I recovered from coronavirus disease (COVID), getting a clean bill of health and a life out of isolation. Only a few days later though and I was sleeping for longer and longer. It got increasingly difficult to get up from sleep. And then, to get up at all. It had never been this much of a struggle to go to work. I moved through a viscous world in slowed-down time and experienced myself detached from the world which tricked in, subdued, to my disinterested consciousness. At times, I found it impossible to attend to anything, or I should say: nothing arose or formed out of the dispersed nowhere-ness that had become me. Else, my feelings were deadened and any emotional labour or reaching out was incredibly exhausting for me. This brought about another crisis of doubt regarding the choice of psychiatry as my vocation.

I returned from work beaten down and just slept to occasionally teeter about to sleep again. I don't remember but I must have eaten during these times. I forgot to assess my appetite from among the SIG-E-CAPS (sleep; interest; guilt; energy; cognition; appetite; psychomotor; suicide): a rookie mistake from a rookie resident. That might have been an oversight, but it was trickier to assess a death wish, separating it from the more usual literary and aesthetic Silenian preferring of non-existence. Even so, it intensified, becoming pervasive and the idea of death seemed, at times, too appealing. So, good, I guess, that my impulses were deadened anyway. I found solace, and some pleasure, in the poetic descriptions of misery and gloom, often repeating them mindlessly, like incantations, to myself. (The psych resident has of late – but wherefore he knows not – lost all his mirth.) Telling me – ironically – that at least I didn't have anhedonia.

A mystery here in the concerted assault of all the guilts, regrets, fears, shame, inadequacy, remorse and nightmares, as if all these varied forms of misery are kept together, in readiness to be loosed all together at first chance on a vulnerable mind that has no choice but to give itself up to them. Gradually, they withdrew – in concert as they had arrived – and I got enough of myself back to become aware of the active, consuming emptiness that had lain underneath the entire experience. I don't fully know how to describe it but perhaps best to describe it as a vitiation, or a sapping away of all the active elements of my being, or their lapse into a most profound fatigue.

These symptoms recurred following the first dose of vaccine and brought on a temporary scare and a search into neuroinflammation and neuropsychiatric sequelae of COVID and so on. That faded away in a couple of days and the only trace now is an occasional probing of this experience in the belief (maybe quixotic, maybe self-serving) that it would yield some insight into the condition of those that I treat.