When I was younger, I played tennis.
For anyone who’s ever played tennis, you know that the hardest part often isn’t getting to the ball or anticipating where you want to hit it. Rather, it’s hitting the ball at the “sweet spot,” where the racket makes optimum impact with the ball. You might ask why this is so difficult, given its straightforward location: smack in the middle of the racket. The true difficulty lies in hitting the “sweet spot” while you’re simultaneously moving and thinking about where and how to hit the ball.
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. We readily give this advice to others, and when we are doctors, we will give this advice to our patients.
But as I’ve noted already, there is a big difference between knowing where the “sweet spot” is and actually hitting that target. Like in a tennis match, we are constantly engaged in an ever-changing environment. We always have to-do lists at least a page long, and many of us have bought into the myth: “Sleep, Social Life, Studies — pick two.” The crux of the matter is that we know when we aren’t taking care of ourselves, but we press forward anyway. Meanwhile, we may be adopting unhealthy coping mechanisms without realizing it. Bernhard Virshup’s Coping in Medical School contains an illuminating table (on page 170) that contrasts unhealthy coping mechanisms to which medical students and practitioners often turn with healthier coping attitudes that fosters long-term satisfaction and enjoyment, with less burnout. Do any of them apply to you?
What should we do next?
I don’t know. But I’m beginning a journey of self-exploration to find out — and I’d like to take you along with me. We’ve read 101 articles on mental health issues among medical students and physicians, and what can or should be done to improve it, whether it’s here on in-Training, on JAMA, or on that veritable news source Yahoo News. From doing yoga to getting a vagina steam, we’ve been inundated with ideas.
There are a number of problems with this approach. For one, we don’t have time to try out everything we’ve been told will “definitely” make us feel healthier. We may not have the resources either; barriers such as finances and transportation seem to loom large and make it easy to quit and return to less healthy habits — or to never try in the first place. Equally important is the fact that we are all different. What works for one person may not work for another, and it can be difficult to determine what to pursue, what will make us happiest.
And, with all this in mind, this column has been born. I hope to make it different from other columns about improving mental health. I plan on being your arms and legs, so to speak; I will try out various ideas myself — I may pass on the vagina steam — and report back to you with my personal experiences. I’ll give you the run-down of what I got out of it and suggest who might find it beneficial, and who might not. I’ll describe ways to explore the various activities despite potential concerns such as money, time and transportation. I’ll talk to others who are invested in these activities, and ask them why they would advocate for it. I’ll also inform you of worthwhile alternatives to consider in each case. In the end, you’ll know that these ideas and activities are things another medical student managed to try — another medical student who likely faces a similar reality as you.
I’d love to hear your suggestions, ideas and any other opinions. Stay tuned!
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.