Neha Kumar (18 Posts)Columnist
Case Western Reserve University School of Medicine
Neha is a third year MD candidate at Case Western Reserve University School of Medicine. To combat the cold and snow in Cleveland, Neha spends her time napping, exploring art museums, and taking the local brunch world by storm, one sweet confection at a time. When she has saved up enough money, she plans to go on a world tour and visit every single capital of every single country.
Mind Your Mind
A very important but rarely discussed topic is that of mental health in medical practitioners, notably medical students. According to a study in the Student British Medical Journal, 30% of medical students report having a mental health condition—with a majority of 80% stating the level of available support was poor or only moderately adequate. This column was born from these alarming statistics and aims to stimulate conversation on mental health in medical students, from providing suggestions on how to maintain one’s mental health to discussing the taboo and stigma surrounding conversations on mental health in practitioners/students and how to eliminate it.
A very important topic is that of mental health in medical practitioners, notably medical students. According to a study in the Student British Medical Journal, 30% of medical students report having a mental health condition — with a majority of 80% stating the level of available support was poor or only moderately adequate. This column was born from these alarming statistics and aims to stimulate conversation on mental health in medical students, from providing suggestions on how to maintain one’s mental health to discussing the taboo and stigma surrounding conversations on mental health in practitioners and students, and how to eliminate it.
During our many years of medical training, we study complex physiological processes running the gamut from acute sepsis to the equally devastating progression of chronic diseases. We spend countless hours in lectures and on the wards, attempting to gain exposure to proper medical management of bread-and-butter medical problems as well as more obscure diseases which may only affect a handful of patients annually. However, most medical schools neglect to teach one crucial area of expertise — training in advocacy skills to address social determinants of health.
I recently finished reading Tracy Kidder’s Strength in What Remains, which highlights one man’s journey from the genocide in Burundi and Rwanda to becoming a refugee in New York City. Some chapters are quite graphic in their descriptions of the slaughtering of Hutus and Tutsis — the pain, suffering and atrocities he witnessed. These deaths seemed nothing like being on a morphine drip in an ICU bed or falling into a final deep sleep as your family surrounds you with tears and prayers. Instead they seemed gruesome and inhumane.
Shortly before returning to the United States for the holidays from Malawi, a truck full of police and military men pulled up next to my car as I was driving and demanded my driver’s license. They claimed I was “dangerously parked” while stopped in a long queue of traffic to let my friends hop out across from a bus station and would, therefore, be fined K10,000 (approximately $18).
It should be no surprise that when I asked my fellow medical students their suggestions for ways to de-stress, one of the first answers I heard from all of them was: “Yoga.” I should admit that I have always been a bit skeptical of yoga — I enjoyed cardio-based workouts far more. However, after doing some research, I found a study by Bansal et al. which found that medical students in India who did yoga every day for just one month showed significant improvements in both their general and mental wellbeing.
Doctored: The Disillusionment of an American Physician is Dr. Sandeep Jauhar’s second book. In keeping with good narrative nonfiction, Jauhar offers a mix of personal stories, thoughtful interludes and an obvious effort to back up claims with facts and statistics. He offers compelling anecdotes, which allow the reader to situate him or herself into the context of health care in New York City. These personal vignettes are especially helpful for highlighting concepts difficult to discuss; an ethical dilemma or complex criticism of the health care system becomes much easier to understand when tied to a tangible person or place.
To me, hitting a tennis ball is a symbol of how we as medical students perceive mental health: we know very well what habits are good for us and which are not. We know that we need eight to nine hours of sleep each night, a healthy diet and regular exercise. We know to engage in positive thinking, to nurture healthy relationships while cutting out toxic ones and to take time to “take care of ourselves” even when we are at our most stressed.
Like many bibliophiles, I keep a running list of books “To Read”, and I have a complicated system for deciding what I will read next; because of this, any new recommendation must go to the end of the queue. Every now and then, though, a book comes along that disrupts my whole system. In this case, I read an excerpt in The New Yorker that moved me: I was struck by the clarity of the writing and finished the excerpt wanting to know more. Over the next week, three different people recommended it and I began seeing it everywhere. Sensing that this book was something important, I bought and immediately began reading When Breath Becomes Air by Dr. Paul Kalanithi.
With each new year, we are pressured to construct a “new self” guided by resolutions. We design a “new year, new me,” fueling the marketing of self-improvement products around December and January. The explosion of fitness equipment in stores during this time attests to the pervasiveness of an annual self-improvement routine in our culture. Importantly, this phenomenon of constructing resolutions to improve body image represents some of the elements of our potentially misaligned “beauty culture,” where popular culture could be involved in driving individuals to extreme measures to achieve weight loss.
Before my year abroad, I decided to pursue a masters of public health at the Brown School of Social Work at Washington University. During the weeklong MPH orientation last fall, we had an eight-hour mandatory session on cultural awareness, which included drawing our cultures with crayons on blank sheets of paper and sharing them with the group. Throughout the day, one of the students kept emphasizing how much she has been grappling with her white privilege lately. At the time, I had trouble appreciating what she was referring to, but after almost four months in Africa, my “whiteness” is part of my daily thoughts.
“When I was in Laredo, I studied cello when I was in undergrad. My ultimate goal with the cello I guess “professionally” was to play cello with the Laredo Philharmonic Orchestra, which I did in April of my senior year. It was a huge deal for me. Since I was really young I always wanted to play with them — [it was] definitely my ultimate goal in music.”
Few doctors in the modern era have established themselves so securely as both doctor and writer as to be easily recognized in both circles; this is perhaps because of the difficult and time-demanding nature of both careers. One notable exception is Dr. Atul Gawande, a renowned general surgeon in Boston, MA, who also happens to be a widely published and well-known author of several books. In his most recent book, “Being Mortal,” it is clear that he has grown, not only as a writer, but as a doctor and a human being as well – which, after all, is what this book is all about.
Brent Schnipke (18 Posts)Medical Student Editor, Writer-in-Training and Columnist Emeritus
Boonshoft School of Medicine at Wright State University
Brent Schnipke is a third year medical student at Wright State University Boonshoft School of Medicine in Dayton, OH. He is a 2014 graduate of Mount Vernon Nazarene University with a degree in Biology. His professional interests include writing, medical humanities, and higher education. When he's not studying, he can be found reading at a local coffee shop, training for his next race, or planning an adventure with his wife. Brent is also active on social media and can be reached on Twitter and Instagram @brentschnipke.
Prints, Pages, and Pagers
Prints, Pages, and Pagers aims to look closely at the lives of medical students and doctors, real or fiction, whose lives and experiences are told in novels, short stories, poetry, or any kind of writing. These book reviews are an opportunity for medical students to learn from the many fascinating stories produced by the field of medicine, and maybe to read something other than a textbook.
