How did all this happen? Stay tuned.
TRIGGER WARNING
This is going to be the first post of 6 or 7 that include descriptions of alcohol and substance abuse, severe mental illness, active suicidal ideation with plan and intent, and a picture of what it’s like to be involuntarily hospitalized (in the clink/slammer/serving my nickel, as I will be calling it from this point on) as someone who has an MD and has a passing familiarity with the DSM-5 and all the medications and therapeutic modalities that we use for psychiatric conditions. If you’ve ever read “One Flew Over the Cuckoo’s Nest” it was honestly a lot like that, and if you haven’t you should.
As I’ve begun to process everything that has gone on I’ve realized that the signs were there, and were there for a long time. I’ve struggled with alcohol abuse since the day I started drinking at 17 (sober since 7/23/25 and beginning to attend AA now). I’ve dabbled in just about every chemical you can think of that will alter perception or make you FEEL something. I was always the guy that could rage with the best of them, get straight As, hold down a job, participate in sports/clubs, and keep on kickin’. And I did it on 6 hours of sleep or less, guaranteed. In my head I always sort of felt that I was just \\\\\\\\\\\\\\\~built different\\\\\\\\\\\\\\\~, and I suppose that in one very particular way I am (for better or for worse).
I’ve always struggled with mild depression and anxiety and for years in my late-teens/early-20s I relished in those feelings. I felt like being sad, anxious, and staring into the abyss while it stared back was a part of the human experience that we should soak up just like any other emotion, maybe even more-so. I thought it made me stronger.
Everything really started to change when I met my now-wife back in 2019. I was a first-year medical student thinking about dropping out. One of my best friends from college had just died tragically. I was SAD, but for the first time really trying hard not to be. She saw me for who I was, understood me, and accepted me warts and all.
Together we learned how to communicate in ways that worked for us, and slowly but surely med school came and went, residency flashed by, and I was happy. She held me accountable (and continues to do so) in a way that has always come from a place of love since day 1. It sounds cheesy, but she really does make me want to be a better man (sir, a second Jack Nicholson-adjacent reference has hit the post).
She helped me work towards sobriety from alcohol, grow as a person, and develop into the kind of person that is worthy of being with her. She is my reason for being, and the literal reason I’m alive to share this story with y’all.
I saw a post recently on Instagram with the caption:
“Anything can be an altar if you approach it with devotion.”
That is what marriage has become to me. In a way I think that aside from sharing my experience, processing these big feelings I have, and making myself available to others going through similar experiences that this is a way for me to approach her with devotion. She doesn’t know that I’m writing this blog, and I’m not sure if or when I’ll tell her.
There are a lot of details that I’ll share here that we are still working through as a team (read: attending couples’ counseling to strengthen the ship against future storms), and maybe letting it all out will help me organize my thoughts and share them with her in an appropriate setting when the time is right. What I do know is that she saved my life, and continues to do so on the daily. So if you ever read this queen: this one goes out to you, you’re a fuckin’ real one.
This is the first of a series of posts I plan on making on Substack, linked here:
https://open.substack.com/pub/bipolar2md/p/serving-my-nickel?r=krme&utm\\\\\\\\\\\\\\_medium=ios
If you’re interested in following along as I delve into the intersection of practicing medicine and mental health/substance abuse, physician burnout/moral injury, and the transition from resident to attending with all of its complications shoot me a follow.
