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.