This piece is part of in-Training Mental Health Week.
Neuroanatomy lab exam. You’ve got this. You studied hard. You’re good at anatomy, you know that. Okay, found a tag you definitely know. Start at the one you know. You’ll be okay.
It’s the way I try to start every exam. I try to talk myself up to push away all of the negativity slowly flooding my brain. Anxiety is a tough card to be dealt, especially in medical school. There are only so many ways to cope with the mounting pressure.
My first memorable bout of test-related anxiety started in my junior year of college. I was in the middle of one of my toughest semesters yet, packed with a full load of science courses. At the time, I didn’t think the strange thing happening was anxiety-related at all. I would walk into my organic chemistry tests confident and ready to succeed, take the exam and finish with time to spare. On my walk back to the shuttle, all of my previous confidence would crumble to pieces and I would cry to my mom on the phone. A few days after our grades would show up, lo and behold, I would pass with flying colors.
You may think that after being shown that I had the ability, I would stop freaking out. The problem was, I saw no issue with my short instances of panic. Maybe they were actually a good thing, I would tell myself. Maybe it was like a charm and every freak out I had was really helping me in the long run. I was incredibly wrong.
Fast forward three years. Now in my third term of medical school, my anxiety has returned to haunt me 10 fold. Instead of freaking out after exams, it has become an ever-present event, a battle to stay levelheaded. Sometimes I’ll have full symptoms, mentally and physically. Other times, only my body will respond with panic. It’s confusing, scary and incredibly distracting during an exam.
As I round the corner to the second question on the lab exam, I freeze. I do not know the answer. I can feel my hands start to shake and my pulse quicken. I can feel my heart beat through my chest and hear it in my ears. My eyes dart around frantically, watching my other classmates scribble answers on their papers. It feels like I need to run, like I’m being chased — the beast of my anxiety is out to ruin me. I stare at the tag and secondary question for a good 15 seconds, which feel like an eternity and warp speed all at the same time, before any words start to float around in my now vastly empty mind. I run out of time before I can answer the second question and I quickly jot it down to maybe answer later.
After about six questions a professor spots me rocking back and forth on my heels, something I was unaware that I was doing. She comes behind me and assures me I know more than I feel and that I need to keep breathing. No one had ever attempted to calm me down during an exam. In reality, it’s not really plausible to do so. Maybe it was my once instance of luck. While I had a few more moment of panic, I was able to come back and not let it destroy my focus.
I actually ended up doing alright on that lab exam (of course a shock to me). But I haven’t always been so lucky. More times than not, my anxiety is a large hindrance to my performance. I’ve long since gotten over thinking I’m not smart enough to do well in medical school. For most students, getting accepted to a medical school means you’ve got “the right stuff.” Sometimes the right stuff just hits some solid road blocks.
What makes medical students so prone to panic attacks, or the less refined, yet common, freak out session of intermittent panic and self-depreciation? I suppose to main reason is obvious. One day we’ll be responsible for the lives of our patients. If we don’t know our facts or have the ability to answer complex questions, how can we be expected to help patients? It’s part of the truth, but overplayed and cliché in my personal opinion. I think the real reason medical students are found in some less-than-flattering states of existence is the overwhelming fear of failure and the possibility of ruining future opportunities.
To be blunt, medical students are neurotic. Most of us don’t truly handle the pressure we were screened for in those interviews. We trudge through it, and more often than not make it out alive. How can you recognize, though, when you’ve gone too deep? How can you tell when you’ve gone from relatively normal amounts of stress to full blown, out of proportion panic attacks? You would think that the lines would be clearly defined but it’s like being put in a pot and slowly bringing the water to a boil. It can be too late before your realize what has happened.
I’m working on managing my anxiety from as many angles possible. It’s too late to tell my 20-year-old self to stop worrying over every tiny thing. Medical students will always undergo panic and stress. It’s almost a rite of passage to completely break down from the pressure. But it cannot stop the progression. Anxiety doesn’t have the place to stop anyone from reaching their goals. I really do like being a medical student and learning the things that will one day make it possible to help others.
It always gets worse before it gets better. Don’t I know it. And yet here and I am, still pushing through, still refusing to give up. My battle may be an internal one, but that doesn’t mean I still can’t come out the victor.
If you find yourself in a similar situation, reach out. People want to help you. Professors, friends, physicians: all of them want to see you succeed. Don’t let the anxiety get you before you can stop it. I do believe I am slowly but surely making progress to quell the beast. I’ll always have it looming over my shoulder, but once you know how to defeat it, you’ll always be the victor.