and mental illness. She also freelances, writing research essays, fact-checking, and translating academic articles for the layperson. In her spare time, she organizes an elementary school reading program, runs a local writing critique group, and plays violin in a community orchestra. She married her college sweetheart, dotes on her dog and cat, and lives in Hillsboro, Oregon.