Nietzche ‘He who has the why to live can bear almost any how’ multi morbidities: is there a better way?

Why such detail about my own personal health.  Traumatic brain injury TBI is an unknown.  It is about the Brain.  Today January 15th my fear of dementia advancing to Alzheimers is outlined and you will then no why each groundhog day I try to keep my brain active.  The report is by dated 12th January 2016 and it is still about the great ‘unknown’.  Search: ‘Understanding the Link Between TBI and Alzheimer’s Disease’.

“New Study from The University of Texas Medical Branch at Galveston fills an important gap in understanding the link between traumatic brain injury and neurodegenerative disorders such as Alzheimers disease…….”.

“I had a black dog (Churchill); his name was Depression….”

Today 25th January 2018: Now diagnosed with cancer (see Breast Cancer articles Chapter 1 to 4): I believe that the system of medicine and treatment must change in the way that disruption applies to other fields.  I recommend this TedTalk and all doctors especially in primary care together with Ministers like Simon Harris and An Taoiseach, a doctor, Leo Varadkar, because disruption and a policy of Irish style leap-frog could end the crisis in A&E and trolleys in such a productive way.  People need to be more involved in their health at a personal level and if you want to be convinced please listen to this TedTalk.  Therein is hope for people and especially the elder lemons who have sufficient time on their hands to engage with technology and come up with options that may even become solutions.

29th May 2018: I have today listened to a talk on 60 minutes show (CNN via Google) regarding ECT.  I can recall the light referred to after my 15th session of ECT in 1998 and since then any depression has been dealt with by medications;  I received ECT in 1998 because no medication worked for a year or more.


8th March 2015.  Why today?  JJ would have been 94 today if he was alive.  Five years old and JJ entered my life as a significant person, in a time of turmoil and uncertainty.  He was a mentor but he was family.

Traumatic brain injury (TBI) in 1993 (as detailed) for me resulted in elucidation of my youth and my life before the horse-riding accident.  I was 32 years old and living in Zimbabwe and my life changed beyond all comprehension.  Floundering gradually it was routine and structure within the day that led to a new creativity most obviously through the written word and the need to conquer the helplessness  and fear that renders you a different person defined by brain damage.  For me my expectations must be that I will once again contribute to society and it is my intention to re-enter the work environment again. Disabilities have carved out that hand of cards for me and it is within my core being that a work ethic is the driving force to productively create that sense of purpose that creates a motivation for survival.

Anxiety is so often passed off as secondary to depression.  For me anxiety, fears,  phobias, obsessions, unchecked are a precursor to the depression and to the bipolar that are wholly detrimental to mental, emotional and physical health.  Zimbabwe only had one elderly neurosurgeon in 1993 who told me (although I don’t recall) to keep a diary and write everything down.  I have lever arch files, I have drawers full of copy books, I have diaries and then I have gone virtual.  Added to this are books myriads of them read but immediately forgotten but it is the power of the physical book that allows you to highlight, to write notes, to identify with others, to receive as gifts, to browse in book shops and of course one cannot exclude the selections to be found in charity shops.  The PC for me is the location and the location is my desk full of books that have re-assured me and given me purpose throughout two decades now.   But the head is a vacant space clawing out for information, for conversation, for books, for newspapers anything that will allow me to interact at a social level.

The interpretation of others most likely will not be shared by me because for me the significance is determined as a consequence of a horse riding accident in Zimbabwe in 1993, a fractured skull, no memories of same or little thereafter and what it is like to live in a Groundhog day routine enforced by circumstances.  22 years yet each day I awake deep in a mire of darkness not motivated by anything that memory can inspire.  It is only now that the decades pass and I am gaining a confidence based on what was once was such a different trajectory.  For me, thanks to tenacity and allegiance of my partner KT I have made it possible to engage with life, with people, with technology, with social media.  KT has the most remarkable memory and can write with a level of sarcasm and a scope beyond my wildest aspirations hence the quote captures me.  23rd November, a winter day, I was beaten down by sickness and stood at a bus-stop on Mespil Road and this man spoke to me….the rest is history.  It was the 46A bus.

Routine when you look at the health history which is detailed and attached would come and go but in 2003 it was the onset of Chronic Fatigue or absolute mental burnout that completely debilitated me and it lasted years.  Systematically KT enabled me to rebuild a structure and routine. KT became my advocate, my mentor, my tutor, my organiser.   Most incredibly he had the memory that was robbed from me with TBI.  It is for this reason the quotation by Lewis Carroll “It’s a poor sort of memory that only works backwards”  becomes the jest I rely on when I want to say life is not just about memory that there is something refreshing with my limitations because what is new cannot be stale and can be about hope.  Encaptured in each day by a routine that says engage ie 1 to 5 which starts with the rigid rota enforced by KT of : eat breakfast, take medications, get clothes, wash teeth, brush hair.  Its the only mechanism that ensures me I don’t forget.  More recently I have added to this list washing the dishes but thereafter it is a process of feeding the brain data.  Books newspapers and magazines had to be underlined and stored.  Fear predominated.  You read you recall nothing.  You know there is nothing you can remember at will because like a computer in fragmentation mode what goes in falls away to oblivion.

However what I did learn and it took me over a decade and only with the direction of KT that I could develop a system that would tap into some underlying character traits and could expose a creativity that would explore the knowledge I had gained before the riding accident and relate to current affairs albeit only within the day.  Add this to KT and between us we have shared a decade writing on an open publishing/citizen journalism site and to politicians and socially motivated people about current affairs making my bottomless well of no memory consolidated in a written format which was created by Google and a technology that for me is essential because it is adaptive to my special needs and to others for their explorations.

But what about 1993 to 2003, the foregoing is part of a process that paves the way to how I live today.  It is here that I introduce the spine of this project because I feel that there is a duty based on the experiences I have had to contribute to Psychiatry, Psychology and Neuroscience, to ensure other people that you can survive, you can improve the quality of your life, your education, your relationships with people and make friends.  Life events don’t stop with a TBI, relationships falter, in my case there was most harrowing acrimonious divorce, a Church annulment, loss of pre-accident friends, family complications being an emigrant to England in the late 1980’s first and then to Zimbabwe I was catapulted home to my family in Ireland with all the complications for them to pick up the pieces.  The inability to sustain friendships especially with all those who supported you in the early days of the post accident.  However my training as a typist, a skill set, proved essential.  I had brought my computer to Zimbabwe so I have a whole history of documentation both in hard-copy and on file.  The computer is the adaptive technology that is my memory, my brain and now my source of creativity.

Health history is my framework because as I have so often written illness can render you so helpless that you are the sum total of your own ill-health.  Chronic fatigue or which I consider more aptly described as mental burn-out,, problems with immune system, and as this history details steals so much time from your life.  Organisation was not a problem pre TBI, in fact as a secretary, and working in investment banking for an American company in the City, I was lucky to retain core skills of filing which enables me to outline this health history with the addendum that documentation exists to back this up.

I am not quite sure how this will appear on WordPress.  I am learning and am limited to minimalism because short term memory is affected.  My broad plan is to create a form of index.  Coincidences all seem to lead to Trinity College Dublin.  A gift so precious that although I failed at the final fence to get my final exam for the Business Economic Social Studies degree, I had completed the course, the essays, the projects and endeavours to have a final assessment instead of exams were superseded by ill-health and confusion about what exactly was required ie two essays or five.  I made a submission on the date required but it remains in limbo.  It is my intention to publish some 12 years later what I submitted to Trinity College Dublin BESS department.  There is much interaction between different faculties related to BESS, the Disabilities Department in Trinity, the Counselling Services and most importantly from me in the files of Trinity and in my own files to substantiate how the confusion resulted in the submission I will include.  The health history up to 2003 was provided to all the relevant departments as part of the application for alternative assessment.

Trinity College Trinity Horizon Programme explanation grounding.  UCD women studies….  Trinity College BESS.  Re-construct.  Reading, writing, Vincent Browne.  Books as a source of understanding. Email.  Citizen Journalism Twitter

1992 to 2017 – Health history:
Michelle Clarke Dublin 4.

May 1992

  • Ireland (Psychiatrist) – first serious unipolar incident of depression – ECT necessary but alternative was that I remained at home and psychiatrist Jim Maguire visited me while I stayed at my mother’s home.  This lasted nearly 6 months.  I then moved to Zimbabwe to join my husband.


  • Neurosurgeon Zimbabwe (Hospital – fell off horse while jumping).  Skull Fracture. (X rays returned to Ear Nose Throat specialist Mater Hospital, Dublin)
  • Ear Nose and Throat Specialist Zimbabwe.  Deafness right ear established and loss of smell.


  • Ear Nose and Throat Specialist – Mater Private Hospital (Verific. Zim)
  • Specific hearing examination
  • General Physician (5 weeks Lourdes Hospital, Drogheda)
  • Neuro-Psychologist (Only person practicing.  Mainly court work)
  • National Rehabilitation Board, Clane – accepted
  • Speech Therapy re. (Aphasia, concentration)
  • Physiotherapy – To walk forward, I might walk backward, falling, ataxia
  • Irish neurosurgeon, Mr Staunton.  No interest or belief in neuro-psychologist who had been recommended by my psychiatrist.
  • Heart Physician (drugs impact)
  • My husband wanted me to return to Zim.  Likewise I wanted to go.  Neuro Psychologist,  preference was that I attend rehab Ireland as marriage unlikely to withstand…(refer Report).
  • Trinity College Dublin – Speech Therapist St. Giles Harare
  • Physiotherapy – Harare
  • Monitoring of drugs by GP.  I had to return to Ireland every few months for prescribed medications and to meet with psychiatrist.


  • Psychiatric admission Harare (Marriage had broken down).  Drug issue.  2nd time almost told I nearly died.  They were unaware of  ‘cocktail’ implications.  Psychotic in retrospect.  Anorexia re-activated and significant loss of weight.
  • My husband was unable to cope with my accident and the complications.  The outcome was he placed me in psychiatric hospital in Harare and left me there until my brother came to collect me – of which I have no recollection.


  • Psychologist – Dr. Sean Collins (Psychotherapy) – Penebaker process used,under his strict supervision. This was most severe breakdown. Sean hoped this would work, he was determined having seen me ‘try to cope’ that I didn’t need another depression
  • Psychiatrist Dr. Jim Maguire said (no to group counseling or sports activity on Trinity Horizon).  Jim believed that as my depressions are so severe, there is no point during the time I am well to invoke anything that would cause pain.  I hold Jim Maguire in very high regard.

1997 Accepted BESS Trinity College Dublin


  • Sick 9 months – 5 in Navan, Co Meath Psychiatric Hospital (no memories) apart from what was written in diaries. 15 rounds of ECT. Change medications to Lithium cocktail.  MAOI’s stopped.
  • Heart Physician Dr. McGarry at Navan Hospital
  • Psychologist, Navan Hospital.  I was over 5 months in night clothes only.  It was a public hospital.  There were six in the ward.  A woman in the bed opposite became very disturbed.  I sat with her and talked to her for hours explaining Why not?  How hard it is for the children? I tried to dissuade her.  Poor Eleanor wasn’t persuaded….she hugged me and I stupidly thought I changed her mind….but no.  Her children were professional, one an actuary.  She told me to pursue education – she gave me a poem specially written for the Student.
  • Before I left hospital I met with the psychologist there to prepare me for coming out.
  • Speech Therapy department Trinity College Dublin.  Probable that the academic standard and exposure to language prior to age 10 built up a sufficient stock of words, which I was able to draw on.  Probable as my parents read; father read all newspapers and had a keen interest in politics and my cousin Sir James Comyn a barrister, came home from London every weekend and there was intellectual conversation for a child that was not exposed to children.
  • Psychologist at Counselling services Trinity College Dublin.  I have attended Tenia since 1999 when I returned to College.  This was cognitive behavioral therapy. Tenia was exceptional in her commitment.
  • GP in Castleknock re. drug prescriptions/blood tests
  • GP Ballsbridge re. drug prescriptions/blood tests.  Lithium must be monitored.


  • Eye Specialist – Professor Lorraine Cassidy (Trinity). Report provided to Trinity.  Copy on file.
  • Suicidal Depression – possibly reactive.  Trinity notified.


  • More brain damage determined from the head injury in 1992 meaning all 5 senses are affected by damage; 6 hours of neuro-psychological assessment as the Disabilities department Trinity College Dublin claimed the other reports were of no importance.  Likewise when I presented with this in May 2003 Disabilities officer, Declan Treanor, paid scant attention to it,unlike the advice of the psychiatrist who suggested Martina McEnroe-O’Connor (neuro-psychologist) in 1993 when she was the only person with her qualifications and attended high court actions etc and of course Tenia Kallionitz, Cognitive Behaviour therapist who worked for Trinity College Dublin counselling Service.
  • I was man handled by four gardai at the Peace March at the Dail.  They would not listen to the screams in pain (mobility, muscles weak, stiff) due to the neurological/medical complications that retards my movement to very slow calculated pace and severe pain.  Unexpectantly Gardai charged at protesters. 4 Gardai grabbed me and moved me some distance before dropping me.  My head banged off the pavement. I was removed by ambulance to St James’ Hospital Accident and Emergency and later released.
  • Health deteriorated rapidly.  Unable to leave home and attend doctor.  This would have been the only time I did not attend Trinity this year.
  • It transpired I had developed a thyroid deficiency and was in need of eltroxin.  My metabolism had been affected.  This happens with Lithium and is further life medication.
  • The medical report from St. James remains there.  The system is so incomplete that you can get neither the hospital nor doctor to request same.  They mentioned I may have Parkinson’s also but of course that like other illnesses is always a possibility with mental illness.  Also encounter anorexia periods i.e. side effect of antidepressants.
  • Precipitating events or maybe it was just effects of TBI difficulties re-activated agoraphobia.  People tend not to be aware that each precipitating event with depression throws up the phobias to be dealt with again.  Agoraphobia created major problems in my teens.
  • Teeth: considerable work done by Edward Cotter dentist – Clyde Court, Dublin 4. Medications cause gum problems.

This was what was submitted based on request from Trinity College Dublin as follows: 

This is Michelle Clarke’s Health History
Submitted to: 

Dr. Margret Fine Davies – Centre for Women Studies
To Disabilities Department Trinity
To Psychology Department Trinity
To Tutor Brian Lucey
To Professor Holton
To Professor Laver  (The sole reason these people received this report related to the  conference they held regarding my application for accommodation of my needs re. the final section of my degree).

16th November 2003 submission date, I delivered to the BESS office what could have potentially provided me with a BESS Degree.  In the absence of acknowledgment, I intend to publish same on WordPress now and only now after a further 11 years of ill-health.  It may be an advantage to someone else.  I have been asked by a variety of people to write up on my experiences, people who often are seeking advice concerning mental health, traumatic brain injury, the power of education and the importance of third level education especially if you have mental health or neurological difficulties as a stepping stone to acceptance.

  • 23/11/03 – Met Kevin Walsh who took a pro-active approach – initial focus diet, exercise and confidence building.


  • Circa February I met with Dr. Moroney and two weeks later underwent an MRI scan.  Dr. Moroney gave a thorough examination.  Nothing organic was found.  The concern was the Parkinsons as suggested at St. James’ Hospital.
  • Still feeling unwell and visited General Practitioner.  He sent me for a lower back xray at Baggot Street.  His locum, Dr. Hurley explained the damage to the lower three vertebrae.  The cushioning/sponge was no longer there.  She listened to both what Kevin and I had to say and she felt it advisable to attend a Rheumatologist.  At this time, there was considerable body weakness and shortness of breath.
  • Next appointment was at the Mater Private.  I was very distressed at this stage and caged in.  Mrs. Fenlon’s daughter (Dentist who I attended when I was younger) was the radiologist.  The xray revealed a clouding around lower back.
  • Then I went to Cardiology.  This proved okay.
  • Still unwell.  Mum intervened via Kevin’s suggestion.  I went to Bons Secour for an onslaught of tests (in excess of a week).  Conor Burke’s letter said that basically all was okay – nothing organic was found.  The Bone Density recommendation of change of lifestyle.
  • The neurologist questioned the weakness and reiterated the point.
  • Mr. Moorehouse, Psychiatrist, stated clearly that the body weakness was in line with the use of my mental energy and in line with Dr. Cassidy’s report about my right eye.  
  • Dr. Griffin, Endocrinologist found a problem with my thyroid levels but this was something that would take time.  As per Jim Maguire, she stated the Lithium/thyroid balance and monitoring.
  • The appointment with Dr. Sant did not happen while in hospital.  I was to contact her for a private appointment (i.e. Rheumatologist).  
  • Mr. Corbett, Psychiatrist, came twice to visit me.  He had identified the issue of Anxiety and took an extensive mental health position.  He knew my psychiatrist, Jim Maguire.  I found hospital extremely distressing – my last visit was 5 months in psychiatric.
  • I provided Conor Burke with my personal outline of my health, together with the third assessment of Dr. Martina McEnroe O’Connor, Neuro-psychologist and two articles I had written given this is all I appear to be able to do.
  • Phobias extremely severe.  Afraid to contact people, use, phone, collect prescriptions etc.
  • With little numeracy, high fatigue, poor nutrition, and ‘drop dead exhaustions’, mobility problems, I had to leave Trinity College Dublin just before my final summer exams in summer 2003.  The Disabilities team and the psychology dept in Trinity were acting with me to try an establish alternative assessment.  Exhaustion became very severe.  Intend to contact Provost Mr. Hegarty again when I get strong.
  • Kevin T. Walsh met me (Nov. 2003).  Kevin’s knowledge, understanding and compassion has had an outstanding contribution.  It is a person centred approach.
  • Several weeks ago (Oct I had kidney infection yet again, pain and headaches so bad  I had to go to A&E in St Vincents. Phobic fear (related to Agoraphobia) resulted in me panicking and walking out of hospital.  They phoned with prescription details etc.  A lot of weakness lately and tiredness.


  • No improvement. Exhaustions governed mobility. Considerable physical weakness but mentally strong.


  • Kevin had to go away for a 6 months on business.  Mum persuaded me to attend Baggot Street Community Hospital.  Introduced to Social Worker, Susan Hartnet.  Complete mess.  They wanted me to attend day clinic.  They did not understand that I had only 3-4 hours a day due to the Chronic Fatigue and I was able to control same.  Dr Kingsley said he had never heard of neuro-psychiatric and substantially reduced my medications causing panic. This is a whole complete story, (Files exist).  The outcome was Kevin came back, sorted things out and I decided to attend Dr. John Cooney at Charlemont Clinic.  Formal complaint made to the Medical Council regarding Fitness to Practice and the conditions of Baggot Street Community Hospital and its medical team.


  • Participated on the Mental Health Advisory committee of the Work-Life Balance project (Dr. Margret Fine-Davis. Senior Research Fellow. Sponsored (Trinity College Dublin/Aware/Age Action/IBEC/ICTU/FAS)
  • Dr. Harte, Haddington Road – Urinary tract infection and feeling unwell. Exhaustion, mobility problems, infections constant.


  • 01/11/08: St. Vincents University Hospital (Accident and Emergency). Urinary tract infection.  Flank pain.  Prescription given
  • Eyes and improved glasses
  • Back passage bleed for several months.  Admitted to St. Michael’s Private hospital, Dun Laoghaire 3rd June 2008 under Joseph P. Duignan.  Problems with diet, lot of projectile vomiting around that time.  Had private appointment first with Mr. Duignan


  • Dr. Martin Callinan and his wife Geraldine recognised I was unwell and recommended I attend Dr. John Barragry, Consultant Endocrinologist.  Further appt set up for 21st January:  Ultrasound of abdomen, pelvis and chest xray.  Dexa scan @ MRI department.  ECG at cardiology department.  Health continued to deteriorate.  Shakes, freezing cold, psychosis, urinary tract infection. Admitted A&E Tallaght Hospital
  • Breast Check St. Vincents (OK)
  • 12/08/09: Dr Martin Callinan gave me the letter from Dr Barragry to Dr. John Cooney and Dr. Cahill.  Presumably team under consultant Mr. R Murphy, Dr Kevin Walsh issued their findings which concern the lithium poisoning.  Creatines too high.


  • Long history of Bipolar Affective Disorder on lithium therapy/traumatic brain injury 1993-frontal lobe damage/Chronic Fatigue Syndrome
  • Admitted to hospital: 16/01/09:  History of anorexia, nausea, dehydration and tremor and was confused and inarticulate and dehydrated.  Investigation confirmed Lithium toxicity.  Associated with mild increase in serum creatine and a leucocytosis.  CT and MRI showed no acute lesion. Thyroid was normal.  Vitamin B12 levels were low.  Temporary cessation of Lithium occurred.  Seen by Liaison psychiatrist.  Lithium re-started but with a lower dose and Olanzapine was added.
  • Broca › … › For the Media › Current News Releases
  • Psychosis Lithium Poison complicated this period


Tilda (Study re Ageing) out at Trinity College Dublin (Laura Dunne – 8962509)


  • Continual period for about 5 months bleed.  Maura Collins advised me to get it checked out.  Appointment to see Dr. Mona Joyce
  • Procedure 17/06/11.  No periods since.  She would not carry out hysterectomy in spite of the fact I asked.  Attended Mount Carmel with Kevin.


Tilda interview by Kathleen Clarke. 

For first time in years health improving apart from odd flu, a few aches but definitely beginning to push out the boundaries and do a few extra things daily.


Pain right side of chest, more an ache
Problem with swallow and choking.  Possibly related to TBI


  • Endoscopy  slight inflammation and sent for barium function September 2014; still awaiting results.
  • Attend Dr Cooney, Psychiatrist, Northumberland Road Clinic, Dublin 6 every three months, since 2006, following an appalling experience of public health mental health at The Royal City of Dublin Bank of Ireland.  Only for competent staff at Boots Pharmacy, life with problems is so complicated.  Medications now generic so no longer recognise names except Lithium Benzos and others.


    Dr Barragry:  Lithium poisoning in 2010.  My kidney working at about 75% function. Cholesterol high at 7.5.  Need to consider Statins or improve diet and exercise.  Also may have to reduce Lithium medications. This makes me so fearful I don’t think I can make it through yet again another depression.

    Dr Garrett Cullen, SVUH.  Medications and follow up appointment re choking and oesphagus.  It is Dismotility.  2nd Appt: Young consultant reviewed Endoscopy and gave me antibiotics.  She identified in Endoscopy report (not identified before)

Updated 12th February 2015 by Michelle Clarke

Dentistry ‘Orange is the new Black’

2015 Oral health year for me.  Medical conditions can be so time consuming and teeth as they identify in the US ‘Orange is the new Black’ are always a challenge when you look at taking psychiatric drugs, or especially people engaged in illegal drug addictions or even taking too many antibiotics.  Personally I was embarrassed to speak and definitely to laugh or smile and tended to cover my mouth.  Smiles and Dr Dan have been excellent: Cleanings, teeth removal, braces an operation to place a piece of gum from one area to the next. He confirmed that it is the Dental Services that fails to provide for our most vulnerable people and elderly due to lack of State funds.  Smiles Waterloo Road.

    • Dr Dan Gruenfeld

      Dr Dan Gruenfeld graduated from the University of Tuebingen in Germany in 2006. Dan spent two and a half years in the south of Germany in a general practice. In 2009 Dan moved to Ireland and started working with the Smiles Dental Team in 2010. Dan is committed to continuing his professional development and has a particular interest in aesthetic dentistry, the replacement of missing teeth with dental implants and various surgical procedures. Dan is also member of the “German Society for Dental Implantology” (DGZI) and the “Irish Association of Aesthetic Dentistry”.

Article Irish Times 11th February 2016 letters page:  Summary:

Gerry Kaar, BDS, Clonmel Co. Tipperary.  Resources and Dental Health.  He writes about a diminishing supply of patients in relation to dental health.  He goes on to say that dental health affects patients in many ways.  The link between gum disease and heart problems and diabetes are just two of the most serious.  (The Tilda Research programme in Trinity College are research people and their teeth as part of the Study.  They recommended that make my teeth a priority.  He highlights patients who seek dental certificates for fitness for medical operations.  The abolition of the PRSI scheme in dentistry and the virtual annihilation of the dental medical card scheme, this is a health dimension train rolling down the tracks fast particularly in an ageing economy.  He also stressed the importance of dental hygiene for children.

May 2017

BreastCheck – Merrion Row letter to have a mammogram.  The outcome was cancer, surgery by Mr Gerraghty, next phase is Oncology with Professor John Crown and Radiology with Professor Armstrong.  I will conclude this section and in future I will write under the heading of BreastCheck – Oncology and Radiology on


To conclude I will relate to quotations to sum up the appreciation I have for KT who I met at the bus stop on Morehampton Road, Dublin 4, in November 2003. Advocacy, support, compassion, realities, can never be underestimated these are the powerful resource that enables a person who has sustained life changing events and significant health disabilities in rapid succession to continue to move forward and gain strength even though the tortoise is moving faster and smarter than you. To my Jack Russell, for him it made me push out the boundaries.

C.S. Lewis

‘There is truth to what the book of Ecclesiastics says,
“better two than one by himself [or herself]” (Eccl 4:9)

and to what Charles Williams, C.S. Lewis’ friend, warns us:

“No mind is so good that it does not need another mind to counter and equal it, and to save it from conceit and bigotry and folly”

Above is my health history:  I include here some background information about being a student with disabilities in Trinity College Dublin.

Medical Ethics:

Tedx talks: A most impressive Physician who I will listen to over and over again.


Outline of paradox.  Impact of Traumatic Brain Injury to Bipolar/Anxiety/medications and finally Chronic Fatigue … what happened?  I did not get my Degree in BESS.  I fell at the last fence again.

Another posting details how ill-health through deterioration possibly based on exhaustion resulted in me not gaining my degree.  Negotiations wavered.  It was intended that there would be alternative assessment instead of final examinations in BESS.  I was asked to attend my neuro-psychologist and produce a report to the Disabilities Department in Trinity College Dublin.  By chance I located this.

2nd Meeting with Neuro-Psychologist
Dr. Martina McEnroe O’Connor
Tuesday 20th February 2002

Just my on personal comments about ‘me’

To read/write I use intense concentration on the function and provided I can identify with the material, I will recall it at another time, on receipt of some prompt. I cannot recall chunks of information.

Inability to work for extended periods of time i.e. several hours with breaks no longer possible. One hour lecture – I can feel exhausted after it.

Annotate for an essay: No use – I can’t recall. I need to highlight and configure the essay on the screen.

Particularly when tired: I hear and write the word but am aware that as I write, it is the wrong word that I am writing. To correct this initially at College I used to hold a tippex pen in one hand and wiped out the word and replaced it. Now that I have less stamina I tend to skip words and not notice as much that I am writing the wrong word. Does this relate to the Aphasia that you recommended I attend the speech therapist to deal with. I had a whole set of words that I used to replace what the word should have been and the exact word exchange error tended to occur each time…When I become very tired this recurs.

Amnesic blocks / severe depressions: Loss of foundations. Process of building back by asking people obvious questions each time I begin to recover. I write down interesting points from the radio and TV and add to a Snippets file that can be referred to. One point I have just managed to grasp is that it was this time last year that I register moving to the flat and a period of high’s/lows. I recall Palestine and the Peace March because I became obsessively involved with the issue – I cannot recall the data but I can recall the performance of sending emails to almost 600 per night. It is muddled and if tired I become confused as to which year all the trauma happened.

Timeless is a huge issue. I cannot register season, month, time of day, – it is improved as several years ago I could get up and go to the bus stop in the middle of the night now I get up and work for a while.

‘Stop going abroad without a passport’ – my words to try and halt me from seeking the obscure in the essay title rather than deal with the issue. Mentally I cannot relate to writing essays previously in Trinity or doing exams. If I think I am at Social Theory, it is really difficult to think of my next lecture say Themes of Social Enquiry. This process feels like I am placing too much in and the outcome is confusion. If I get muddled with the timetable, I will constantly make the same mistake each time and miss the lecture. Say a 2 O’Clock lecture. I will look at timetable and see it as three and am quite likely to do the same the next week. I have introduced colours and other methods but realistically it relates to the level of exhaustion. I read extensively to find solutions and possible remedies.

Ideas are constantly emanating from my head…..I can see forward in perspective (not regarding me but ideas) but I cannot remember in a structured way. I look forward to a lecture that will stimulate thinking and ideas and the formulation of concepts. (This is by way of being a loner possibly).

I interact with politicians who never respond putting forward the concepts/ideas related to the lectures I have attended. Also re. Mental Health matters, and areas I have direct experience of, I write about. I email Dr. Margret Fine-Davis and Dr. Mary McCarthy who carried out research related to women and depression and re-entry to work/study. This was the Trinity Horizon Programme 1996/97 and I have copied them with all my correspondence in case there is a follow on in research. They are presently researching flexibility in the workplace (people with mental illness are one of the groups reviewed).

Carl Jung said that the patient should be included in the diagnosis, including their explanation of their hallucinations and dreams. I wholly concur with this. I believe that the education system and medical system ought to be expanded to take account of the person who experiences the disability/illness. At the IPRT (Irish Penal Reform Trust) on mental health – I spoke from the audience in reply to Dr. Mary Robinson and her speech. I mentioned that the last time I met her was in Zimbabwe and that I was speaking as a person with both intellectual and mental disability. I stressed the importance of a structured routine, the need for programmes similar to the Trinity Horizon programme and the facilities provided by Trinity and other universities for people with mental and intellectual disabilities.

I conclude with the above reference by Carl Jung. This is a ‘Take Responsibility’ approach. I think I also mentioned that psychiatric patients can relate well with those with physical disability, from my experience. It was Cathy – who hopefully will qualify as a social worker this year who identified what was really affecting me. She noticed that I constantly referred to the way I was and was highly critical of the ‘new’ situation. She recognized this because she was born with her disability, she did not have a comparison factor, she worked on the basis of accomplishments. I was a perfectionist as a secretary, housekeeper, etc. etc. traits consistent with depressives. They tend to find work with an ‘immediate gratification outcome’. Again, this ties into low self esteem. Professor McKeon makes reference to their dedication as workers when he gives his annual lecture at St. Patrick’s Hospital. Two psychiatrists from Rampton hospital then spoke and they too were applying a structured approach and availing of a multi-disciplinary approach. Their study relates to those categorized as pathological.

I cannot multi-task any longer. I cannot prepare a meal or coffee …. Confusion re. timing, whether I ought to be talking —– muddled. This is really complicated by anxiety. The anxiety no longer requires 10 x 10 mgs of Librium but I do take three. Jim (Psychiatrist) is anxious for me to start cutting back.

I can only operate around ‘Truth’. Fabrication confuses me and causes me to back away from the people. My experience with the people with physical disabilities is that they too ‘speak the truth’. This may be due to comparison with pre-accident, when I too would not necessarily tell the truth. This relates to the fact that at that time if I was telling a lie, I could remember that I had and not get caught out and life sometimes necessitated particularly in work situations. This was more an Irish experience that when working in London.

If I get too tired – direct affect on balance. I return home as a ‘drunk’. The dark and tiredness have a negative effect. Alternatives get mixed also (have to really think whether to use word negative or positive).

If stamina is low – another issue is the speed people walk at and the fear that if I am in their way, I will get pushed over. I have developed a way of avoiding crowds, queues etc. – in the fear scenario – avoidance techniques. Walking up stairs is very difficult – there is acute tension in my body. Phobias also apply. It has taken years for me to use the phone and as I become depressed, it and not wanting to eat/drink (drugs impact) are the precursors to withdrawal.

Aim to establish: (Trinity – 3rd year BESS – Sociology and Politics)

Balance Sheet transaction required.
In exchange for my deficits that preclude scientific research SPSS and numerical ability, that I provide ‘The Profane Life Experience that relates to Bipolar mental illness, Acute Anxiety and neurological damage sustained from the head injury I sustained in a riding accident in 1993. To this now must be added the damage (only recently recognized by Professor Lorraine Cassidy – report with Declan Treanor) to my right eye damage/blindness and neural damage. I have submitted 10 page account already as an indication of my life experience since that date.

Can Trinity accommodate my Special Needs?

Trinity have introduced two subjects Third Year:
Mental Health (Sociological perspective) and Disability. I am willing to be directed in any way they consider that I can contribute to an improvement in this area of health and disability. There are already three research reports that can be made available to them within Trinity.


These are of no benefit to me. In the past, I will have scraped a pass or a little more. If I have to sit exams this year (3rd) it is probable I will be at a disadvantage based on the foregoing. I am aware that structured work is an unlikely prospect for me making the education I have received inconsistent with the normal employment expectations. However, initiative and innovation always exist.

I worked for 15 years, I worked three jobs at one time (my former husband and I set up a construction company in the 1980s and I dealt with funding, admin – it ended up in liquidation and emigration) but at the same time I was in full time work for a Chief Executive of an oil company and responsible for currency transactions, treasury management, secretarial duties and entertainment. In London, I worked in Corporate Finance with Pru-Bache and studied law at night. I have already started what will be my life’s aim i.e. writing and writing with lassitude. I have my folder of Essay’s that were high grades (one at 75). I use these if an issue becomes apparent and I want to write about it.

My cousin, Mary East, a Professor of Education at the University of Toronto, suggested based on what she had received from me that I undertake an Autobiographical Thesis. There is a more holistic approach to education in Canada and she encourages me to suggest this to those concerned in Trinity. Mary has published several books.

Professor McKeon refers to depression – ‘You know not the day or hour that it descends’.

I can vouch for this.

All I know is that there are ‘dips’ and they are hell and the easiest way is ‘out’. I have just come out of one of these acute dips and hope that maybe just maybe there will be a longer period of being ‘on level’. My body is extremely tired. I can never envisage going on a holiday again or anything really. Life is the day and I was not this kind of person. I have adapted but challenge an educational and health system to a broader scope. The age of managerialism needs to be willing to adapt to life-long learning and an acceptance of change to mean opportunity for oneself and others.

As daughter of two doctors, exposed to lawyers, I am determined that if life says I am ‘to be the patient, the service user, ‘whatever label’, I will remove the veil of secrecy that complies with a system of inequality and does not empower the person as distinct from diminish them. I can only believe that I have been dealt a hand that says ‘Change attitude to mental illness, and suicide’. My Psychiatrist and Psychologist(s), the Trinity Horizon, Trinity re-constructed me.

Michelle Clarke.
19th February 2002.


Martina O’Connor – Neuro Psychologist
Jim Maguire – Psychiatrist
Prof. Holton – Sociology Department, Trinity College Dublin
Tenia – Psychologist, Trinity College Dublin
Ray Fuller – Tutor (formerly Brian Lucey), Trinity College Dublin
Dr. Margret Fine Davies – Trinity Horizon Programme, Trinity College Dublin, Centre for Women Studies)
Declan Treanor, Trinity College Dublin, Disabilities department

2017 I was called for Breast Check.  I was diagnosed with breast cancer and treatment ensued.  I wrote a book just in case some of my life experiences with head injury; manic depression; social and other anxiety disorders could be of benefit to others.

So far it is June 2021 and I am a survivor

Published on Amazon

Fortune Favours the Brave by Michelle Marcella Clarke

About michelleclarke2015

Life event that changes all: Horse riding accident in Zimbabwe in 1993, a fractured skull et al including bipolar anxiety, chronic fatigue …. co-morbidities (Nietzche 'He who has the reason why can deal with any how' details my health history from 1993 to date). 17th 2017 August operation for breast cancer (no indications just an appointment came from BreastCheck through the Post). Trinity College Dublin Business Economics and Social Studies (but no degree) 1997-2003; UCD 1997/1998 night classes) essays, projects, writings. Trinity Horizon Programme 1997/98 (Centre for Women Studies Trinity College Dublin/St. Patrick's Foundation (Professor McKeon) EU Horizon funded: research study of 15 women (I was one of this group and it became the cornerstone of my journey to now 2017) over 9 mth period diagnosed with depression and their reintegration into society, with special emphasis on work, arts, further education; Notes from time at Trinity Horizon Project 1997/98; Articles written for 2003/2004; St Patricks Foundation monthly lecture notes for a specific period in time; Selection of Poetry including poems written by people I know; Quotations 1998-2017; other writings mainly with theme of social justice under the heading Citizen Journalism Ireland. Letters written to friends about life in Zimbabwe; Family history including Michael Comyn KC, my grandfather, my grandmother's family, the O'Donnellan ffrench Blake-Forsters; Moral wrong: An acrimonious divorce but the real injustice was the Catholic Church granting an annulment – you can read it and make your own judgment, I have mine. Topics I have written about include annual Brain Awareness week, Mashonaland Irish Associataion in Zimbabwe, Suicide (a life sentence to those left behind); Nostalgia: Tara Hill, Co. Meath.
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7 Responses to Nietzche ‘He who has the why to live can bear almost any how’ multi morbidities: is there a better way?

  1. Pingback: Nietzche ‘He who has the why to live can bear almost any how’ | canisgallicus

  2. Pingback: Nietzche ‘He who has the why to live can bear almost any how’ co Morbidities: is there a better way? | canisgallicus

  3. Pingback: Nietzche ‘He who has the why to live can bear almost any how’ Traumatic brain injury 1993. Medical history in detail and to date by Michelle Clarke | canisgallicus

  4. Pingback: Breast Cancer:- Chapter 5 (Highlights of San Antonio, Texas Breast Cancer Symposium 2017 – “SABCS” written by three NICB cancer researchers included) Chemotherapy over; Herceptin going forward and Radiation February 2018 | canisgallicus

  5. Pingback: Breast Cancer in Retreat: Routine of Chemotherapy and Radiation is over; now it is Herceptin every three weeks. Chapter 7 | canisgallicus

  6. oldpoet56 says:

    Darn girl, you have been through so much. You have proven to be one of the strongest people ever on this planet because you have survived. As our race winds down it is so very important to not give up our faith now. Never ever let the darkness win.


    • michelleclarke2015 says:

      Hello. Just realised that I can reply to you. Thank you for your kind words. Darkness must not win. All the best from rainy old Ireland Michelle


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