I recently was asked what do I wish I knew prior to entering medical school or as a first year medical student.
I wish I had known how much my priorities would be challenged. I remember sitting at my white coat ceremony and the second year class president giving a speech saying we were going to feel so pressured for time that we would feel as if we didn’t have time to go grocery shopping, do laundry, or other basic life things. I remember thinking that was absurd. Having had a job and lived on my own before medical school I definitely didn’t think it would happen to me. I felt like I knew what it meant to take care of myself. Well I was wrong.
Towards the end of my first year of medical school I was driving, passing a gas station, and I remember looking down at my gas gauge seeing the needle hovering just above E, cringing, thinking I don’t have time to stop for gas. I felt so ridiculous. His speech flashed back in my head and I realized I had lost sight of my priorities. It was an eye-opening realization to suddenly see how broken I had become in a relatively short period of time. I struggled with not only feeling like I didn’t have the time to get gas, but I realized I had stopped eating regularly, an issue I struggled with in college. I found myself having PTSD-type flashbacks that made it hard for me to shower and sleep. I would cry about the most random things on the radio. I felt alone. I had no family in the area and I rarely saw any of them. Not sure if it would have helped. Medical school is really hard to relate to or explain to people who aren’t in it. I realized that I was suppressing so much of my personal struggles that I was starting to drown.
Throughout my first year of medical school, especially after gross anatomy (our first course), I felt like I was just barely treading water in our coursework especially in conjunction with the leadership positions I had taken on partway through the fall semester. I have always had a tendency to spread myself thin and I thought medical school was going to be different, mainly because I told myself I was going to avoid leadership positions, but old habits die hard as they say and I did what I always do. I prioritized other people and their wellbeing over my own. I have always taken on a motherly role in my social circles and the same thing happened here. I am not one to sit back silently when things are wrong and we had issues among our class, with administration mostly, and so my classmates quickly adopted me as a spokesperson for getting shit done when it was perceived to be broken. This role became quite consuming for me and in part may have been exacerbated by the underlying depression that I was no doubt dealing with at the time. So struggling in every aspect of my life made it really easy to lose sight of what I needed to do to be healthy, happy, and whole.
I think as a first and second year student it is very easy to lose perspective and I feel that is exactly what happened to me. You are surrounded by people who all seem to really have their shit together and seem to be doing so much better than you in every aspect of life and you really start to feel like you missed the boat somehow and have no idea how to get back on deck. It can be very isolating. I lost sight of what was really important in life and it wasn’t my neuro final that is for damn sure. I realized that I needed to start taking stock of my little victories and really cherishing those moments. I realized that I needed to be kinder to myself and draw some lines in the sand so I didn’t overstretch myself. I also think having some distance between now and the struggles faced in those first two years has given me an opportunity to really reflect on them. In the past year and a half, especially, interacting with so many individuals at different stages in their life and at different levels of health, I have come to realize more and more just how important it is to prioritize your wellbeing, take care of yourself. You come to realize how insignificant that one exam really is in the grand scheme of life. You come to see how lucky you are and how you need to find joy in every day because you honestly don’t know when it will be you last (morbid I know, but it only takes one 28-year-old patient to make you realize that you are not immune to getting hurt or sick). That I think was the biggest change for me, trying to find joy in as many days as I could. If I had been pushed earlier in my medical school career to keep that in the forefront of what I did and the decisions I made, I think I would have been a happier first and second year medical student, and maybe more successful.
Being a mentor now to many first and second year medical students, I have made a concerted effort to stress many of these points to my students. I stress the importance of taking time for themselves and most of all not feeling guilty about taking that time. I think offering up my struggles has been helpful for many of them. Especially because I think a lot of them look at me and think exactly what I thought when I was in their shoes, “man how does she have it so together?!” Letting them know they are not alone and that it’s going to be ok. I know I would have appreciated someone saying that to me. I think one of our biggest fears as medical students, and health care providers, is failing. However, I think we really need to become more comfortable with failing. It’s inevitable. We are human. We as a profession need to deal with our insecurity around this topic. Yes, we do live in life or death situations, but we can’t always get it right as hard as we try. In order to foster this type of mentality, we need to start grooming medical students to deal with their aversion to failing. In my role as a mentor to medical students at many different stages in their medical education, I have really tried to nurture an environment where it is safe to fail. By no means do I think that I am comfortable with my own failings, but I think it is something that I am working on and want to help my peers and mentees with as well. However, I don’t know if complete comfort of failing is what we should strive for. Failure pushes us to continually be better. I firmly believe failing is a necessary process in life. We learn a lot more from our failures than our victories. In the end in medical school grades are just grades. It’ll all work out. We’ll all be good doctors. However, through this process of becoming a doctor we need to make sure that we keep our humanity and treat ourselves as humans.