I’ve always been a bit confused about pride. My parents were atheists, but my allegedly Anglican grandma (although I never knew her to go to church beyond the hatch, match and dispatch variety of service) would tell me that pride was a sin. This view was sometimes echoed in school assemblies, leaving me baffled when those very same teachers, frustrated by untidy handwriting and ink blots, would tell me that I needed to take more pride in my work.
When I signed up as a student midwife in 2000, our lecturers were very clear that we should feel proud, that in electing to become midwives we were embracing a special role as autonomous practitioners. “When you walk down the corridor in that uniform, you can hold your head high,” a lecturer told us on our first day, “because. You. Are. A. Mid. WIFE!” We got the message: we were supposed to see ourselves as a cut above mere nurses.
I couldn’t wait to get started. I was already a qualified antenatal teacher running classes for the National Childbirth Trust, but I yearned to be in the delivery room, to be what our lecturers called “hands on”. My clinical mentors taught me to practice skillfully, to combine the science of the university with the art of the delivery room, to help women give birth where possible without the need of doctors, without the need for intervention. I took as much pride in carefully catching a baby or skilfully delivering a placenta as I did in my academic work. “Midwifery is the best job in the world!” my delivery suite mentor would say, before praising my intuition, my dexterity, my commitment to our clients. I knew she was right on all counts.
I quickly began to feel that midwifery was my absolute vocation, that if you sliced me down the middle you would see not a collection of viscera but “Mid. WIFE!” I started to feel that I was born to be a midwife, that I excelled at it and was already one step ahead of the rest of my cohort. The work was stressful, naturally. I was juggling classes and essays with clinical shifts and a young family. I was working people in extreme pain, where bad outcomes were possible, sometimes rushing into theatre, my heart in my mouth. I was sleeping very little, yet I felt more than able to live with the stress, to use it as a springboard for success. I was flying high, already envisioning a bright future in the profession, and so very proud of my progress.
Pride, my grandma also liked to remind me, comes before a fall.
I have seen mental heath crisis described as the point where you are no longer able to take care of yourself, where you fear that without immediate support your mind is in danger of snapping. For me, there is an additional element to a crisis, that of being stripped of all pride. Because it’s the point where I can no longer pretend, no longer put up a front or wear a mask of normality. It’s the point at which I no longer have a choice about who gets to see my suffering, and where. It’s all out there, in public, whether I like it or not.
Pride (or what I would now recognise as grandiosity, a tell-tale sign of hypomania, just like sensation of flying high, like the sleeplessness) came before an overdose. It came before being wheeled by paramedics through the front door of the very hospital I worked in. Pride came before realising that the chair of the local NCT was working on reception, before hearing the horror in her voice as she left her post and ran towards my trolley. Ensconced in A&E, numerous concerned relatives stood over me as I crawled around the cubicle floor in a hospital gown, leaning over an emesis basin and shoving my own fingers down my throat in response to the unbearable nausea. I no longer felt human, because I didn’t have any of the things that made up my persona – the ability communicate, the ability to relate to other people, the ability to care who saw my knickers.
In the 11 years since the overdose, yet my life has continued to be dominated by the peculiar tension between bipolar disorder and pride. I have continued to swing from the pathological pride of grandiosity to the pain of feeling stripped bare, the pain of having to allow unfriendly colleagues, bemused in-laws or unsympathetic duty doctors see just how desperate I am.
In my eight years of remission, I build what felt like a solid career with the National Probation Service. I did well, moving up through the ranks, doubling income in a few years. Was I wrong to be proud of my achievements? Of course not. Did I know how to separate pride in my work from bipolar pride, know how to notice the subtle slide into grandiosity? Unfortunately, no. The fall came when I could not stop crying openly at work and had to take leave. The fall continued when I lost my managerial contract, was forced to take step backwards to practitioner grade. I was once a skilled report writer, pulling together complex information from a variety of sources; after the fall, I couldn’t read a single page letter from the DWP. I found it humiliating to lost my work identity and it took me a long time to process my shift from professional person to “client material”.
As I consolidate my recovery, I am beginning to return to the world of work. If I have learned one thing from this most recent episode, though, it’s that this time I need to be pragmatic. I could easily take on more and more work; I like it when people to ask me to undertake jobs/tasks, and I hate to say no. And for a time, I would be fine doing that. Experience has taught me, however, that I cannot sustain it long term. The prideful part of me wants to prove how I can achieve in my new field, how high I can fly and how quickly I can get there but the newer, more pragmatic me, means relinquishing the buzz I get from pride.
I hope, though, that it also means reducing the pain of my next fall.