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(The points expressed here are completely mine, it is not meant to offend and cause grief to anyone. I am in NO WAY a professional about this topic, just writing this essay to show my thoughts on the matter)

Today, I stumbled upon some scenes from the movie “Me Before You” and dove deep into researching the movie without actually seeing it (yeah, what a fucking bummer). I realised the main plotline surrounds Dignitas, a Swiss non-profit organisation that assists “dignified” suicide (e.g. death, euthanasia, etc.) for people with terminal physical and mental illnesses. It didn’t initially come as a shock because I’ve heard about assisted suicides before, mainly from Adam Maier-Clayton, a Canadian activist for assisted suicides and such. Eventually, my interest and curiosity spiked and lead me to watch documentaries about Dignitas specifically. Oh my god, what a fucking emotional roller coaster it was. Still, now, I am absolutely in awe of how to feel about the situation.

One side of me believes that assisted suicide is the right that the patients have and it is valid as any other human right. We are living in a free world where most people are free to do whatever they please because it is not a government’s choice to interfere with the citizens’ personal lives, as long as they abide the laws that are made to protect us and others and keep society in check. Nobody with the sane, stable mind wants to die. Life, with its struggles and hardships, is exciting, wonderful and thrilling. People who go to Dignitas are happy, vibrant people that enjoy life, but they are there for a good reason. These people have spent countless effort, energy, time and money to ease the suffering that may never be eased, Treatments are unsuccessful, cures are non-existent and there is absolutely nothing left to do. It’s making them more upset day by day to live in so much pain, there is absolutely nothing to look forward to. These people barely survived, but they are stuck in this hopeless state and will be for the rest of their lives. For a life and a situation that nothing can be done about, the person has the choice to end it if it doesn’t make them happy anymore. Dignitas and assisted suicide

As much as I believe that everyone has a right to do whatever they want, unfortunately, I believe I have more reasons against Dignitas and assisted suicides in general. Assisted suicides show the image to other disabled people that their illnesses are that intolerable that they need to die, completely striking any hope and even promoting depressive, suicidal thoughts. It shows illnesses as curses, something that you can’t absolutely live with and it completely undermines people who have those illnesses that keep on living. Yes, the illnesses need to be shown in their true colour, the real struggles but the exposure should serve to show that these illnesses are not the end of your life, that there are people who are happy living with it. As ignorant as it sounds, life is about struggles and the legalisation of assisted suicides appeals the idea that but if it got “too hard”, you could easily kill yourself. It makes people weak because they have a choice of ending it easy, leaving life without any struggles. Obviously, there are precautions taken of the approval of the procedure, showing the proof of medical illnesses and treatments tried, ensuring the person isn’t just suicidal, etc. but it’s difficult to fully trust Dignitas because it is a non-profit, non-government organisation that has been riddled with controversy. A procedure as serious as assisted suicide should be government-controlled for the guarantee of safety, ensuring no malicious and corrupt intentions are present in the organisation. If it isn’t, organisations for the sake of profit, accept and endanger patients who actually don’t have terminal illnesses and are depressed and suicidal. 

For the solution of my long and hard thinking, I believe assisted suicides should be legalised but only done by a government organisation and the public healthcare, not by any private ones and the stigma and confusion should be cleared from the beginning, that:

Assisted suicide is only for people who have terminal physical and mental illnesses 

Reasons for assisted suicide would be heavily looked upon and considered, not anyone can easily sign and get it done

Check-ups would be done to ensure that the patient is terminally ill and the general mental health of patients would be examined to see that they are not just suicidal or depressed and would be given therapy and professional counselling to talk about their choice

Death and suicide is not an easy “way out”

no te lo tomes personal, yo suelo alejarme de todo(s) cuando me siento mal

I wish everyone would experience one day of suffering from bpd.

I wish they could experience my emptiness, how it feels to never belong anywhere, to be left behind, to be forgotten.

I wish they could feel my pain, feel the urge to self harm and to die.

It may be selfish but I hope it might offer you a new perspective on life, my perspective.

The perspective you call overdramatic, overreacting, too sensitive..

Yes, I confess, I want to see you crying your eyes out. I want to see the desperation in your eyes. I want to see the emptiness in your eyes that you’ve never seen in mine..

I want to stand there and tell you “it’s all going to be better”, or that you should “stop overreacting so much”, that “everything is fine” you just have to swallow your invalid feelings even if they want to kill you.

I know you’d feel even more alone, even less understood, emptier than ever before.

The power of Active Recall is no joke, you know.

I get bored very easily and my mind has a tendency to wander, so sitting down and reading notes or, even worse, re-reading notes is borderline impossible for me. This was, however, what had always worked for me prior to medical school hence it was what I went to when it came to revising for my exams at Cambridge.

This… did not go well. 

I went back to the beginnings of this blog and I can see that for a while, I was still trying to make old methods work. Reading and consolidating notes, trying to summarise conditions etc. I remember even back then just feeling overwhelmed by how much there was to do.

Then I tried Active Recall. I stopped reading notes, I stopped summarising and making notes, I stopped referring to different textbooks. I bought a subscription to Passmedicine and once I knew what topics were coming up in my next exam, I started working my way through the questions. 

When I finished them, I did the ones I got wrong the first time round.

Once I’d done that, I reset the question bank and did them all again.

I have passed every single exam I’ve done since I properly implemented this by a significant margin. I average around 65-75% (highest was 90, lowest was 58- f u cardiology- and most sit at just above or just below 70). Pass mark is 50, if you’re curious. 

Just as a trial, for my Neuro exam I made notes on top of doing all the Passmed questions. It did not improve my percentage at all and was a lot of extra work for nothing. I never made this mistake again.

In Part 2 of the series (https://www.youtube.com/watch?v=Z-zNHHpXoMM) , Ali also talks about Spaced Repetition and I guess the way I answer questions multiple times kind of automatically meant I was doing this. 

I figured out in my 4th year that if I kept doing med school the way I was doing it, I would burn out and maybe even drop out. And that was just unthinkable. So I needed to work out some sort of way to work around this. 

I did that by starting the questions early enough so that I had time to go through all the questions a few times. My Finals were in March this year, I started answering a few Passmed questions every couple of days as early as October. 

Trust me when I tell you that you have not seen anyone as relaxed as I was during Finals week. 

I was helping my friend in 3rd year revise for his impending OSCEs (which, to be fair, was pretty much revision for my own since the first and final years of Clinical placements tend to cover the same ‘general’ areas), I went to see Hamilton, I took an entire day off because I literally just couldn’t be arsed to revise and decided it’d be more productive to give myself a break than force myself to study and really the only additional revision I did was go through the case studies in and answer questions from Oxford Cases in Medicine and Surgery (BRILLIANT book btw) and look up ‘Key Guidelines’ for high-yield conditions like Stroke, MI and Pneumothorax etc. 

I passed. 

I’m not trying to show off here, please don’t think I’m patronising you. I’m someone who was literally at the bottom of the heap for so long simply because I was doing things that weren’t helping me in any way, shape or form. As soon as I figured out what actually works, it changed my academic performance and improved my own personal wellbeing by an unbelievable amount. 

It took me a long time to get to this point, and the point of my linking these videos in this post is that there is evidence to prove that the methods I’ve been using actually are better for you. 

Active Recall- as you’ll see if you watch the videos, the way Ali does this (coming up with his own questions and answers) and the way I do it (using Passmedicine) are different. Again, use whatever works for you.

and 

Spaced Repetition- just… do it. Start early. Doing ten minutes to half an hour of work a day for a few months will serve you much better than 17 hours straight every day for 2 weeks before Finals. SLACK YOUR WAY TO SUCCESS, GUYS. This also makes it much easier for you to take care of yourself and give yourself breaks when you need them. It’s so much better for your stress levels and general mental health. 

… look at my arms … 

odell beckham jr. met gala, 2019. 

From professionals 

A therapist refused to treat me because she didn’t want to deal with a “borderline patient”.

A therapist refused to put my BPD on paper because she was worried about how it might affect my future.

Upon being informed of my diagnosis a doctor in an inpatient hospital immediately placed me on extra precautions (consequently limiting my freedoms even more) despite me giving literally 0 reasons beyond “I have BPD”

From “friends”

A friend responded to me with uncalled for pity and said “I don’t envy you” because she was told that BPD is an impossible illness to handle or even survive.

A friend (who is studying psychology) suddenly went quiet and refused to continue the conversation when I revealed my DX to her. She later stated that she didn’t know what to say because she was taught all people with BPD are bad people. She was taught this in the same classes that most mental health professionals will take in some form before going into the field.

A friend (who works as a LSW) told me she hated borderline patients and followed that up with a ridiculous amount of ableist slurs.

From psychology teachers

“BPD is untreatable”

“Borderline patients are impossible/draining/awful/hopeless/etc.”

A lot of this is also said about other cluster B disorders which was not in any way a fun time for me when I was questioning NPD nor is it great knowing I likely having co-morbid HPD.

This is not to say there are no good professionals but it is to say that there are some very good reasons someone may prefer to self-dx and that’s ok. The mental health system is terrifying and fucked up in a lot of ways and if someone doesn’t want to navigate it to get their DX professionally backed up that’s their choice and it’s not up for debate.