Tuesday, December 7, 2010

"it was a really good learning experience" is code for "my life sucked"

We medical students cannot just say that things are bad. So we've found new code words for expressing our distaste in things. WE'll talk about the hellishness of a rotation and instead of just being able to end it with that, we always have to add "well, I mean it was a good learning experience. I learned a lot." If one more person says that to me I'm going to kick their ass. Because I know! I know that means they hated every second of it, but for some reason we have to put a happy face on everything and pretend we love stuff that we dont! WHY?! It makes no sense! Is it just that we don't want to show any kind of weakness? Or that we are worried by saying we didnt like something we are going to get a bad evaluation, someone is going to think we are uninterested? Are we just trying to be more PC? I do not know. All I know is that I do it too. No one finishes a crappy rotation or class story without saying "well at least it was a good learning experience."
What does that even mean? I learned the self control not to kill myself or others? That's what it means to me. I learned how hellish life can continue to be. I learned that I hate certain parts of medicine. I learned that everyone is more interested in medicine than I am. GAH!
Why can't I just say "hey, this place sucked, and the experience sucked, and I hated it all, and I don't care if there was a good learning experience portion of it, I'm just going to talk about how much it sucked?" I mean, I know people should look on the bright side of things, glass half full and whatnot. But sometimes it just gets ridiculous.
I really have nothing more to say on this, except that I feel like a bad person if I don't end everything with "at least it was a good learning experience." But when you hear someone say that, run the other way from whatever they were doing. It's like when a guy asks someone if a girl is pretty and they say she "has a great personality." Code blue code blue! Run the other way.

Saturday, November 20, 2010

Boards Post Traumatic Stress Disorder. It is real

Many people probably think I'm just making excuses for the way I feel about test taking these days, and no one wants to hear me talk about failing the boards one more time. But the fact of the matter is, it has permanently and horribly affected my life. I can't just get over it, like people seem to think I can. And in talking to other students who have also failed the boards, it seems to be a pretty common theme.
We have been through a traumatic event. We may not have been in 'Nam, or in Iraq. We may not have been brutality beaten or held hostage (at least, not literally). We may not have been in a natural disaster and almost lost our lives. We may not have been in a plane crash or been witness to a murder. But in our own way, we have suffered a trauma that isn't likely to leave our minds any time soon.
The boards are built up to be the end all be all of tests. Nothing in life matters quite as much as your board scores. They determine your entire future, your ability to get a good residency, fellowship, attending position. You will forever be judged on your board scores. And maybe none of htat is really true, but by the beginning of second year that is for sure what you think. You spend all of your time studying, worrying, stressing, crying, and then studying some more. the atmosphere during boards prep time is the worst time you'll ever have in your life (at least, I have to hope that is the worst experience I will ever have). And then the dreaded day comes when your scores come in, and you find out you failed.
The world really does feel like it is ending. You see all your hopes and dreams for the future fade off into the distance. All of a sudden all you can see is this failure, it defines you, it has ruined you, it means everything to you. And no one who hasn't failed the boards can truly understand what that means. They think they can, and they can be supportive of you, but when you've failed teh boards, you have lost a piece of your life. It is a dark, dark day. It shouldn't matter as much as it does, but sadly it does.
A friend of mine who also failed the boards said she went through the five stages of grief, and it is totally true. It is just like any other tragic moemnt in a person's life, except that it shouldn't matter so much. So when I tell people that I have PTSD from it, they laugh and tell me to cut it out. But they don't understand that I do wake up in the middle of the night freaking out about having failed. I do dwell on it and what it means for my future. I dread being denied residencies beause of this failure. I feel like it completely defines me. And the worst part is, it has taken all of my limited test taking confidence and killed it.
So now, when it is test time, I fall into a horrible depression. I can't get out of bed. I snap at everyone. I worry about failing. I can't focus long enough to study. I dont want to study. I'd rather stare off into space than get out my book. I start to cry, my stomach ties up in knots, and all I can think about is how I failed the boards and will never again be able to take a test. I try to tell myself that I will pass the rest of these tests, that if I study hard enough I'll be fine, that this time around I'll be prepared for whatever test is coming, but the week before the test the same thing happens: I realize I haven't spent enough time studying. I start to stress about how I shold be studying more. I try to study but become distracted by anything and everything. I feel a deep sense of dispair, and worst off, I don't care about anything. I'm so busy being stressed and anxious and depressed about the test that I have no energy left to study. So I stay in bed all day. I watch television. I stare at the ceiling. I take naps. I write blogs. I do not study. I do nto do anything productive. Because I tell myself I don't have time to go to the gym because I have to study, or I don't have time to clean or cook because I have to study, but then when I go to study, I just can't do it. And for some reason I never say I can't lie in bed all day because I have to study.
Then test time comes around and it is basically a self fulfilling prophecy. I don't do well on the tests, because I can't get myself to study. I have lucked out thus far and not failed another test, but maybe it is just a matter of time. Will I ever be able to get over this? Is it something that can even be fixed? I have to hope that eventually I will get over this and be able to study again, because the test taking is not anywhere near over. That all being said, I should probably go back to studying for my test next week...

Tuesday, November 16, 2010

Another example of how I am not a good medical student

I haven't blogged in awhile because I've been so busy with third year, which for all of you struggling first and second years out there, third year is awesome. I'm finally starting to feel a purpose towards this crazy life I chose, and am reminded of why I wanted to do this in the first place. Third year has given me hope that I did not make a mistake and that I do, in fact, want to be a doctor, and that I am, in fact, fully capable of being a good physician. Not to toot my own horn or anything but I am an excellent communicator, patients and other staff love me, and I'm a hard worker, so eventually I am going to be a good doctor, as soon as I figure out all this medical stuff. And I'm starting to see that that will come in it's own time. It was great when a doctor told me that the purpose of third year is not to learn everything about medicine, but to learn how to learn and how to practice as a doctor. The learning everything comes slowly over time. That is nice to know.
So, that's the good news about third year. I've figured out a couple of secrets to help me get through the rest of the year. Unfortunately, all of these secrets make me feel like a horrible slacker, and makes me worried about my future in medicine if already I'm finding all these shortcuts for life. However, I have also decided that when I want something, I'm willing to work hard for it, and I don't see the point in busting my ass for something that isn't going to make a huge impact in my life.
For example: I have pretty much decided that I'm either going to do internal medicine or pediatrics. Unless my neurology rotation is just the greatest thing since sliced bread, I don't really think any of the other stuff holds any interest for me. That has lead to me checking out completely in my rotations, which is bad. I am currently in my OB rotation, and I've realized that OB is just not for me. So I'm not going to go into it. However, if I were a good medical student like all the others, I'd still work my ass off for an amazing grade or whatnot. I am not like the other students. I have realized that I am not going to honor or high pass this rotation, and if I just do well enough, I am going to pass. So, instead of working my ass off to just pass, I've decided to just pass. That means showing up on time, being nice to my patients, doing my work, leaving, and studying for the test. It does not involve getting to work early, trying to overly impress people, and going above and beyond. Is that bad?
I think it is a little bad, because now my attendings can tell I have no interest in OB, and they probably think I'm a horrible medical student, and that really isn't good. But on the other hand, it is helping me stay sane in this crazy world. Saving up my energy for my rotations that are going to count for my future. Right? I sure hope so. Otherwise I'm just a bad student, and does that translate into being a bad doctor? I sure hope not.
The things I've done, that I'm pretty sure no other medical student has done in the history of medical school. Okay probably not that big a deal, but still:
1) I take naps. Why not? You know the saying "eat when you have a chance to eat, sit when you have a chance to sit, pee when you have a chance to pee?" I take that a step further and nap when I get a chance to nap. There is a call room for students on this rotation, and sometimes I have absolutely nothing to do, and I can't stand the thought of studying anymore, so I take a little nap. Apparently that is horrifying to some of my classmates. I think it is just good thinking.
2) I leave when I have a chance to leave. I am not one of those "are you sure?Maybe I should stick around," types of students. If the attending says there is nothing going on and I have the option of just sitting around waiting for something to maybe happen or leaving now, I'm going to leave. And if there has been nothing going on for hours, I'm going to ask if I can leave. It's just one of those things. So yes, I've left the hospital on a weekday at noon before, because someone said I could. And at 430 I've asked if I can go home to study or whatever if I haven't done anything since noon. And I don't think that is going to affect my evaluation enough for me to really worry about it.
3) Rotations where high pass is determined by a test grade automatically means I'm just going to pass. Therefore, I am not going to put too much effort into it. I cannot do well on tests. I have anxiety, I don't study enough, I have no self esteem. It's just a thing I've gotten used to. So while I believe if I study hard I can pass the test, I know that for most of these rotations I am not going to do that well. So what does it matter if I pass with a 70.1 or a 89.9? It doesn't, especially since all they see is pass. So I'm not going to kill myself to turn in stellar work for our busy work that we are given. I'm not going to try and be the best student ever. I'm going to do what it takes to get through, learn what I can in the meantime, and try to hold on to my sanity.
4) I plan things during rotation time so I can get out of rotations. Especially in the ones I'm not passionate about. Sure, I'll come have a meeting on campus at 3pm! That works just perfectly, that gets me out of clinic for awhile. It's for school right? Oh I have a doctor's appointment...oh yeah...hmmm...dont' feel bad about it. Granted, I don't do this every day, but I probably do it more often than I should.
5) I am devious. Recently I have started playing attendings against each other. Not really in the horrible way that sounds. More in the "oh Dr. so and so said I should work with them today..." and then turning around and being like "oh I need to get back to work with the other doctor" and then leaving. Or hiding out to study. They don't seem to notice. It's pretty awesome. Or going to preceptor in the morning, coming home and napping before going back to my rotation. Yep, that is me.
Hopefully none of my attendings will ever read this blog, or I will be busted big time. But honestly, I don't think any of this is going to have a negative effect on my ability to treat patients, because when I'm with a patient I give my best, I give them everything. I'm passionate to work with people, I want to help them as best as I can, I like to be there for them and be the one to take care of them. I just don't put up with a lot of bullshit, and I can't pretend to be something I'm not. Which is a gunner. So, yeah, maybe that makes me a bad student, but I don't hear my patients complaining. Maybe it's because I leave before I can hear them. hmmmm....

Tuesday, October 12, 2010

sitting to study brings me to tears

Hopefully I will be able to get over this soon. The past seven weeks I've been in adult ambulatory medicine and I will let you know, I am not studying. Occasionally I have busted out my book and tried to read a few chapters, but that usually results in me staring off blankly into space or falling asleep. It always ends in me putting away the book not sure I've actually learned anything.
But, Friday is test time, and I'm starting to get a little anxious. However, my anxiety is not of the type that will help me study. Instead it is that crippling "I don't want to study I don't give a shit about this" type of anxiety. This is bad news. I know I'm not smart enough to just do well on a test without studying. But I also can't seem to get into my head that studying is going to have any impact whatsoever on my grade. For someone with such low self esteem I sure do have a lot of faith in my ability to kick ass on tests, even though I have repeatedly shown myself that I am not good at tests. You'd think this would lead me to study, but instead I get trapped in this half-panicked half-defeated frame of mind that is not conducive to studying. "I should study so I can do well on this test," I'll say to myself. Followed quickly with "why? I can't honor the block anyway, why bother? I'll just pass this one." Which is closely followed by "but what if I don't pass the test? I suck at tests! I should study." That usually results in me at least picking up the book and opening it. But that then leads to me staring blankly at the pages, arguing with myself about how important this is even if it is super boring and no I don't know everything in the book as much as I try to convince myself I do and just reviewing right before the test has never worked out to my advantage before so why should it now?
But the worst of it, worse than the pure disinterest and dislike of studying is the depression that comes along with studying. I've been in a bad mood all day and finally figured out it's not because I'm lonely here in Montrose (I only have two days left here, I can get over it), and it's not because so and so didn't call me today or return my texts, and it's not because I am tired of my host mom, or no one emailed me today, or any of those other things I can usually attribute my bad mood to. It's not PMS because it's not that time of the month. It really is just a severe depression that comes with studying. I forgot that I get it, because the past seven weeks I've been convincing myself that I'm learning enough in clinic without studying, and that my time is better spent riding my bike and enjoying the beautiful weather. So last Thursday was the first day I actually sat down with my book in a coffee shop and studied. And it sucked and brought back horrible memories of the past two years. So I stopped, mostly because I didn't care but I blamed it on the fact that my mom was in town and we had an adventure planned.
Yesterday I was so proud of msyelf, I went for a bike ride AND managed to get to the coffee shop to study. And I studied for like three hours. Okay, I sat in the coffee shop for three hours. I'm not sure how long I actually studied. Because within minutes of oepning my book I wanted to close it back up again. But yesterday I just felt bored. Probably because the stress of the fact that the test is days away hadn't quite caught up with me yet.
That stress caught up with my today, and I've been on the verge of tears all day, and I couldn't figure it out for the life of me. What was wrong with me? Why am I in such a bad mood? I should be in a good mood, I'm almost done with this rotation, I get to go home soon, I only have one more day of work. But I guess that slowly the realization that on Friday I have a test that I am not prepared for but cannot seem to make myself become prepared for. I know I need to study, I'm stressed out about the test, I'm worried that I'm going to fail it, I don't feel confident, I know a panic attack is in the makings, but I cannot sit down with my book. Instead I just sit around thinking about how stressed out I am and should study, but when I try to study I want to cry, so I stop studying just to get stressed about studying again.
This is why I failed the boards. More than any of the other crap, it was this, this feeling of knowing I need to study but not having the ability to do it. I simultaneously care and don't care about this test and my need to study for it. I'm defeated, I know I can't honor, I know I'm barely going to pass, but for some reason I can't convince myself that I need to study because I might not barely pass. I might not pass at all. And I don't want to remediate anything. I don't want to fail another test. I just want to move on with my life. But I can't. I cannot study, and I don't know how to fix this problem. I can hope it gets better with other blocks, and with the cold since I won't want to play outside. But what if I'm like this forever?
It worries me that I have no desire to study or learn. All I want to do is treat patients, but I don't have the knowledge to do so, and I can't seem to drum up the enthusiasm to learn things. I don't know what medication I should use for diabetes management. I don't know what labs I want to run on a patient. I don't know what to do if a patient goes into cardiac arrest. All this information is at my finger tips, but I don't give a damn enough to look up the answer. I keep thinking that I'll learn it, but when will I learn it if I won't study? It doesn't make any sense.
I need some kind of motivation pill or something. Something that gets me focused and excited to learn. Something to help me succeed. But until I find this magical pill that doesn't exist, I am going to have to figure something else out. Maybe just sitting with my book long enough, reading one word at a time, one sentence at a time, not trying to get too ahead of myself, and eventually I'll learn something. Right? Let's hope so.
I'd like to say I'm going to go back to studying now, but really I'm going to get ready for bed. I'll then probably lie in bed for an hour worrying about how I didn't study enough today and won't have time to study tomorrow, I'll get no sleep, but I won't get out of bed to study, I'll just lie there freaking out. At least I know myself well enough to know this is how my night is going to go...That's progress right?

Wednesday, September 29, 2010

Can I be a doctor if blood makes me queasy?

I often feeling like I'm a fake medical student. All the other medical students are so excited about hands on training and getting to do procedures and all that jazz. I enjoy the occasional procedure. But really, I'd rather just listen to hearts and lungs and people's problems all day. If I could be a psychiatrist and cardiologist at the same time, I would. but I can't be a psychiatrist because I don't deal well with other crazies and I like my stethoscope too much.
What I do not like, is blood. I used to have all kinds of ways of justifying it. we'd be watching a gory movie and I would just say I didn't like the way it was portrayed, or that it was different in real life, or something. But when it comes right down to it, I'm just kinda squeamish. And I feel that that does not bode well for my future as a physician. I literally turn my head any time a television show or movie shows blood and guts. I do not think it is cool. I do not enjoy looking at it. But somehow I want to be a doctor. Hmmmm.
I thought I was getting over my crazy dislike of blood. when I lived in Jordan I almost passed out one day in the ER because there was this person with a huge gash in his hand and the doctor was like digging a probe in it to show me the tendons and everything. But I hadn't had a similar episode since starting school. Turns out that is probably because I haven't been around bleeding people since starting school. Sounds strange, since I work in hospitals. But except for the occasional blood draw, I really didnt have that much contact with blood. So I foolishly convinced myself I'd gotten over that fear.
Wrong. Monday I was watching a skin biopsy, again of the hand, of this little old lady. The doc was taking a chunk of her skin to send to pathology to see if it was cancer. I was going find until he was done, and she was spewing blood (or just leaking a little) and he was showing me the tendon again (maybe it's the tendon I'm scared of?) and then felt like I was going to pass out. I managed to play it off pretty well, he didn't notice, but I felt sick the rest of the day.
Then the next day, when I'm finally starting to feel better, he tells me that another patient is coming in for a skin biopsy of her nose the next day and I could do it. Any other medical student would have been so excited to get that chance. Not this one. My first thought was "holy crap how do I get out of this?" But throughout the day I slowly resigned myself to the fact that unless I wanted to be unfairly judged, I had better pretned to be excited about this. So this morning, full of terror at 1) mangling some poor old woman's face and 2) passing out, I brought a tomato to work to practice, under the direct supervision of the doctor.
After watching me work my magic on the tomato, the doc said "I think for this one I'm just going to let you see one." Awesome shot to the self esteem. But, I was happy, although I will admit slightly bummed, that I didn't have to do it. I just watched. And for some reason, the blood didn't bother me today, good news. And just as I'm getting out of there thinking how lucky I am, the doc tells me someone else needs a biospy later and that one will be all mine.
Who was it? A nurse at the doc's office who had WATCHED ME DESTROY THE TOMATO. Apparently she has no fear, and really believes in teaching students, because she let me go to town with her skin. Hacked off a nice slice of it, and it bled like crazy, and my hands were shaking, but I didn't pass out. But, I honestly don't want to do another one, ever again in my whole life.
What can I say? I don't like procedures. I think that makes me weird, abnormal, not cut out to be a doctor, but that's just the way I am. I have no interest in sticking people or cutting them up or removing things from them or inserting things into them. My personal nightmare: knowing one day I may have to remove someone's toe nail. I might vomit all over them, that shit is gross. I would rather a patient vomit on me, to be honest, that doesn't bother me at all.
Eventually I'll be able to find a career that involves only those things I like: my stethoscope, looking in people's ears, looking in their eyes, talking to them about their problems. I don't think I'm going to be in a position that involves a lot of cutting, blood, guts, etc. But until I get to that point, I have to put on my brave face and pretend I really enjoy making other people bleed so that I can stop their bleeding. It's going to be a long couple of years...

Saturday, September 25, 2010

I know exactly how you feel

I have found, during my months of soul searching, the the thing that helps most is having someone who feels the same way you do. It helps to normalize feelings and make you think that you are not as crazy or messed up or horrible as you seem. For instance, it really helped me to know that other students struggle in medical school. It always helps me when my best friend says "man I hate that bitch" whenever we find out one of our friends is engaged. Because I'm not the only person who deep down inside hates everyone for being happier than I am. It's comforting, in it's own sick way. It makes me feel like I'm not as horrible of a person to hear other people say that they know how I feel, and actually do. At first I thought it was just because then I didn't feel like such a bad person. and it is still kind of like that, but there is more to it I think. It's comforting to know that other people feel the same way I do because it makes my feelings seem somewhat rational. It doesn't always take the feelings away, but then I at least don't have to worry about also feeling bad about the way I feel.
Case in point. When I failed the boards, the best part of that day was when a friend of mine called and said she also failed the boards. At first I felt like a horrible person for thinking that way. Because my immediate reaction to her failing wasn't "oh I wish that hadn't happened to her" or "that sucks" but rather "YES! Someone else failed." I didn't necessarily want it to be her, I'm very sorry she failed, but it was comforting to have someone else who I knew and got along with and felt on par with also fail the boards. But then I felt guilty and like a horrible person because I was glad she also failed. Part of it was, I'll admit, vindictive. Yes, someone else failed. Someone else has to go through what I'm going through. But mostly it was just comfort at not being alone. And when she told me that the only thing that got her through finding out she'd failed the boards was knowing that I had failed too and there was someone else going through what she was going through, I was finally able to at least let go of the guilt of having those feelings. One less feeling to have.
That same friend and I were talking the other day about all the other crazy feelings that we have that we are ashamed of, but that the two of us share so hopefully everyone has those feelings. It made me feel better at least to hear that she also felt the same way about certain things. Like how we've gotten to the point where we get mad at other people in class for being curious. Ask a question of someone and you are sure to have earned my scorn. Why? Is it because you asking a question makes me feel dumb? Or like I should be more interested? Why is it that when you ask a question about something I have no interest in finding out the answer? Then I just feel bad because I no longer care to know about things. And I can justify this all I want- oh I have so much to learn already, I can't take in anymore, whatever-but when it comes down to it I still feel bad for the feeling. Until someone else comes along and says "yeah, I totally feel that way. When someone asks a question I get frustrated that I'm going to have to sit and listen through an answer instead of being excited/interested to know what the answer is." A breath of fresh air. Because now I can convince myself that everyone feels this way.
Normalizing the feelings at least helps me to not feel bad for the way I feel or react to things. And I think that it may be the secret to really helping other people get through hard times. I mean, it won't always work. Because you can't really normalize murdering someone or stealing or stuff like that. But you can normalize wanted to throw a rock at a window for no good reason (also known as a compulsion) or your immediate reaction to your friend telling you she is engaged being "that bitch I hate her!" instead of feeling joy for another person's joy. Having someone else tell me they went through the same problems I'm going through helps me not feel so alone in the world all the time, no matter what it is I'm going through. Someone else failing a test, someone else wondering every day why they are doing what they are doing, someone else feeling envious or infuriated at friends just because they are smarter, someone else hating every second of the past two years. It's a sense of camaraderie with other people, something to tether you back to the world of others.
So really all I can say is I know how you feel. And I hope that knowing someone else is feeling the same way comforts you as it has managed to comfort me

Friday, September 17, 2010

I actually don't like other medical students

Don't get me wrong, I have some AMAZING friends in my class and within the school. But outside of them, if I don't have to spend time with other students, my life is actually much happier.
This is a new finding for me. I had always enjoyed the pack mentality in the past. Working together, having someone else to feed off of, having someone to cover me if I didn't know what was going on, having someone to bitch too when things weren't going right. And it worked great in things like anatomy, where I sure as hell didn't want to be doing all that work by myself. I didn't want to be doing ANY of the work, so I needed a team. And when I first started volunteering for elective clinic sites, I never wanted to go alone. I needed someone there smarter than me who could show me the ropes so that I wasn't the dumb medical student always asking questions.
When did this realization that I really just don't enjoy being around others of my kind come in? In retrospect, it really started when I was studying for the boards the first time around. I started realizng that while I was dependent on other students being around so I didn't feel like I was suffering alone, really they made me suffer more. By constantly telling me what THEY were doing to study and how many hours they put in and how well they scored on practice tests really kinda made me want to kill myself. Self esteem dropped more and more by the day. Anxiety increased. Heart raced. And the amount of time I spent in the bathroom crying definitely increased. And then I fucking failed the boards anyway, so what good were those other students?
But I didn't really understand I didn't want to be around other medical students. I was very excited that I was doing my internal medicine rotation with other people in my class so I wouldn't be alone at Denver Health trying to survive each day without looking like a complete idiot. I even remember looking at the list and seeing I was on a team by myself but two of the students were on a team together and I was jealous that I wasn't on a team with someone else, that it was just me, fending for myself.
Now I thank God every day that He didn't put me on a team with anyone else. Why? Because medical students are evil, evil, backstabbing people. In the medical school situation that is. In general we are all very nice, well meaning people. But put us together and grade us against each other, and oooohhhh will we turn on each other. Sometimes you don't even realize that you've just been stabbed in the back. Example: another student bringing in an article FOR YOU because you guys had been talking baout it the day before. Seems friendly right? But no, it's really just a way for other student to show she is better than you. They were paying attention, they did some research, they showed that YOU didn't do the research but they did. Look at me look at me! Bitchslapped, that's what just happened.
But, I thought it was just the way of the world. The nature of the beast, so to speak, something you had to deal with. Then, I was sent to west side clinic. And at first, even with my hatred of other students, I was scared to be off on my own. I didn't want to! I needed someone! I needed a crutch. Maybe just a nice medical student? Maybe? Why must I go alone? I was terrified.
But then...oh then I realized the magical magical world of being the only medical student in a practice. It is amazing. Every day, I show up, and I don't have to worry about whether another medical student got there earlier than I did. Because God forbid I be the last medical student to show up. It'll look like I don't care. Even if I can get all my notes done in thirty minutes and pre-round on all my patients,so I dont NEED to be there at 5am, the fact that another student got there at 5am makes ME look bad! Even though I'm waymore efficient! The resident/attending won't necessarily see that. They'll see me meandering in all late and stuff while other medical students are diligently and happily there working before I am. It's a no win situation!
But at West Side, I could just show up, no worries. And then, when patients came, I just got to have them. I didn't have to fight for them with another student. They were just mine. I could spend all the time I wanted with one, and do my job, and actually learn things, instead of spending all my time worrying that the other medical students were doing better than me and were working harder than me and were sucking up more than me. I didn't have to impress people by being better than everyone else, I just had to impress them by doing my thing, which is good enough. I am a good student. I am going to be a good doctor. but I am not THE BEST, and I don't care to be THE BEST, and I don't do well in competition because I spend more time thinking about competing than I do working. So that cut the anxiety and stress of competing out, of constantly worrying that othermedical students were smarter than me.I could just be me, and do my job, and I realized that it was good enough. And I realized that it wasn't just that I was stuck with some gunners in myother rotation. I realized that it is just the way we are when we are together.
Because wednesday mornings when we get together for didactics, it's the same thing. Everyone trying to impress everyone else with their knowledge and how much they care about things. And being a medical student, I can' help being competitive even though I hate being competitive. I have to shout out the answer if I know it. So that everyone knows I know the answer. Why? Because that is what we do. and it SUCKS.
So now, I want to do all my rotations where I am the only medical student. I don't know that I can manage to do so, but if I can, I will. Because I have finally realized, I don't like other medical students...

Thursday, August 19, 2010

All I want is some free time. Until I get it. Then I have no clue what to do with it

As a medical student, well as a person in general I guess, a respectable "adult" with things to do, nothing is more sacred to me than my free time. And all I want is some more of it. I love free time. It's my me time, when I can get stuff done, relax, take in a movie, sleep, run errands, pay bills, clean, do my laundry, mostly just to chill. I can do whatever I want. I can go to the mountains, I can ride my bike, work out, go for a swim, whatevs man. It is very exciting. I spend most of my day dreaming about my free time, and what I'm going to do with it, and how awesome it is going to be. I'm just going to sit on the couch, watch some television, read a book, take a nap, eat, and have a perfectly wonderful, stress free period of time.
The problem with free time is that we are all type A personalities. We don't know what to do with an unscheduled moment of time. So we end up planning things for our free time, like doing the dishes, paying bills, cleaning the apartment, anything to keep us busy and make us feel important. And there is the fine balance between just enough free time and too much free time. Too much free time leads to disaster. At first you think it's going to be great: a week with absolutely nothing to do. Monday starts out, you sleep in, relax, watch some tv, make a to do list for the rest of the week. Tuesday comes around and you do exactly the same thing, rarely leaving your house for anything. By Wednesday you are itching for something to do, to get you out of your house, or make you feel important.
There are two ways to respond to this. One is to make random projects for yourself. Get out that to do list and start cleaning, laundry, bill paying, bike riding, and all of a sudden you realize that your free time is no longer free, you are doing stuff with it. What happened to relaxing? Now you are just stressed out about all the stuff you need to do. Some people are able to do one important task per free day, and then enjoy the rest of it.
I am not one of those people. I respond this way: Oh, I'll do it tomorrow. I get so bored just sitting on the couch watching television, but I refuse to spend my free time doing something important. That would be a waste of free time. But then I start to feel guilty, and start thinking about all the things I should be doing instead. But I didn't make plans, and I'm not a spontaneous person, so I just sit there, wondering what to do with myself. Every once in awhile I get a random burst of energy, in which I can do something productive or fun. Sometimes I can get ahold of someone to hang out with me and keep me entertained. But more often than not I just create lists of things to do and never get them done.
Case in point, I've had this entire week off. It is now Thursday. Today I finally did the dishes, cleaned the kitchen, vacuumed the living room, paid some bills, and got my pager set up. The rest of the week? I've sat around watching television. Occasionally go for a bike ride. Mostly napped. That is how I handle myself. Instead of doing what I should be doing, I figure it can all be done later and just take a nap. So now I'm going to start back up in rotations on Monday, and I'm sure there are millions of things I should have done by now but haven't. All because a week of free time is absolutely too much for me to handle. I need like two days. That's my max. I can be productive AND get relaxed. After that I start feeling guilty about all the stuff I shoudl be doing, but instead of doing it I just sit there feeling guilty about it. I go to bed each night thinking "Tomorrow, tomorrow is going to be the day." Then tomorrow comes and I decide I'd rather lay in bed until noon, then watch a movie, take a nap, and convince myself I have plenty of time to get all my work done the next day. In the mean time, i try to figure out how to entertain myself. Because I get bored fairly easily. But instead of doing all the things I should be doing, I play solitaire in front of the tv, thinking if I do two things at once I'm multitasking and not being so lazy, right? Upstairs the bills are still unpaid, the laundry is still dirty, the bathroom has not decided it wants to clean itself. And for some reason putting the dishes in the dishwasher seems like too much work for me. At some point I'm oging to have to get all this work done, but I'm not sure when. Tomorrow I guess.
What is worse than large amounts of free time is unplanned free time. You would think that unplanned free time would be a blessing. Like yeah! Where did this hour come from? I can use it to relax! Not the case. Unplanned free time causes stress. Becaue it is never enough time to get anything done. It's always like an hour, and then I have to be in class again, or at the next meeting, or whatever. 45 minutes? What the heck do I do with that? I could take a nap, but I'd need to find a safe nap place. I can't go home and get things done because I live at least fifteen minutes away from everything. I can't study, because by the time I pull out all my books, set them up, find my favorite high lighter, and get down to reading, it's time to pack them all back up again. Unscheduled free time is a medical student's worst nightmare. Mostly because there is always something you COULD be doing, but it just isn't enough time. Or I just can't get there and back to what I need to be doing. And it never comes in at a handy time. It's never like I got off an hour early from school and don't have anywhere else to be. It's more like, class ended twenty minutes early and I have a meeting in an hour. Awesome. Or like at one of the hospitals I rotated through, where we had morning report from 1030 til 1130, then noon conference at noon. What am I supposed to do with that half hour? It's just enough time to start something thatI can't possibly finish. It's a disaster.
So, while you will constantly hear me moaning about how I don't have enough free time, the second I get some, I garauntee I'm going to waste it in some way shape or form, even if it is just by resenting at what time it came to me. But that won't stop me from convincing myself that if I only had a little bit of free time I'd be a better person. It's a vicious cycle that cannot be broken.

Sunday, August 15, 2010

It doesn't matter what you tell yourself. If you're upset you're upset

We try all we can to convince ourselves that our problems aren't that big and that we shouldn't be upset about things. I'm a medical student, I'll say. How can I equate my problems with real problems? Tests, studying, hating school, all of that is nothing compared to real people's problems right? So why am I so upset about everything? Why do I hate my life so much? Really there is nothing wrong with it. I've got a great opportunity ahead of me. I'm not starving, I'm not crippled, I'm not looking for work, I'm not really suffering in any way. I should be happy. I shouldn't complain. In fact, telling people my problems makes me feel even worse about them, because I listen to how stupid they are and wonder why i'm even upset about such things.
But the truth of the matter is, it doesn't matter at all why you are upset about something, it just matters that you are upset. It doesn't matter how stupid something is, or how juvenille things have become. Trying to convince yourself that you shouldn't feel bad about something only makes you feel worse about it. And what makes it the worst is that you feel like you can't talk to anyone about it, and it just starts to eat you up inside.
Why can't we all just openly admit that we feel like crap most of the time? why do we have to pretend that we love everything and have no problems? Why do we have to pretend that everything is okay? Why isn't there anyone out there telling us that things are okay? Or at least that it is okay for us to feel this way. Tell us that it doesn't matter what our problems may be, or how small they may seem, just the fact that we have problems is okay and we don't have to explain them away.
We should be facing our problems, and facing the fact that we all hate things every once in awhile, or always, whichever it may be. And that is okay.
Every day we wake up, we feel like crap, and we keep going. We keep the faith and hope that one day everything is going to be better tomorrow. Somedays we really can't believe that is true, and we have no reason to believe that it may be true, becaue things keep feeling like crap no matter what we do. And nothing makes it better, and thinking about how our problems really aren't that big of a deal doesn't make them go away.
So what can we do? how can we make things better? Maybe by just admitting that things aren't perfect, and finding someone that we can talk to about the little things. Because it's all the little things that build up, making us all feel crazy on the inside. None of the good stuff matters when all we can feel is inadequate, unloved, and unhappy. Life doesn't stop for us because we are on our way to becoming doctors. We still have all the same old crap to deal with. Dating, family, friends, drama coming from every direction. It just adds up onto the feelings of not being satisfied with where we are in life, wondering if any of it is worth it. And it doesn't just happen to medical students. Everyone out there feels bad about something, hates something about their lives, has woken up one day unexplicably upset about something, feeling depressed. And most of us try to push it off, pretend it doesn't exist. Pretend that it doesn't matter that much, or that we shouldn't be upset about it. But the truth of the matter is, no matter what you are feeling, you have a right to feel that way. And that's the best advice I can give to anyone out there. Don't hide your feelings behind more feelings of guilt for feeling the way you do. Just feel. Let it out. Find someone to talk to. Don't listen to yourself when you are talking to them, so you can't tell yourself you're being stupid.
It's okay to be upset. It is okay to be depressed. It is okay to be sad. It doesn't matter what the reason is. You don't have to suck it up and move on. Sure, you have t ocontinue living your life and make sure you don't let it all get to you, but being an adult is not about feeling good all the time. It's not about making all the right decisions. It's about knowing that if you just keep putting one foot in front of the other, you're eventually going to get there.
My problems sometimes seem so insignificant that I can't even believe I waste time thinking about them, let alone going to therapy to talk them out with someone. But the more I think about them, the more I realize that it really is the little things in life that have the biggest weight in my life, and if I can't learn to deal with those, if I can't find it in myself to recognize that there is a problem, and that I shouldn't be ashamed of the problem, I'm never going to be able to get over it, no matter how hard I try to push it out of my mind or out of my life.
The only reason I know to do this is because someone once told me it didn't matter why I was depressed. It only mattered that I was depressed and that I should work on taking care of it. I didn't not deserve to be treated for depression just because I was a medical student and I'm overwhelmed with school and really it is no big deal. That is total bullshit. It doesn't matter why, but it does matter. So don't hide your feelings. And don't ever tell someone to get over their feelings. But be honest with each other, and find someone you can share with, who you can trust, you won't make you feel like the biggest asshole in the world for being upset about a date that went wrong while there are natural disasters around the world ruining people's lives. If you can't find someone like that, come talk to me. I'll be there for you.

Wednesday, July 28, 2010

We're all on our own journeys

I'm actually feeling a little bit good about life, so thought I'd take some time to not be such a debbie downer about school. Don't get me wrong, it still sucks, but as I get ready to take the boards again tomorrow, I'm feeling a sense of peace. Sure, it is terrifying, and yes it set me back, but when was the last time something gone the way I wanted it to? If I had had my way I would have gotten into medical school the first time I applied, and I'd have just graduated. Instead it took me two long years of trying, and in that time I went to Jordan, I learned to salsa dance, I made new friends, I realized I was not cut out for teaching, and I grew to be a stronger person.
When I lived in Jordan I adopted a new life motto: as long as it makes a good story, it doesn't matter what I go through. I realized this on a trip to Egypt where everything seemed to go wrong. And though I was in tears for part of it, I LOVED that trip. Nothing went the way it was supposed to, but we had the craziest adventure, and I got to tell people about it and they laugh so hard when they hear about it. And I've really tried to live by that motto. Bad days teaching were fine because I just thought about who I would tell what had happened and how they would react.
I've managed to hold onto that for most of medical school, but in the last month I've definitely lost sight of that life motto, and so now I'm trying to get it back. Sure, I've been trying to look on the bright side: I get to ride my bike a lot, I'm not in surgery right now, I've gotten more sleep, I can go salsa dancing in the evenings if I want to. But in reality, I've spent more time thinking about how all of this is going to set me back, and how hard it is going to be to get back on track. And for good reason, this has been a horrible experience, one that I really can't make out to be a funny story.
But it is one that I can turn into a story that I tell people. Hopefully my story will have a happy ending. It's not going to have the ending I was expecting. Because of this set back, and because of the fact that I'm not kicking ass and taking names on any tests or blocks, and I'm going to graduate as a mediocre student to the last, I might not get what I want. But I am going to be a doctor, and isn't that all that matters? Instead of worrying about the future, shouldn't I be enjoying the journey I'm on? And I will have a story to tell, one that people will be interested in, because I didn't get to go the easy road. I had to go this criss cross crazy path, and yeah I'm not a great test taker and none of my grades show that I'm I'm an accomplished person.
When it comes time to find a residency, I really believe I'm going to have to fight to get one, and that I might not get the residency I want. But damn it, I made Nebraska a fun place to live, I can do that anywhere. And what I'll get out of the experience may be much more valuable to me than it would have been in the residency of my dreams. My uncle, who is a kick ass surgeon, is only a kick ass surgeon because he didn't get the residency he wanted, he ended up somewhere no one wants to go, but he got more experience actually performing surgeries than he would have if he'd been here, and because of that he was highly sought after when he graduated from his fellowship.
It's time to remember that that which does not kill you only makes you stronger. And it is true. My collegues will all be fantastic doctors, but I am going to have a strength that few of them do. I'm going to have an appreciation for what I have because I've had to work twice as hard for it, and I've proven again and again and again that I can pick myself back up and be a stronger person for that. And that is an advantage that is finally going to get me where I need to go. I'm not sure why I had to take this path, but there is a purpose to it. And while right now I'd've really liked things to have been easier and more direct, there is a reason it wasn't.
Maybe it was only so that I could help others who struggle as well. Or maybe it is because I'm meant to be in some horrid small town hospital for my residency. Maybe I'll gain experience no one else is able to get. Maybe I'll have opportunities no one else will get.
Maybe I should stop planning what my life is going to be like and just get back to living it. Because obviously things don't work according to my plan. so instead of worrying about how all the pieces are going to fall into place, maybe I should just let them fall as they may. I seem to have no control over what happens, but I have control over how I respond to it. Maybe my resume isn't going to look awesome. Maybe I didn't honor my rotation like I thought I was going to. Maybe I'm just average when it comes to grades and evalutations. But none of that matters. What matters is that I'm strong enough to take whatever comes my way. What matters is that patients love me, and trust me, and team mates rely on me and find me competent. I can do my job, even if I can't seem to prove it to those who control my grades.
All I can do is keep telling myself that I'm going to be okay. And only lilsten to the positive. Sure, I didn't high pass the rotation when I was sure I was going to. I'm still not sure why, but I didn't. But I did have numerous people tell me I worked at an intern level, and that I was going to be a great doctor. I had patients open up to me. I was able to draw conclusions and put things together and work hard, and I made a good impression. Sadly I only make a good impression face to face, but if I just keep working hard I'm going to get where I need to be.
It's hard to hold yourself up when the world is trying to pull you down. I've had my share of bad times, but they are all part of my journey, of who I'm going to become. And yes it sucks, and if I had control over things this isn't the way I'd want them to turn out. But I don't have control, so I'd better just hold on.
Tomorrow I step back into the ring and hope to God I don't get the crap kicked out of me again. I have to stay positive and sure of myself. And God willing I'm not only going to pass this time but kick ass. And instead of feeling like people are demeaning me when they say how proud they are of how hard I've worked, I should take the complement, and realize that I have worked hard, and although I'm tired of proving myself, I'm going to. And everything is going to work out.
So have faith friends, it is all going to be okay. I can't promise that, but I have to hope for it. We are all on our own journeys, sometimes the journey leads us into a dark place, most of the time we can't help compare ourselves to others, but all that matters in the end is that you've lived your life and done what you need to do. Hold your head up high and just push on t hrough. It's what we do.

Tuesday, July 27, 2010

Did I really used to enjoy studying?

I specifically remember telling people that I enjoy studying when I was trying to get into medical school. "Oh yeah" I would say "it'll be hard, but I actually kind of like to study." Oh I rue the day I said those words. Because come to it, I don't like to study anymore. And really, I can't remember enjoying studying before.
Maybe I just enjoyed it because I was good at it. Or not necessarily good at it, but I would do it and then I would get good grades. Kind of like how I love math when I get the answer correct, but if I can't do it correctly I get really mad. Maybe medical school has just sucked my soul right out. Because I definitely do not enjoy studying any longer. I would rather do just about anything than sit down with a text book. I would rather stare up at the ceiling while lying on my couch. That is more entertaining to me than studying is.
What happened? Was I just a big fat liar all those times I said I enjoy studying? Because I kind of remember it partially somehow being true. I liked libraries, where I could sit quietly with a pile of books, or coffee shops where I could pretend to look busy. I must have at one point enjoyed learning at least right? I wouldn't have come this far if I didn't have some kind of sick pleasure from all of this...
I have noticed, however, that not only do I no longer enjoy studying, I don't even enjoy learning all that much. I used to be full of curiosity, wondering how things worked. If I didn't know, I'd ask, or I'd look it up. Now, if I don't understand it, the most I'm likely to do is check and see if wikipedia has the answer. Or if the girl sitting next to me in class has it. I don't want to ask questions anymore. I generally don't care how something I don't understand works.
I think it is from information overload. That and my happiness and lifeforce are being sucked away by medical school. But hopefully mostly the information overload. It comes to the point where I know that if I have a question about something and look it up, all it is really going to lead to is another question, and I'll have to look that up, and so forth and so on, because there is always something more to learn. And I just can't take that on. Unfortunately, the baseline I set myself at is fairly low, so there is quite a bit that I don't know and am not willing to learn.
Luckily, third year changes that a bit, or at least I felt like it did. I still don't enjoy studying. But now at least when I study something its because I am seeing it. Wegener's granulomatous disease comes to live when I actually meet someone who has it. Sarcoidosis is no longer a figment of some test maker's imagination. And all the path and phys and pharm start to slowly click into place. I can't wait to get back to that. But it still wasn't all there, and I found myself still not wanting to ask too many questions, because after awhile I just stop listening to the answer. I can only hold so much in my poor little brain at a time.
And I still don't enjoy studying. Studying is now equated with nap time, because I'm more likely to be asleep on my books than actually reading them. Unfortunately gaining information through osmosis does not actually work, try as hard as I may. And I've got to be really interested in something to spend time lookingstuff up about it.
So, whether or not I used to like studying, I sure as hell don't now, and kind of wish I had known this before making this leap into medical school. Because it sure is a lot of time spent doing things I don't like, mainly studying. But every hopeful medical student to be I meet, or that you will meet, or that you once were, will say to you "I actually kinda like studying..." Yep, you keep telling yourself that.

Friday, July 23, 2010

I know I can do it, I just don't want to anymore

Oh the life of an underdog. It always seems so glamourous in the movies. Guy works hard, gets pushed down, gets back up, succeeds, wins glory and fame. Things finally start working out for him, and after a long hard road he makes it and then it is happily ever after.
Not so much, I've learned. I never would have considered myself an underdog before trying to get into medical school. I worked hard and I got what I wanted because of it. The amount of effort I put into something was equal to the amount of gain I got from it. I didn't struggle, I didn't get pushed down, things just worked. Probably the first time I realized that this wasn't going to be the case forever was when I took the MCAT. That was a bitch of a test, and I tried to study, and I thought I was doing what I needed to do, and yet it didn't work out for me.
So, I perservered and took it two more times and finally did well enough to get into medical school, after three years of trying. And I thought, okay, I did it. Look what I accomplished. Against the odds I got into medical school. Now it's time for my happy ending. I still didn't really consider myself an underdog. I mean, eventually I was going to get in, it just took some more workthan I thought. I came from a privelidged background for the most part. I didn't have to struggle against all odds to make it through the world. I pretty much was doing what was expected. I went to high school, went to college, graduated, and went to medical school. Sure, it took me awhile to get in, and a lot of hard work and disappointment, but I figured that was just what I needed to make me strong enough to get through.
I didn't realize how strong I was going to need to be, or that once an underdog, always an underdog. Because it did slowly start to seem like all the odds were stacked against me, in some strange way. I never struggled to learn before, now all of a sudden I struggle every day to learn. I used to just get things. Now it seems like no matter how hard I try I can't figure anything out. I became an underdog. No one doubted my abilities at first, but now they all probably do. I was never considered an "at risk" student, but I sure as hell became one somewhere along the way.
But, what I'd learned from not getting into medical school (bitter disappointment), has in fact helped me through medical school. The difference is, I worked hard and then got into medical school. I now put in a lot of hard work and get crap back from it. And I feel like I have to constantly keep proving myself, and it gets tiring. Yes, I know I can pull myself up off the ground when knocked down, brush it off, and start again. So why do I have to keep showing that? Why do I constantly have to prove myself while others just manage to get by. I'm not saying they don't work hard, they do, but they get what they put in. Whereas I feel like I put all my energy into just getting by, because every time I get my feet back under me someone knocks them back out.
So yes, I can do it. I can re-take and pass the boards. I can work harder to have things on my resume that will offset my bad grades. But I don't want to. I want to get things right the first time. I want to work hard and get what I deserve out of it. I don't want to have to convince people that I'm going to be an awesome doctor, I want my grades to show that. I want my happy ending damn it!
and I know that I'm not quite at the end yet, and so maybe I just have to realize life isn't a movie. Or that I'm still the underdog, and I haven't reached the part where things just start to go well. Or maybe I should just resign myself to the fact that things are going to be harder for me than others, and I'd better get used to it. That is a depressing thought, but the one I'm going with the most so far it seems.
I know that my journey is different from everyone else's, and that there is a purpose behind all of this. And one day I am going to be a damned good doctor, no matter what path I have to take to get there. I just sometimes wish I wasn't paving my own path, but walking on a nice paved road that would get me where I want to be. I need a life GPS it seems, and I want to stop taking so many detours. But, as they say, it's not the destination, it's the journey. So I'd better get back to mine, even if I hate it right now.

Thursday, July 22, 2010

It is in fact okay to cry over failing a test

I have been through a lot in medical school, a lot of disappointments that continuously break my spirit and pull me down. And I need someone to tell me that it is okay to be upset, which is something no one says to medical students it seems. But it is something we all need to hear.
Instead we hear things like "pull yourself together." Or "crying doesn't solve anything." Or "you have to be strong, brush this off, and try again." That is all true. We do have to pull ourselves together, brush it off and try agian. But who determines what strength is? I can still be a strong person, as I've shown a million times, and yet sometimes find the need to cry in the bathroom for half an hour. Can't I? why isn't that okay too?
In everything there is a grieving process, and the same is true in medical school. Bad things happen to us, and while they may not seem like that big of a deal, they can totally bring us down, and they are a big deal to us. So sure, if I fail a test I have to get my shit together and pass the next one, and work harder to do so, and I've done that a million times it seems. But why doesn't anyone ever tell me that it is okay to just sit and cry over something? Sure, I have to pull myself together, but I'm allowed to fall apart before that happens. I'm allowed to grieve, and bemoan my fate, and hate everything. As long as I eventually get up and pull myself back together.
Sometimes it feels like we aren't allowed a grieving period. Mostly because there just isn't enough time. We don't have enough time to be upset about one test before we have to start studying for the next test. And sometimes the disappointments just keep coming, to the point where we start to feel like every time things begin to go right something will go wrong. I am chicken little, waiting for the sky to fall. Because that is the experience I've had. Do well on one test, fail the next, pull my self back together. It's exhausting. It leads to constant self doubt which just makes me more likely to fail.
I constantly feel, and I'm pretty sure I'm not the only one, that I'm being pushed down into the mud, and every time I manage to get myself back up, I'm pushed back down again, and someone is just standing over me yelling to get up, brush it off, try again. And I'm good at getting up, I firmly believe you have to get up, and brush it off, and try again. But sometimes what I really need is someone to sit down in the mud with me, and hold me while I rest and cry for a little bit. I'm going to get back up, I'm probably going to get knocked back down, but can't I have just a second? Just a little while to lay crying in the mud and bemoan my fate and be pissed at the world and lack some self confidence and feel like a victim and wonder why this is happening to me? That's what I really need.
So since I need it, I'm going to assume everyone else needs it too. So I'm going to tell you, that if you get knocked down, it's okay to stay down for a bit. Take a rest. Weep, grieve, destroy things, be pissed. IT is okay to have emotions. It sucks, I know. Whatever you are going through sucks and there is no one or nothing that can make you feel better about it. Take that minute, cry your eyes out, bemoan your fate, hate everyone and everything. Emotions and feelings are good things, and we need them to survive. If I could I'd give you a big hug while you cried. And I'd just let you cry, let you be upset, let you vent without trying to tell you it's all going to be fine, because right now it doesn't feel like it is going to be fine. I'm not going to tell you people have it worse because you already know that, and don't care about them right now. I'm not going to tell you to try harder because you are trying your hardest. I'm going to let you feel, for once, whatever it is you want to feel, without passing judgement on you, without telling you to brush it off and try again. Because I have been there, I have had days when I can't even drag myself out of bed, because nothing seems worth it. And the harder I try the more disappointed I get. And it is hard.
All of us are strong people. That is how we got into medical school. That is how we are going to survive medical school. Just like you wouldn't tell a grieving mother to just get over the loss of her son, but would try and help her work through it, you too need to work through your disappointments. You need that time to be upset. And once you're done feeling all those things, that is when you can pick yourself back up out of the mud, stare your torturer in the face, and, with your shoulders back and head held high yell "thank you sir may I have another."

Wednesday, July 21, 2010

My textbook became a coloring book

As I'm reading through my friend's "First Aid for the Boards" and seeing all her crazy color coding, I am brought back to anatomy, when I realized that I really was in kindergarten coloring class. I bought a pack of colored pencils, and I would literally sit drawing all day calling it "studying." You know that picture of the kid who is coloring and looks like he's screaming and at the top they put "I fucking love coloring!!!"? that is totally me. And I would think that in my head every time I pulled out my colored pencils to draw whatever the professor had put on the board. Then it got time to study in the library so I'd rent some expo markers and make my color coded maps all over the white boards in there. All my notes had to be color coded. That continued on through the rest of medical school, even when I didn't have to draw things quite so much. I gained comfort from color coding my notes.
The problem is, eventually I got too many colors, and I didn't know what they coded anymore. So looking back on my old notes, with fifteen different highlighted sections, all of different colors, all supposed to mean something, just gets confusing. I remember sitting with four different highlighters, I knew what yellow meant. Occasionally pink was for drugs. Or diseases, depending on what I was reading. Blue was for something I wanted to stick out. So like a word, and then I'd highlight the definition in yellow. Sometimes something would be important but didn't belong in the blue category, it was too important for that. So I'd bust out the orange. And pretty soon I was just highlighting things for the hell of it.
My first aid for the boards literally is a coloring book. I don't know what the colors mean, each day I'd just grab a different pen and get to work. I always intended for it to have some purpose. Purple underlining was supposed to represent something distinct from yellow highlighting. But underlining never really works for me. So then I'd start boxing words. And each section I'd use a different set of colors. And sometimes there were pictures that I seriously would sit and color in. Every artery a different color. Those were my favorite days. Now I look back on my notes and think to myself "I have no clue what that means, but it sure is pretty."
And as I'm sitting here studying from someone else's book, I have the overwhelming desire to bust out my colored pens and finish coloring in the pictures she left blank. Not because I actually think it will help me to have everything color coded, but mostly I just fucking love to color.
Another friend of mine loaned me a book and told me what all the colors stood for. Blue was for something, purple for drugs, green for diseases, pink for co-relates. I was amazed. "You actually know what your colors stand for?" I asked. She seemed surprised that I didn't. I mean, I have a general idea of why I decided something needed to be in orange instead of blue or green, but I can't really put into words what that reason is. Pink=drugs, that I know for sure. But the rest of the colors, man they are a mystery to me. But my book sure is pretty.
This time around studying I'm not highlighting anything, or writing things in the book in different colors, because I don't have time. I just sit down, read, and write things on a notepad with a red pen, not even to look over again, just hoping hte act of writing will get some of this stuff in my head. But man, it is hard work to control myself this way. To not try and figure out a system of organization that is going to take me longer than actually studying does. To only use one pen every day, and it represents everything. To not highlight every word in the book. I'm surprised I can do it. But it really is good for me, because I did spend more time coloring and organizing than actually studying. And the worst part was, my system changed pretty much daily. So now the organization makes no sense. If anyone else saw it they would be totally flabbergasted as to what all the colors were. It made perfect sense to me as I was coloring, but now, I have no clue.
So here I sit, trying to decifer my friend's colors. If I don't think about it too hard, it all makes sense. Yes of course that would be green instead of yellow. But if I really try to figure out why she decided something should be green instead of yellow, I will go completely crazy. And I wonder if it makes sense to her, or if she just fucking loves to color as well.
My life has really become kindergarten art class all over again. except I can no longer stay in the lines. Coloring things in is still the best part of my day. And even if my books/notes make no sense, they sure are damned pretty...

Tuesday, July 20, 2010

All the reasons we say we're okay

I've been wondering about this a lot lately. Why is it, that when people ask me how I'm doing in school I say that I'm fine, or that it's going okay. Well, I personally got tired of lying to people so now when people ask me how school is I usually say "it's still there." Or "same as every day."
But even other medical students will say to me that they are fine. Or when I'm complaining about hating school and ask how they are doing they say "oh you know, it's hard, but I'm okay..." And I'm never quite sure why we can't just open up and say how we really feel. Maybe it's that only I hate medical school and everyone else really is fine. I find that hard to believe. Maybe I just don't want to believe that. Or maybe that is what they have to tell themselves to get through each day. Or maybe they really do think that this is okay. Some of us have reached the deep dark place and we are willing to admit it, but maybe not everyone else has. Good for them. I hope they can stay out of the deep dark place because it is a horrible place to be.
I've become more of a hermit these days, as I get closer to my test date and trying to make sure there is no drama in my life. But I have managed to have a few conversations with students that have given me a bit of an insight to why we are so opposed to telling people, even each other, how much we are struggling/suffering. I'm sure it isn't an all inclusive list or anything, I'm sure there are plenty of reasons, but these are the ones that seem to be the most prominent I would say.
The first one is that, as I said before, some people really are okay. They study and they may wish they had more of a social life or they may feel like it is too hard some days, but for the most part they really are just fine. They study, and when they study they get good results. They know medical school is hard but they are up to the challenge, and while things may not be perfect, they are good enough for them.
Some people have managed to coem up with a really great balance in their lives. They can still have a life and study just enough to do as well as they want to, and don't let medical school pull them down any farther than they allow it to, because they realize that they can still be a great doctor without being the perfect student.
I generally think those are the exceptions to the rule. Maybe I'm wrong, maybe I'm the exception and they are the rule. But deep down I feel like most people struggle and hate school and aren't willing to talk about it, for the following reasons.
I think there is a lot of shame and guilt about not being perfect. We've all worked so hard to be the best, and some of us have worked so hard just to get into medical school, and we are on a path that is going to lead us to a really great life, and we should be grateful for all of this, and we feel bad that now that we are finally here we are hating it. This wasn't what I expected. I knew medical school was going to be hard, but I thought I was going to be fine. I thought I was going to love it. And now I don't, and I don't know how to tell people that, because for years all I talked about was getting into medical school and how my whole life would be better once I finally did. How wrong I was. So I tell friends and family that I'm fine, because I don't want them to know how much I scorn and look down and hate this wonderful gift I've been given.
Shame seems to be the overriding theme, and I think another reason is that we feel shame that we are no longer the best. All my friends and family thought I was the smartest person ever, and now I no longer am. I'm in a class full of the smartest people ever, and compared to them I am just average. But I'm so used to being that smart person that I don't want anyone to know that I'm not anymore. I don't want to disappoint people by letting them know that in fact I'm not smart at all, I have no clue what I'm doing, I'm barely holding on, and one day I might be their doctor.
With that also comes the competition. Just the sheer fact that I've been competing against the other smart people in my class for years, and have always been able to best most of them, and now I can't. And I look around and it seems like no one else is struggling, because either they aren't or they aren't telling me about it, and I feel like I'd be showing some signs of weakness if I let them know that I wasn't doing well or was having trouble. I feel like they would pounce on me, and prey on me when they found that out. Or look down on me and pity me, and always think I'm not as good as them. And if someone else, or everyone else, is telling me that they are okay, I start to think I'm the only one who is not okay, so I keep silent because I don't feel comfortable talking about not being okay around a group of people who are so okay.
When I do finally open up to people, I get a couple of responses. The one I like the best is when they finally feel like they can open up to me and tell me that I'm not alone in all of this and that I'm not a bad person because I feel this way. The response I hate the most is when another student tries to convince me that everything is actually okay. Yeah, they have trouble with medical school as well, but at the end of it they are happy they are here and want to keep going, and overall everything really is okay. I'm happy for them, I'm glad they can find some silver lining in all of this. But it makes me feel like less of a person because I cannot, and all I can do is wish for it to be over. And it makes it worse when I realize that in opening up to people I'm not helping them open up more, I am just making them worry about me. Everyone seems to have this crazy idea that I'm the happiest person in the world and that I love everything, and when I tell them that I have dark days, they start to worry, and I feel guilty making them worry, so I go back to pretending everything is okay so that I don't have to think that people are worried about me. I don't want them to fret even though that is exactly what I need. So I go on pretending to be great, and some people notice that things aren't really going that great, but they may not point it out. Or they'll tell me they want me to open up to them, but then it somehow just makes it worse when I do.
My friend wanted me to mention that sometimes the reason she says everything is fine is because when talking to non-medical students, they just can't possibly understand what we are going through. Most of them went through school of some kind, but never like this, and they just cannot believe that this is our lives. It goes right back to it being true that the only person who you can talk to is another medical student, and they are the last person who is going to open up to you.
Why? Shame, guilt, competition, feeling like it is unsafe. I'm not sure. But it's even hard for me, who is so vocal and so past all the bullshit, to tell certain people that I'm struggling and I hate every second of every day that has to do with medical school. Because they're either going to make it seem like they are okay "well, yeah it's hard, but I mean..." and then some nonsense about how it really is okay, and then I'm going to feel bad about not being able to pull myself together when everyone else seems to be doing okay, or they are going to be all worried about me and I'm going to feel like they are looking down on me. And God forbid any know that I struggle. I even struggle writing these blogs, because people know who I am, and now they know how I really feel, and I feel like I've given them some kind of power over me.
How do we break this cycle? How do we make it so that either medical school is not this hellish place we have to go through, or at least we are finally able to tell everyone that it is a hellish place and commiscerate with each other about how horrible it is. How do we make it so that people feel comfortable talking to each other about this? how do we make a safe place. Because I know some people out there would totally oppose what I'm trying to do. They want to continue being fine or telling people they are fine, they don't want to tell anyone their secret stories, they don't want to admit any kind of weakness. And that makes it hard for everyone else to open up. And then we end up here, people reading my blog and saying they feel the same way, but not knowing what to do about it, and not having anyone else to talk to than me. Or still refusing to talk about it.
All I can hope is that my blog is a comfort to some people out there, and that people will soon be more willing to open up about things and say how they really feel, in the hopes that they will no longer have to feel that way. If you have any ideas or want to help in any way, please let me know, because I really am trying to figure out something we can do for medical students to make their experience less horrible.

Wednesday, July 14, 2010

Can't you see my problems are more important than yours?

There is another session I distinctly remember from orientation into medical school. In fact, I think I heard this more than once. But it was always in the context husband/wife/boyfriend/girlfriend, so I didn't take it that seriously. It wsa the advice from other students to remember that other people in your life also had problems and issues and they were just as important as your own. And it was kind of like "duh" when I first heard it. Even when I heard it a second time. I mean, I'm going to be a doctor, I want to help people with their problems.
But somewhere along the line, as medical was stealing my soul, it also stole my perception of things. I entered the medical school bubble, and very few things were important enough to get me out of the medical school bubble. I realized that I honestly didn't care about other people's problems. And what's more, I couldn't understand why they thought they could take up my precious time by telling me their problems when obviously I have more important problems of my own, like passing a test that has so much information on it I want to scream but all of it could save lives. And I became very self-righteous and big headed, even while my self esteem was being crushed to the ground repeatedly by medical school. Because damn it, I'm a medical student, I'm going to be a doctor,and that is important, and that makes me more important than everyone else, doesn't it? That's what the culture of medical school is instilling in me.
I would literally sit listening to my mom or sister telling me about their awful day and all I could think was "I don't care. I have to go study. My life sucks more than yours." That was pretty much my entire first year of medical school. Why are you people bothering me with your trifle issues, don't you understand I am in MEDICAL SCHOOL? I have a lot to deal with.
You know, I'm not sure when becoming a medical student filled me with this false sense of importance, but I still have trouble shaking it some times. Really, I have to go study? That's more important than my best friend telling me she had a fight with her boyfriend? Looking back on it even from just now, I am suprised and ashamed that I had to have a mantra running through my head when listening to other people "other people have problems too, they are just as important to them as your problems are to you, other people have problems too."
I'm hoping that it is a product of being a medical student, and not just that I am a selfish bitch who only cares about herself. Since it makes me feel better to think that it is a passing phase of being a medical student, instead of just thinking I'm a horrible person who couldn't care about anyone but myself, I will continue to think what I like.
It seems so ridiculous, looking at it from the "outside" as I'm doing now. My whole behavior to people the past three years (and it's a behavior that has been continuing and I'm only slightly improved about) has been horrible! and based of this silly notion that what I'm doing has so much more importance than what anyone else is doing. I think it's all part of the culture of things, and just the sheer stress of it all. You're being told from all sides that everything you are learning is so important, and you have to succeed, and you have to learn it all, and you have to be the most amazing student in the world to get a residency so that you can be a doctor and do what you really want to do. And when you get sucked into this bullshit reality, you really have trouble remembering that it isn't everyone else's reality. They have their own reality to deal with, and somehow you have to remember that their reality, their problems, are just as big as yours are. Even bigger sometimes, because when it comes down to it I'm in SCHOOL. That is my reality, it's not that important. There is more to life than just how much mine currently happens to suck. But I can tell you that even now there are certain days when someone tells me something and I really not only couldn't care less, but wonder why they have the gall to take away from my study time by telling me something in the first place.
So now my friend from outside of medical school are reading this thinking "gee thanks, we thought we could go to you with our problems." And truth be told, most of the time I am able to pull my head out of my ass and put things into perspective, and listen to your problems and your day and really I am interested (please still be my friend). I even sometimes find that other people having drama is perfect for me, because then I can live through it but don't have to have my own (I'm really not doing a good job of explaining why you should still be my friend...).
I think medical school is so competitive and so isolating that you just get sucked into yourself while you are there. And somewhere along the line you can't figure out why people think they have it harder than you do. All you can see is your own problems and your own struggles and your own life, and you have this twisted vision of everyone else's lives and how perfect they are and how trouble free they are. And you can't see through any of it. I still have this problem with my friend, now more my medical school friend than others. They'll tell me about a bad day of rotations, and all I can think is "I FUCKING FAILED THE BOARDS! Your problems cannot even come close to that." And yet they are talking about way more important things, lives saved and lives lost, hopes and dreams shattered. But I cannot get out of my own self-important bubble and let that in.
But, I will own to the fact that I am getting a bit better. Well, I was. Right now I'm in a world of hate so forgive me as I isolate myself to stop myself from being rude. But for the most part I am getting better. I can take a moment to hear what other people have going on in their lives, and remember that mine isn't quite as important as I think it is. I'm slowly starting to learn to separate my problems from other people's, and find I even enjoy people coming to me with their problems so we can talk through them. I've learned that their problems are not mine, and I don't need to take them on as mine, but I can lift the other person's burden a bit by being there for them. And that helps me remember that I got into this whole mess in the first place because I wanted to help people. So bring on your troubles friends, I am here for you.
It's all about perspective, which I think we lose sight of in medical school. It gets so twisted around, and we focus on things we think are so important and we just get so caught up in it, but if we could take a step back we'd realize what was truly going on. It doesn't always help. Honestly sometimes I cannot for the life of me figure out why someone is taking up my time by telling me something that seems very trivial. But then I remember that people sit and listen to me bitch about studying all day, and I'm pretty sure they couldn't give a crap less. So medical student friends, tone it down a little. I know your life sucks, you know your life sucks, but don't forget that other people's lives suck as well, for different reasons.

Monday, July 12, 2010

"Miniature disasters and minor catastrophes bring me to my knees " (c) KT Tunstell

Truer words have never been spoken, and often when listening to that song I wonder if KT is secretely a medical student.
Doctors are known for being calm and cool in a crisis. That is what we are good at. Especially ER doctors. Because no one wants a doctor who runs screaming down the hallway when something happens. We have to keep our heads about us, gain control of the group, and take charge to solve whatever problem may have come our way. All of us have that skill. In fact, I think on every medical school application or in every interview, a soon to be medical student says "I'm great in a crisis. I thrive off stress."
And it is true. In a real life crisis, I am fantastic. Building burning down? I'll get everyone to calmly leave the place, maybe even throw a kid over my shoulder and get them out of there. I was a resident assistant in college, I could break up any crazy party that was going on. Road side motor vehicle accident? A doctor will go right in there and get to work. If something huge is going on, I know how to pull myself together, take control, and go fix whatever needs fixing, or at least keep my cool well enough to be of some assistance to whomever is in charge.
But it's those little things that we medical students can no longer handle. If I can find the pair of shoes I wanted to wear in the morning, I will trash my room looking for them, never find them, lay down on my bed sobbing about how my day is ruined, and not be able to function for the rest of the day. Got a speeding ticket? My life is ruined! Why does God hate me?
I actually have always been this way, I have cried over lost insurance cards, cursed my fate over taking the wrong exit, and wondered how I could possibly survive now that we are out of apples this week and there is no time to go to the grocery store. In my head it is all perfectly rational, becuase I spend the majority of my day keeping it together and playing it cool, working off the stress and getting things done, but once something goes wrong, it all goes wrong. And if it isn't a full blown emergency, I can't deal with it. Everything gets immediately blown completely out of proportion. The term "fuck my life" is not enough to cover it. My iPod battery would run out some morning so I couldn't listen to lectures in my car on the way to school, and therefore I would cry all the way to school, lamenting over how much my life sucks and how no one can possibly understand it. Stuck in a traffic jam? You can garauntee that I'll be screaming at the top of my lungs obscenities that would make a sailor blush.
And then, I pull myself together, feel like an idiot as I find the pencil I was frantically searching for has in fact been in my hand the entire time, take a couple of deep breaths, and move on with my life as if nothing has happened. People who witnessed the fury stand back, afraid to move, worried that I may attack again. I completely lose my shit, and I'm always mortified by my behavior later, but by golly at the time it seems perfectly justified. My world comes crashing to the ground because I can't get my computer to plug into the wall. I forgot my water bottle at home, how will I drink water today?
The more stress that comes into our lives, the less we can handle. It used to be that we thrived off stress, but on the stress-o-meter we have crossed a special line from "thriving" amount to "going ape-shit" amount. And after a certain point, that is where we live. We have so much stress in our lives and we don't even realize it until we go completely bananas over something small. I can't get my bottle of gatorade open, so now I can't work out, so now I'm going to get fat and have a heart attack and die. My life is ruined.
You think I'm joking, and I know you are all laughing as you read this, but sadly, this is my life. So I just have to warn you, if you see me searching frantically in my bag for something, walk away. I've probably lost my wallet at the bottom of it AGAIN and the water works are about to start. You can't do anything unless you grab my backpack from me and find my wallet. And I will just be embarassing myself in front of you. So seriously, slowly walk the other way, don't make eye contact, and maybe, just maybe I won't lose control in front of you.

Sunday, July 11, 2010

When the office supply store becomes your new happy place

A very wise doctor once told me "if you didn't have OCD going in to medical school, you will when you come out." And it is so true. We all have some OCD tendencies to help us get through medical school, or they might have been what got us into medical school in the first place. One of the key ways we keep our sanity through the craziness that is medical school is by organizing things. Even though of us who are completely disorganized most of the time have some kind of study organization that they swear by. Most often it involves at the very least yellow highlighters and a blue and red pen.
Sometimes it gets a litte more advanced. Seven different colors of highlighter, all of which have a different highlighting purpose. Yellow for important details, blue for new topics, green for words we haven't seen before, pink for drugs, purple for diseases, and orange every once in while when you can't figure out what color something should be.
You can move up from there to colored pens. Write things in different colors to signify different levels of importance or different pathways. Purple for enzymes, green for activators, red for inhibitors, blue for substrate, black for product.
Even if you type up all of your notes,you have it organized some way. I like to make tables, and then have tables within tables, and bolded things and underlined things and italic things and sometimes, if it is really important, it will be bold AND underlined and possibly in all caps. Microsoft world becomes the bane of your existence because it won't let you organize things the way you want, and the autoformating it does makes no sense. I used to spend more time making the tables then actually learning any of the things in the tables I made.
I remember deciding to stop typing my notes because I wasn't actually learning, and go back to writing. But my blue red and black pens just weren't enough. So my mom bought me some colored pens online. The day they were shipped to my house was like Christmas day in my sad little world. Twenty fine tipped pens of different colors, in their own carrying case that also served as a stand. Oh the power. The next day I went to class, pulled out my new pens, and felt like a queen as everyone came over to look at and admire my pens. I even let some people try them. I had people threaten to steal my pens. And in fact, when I would leave my backpack someplace (because I randomly just leave my stuff everywhere), the first thing I would check when I came back to it was that my pens were still there. Who cares about the wallet, computer, car keys etc in there. The most important thing was my pens, and I would have freaked out if anyone had stolen them. One day one of the guys in my class pretended to steal them. I looked straight at him and said "Listen, I'll let you live for a lot of things, but I will kill you over those pens." And I was dead serious. Lucky for him he gave them back.
Beyond pens and highlighters, there are whole worlds of organization to make the crazy in all of us happy. Why, there are sticky notes of all sizes and colors, there are index cards, there are index card holders, there are file tabs, page markers, calenders, day planners, white boards, and a whole other array of things you don't actually ever find a use for but are convinced you need.
It is a sad day when you realize the office supply store is your happy place. Really? My life has come to this? But there are just so many amazing (and practical) things that you can find in there. All arranged in a very organized way so that when you are going in for pens, you can compare every type of pen available and make sure you are getting the right one, and then you can remember you are completely out of tape, and now that you write in pen you should probably get some white out, but pick up some pencils because maybe you'll switch to those, and what are those new nifty organizer things? What?! Three ring binder rings without the binder?! What is the magic? I can keep things together without carrying a binder around? Oh happy day.
You soon realize that not all pens are the same, and in fact you can only write with one specific type of pen. Or if you can use more than one type of pen they each have different functions. Your every day pen, your really important notes pen, your colored diagram pens. It got to the point where I was one day frantically searching through my box of pens and asked my neighbor if I could borrow her pen for the rest of class. She looked at me and said "you have a box full of pens." I couldn't explain to her that none of those pens were for every day note taking, and so I couldn't possibly use them. They'd be ruined. And I soon came to find out that sometimes I couldn't borrow a pen from someone else. How they could possibly use that type of pen was beyond me, but I sure as heck couldn't write with it. And so borrowing a pen became as difficult as finding the same type of pen that my best friend uses at a different office supply store (of note, our favorite pen brand stopped selling the pens we loved best. It was a tragic day).
I look around my study sometimes, now that I'm not doing classroom learning anymore so don't have a need for all the sticky notes, highlighters, pens, pencils, binders, etc, and I kind of miss them. I still hoard them, because maybe one day I will need them, I don't know. I still have twelve different piles of sticky pads, and am always in search of a sticky note to write something on. I'll sit and study and say to myself "if only I had five different colored highlighters right now, I'd be so much more organized and smart."
It's a sad, crazy place that a medical student lives in. Even those of us who never thought we'd become this have in some way become like this. Whether it's that you HAVE to take a new pencil from the front for each exam and cannot return it or ever use it again, or you have to sit in the same spot every day, or you can only write with the sharpie pen, or you have to have everything at ninety degree angles on the desk, we all have our little bit of crazy.
And if you haven't become OCD yet, you will. Just wait and see...

Friday, July 9, 2010

Try all you want, you'll eventually fall into the trap of comparing yourself to others

The best advice I can give you as a medical student is the hardest to follow. Don't compare yourself to others. It is a horrible thing to do, but we all do it. I, for instance, will stand in front of the list of scores for each test and count the number of people who did worse than I did. I will then count the number of people who honored and secretely hate them. Or not so secretely, considering most people know my feelings. We are all so used to competing and being better than everyone else that it is hard not to do the same thing in medical school. Although I truly believe the outcome is far worse. In undergrad if someone was doing better than me in a class I couldn't stand it. I either hated them if I couldn't be smart than them or kicked my ass into gear until I was doing better than them. Slyly asking people how they did on the test to see if I got a better score, asking how long they studied. Feeling smug to be better than everyone else. And to be honest, that is part of how you get into medical school. It's a competitive world and to get in, you have to be the best. And you think you have to stay the best.
It becomes very hard when you get into medical school to remember that you are on an individual journey that is not the same as everyone else's. We all sit around comparing study methods, talking about how we studied thirty hours in two days for this test, then honored the crap out of it. We talk about the awesome things we get to do with our preceptor. Anything to make us stand out. We even have people who will come in dressed in suits and when asked why they are all dressed up they say "oh, I'm meeting with the director of the residency program I want to get into, just to chat a bit, and I figured I should look my best." Bite me. That's a different story though.
The point is, all of us have a different set of struggles, and we all have a different set of experiences and priorities and everything else. And all of it is going to get us to our endpoint of being fantastic doctors. For instance, I do not get to do many procedures with my preceptor. It just isn't something I got a lot of exposure to. So listening to friends who worked in the ER and got to stitch people up or do some other awesome procedure used to make me really jealous. And then I realized what I was getting from my preceptor. I, unlike many of my classmates, learned early how to write a history and physical exam, give an oral presentation, participate in rounds, and other things like figuring out hte computer system, learning how to put in orders, learning how to write things up, find old X-rays, get to the ER, etc. All mundane seeming things, not nearly as exciting as stitching or pericentesis or anything like that. But let me tell you, I was at such an advantage my first week of internal medicine because I did it at the hospital where my preceptor worked, so I already had computer access, knew how to get to the ER, knew where all the paperwork was and how to fill it out, how to do a history/physical and give an oral presentation, and know what was expected of me at rounds. So I oculd work on the things that everyone else found so easy, like knowing what to do with a patient or the details of the disease process they were suffering from.
We are all so obsessed with being the best that when we can't be the best we try to make everyone around us think we are the best. I've said that before, I truly believe it. So if you are constantly comparing yourself to other people, you are always going to seem like you are coming up short, because very few people are truly honest about what they are going through. All you see is that they study and get good grades, or they don't study and go play golf and still get good grades, and you are spending as much time in the library as you can and still not getting good grades. And then you start to doubt yourself. And that is when the struggle becomes too hard. Because no matter how hard you try, there is always soemone better than you who doesn't seem to be struggling as much as you do, and then you fall into the whirlpool of dispair. When in reality, those other people may see you and think you are always so together and never struggling and they always feel like they are having trouble but since you aren't, they don't want to tell you about it.
It's a vicious cycle, a culture of competition that needs to be broken so that people can get back to remembering that they are on a noble journey towards being a physician, a healer, not some guy that everyone thinks is a badass. If the only reason you are in medical school is for fame/prestige, you are an idiot.
I have come to the conclusion that 85% of the time, people are lying to me. It is actually kind of comforting. It used to drive me crazy to have a friend tell me he studied for like three hours and then went and played golf and still did better on the test than me. And it used to make me feel like a complete failure when a friend said they studied for 10 hours a day and I only study for like 6 or so and maybe that is why I'm doing so poorly. And nothing filled me with anxiety quite like someone saying they were studying for Step 1 during the first year. Pulling out their first aid or talking about doing practice questions.
I slowly realized that a lot of people were just full of shit. A friend of mine told me a story about how one of our classmates told her he was probably going to honor anatomy, no big deal, and she had just gotten comfortable with the idea in her head that no one really honors anatomy and passing is just fine. And she started freaking out, wondering why she wasn't even working towards honoring. What was wrong with her that she had already gotten comfortable with just passing? Turns out that guy actually failed anatomy and had to remediate. I once was studying in a room with a classmate when another one came in and said "tell me you've been here all night studying" (it was now 730am, I was early for class). So I said "okay, I've been here all night studying?" And he asked if I really had and I said "hell no, I just got here a little early this morning." And he was like "oh damn, I've been here all night studying and was just hoping someone else had been suffering as much as me." Really? First off, I don't care that you've been here all night. I've been sleeping and taking care of myself. Secondly, don't throw what you think as of a major accomplishment in my face. And third, you probably werent' studying all night.
People know I tell it like it is, and I think they realize that I'm not living in a happy world of success in medical school, so I am often privy to information that I'm not sure people are willing to share with others. I have numerous times heard people say "oh man, Joe Schmoe told me he is not only studying for class, but also has started studying for the boards, and I can barely accomplish the one, I really don't have any more hours in my day!" My general response is that Joe is LYING to you. He needs to feel self important and if he's not doing something fantastic at least wants you to think that he is. Sure, maybe he is "studying" for the boards. MAybe he carries his First Aid around in his backpack and pulls it out and puts in on the table, and sometimes opens it and reads something in there. But he has no clue what he is doing. So don't let him get to you. Don't compare yourself to him, because maybe you only put in three hours of studying a day, but it is three hours of real, hard core studying, and Joe puts in ten hours a day but most of it is sitting staring at the wall.
Everyone has their own way of doing things, and that is the hard part to remember. It may not work for you to not study ever and then pull an all nighter and memorize everything. It may not work for you to study a little bit every day. Class may be your idea of hell, or it may be the only way you can learn. Don't worry about what other people are doing. Figure out what works for you, and don't let anyone else tell you that their way is better. In fact, don't even ask them about their way, unless you really are in search of a different way. Because everyone's journey is different. We are all going to get out of medical school, some of us will take a little longer, some of us will have no souls, some of us will feel like rockstars all the time. It doesn't matter about everyone else, it only matter that you are going to get through this.
When it comes right down to it, there are some people that just don't have to struggle as hard as you do. There are some people who just get it, who just feel great all the time, and know how to study really well, and do well on the tests, and seem to have their lives totally together. Good for them. But that doesn't mean that everyone is like that. And it sure as hell doesn't take away from your value as a person or from your ability to be a doctor because you do struggle. I honestly believe that the people who have the hardest time but are able to persevere are the ones that are going to really really succeed in life. Or at least I only hope that because it makes me feel better about struggling.
It's the hardest thing to do, to say "I am me, I'm doing my best, and I don't care what others are doing." And it is even harder when you are in a place where the culture of competition leads people to always be showing off. But take comfort, you will be an amazing doctor in your own way, your journey and experiences will be gifts that help you succeed in the world, and we are all going to get through this. And if nothing else, remember that I struggle too, so now you know someone else is struggling as well.