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.

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.

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.

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."

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...

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.

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.

"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.

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...

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.

The only four responses you'll get from non-medical students when you complain about medical school

I love my friends. And I really love having friends outside of school, because those friends don't compare grades with me, or talk about all the answers on the last test, or make me feel guilty for not studying. We can talk about the important things, like boys, fashion, the latest gossip, movies, whatever. It is a great release from the stresses of other type A people. And you realize who you really are friends with by the people you are willing to keep touch with outside of school. Becaue it is really hard, to fit in time for people and let yourself relax. Non-medical school friends are very important to the sanity of a medical student.
That being said, people who are not in medical school or haven't gone to medical school have no clue what we are going through. It's very difficult for them to empathize with our bitching and moaning, because to them it is just school. And for them, most of us have always been really good at school, and this is what we've always wanted, so why aren't we happy? Because they don't know. I have noticed four variations of replies from my friends when I complain about medical school or how much trouble I'm having. They think they are being helpful, but really, it doesn't make me feel better. Here we go:
1. Oh I'm sure you'll be fine. You're always fine, you always do well, I'm not worried. You're so smart you can do anything.
Why this isn't helpful: we know you mean well, and we thank you for the faith you have in us and for the compliment. But the point of all of my complaining is that I'm no longer smart, I'm average. I honestly do not feel like I can keep up with what is going on, and I feel like an idiot every day. And the fact that I used to be smart just makes it worse, because you are right, I am smart and I always used to do well. But now I'm not doing well and everyone has high expectations for me to be doing so great. It's a lot of pressure to put on a person who already has a crapton of self inflicted pressure put on them. And then when we do fail, it makes it even more difficult, because everyone was rooting for us and never had a doubt in their minds about our ability to do well. Now we've shown them. We've built this entire friendship around you thinking I'm a smart, hard working person who always does well. Now I have to prove to you that in fact I am an imbicil who cannot get anything right. You saying that I'm going to do just fine because I always do well and you aren't worried doesn't instill me with a feeling of confidence. Instead it puts on pressure that you didn't realize you were putting on me.

2. Well of course medical school is hard. You're going to be a doctor, I want it to be hard. If you are going to be in charge of the health and wellbeing of people, medical school should be hard.
Why this doesn't help: DUH! We know medical school is supposed to be hard because we are going to be doctors and that is a big responsibility. This response just makes us think that maybe we really aren't cut out for this. If I find medical school so hard, maybe I just don't have what it takes! And you're right, I'm going to be responsible for peoples LIVES! If I don't know every little fact about every little disease or process or medicine I could KILL people! Thanks for reminding me of that. I now have to leave your company and go study some more. We joke around in medical school (it's a pretty sick joke, but we are pretty sick) that only needing a 70% to pass a test means that 70% of our patients will live. Obviously that isn't really how it works, because I definitely know more than 70% of the stuff I've learned, I just can't always answer the test question correctly, and in the real world I'll be able to look things up or ask my collegues. But when my friends says "it's supposed to be hard because you are going to be a doctor, I want it to be hard, so I faith in going to the doctor," I want to bitchslap them, because again, it just puts more stress on me than is needed. And reminds me of the seriousness of everything that I'm doing and how hard it is and that failure could mean someone's life, and remember the stakes I'm playing against. Seriously, this response just sends me into a fit of panic. Don't use this one.

3. If you hate it so much, why don't you just quit?
Why this doesn't help: Do you know how hard I worked to get into medical school? The hours of studying for the MCAT and all myclasses? The hours typing up applications, the money spent applying, the hell of interviews and rejection and having to figure out some way to make myself more appealing to some medical school to get in? And I finally did and do you know how many hours of studying I've put into this in the past two and a half years? And the financial burden I'm in trying to pay for medical school? I'm not going to quit! How dare you suggest it? This is a totally childish "if you love it so much why dont you marry it" kind of response. Because at the end of the day I still want to be a doctor. This is just harder than I thought. And, I'm a medical student. I got here by working hard and kicking ass, I'm not a quitter! But the worst part of hearing this response is that most, if not all, of us have contemplated quitting at some point. We don't need encouragement to give up, because it would be so easy to just walk away. Deep down inside us there is a voice that constantly asks why are we doing this? Why take it anymore? Why not just walk away and start some new life. Why not go off and be a professional salsa dancer? Or travel the world meeting new people? Or become a chef, or open up a bakery, or become a Disney Princess. I'm a people person, I'm a hard worker, I can get it done right? I can be whatever I want. So why do I want to go through this hell when there are so many other things I could do? It's this nagging doubt about my abilities to succeed that lead me to wanting to quit, and someone reminding me that I should just quit instead of putting up with this isn't helpful. It just makes me think "maybe I should quit..." and it doesn't get to the heart of the issue, which is that medical school sucks but it is part of my life now. That's like someone complaining about how hard marriage is and a friend saying "well just get divorced." There are serious ramifications for just quitting, and it isn't necessarily the right idea. So no, I'm not going to quit medical school, although sometimes running away does sound like the greatest plan ever.

4. Well you knew it was going to be hard. You signed up for it..(this one is the worst)
Why this doesn't help: Because we just want to scream F-k You to whoever says this. Thanks jackass. Yes I knew medical school was going to be hard, and I did in fact sign up for it. Not only did I sign up for it, but I purposefully fought other people for this opportunity, and am paying a lot of money for this hell I am going through. But I can tell you that while I knew medical school was going to be hard and I did sign up for it, I did not know it was going to be THIS hard, and I sure didn't mean to sign up for this hell. I didn't mean to sign up for never ending discouragement and relentless inadequacy. I signed up to study to become a doctor. And if I had known what it really entailed, I'm not positive I would do it again. I'll have to see how I feel when I'm actually a doctor. But you saying this just means that not only do you not have the slightest clue what I'm going through, but you actually don't care. because if you were listening to what I was saying, you would realize that I'm in way over my head. I signed up for medical school, I didn't realize it was going to be the worst four years of my entire life. I didn't sign up for the hell I'm going through right now. I signed up for hours of studying, experience with patients, sleepless nights, long days running around a hospital. I understood all of that going in. I didn't understand that I was slowly going to question everything about myself and my ability to succeed in life every single day. I didn't sign up to cry at least once a day for two months, but I unfortunately lived through it. I didn't sign up to feel like a failure constantly while everyorne else around me seems to understand everything. And I certainly didn't sign up for this overwhelming depression and despair that seems to follow me everywhere. I had NO CLUE what I was getting into when I decided to become a doctor. And now I totally understand why all those people asked me if I was sure when I told them I wanted to be a doctor. No one actually signs up for this. We get suckered into it.

When I brought up the idea of this blog post to another medical student (who completely agreed that there are no other responses you get), she told me I should give you non-medical school friends out there advice on what to say to us when we are complaining about medical school. But to be honest, I'm not sure there is anything you can say. Certainly not the things above. Because for the most part I'm not necessarily looking for advice of any kind, I just need to tell someone what I'm going through. So a simple "man, that sounds awful! How do you cope?" Or "I'm so sorry that sounds like crap, how can I make you feel better?" would probably suffice. Or even maybe asking me what I do like about medical school. But really, I just want someone to listen to what I say and pity me and what I'm going through, because it really sucks. So while I can't tell you waht you should say, I can give you the above suggestions on what NOT to say when Suzy Mc-medical student comes and tells you about how much she hates medical school.

Why do I bother setting goals anymore?

I used to be one of those people that made a list of things to do, and felt so good about crossing each thing off the list. I was very accomplished. And I could set a goal and actually see it through.
Not so much anymore. I'm not sure if it is the stress of medical school, or the ADD that has always been hiding out finally busting lose of all boundaries and taking over my life. I can't remember the last time I actually set a goal and then kept it. I usually keep some kind of variation of it. Demanding of myself to read ten pages turns into "okay I'll just finish this last page" which then often turns into "oh fuck it I'll do it tomorrow."
I also have to bribe myself to finish a task. "Okay, type up two more learning objectives and then you can play on facebook for five minutes." Thirty minutes later I'm still on facebook. How does that thing manage to hold my attention when nothing else does? I waste so much time on it and I don't even know what I'm doing. "read one more page and then you can take a break" which will then turn into me spending an hour in someone else's study room talking to them so that if I don't accomplish my goals, at least I am not the only one.
My week goals always start out so ambitious. I will get all my work done on time, study a little something extra each day, go to teh gym, have some time to send some emails, and accomplish at least one life related task a day. Not so much. I would rather do anything but study. Unfortunately that just fills me with guilt about not studying, and I don't really know how to balance it all out.
I neither know why I bother to set goals anymore nor why I have so much trouble accomplishing them. Little things like unpacking from a trip. I get halfway through and I think of other things I want to do. I had a big pile of mail today to go through, and I got through about half of it, and then put the other envelopes in a pile of stuff to deal with later. What did I do instead? I honestly can't tell you. I think my roommate came home. and then maybe I went out to dinner. But more often than not I just sit staring at all the things I have to do without getting any of them done.
Sometimes I'll sit in a study room with my books up and will be staring at the wall thinking of absolutely nothing, because that is more stimulating to my brain than learning about sarcoidosis, which I believe is a disease no one really actually has. But for some reason I need to learn all about it.
I also find myself acting like a work out trainer, outright lying to myself about how many pages I have left to read. "Okay, just one more. Just read this one more page and you'll be done. Good! Now just one more page! Last one I promise! Just one more quick page! Keep going! You're doing great! Just one more!" Wait a second! How many was that! You said just one more twenty pages ago.
The worst though is when I actually have a productive day. A day when I accomplish and even exceed my goals. That is just a recipe for disaster for the rest of the week. Because you can gaurantee that if I got today and tomorrow's work done today, there is no way in hell I'll be able to convince myself to do anything really productive for the next week at least. I just wear myself out too much. It is a disaster.
I quickly learned not to overexert myself, because the consequences of doing more work than I should was a disaster. Somehow it was better to only barely accomplish things. It keep the mystery in the relationship still alive. I had to find out more about it tomorrow. And so I sitll make lists, but it seems that for each thing I cross off I add at least twelve more. And I never know if everything or anything is going to be accomplished.
It is a daily struggle with myself, constantly hoping that today will be the day I actually get things done. It is of course worse with studying, but it creeps into the rest of my life as well. I have so much trouble balancing the two. The question really is, why do I think each day is going to be different? Why do I wake up in the morning, make a list of things to do, and then not get any of them accomplished? What is the point? And how do I get out of this vicious cycle? Besides getting a diagnosis of ADHD and getting some Ritalin to get me through my day, I really can't think of an option. Even as I'm sitting here I'm making my list of things to do tomorrow. And they are all so grandious. Maybe that is the problem. Maybe instead of saying "tomorrow I will read all of FirstAid, do 200 practice questions, and read through all the pharm cards" I should set more accomplishable goals, like "tomororw I will open my first Aid and finish the chapter I started. I will then do 48 questions and see how I feel from there, I'll take a little nap, get up and see what I want to do next, but hopefully it will involve some pharm cards and some more questions." That even might be too ambitious, I'm not quite sure. I can never tell if I put a larger variety of things to get half done will I be more accomplished than if I just have one long boring thing that I have to do all day until it is done? Which will suit my purpose better.
Either way, it is equally depressing when I cannot accomplish any of my tasks, no matter what they are. Whether it is one simple yet long task (finishing a complete chapter in a book) or a bunch of little things (ten pharm cards, five pages in first aid, 48 questions, nap), I feel equally ashamed of myself when the only thing I've acomplished that day is to take a nap.
When I was interviewing for medical school I talked about how I thrived off stress. I needed a constant level of activity and things to do in order to get anything done. That used to be very true, and I thought it would help me get through medical school. I was a big fan of crunch time. I could get that paper done only because there was another one to write afterwards, and then a test to study for, and work to do, and people to counsel, and organizations to run, and activities to plan. But I managed to get it all done.
Then somewhere along the line in medical school, I got twice as much stuff to do and half the ambition to do it. Why medical school? Why have you robbed me of my ability to get things done? And will it ever come back? Because I can tell you, my "I'll do it tomorrow" attitude gets me no where. Saying I'll return that email another day means I will maybe remember in three months that you emailed me. Saying I'll do my evaluations when I have more time to sit and pay attention to them means they will get done the day I get sent an email about how if I don't finish my evaluations I will not get to be a doctor. It is not good, and makes me worry about my future ability to handle a real job and real life.
Lately my goal has been to accomplish some of my goals each day. That holds true again tomorrow. For tonight, I'm going to go do something that doesn't matter or make any sense to my future, just like usual. Maybe, if I made my goals to ignore my homework and instead to do things like play on facebook for six hours and wander around the library in search of someone to talk to, I'll by some playing of the mind get myself to actually study. Hmmmm, I may be on to something here...

Medical schơol is no place for a hypochondriac

I am convinced that all medical students are crazy. Some of them may hide it better than others, but there has to be some sort of craziness in all of us to be going through what we are going through, and willing ask for more. The two most common crazies I notice are OCD and hypochondriacs. If you weren't one of those before you got in, you are at least one now, maybe both. This blog is for us hypochondriacs.
It's hard not to be one when you are surrounded by diseases all day every day. You would think that in learning about all these diseases, we would be able to safely say, "nope, I don't have that."
But so many diseases have these non-specific symptoms. and all of a suđden it is like watching a anti-depressant commercial. Symptoms like fatigue (why yes, I am very tired lately), listlessness (hmmm...I've got that tơo), general not fêeling well (you're right, I don't fêel well), sore throat (my throat has bêen hurting a little bit more of late), fever (is it hot in here or just me?), cold intolerance (can we turn up the heat? where is my blanket?), aches and pains, dizziness, confusion, headaches, heart palpitations. All of a suđden you are diagnosing yourself with pneumonia, cancer, frontal lobe lesions, some exotic parasite from that time five years ago you went to that one country and ate that one thing, you KNEW you shouldn't have eatten it, but you did. And now you are going to die. And what's worse, is that we don't learn about the normal, fairly mundane and harmless diseases. We learn about the diseases that hit you all of a suđden and next thing you know you are dead.
It's a scary, scary place to be. AT some point or another I think all medical students have learned about a disease and thought "OMG I have that..." I actually went and had blơod tests done to prove that something is wrong with me. Whatever it is it is not in my blơod. I'm convinced an MRI will show some crazy abnormality that is eventually going to be the death of me.
First year was very difficult for me. I thought I had leukemia for most of the year. Yes I am tired more than usual, lacking lots of energy. It MUST be leukemia. Couldn't possibly be due to the total lack of slêep I'm getting these days. I think I do have a heart murmur, and kidney disease, and lung dysfunction. And I must have some bacterial process going on, attacking my insides as I sit here learning about them.
Second year I got a little better. Neurology didn't instill quite as much fear in me as the other blocks. I was pretty sure that I didn't have ALS (yet), or parkinsons, or a spinal cord lesion. I was so proud of myself because I stopped thinking "OMG I have that."
Until we got to the psych section of our learning, which is interspersed throughout the first two years. Then I felt like the posterchild for every disease out there. Yes I do have depression, and an anxiety disorder, wow panic disorder really explains me, rejection hypersensitivity, that would make sense, I think I do have a front lobe lesion leading to disinhibition, maybe I am bipolar, I sometimes maybe hear voices maybe? I have lost all interest in things that I used to enjoy, for example, medicine. Psych was definitely the worst. I diagnosed myself with every depressive/anxiety disease that was out there.
My favorite day in class though, was when we learned about autism. I for once did not think I had autism. I sat through there diagnosing other people I knew with high functioning autism. And from both sides of my classmates turned to me while learning about autism and said "I think I have that..." It was hilarious. I think it owuld have bêen caught by now if you had autism. But maybe not. Maybe we are all just high functioning autistic kids...It would explain a lot.
So as I sit studying new diseases, everything becomes more terrifying for me. Infectious disease: that class made me not want to leave my house, eat, or travel ever again. Those bugs are everywhere! And as I started studying for the boards, I convinced myself I have more and more diseases. All evidence is to the contrary, and I have enough sense left in me not to go to the doctor (I think I'm the only hypochondriac who is afraid of doctors), but still, dêep down I am positive I am diseased.
I'm hoping that as I transition from student into doctor, that fêeling will go away. I'll be able to diagnose things without fear that I tơo have those symptoms. But I'm not positive that is going to happen. So if anyone nêeds a someone to test out their MRI machine, let me know. I would love to sêe what is going on inside me. I know it is in there, just waiting to get me when I least expect it...

I'm only allowed one fun per week

Ever heard that saying "I can only please one person per day. Today is not your day. Tomorrow doesn't look good either..." That is how I feel about anything non-studying related. I can only do one non-studying thing a day, which makes it really hard to be an adult and handle medical school at the same time. And I certainly can only have fun once a week (what we call our one fun per week). Sometimes when friends call to see if I want to meet up all I can think is "I can only have one fun per week. This is not your week. Next week doesn't look good either." And it isn't becaue I don't want to spend time with my friends, I love them, and I love having friend both in and out of medical school. But if I spend too much time away from my books I feel a sense of panic filling me up, that no one but another medical student can understand. And, for all my non-medical school friend out there, I would just like you all to know that I generally have more fun than a lot of other medical students. So just think about that when I can't go to Film on the Rocks or Trivia every week :( or salsa dancing as much as I want to. Or even to the gym more than twice a week it feels.
I remember one time last year I was studying, I'd been trapped at home for a couple of days due to the snow, and a friend came to pick me up and take me boot shopping. And I found boots fairly quickly within the venture, and then decided that it was mean to not spend more time with her, so suggested we grab some coffee. About fifteen minutes into coffee time, I started panicking. I couldn't believe that I was out of my house, not studying. All I could think about was getting back to my studies. It was awful. I think during second semester of my second year I did actually put fun to a stop in the middle of the fun more than once saying I had to go study. I once didn't let my mom finish a story because a panic attack started.
The problem is, there is always more studying that we could do. Taking a day off is a big deal, because think of all you could have learned in that day! Think of what you could have learned in that half hour! So we put things on the backburner. We start by eliminating big things. Date nights, movies with friends, dinner out more than once a week. And we feel like we're doing okay, balancing studying with a social life. Some people are better at it than others.
But then...then it starts getting to be too much. Every second we are away from studying we feel like we should be studying. Now granted, not every second I spend studying is actually spent studying. But if I'm not studying I'm generally obsessing over how I should be studying. Luckily I've gotten a bit better at repressing these panic attacks, but they can get bad. It gets to the point where anything not studying is considered a study break. And suddenly my fun for the day has become washing the dishes, or folding laundry. Or updating this blog.
putting gas in my car is the bane of my existence. It literally takes ten minutes, but I never want to spend that ten minutes stopping at a gas station. Think of all the steps! All the wasted time! I have to park my car, get out of my car, stand there while it takes forever to pump, and then get back in my car and go on with my day. I cannot count the number of times I've come close to not making it to my destination because for three days in a row I've told myself I'll get gas on the way home, or tomorrow on the way to school.
Every little thing starts to take so much energy from us, and we stop being able to balance things well. All of a sudden I realized that I'm almost a month late on my car insurance, which I only pay once every six months. So technically I was uninsured for awhile there. Because putting a check in an envelope and then getting that envelope stamped and into a mail box?! Who has time for that? Laundry piles up on my floor. The dirty laundry manages to get into the hamper. Sometimes it even makes it into the wash machine and dryer. But then it lives in a basket on my floor for a couple weeks. I'm convinced if I just stare at it long enough it will fold itself, but it never does. And it always seems easier for me to just pull clothes out of that basket than put them away just to pull them back out again when I want to wear them. Jackets, piled up on the floor. It's a mess. And my room/car are just metaphors for my life at this point.
I remember in high school, the law of entropy (which states that as you expend energy you increase the entropy/disorder of a system) being explained like this: it's like your room. You have it all neat and organized. But then as you spend energy in other things, you don't have the energy to keep your room neat. So you throw things on the floor instead of hanging them up. And disorder ensues. The more tired you get, the more energy you've spent, the more disordered things become." I have sense learned that that is not really an accurate portrayal of entropy, but that is still how I think about it. And it is so true. As I use energy trying to study, I don't have enough to keep my life in order. I only have enough energy for the one thing.
I need to make a dentist appointment. Right now is the perfect time to do it. I have free time as I study. I can't do it while I'm in rotations. But I don't even have the energy to pick up the phone and call my dentist to set up the appointment! Because I could be doing something else in that precious thirty seconds it will take to get a dental appointment. That and I really just don't want to go to the dentist...
Or take for example the fact that when I was at Denver Health doing a rotation, I and a couple other medical students stopped paying for parking. We didn't do it because we were poor medical students who couldn't afford it. Each of us were willing to pay the parking, even if it is crap for us to have to pay for parking. All of us stopped paying for parking because we didn't want to take the time to park our car, walk down to the machine, give it two dollars, get a ticket, and walk BACK to our car to put the ticket in the window just to walk BACK to where the machine was because it is right by the entrance to the hospital. That takes like a whole ten minutes! So when I got a parking ticket, totally thought it was worth it, and would do the same thing again. In fact, I was trying to think of ways to continue getting out of paying for parking, like leaving the ticket in my door so that it looked like they'd already given me a ticket that day and would just continue on. But I felt like that would explode in my face.
And what did I do with that ticket? I waited until two days before it was due to pay it. There was a problem with the ticket and I needed to talk to someone about it, but I just could not make the time to pick up the phone and call about it. And I ended up flying downtown and running into the office as they were locking the doors (holding them open for another medical student in the same boat) to pay the damned thing...
Studying in medical school is a lot like a mother's work...it is never done. There is always something more to learn, more time you could spend doing practice questions,more time you could spend re-writing your notes, memorizing facts, making flash cards. And so everything else gets put on hold. And everything seems like a huge deal. What?! Send a payment in the mail?! I can barely find the time to pay my online bills! Clean my room?! Are you kidding me? I can't even put my clothes away. Everything goes on the backburner. Even eating. I once had a snickers bar for dinner because I couldn't put in the effort to feed myself. And this was when I lived at home and there was always food in the fridge. Today I ate half cold ravioli because I couldn't be bothered to put it back in the fridge.
However, since all medical students are partially OCD, and if we aren't, we become that way while in school, we cannot last this way. So we do things in big spurts. I start by doing my laundry, then decide to clean my whole room, then while I'm at it, might as well clean the bathroom, and the kitchen, and do my dishes, and take out the garbage. And go get a car wash. and before I know it, the entire day is gone, and I haven't studied at all because I was cleaning up. And sure, I feel better (because often when I clean my room my life seems like less of a mess) that I have a clean space, and I can start afresh tomorrow. But when tomorrow comes, guaranteed I am going to have a freak out about how I didn't study today, how I wasted the whole day cleaning and paying bills and all the other life things I have to do.
And that is why your medical school friends can't go out to dinner. Because if it were just a choice between you and studying, you would win. But if we go out to dinner with you, that's a whole evening of studying we couldn't get done, so we have to do it later. Which means we can't go to the gas station, or the grocery store, because we have to study.
Medical student's worst waste of time? Sitting in traffic. Because you can't even pretend to study then. There is NOTHING you can do but sit there and think about how you should be studying.
So I'm sorry, I can only have one fun per week. This may not be your week. Next week may not look good either. And while you think it is totally ridiculous for me to make plans to hang out with you in a month and a half, it makes total sense to me. I will work my entire schedule for that week around our one activity. But Ican only have that one activity that week. It's a lot of pressure. So go easy on us, dear non-medical student friends. A lot of work goes into this...