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Call It What It Is

It’s 2 a.m. on a Sunday night, and I can’t sleep.

Is this it? Am I dying?

I’m too aware of my heart beating. Each breath feels like trying to force that first puff of air into an unstretched balloon. The tightness in my chest makes it feel like I’m not getting air in.

I’m too young to be having a heart attack, right? I try to take deep breaths. Deep down I knew I wasn’t having a heart attack. Yet, I feared naming the actual cause. It was a label that I felt would define me.

Less than one week into medical school, I was a wreck. I was far away from home and dealing with roommate issues. On top of that, I had a toxic fear of failure, and my boyfriend and I were struggling with long distance. In all, I was overcome with negative emotions I had never truly learned to address. I met with our school’s psychologist who ended up calling my first few months of medical school “The Perfect Storm.” From August to January, everything that went wrong was toeing the line of my breaking point.

A dark cloud overshadowed my life: anxiety.

Anxiety drove frustration with my housing situation, which further increased my stress and decreased my ability to cope. Anxiety led me into a spiral that almost blew up my relationship, the strain of which fueled my fears and fed my lack of confidence. Anxiety made me angry and distant, constantly questioning how I could study let alone practice medicine one day. Each encounter with anxiety propelled me into a never-ending free fall, an infinite hole of stress and fear.

I studied half of my biochemistry notes through a haze of inexplicable tears — perhaps that was just because it was biochemistry. At least once a week, if not more, I had a stupid fight with my boyfriend over my complaints about some minor inconvenience a roommate had caused me. The web of negativity often ended with me crying at night as I tried to study Anki flashcards, panicked I would fail the block. This became the recurring cycle of the storm. Every time I felt I had balanced one aspect of my life, another issue set the whole thing off-kilter. The spiral would be born anew.

I had never felt more alone than I did in those first five months. To top it all off, my anxiety was exacerbated by the fear of others’ judgment. My classmates scared me. Not because they were inherently scary but because I was struggling so much I was afraid I would seem pathetic. I generally felt I wouldn’t fit in. While I already had social anxieties before medical school, in those five months, the anxiety became intense and overpowering: I had to give myself pep talks before attending any non-obligatory event. Those few people I had started to become friends with suddenly seemed to vanish. I spent so many months practically isolated from everyone.

Anxiety held me back from letting my peers in on my struggle, so I pulled away instead.

I would often look around at all my peers and see how easily and confidently they all seemed to cruise through medical school. In the shadows of my own doubt, I questioned if I truly belonged. Each new course and assignment left me feeling like more of a failure even though I was continuing to succeed. Once I looked out from the hurricane inside my mind, I found others who were fighting just as hard. One image easily summarizes this phenomenon: the duckling. On the surface, a duckling glides smoothly on the water, barely making a ripple. Underneath, those little feet are paddling like crazy to keep afloat and move forward. As a group of predominantly Type-A perfectionists, medical students fear being perceived as too weak or as unable to succeed.

For months I wondered how nobody else saw how much I was struggling. Though I can’t have an out-of-body experience to confirm, I imagine on the surface I appeared as confident and successful to them as they seemed to me.

I picked Georgetown to study medicine because in many ways I felt they advocated student wellbeing through their commitment to Jesuit ideals, such as cura personalis, and in the creation of courses like Mind-Body Medicine. The school encouraged seeking help and discussing burnout. Despite that, I still found myself falling victim to the fear of the stigma. How would the medical community, my peers, my family and my friends view me if I admitted that anxiety controlled more of my life than I let on?

After months of fighting that fear, I finally decided I couldn’t live with this constant storm of negative emotion. Struggling to maintain composure and my grades was difficult during those first few months; still, the hardest thing was accepting that I wasn’t going to feel happy if I constantly had to spend half of my energy battling back a wave of impending doom. Counseling and mindfulness helped, but I needed to talk to a psychiatrist as well. Within one meeting with her, she told me I likely had generalized anxiety disorder and, based on what I had shared, I probably had it most of my life.

That anxiety actually allowed me to flourish in high school and college. Part of me was afraid that losing that would make me lose a part of myself: I worried I would lose my drive or my intelligence. For years that anxiety was a part of me. However, I worried that admitting it was really there would allow it to define me. I was wrong.

Anxiety defined me more when I denied its existence than it does now that I’ve faced it head-on. Maybe the anxiety helped me get to where I was, but it was a burden I didn’t have to bear — especially not alone. Even knowing how important mental health is as a future physician, it embarrassed me to admit that I might need a prescription to help me cope with my fears and anxieties. I’m interested in psychiatry, and one day I myself could be prescribing medications to patients. If I wasn’t willing to admit to myself the need and usefulness of the medication, how could I ever expect to tell my patient there is no shame in taking a medication?

In seeking the help that allowed that anxiety to fade, I found that I was able to improve in ways that I had always wanted. No longer was I  snapping at loved ones, panicking, being shy in public, and letting strong emotions get the best of me. I still worry about passing my classes; I still get annoyed by things; I still feel afraid; but those feelings no longer take root and control my thoughts, actions, and behaviors.

I’ve thought about writing on this experience many times. And every time, I hesitated. The more I reflected on that hesitation, the more I realized that it is the very reason I should share my story: if I had admitted my anxiety fully to myself and others sooner, I may have been able to avoid the worst of it. Instead, burdened by a fear of social stigma and a toxic need to “be strong” or “grin and bear it,” I lied to myself that true strength came from pushing through it all.

I now know that this battle isn’t strong versus weak, it is what it is: anxiety. In accepting that, I finally freed myself from unnecessary weight.

Sara Wierbowski Sara Wierbowski (5 Posts)

Contributing Writer

Georgetown University School of Medicine

Sara Wierbowski is a forth-year medical student at Georgetown University School of Medicine in Washington, D.C. class of 2023. In 2019, she graduated from The University of Scranton with a Bachelor of Science in neuroscience and Bachelor of Arts in philosophy. She is currently a member of the Literature and Medicine Scholarly Track, which allows her to continue to enjoy the humanities while in medical school. After graduating medical school, Sara plans to pursue a psychiatry residency.