We finished psych block a few weeks ago: five weeks of learning not only about patients’ psychiatric disorders, but also physician mental health — sometimes jokingly referred to as “psychation.” It’s true — in comparison to other blocks, psychiatry is less overwhelming, mostly because the brain is really difficult to understand. It is even harder to figure out how humans perceive the world in their minds, so there are many mechanisms that have yet to be elucidated. As such, this block is a bit of a break from the normal breakneck pace of medical school.
Mental health has been on my mind lately, but not only because of the “Physician Mental Health” and “Resiliency Training” lectures we’ve been receiving during this block. A few weeks ago, one of my best friends from home texted me to say one of her medical school classmates had committed suicide a few days ago. He was a second-year medical student in the middle of his training to become a physician, just like I am. Even all the way across the country, the struggles that medical school students face are much the same, and though I did not know this student at all, his suicide felt like it hit close to home. Only medical students can understand how unique of an experience these four years are, and we form strong bonds as we are challenged to learn, struggle, and grow together during this journey. He could have been any one of my 179 classmates that I see day after day.
After the initial shock wore off, I was not actually as surprised by this news as I would hope. Throughout this past year, the heart-wrenching stories of suicides by medical students and physicians have only continued to accumulate, and it makes me feel tired. How can members of a profession that claims to bring hope into peoples’ lives become so hopeless? Clearly, mental health is equally important to both the physician and the patient. Physicians are incapable of caring for their patients if they themselves are preoccupied by personal issues or are facing burnout. My medical school has made it a point to expand their mental health program to make sure students are able to access the needed services. Unfortunately, when there’s a seemingly endless amount of information to learn and absorb, in addition to the countless advocacy groups, research projects and student organizations medical students are involved in, time for self-care is often the first thing to go from our packed schedules.
As a patient, being surrounded by a loving and supporting community was one of the largest blessings in my life. They made it possible for me to make it through that year and a half intact, with hope and with a smile on my face. When I grew tired and weary of the pains in my body, my friends listened to me complain endlessly, then encouraged me to face the next day with a better attitude. When my first surgery failed, my parents never wavered in their determination to seek out all available resources and options. When I felt like everything had been turned upside down, my friends reminded me to just breathe as they tried to help me restore some sense of normalcy to life. Though disease infiltrated so many aspects of my every day, and it was tempting to continually wallow in self-pity, I learned that in order to persevere and survive, I had to actively step outside the bubble of Cushing’s disease and stop allowing myself to be defined primarily by my illness. My community never ceased to share my burdens, to rejoice with me in small triumphs and to remind me that I have so many more identifiers than just a patient.
To my slight dismay, being in medical school is honestly not that different: it’s a difficult experience, and it can feel overwhelming and consuming. Ironically, as I was hoping to move on from my disease and leave it as a chapter behind me, my experiences as a patient — the coping skills I learned, knowing the importance of the community on which I relied — came in handy as I learned to navigate the ups and downs of medical school.
One of the biggest realizations I had between the first and second years of medical school was that, just like I had to step outside of my Cushing’s bubble as a patient, I also had to put boundaries on medical school. I learned to be okay with not studying all the time and not knowing every single detail of every lecture. I am happy to be a medical student, but I am also a daughter, a friend, an avid traveler and so much more. For me, it’s far more important to block off some time to visit my family, to catch up with friends and to allow myself mini breaks so that I can be refreshed and have a healthy relationship with medical school.
In both roles, as a patient and as a physician (in training), it makes all the difference to have time and space to process what’s going on in other aspects of life, and to have friends, family and classmates who can walk on the path alongside you.
To some extent, the personalities of medical school students make it hard for us to acknowledge that we can’t do everything alone and that we may need help. We like to plan things way far in advance, we like to be in control of all situations, we like life to be predictable, we try to figure out and understand everything. We are used to having our lives together all of the time. We commit to 200 percent when like everyone else, we really only have 100 percent to give.
I don’t want to hear any more stories of suicide within this community. So I plead with you: dear friends, as difficult and stressful and consuming this journey may be, please take care of yourselves — mentally, emotionally, physically and spiritually. I’m sure our future patients, colleagues and family members will thank us for it.
Lessons learned from both sides — A column exploring the qualities of a physician from the perspective of a physician in training, through the lens of a patient.