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How a 3-Minute Scene from The Bear Reframed My Perspective on Medical School

Published by Sandra Boutros

I was having one of those days in medical school where the weight of everything felt crushing—the pressure to be perfect, the constant comparisons to my peers, and the nagging doubt of whether I truly belonged here. It felt like I was running a race on a treadmill—no matter how fast I went, I was never getting any closer to the finish line. The harder I pushed, the more distant my goal seemed, leaving me with that persistent, nagging thought: Am I really cut out for this? It wasn’t just my abilities I began to question—it was as though my sense of purpose was fading, becoming harder to grasp with each passing day, as if I was losing sight of why I started this journey in the first place.

In need of a break, I turned to The Bear on Hulu, hoping to escape, even if just for a while. Although, like any medical student, I felt initial guilt in indulging in this free time. What I didn’t expect was that within a simple three-minute scene, I would find something that would resonate so deeply it would shift my entire perspective. Watching the conversation between Luca, a master pastry chef, and Marcus, an eager but uncertain baker, I suddenly found clarity in the very thing I had been struggling with for weeks.

In the scene, Luca—a masterful pastry chef—talks to Marcus, a young, hopeful baker, about the true essence of growth. It’s not found in moments of instant success or inborn talent, Luca explains, but in the willingness to embrace failure, to learn from mistakes, and to return with renewed effort. His words landed like a revelation, cutting through the noise of self-doubt that had been clouding my mind. It wasn’t about being perfect from the start; it was about showing up, failing, and trying again. I couldn’t help but laugh when Marcus asked, “How did you get good at this?”—the very same question I had nervously posed to my senior resident just days before. It was at that moment I realized that the path to mastery isn’t about avoiding mistakes but about learning to navigate through them.

In that moment, I realized I had been lost—chasing a version of success that didn’t leave room for imperfection. I had been holding myself to impossibly high standards, forgetting that this journey isn’t a sprint to mastery; it’s a slow, deliberate climb. It’s not about perfection—it’s about progress. And progress, I now understood, demands failure. But it’s not just about making mistakes—it’s about learning to fail well, to reflect, to adapt, and to keep pushing forward. Luca’s words reframed failure for me; it was no longer something to fear or hide from, but something essential to the process of becoming, not just a doctor, but a better version of myself.

I had been consumed by comparisons—constantly weighing my worth against the abilities of my peers, residents, and attendings and of course the worst of all… Uworld. But Luca’s wisdom offered a different perspective: I had been missing the point. My peers were not benchmarks to measure myself against, but resources. Each of them carried their own strengths, experiences, and insights. Instead of allowing their achievements to magnify my insecurities, I needed to see them as guides on this journey. We all have something to offer to one another, and true growth happens when we lift each other up. I can’t count the number of times I have adopted new perspectives or approaches to my clinical reasoning just by simply observing my classmates perform at their best. The key was stepping outside of my own self-doubt long enough to realize that by leaning on those around me, I could grow far beyond what I imagined.

The same went for the residents and doctors I had been comparing myself to. They weren’t there to intimidate me; they were there to guide me. These seasoned professionals weren’t unattainable figures—they were teachers, mentors, and, most importantly, humans who had walked this path before me. Their goal wasn’t to highlight my shortcomings, but to offer me the wisdom they had gained through their own struggles. Instead of thinking, I don’t know if I’ll ever reach that level, I needed to remind myself that every day I show up, I’m getting closer. Every interaction, every case, every stumble is another step forward. I needed to shift my focus from judging my success by the finish line and start rewarding myself for each effort along the way. Growth is subtle, but it’s always there if we choose to notice it. 

That scene also reminded me that medical school is, in many ways, about finding what works for me. Luca’s advice to Marcus about discovering his own path, his own techniques, struck a chord with me. It was a reminder that there is no single “right way” to succeed. Just as Marcus had to experiment, fail, and adjust in the kitchen, I needed to do the same in my studies and in the hospital. This time isn’t just about absorbing information—it’s about discovering how I learn best, how I connect with patients, and how I navigate the challenges of medicine. It’s okay if my process looks different from someone else’s, as long as I’m learning, adapting, and growing with each step. Additionally, it reminded me of the artistry of medicine. Once we learn our foundations and skills, we should be encouraged to add our personal touch and creativity to our approaches, creating a colorful canvas of humanism. 

One of the biggest takeaways from that conversation was the importance of staying curious. Luca’s passion for his craft and his willingness to keep learning, even after achieving so much, was a reminder that curiosity is key to self-growth and improvement. In medicine, curiosity drives us to ask questions, to dig deeper, and to never settle for surface-level understanding. It’s what pushes us to become better doctors, not just by mastering the material, but by continually seeking to expand our knowledge and understanding.

Luca’s openness to new ideas and different perspectives was something I needed to adopt. In medicine, we often come in with our own biases, with rigid plans for our careers, and with preconceived notions about how things should be. But the reality is, we’re given a rare opportunity to interact with people from all walks of life, to learn from individuals who have different experiences and perspectives. By being open to these diverse viewpoints, we can grow not just as doctors, but as human beings. The more open we are, the more we can truly take advantage of the incredible learning opportunities that medical school offers.

Looking back, I see that my obsession with high standards of achievement was holding me back from reaching my true potential. Medical school isn’t about being perfect; it’s about learning, growing, and improving every day in your own unique way. Luca’s advice to Marcus in that scene from The Bear helped me understand that the journey to becoming a doctor is much like the journey to becoming a great chef—it’s messy, it’s full of mistakes, but it’s also rich with opportunities for growth. By embracing the process, leaning on others for support, and staying curious and open-minded, I’m giving myself the chance to reach my full potential, not just as a student, but as a future physician.

Healing’s First Breath

Published by Emilio Blair

The clinic room was quiet, the air laced with the familiar scent of hand sanitizer. Cold air crept out from the overhead vent and slipped through my scrubs, sharpening my focus but numbing my hands at the same time. I was a third-year medical student on my family medicine rotation. Sitting across from me was my first patient of the day, a woman in her forties, here for her routine annual checkup. I settled onto a stool, just below her eye level, and asked the question I had asked countless patients before: “What brings you in today?”

She appeared composed as she began, noting that she had no pressing health concerns. Her voice was steady and measured, yet soft. Nothing was immediately concerning, yet her reserved demeanor hinted that there might be something more beneath the surface. I continued the interview, hoping her story would become clear with time. Slowly, I pieced together fragments of her story: she was a single mother, working long hours to support her children. Having left her home in South America months earlier, she now struggled to adjust to a new life in an unfamiliar country. As I listened, I was reminded of how I felt as an eight-year-old who had just moved from Mexico to the United States. I too had felt far from home and I now could see this personal memory reflected in her words. We continued, exchanging small details about her life and our shared experiences of moving to a new country. Our conversation eventually shifted back to her health and I resumed gathering her history. After a few minutes, I asked her about her exercise habits. She replied, “Because of recent family events, I haven’t been able to exercise as much.”

It was not so much the words themselves as the way she said them—a subtle shift in tone that made me pause. I met her gaze and gently responded, “If it’s not too difficult, could you tell me a little about that?”

She paused before taking a deep breath in, and as she exhaled, her words unfolded a story of deep loss. Just weeks earlier, her younger sister had passed away from cancer in her hometown. The diagnosis had come suddenly, without warning. Her sister was only in her 30s, and there was no family history of cancer. The patient spoke of her anguish and of the barriers that had kept her from being at her sister’s side: financial strain, travel restrictions and political upheaval back home.

Her composure began to falter, her voice thickening with the weight of grief. I listened in silence, handing her a tissue as the first tears fell. Her grief had found its way to the surface and was now pouring out. I had provided only gentle prompting and a listening ear, and her story nearly exploded out of her. By being interested in her story rather than her symptoms, I had provided her with a space where she could discuss the grief she had been carrying. I became acutely aware of how isolated she must have felt carrying this pain thousands of miles from home, facing each day with uncertainty and the overwhelming burden of losing her sister.

I found myself reflecting on how we had found ourselves in this conversation, and I briefly glanced at the last thing I wrote in my notebook: “Exercise.”

What was supposed to be a routine visit had transformed the room around us. A simple question about exercise habits had organically grown into a deeply memorable encounter. I no longer sensed the sharp scent of sanitizer or the chill in my fingers. In that moment, everything else fell away—all that remained was the patient and the undeniable weight of her sorrow filling the air between us. She shared the pressure of managing her grief alone and navigating single motherhood under the shadow of her loss. Her sorrow was immeasurable. Hoping to acknowledge and validate the depth of her struggle, I said gently, “Of course you’re feeling overwhelmed. This has been an incredibly difficult time, especially handling it on your own so far from home.”

The relief on her face was visible, as if a burden had been lifted. She opened up even more, describing the emotional weight of managing her grief without a support network nearby. She spoke of her isolation, the way it sank its fangs into her life and made her grief even more difficult to bear. She spoke of the sadness that filled her days and the loneliness that seeped into her nights. We shared a long silence as she looked at the floor, processing, and I found myself profoundly humbled and inspired by her resilience. Her strength was undeniable.

This encounter reminded me that healing often begins in small, unexpected moments. I had entered the room prepared for a routine exam, but by remaining open to her words—and, just as importantly, to her silences—I had been drawn into something profound. In an instant, routine was transformed into a moment of profound trust, creating an opening for her to consider counseling and antidepressant therapy, tangible steps toward healing. I felt gratitude for the connection that had quietly grown between us; the therapeutic nature of our conversation now felt as tangible as the emotional vulnerability she had shared. The air around us, which was thick with sorrow moments before, now held something lighter: hope.

I was moved not only by the patient’s story but also by my own growth in knowing how to elicit it. Just a few years ago, I might have overlooked her comment, reducing “not exercising” to a checkbox in a hurried note. Back then, I was so preoccupied with perfecting my formulaic history-taking technique, anxious about sharing a room with someone who had been a stranger just moments before—someone I had to quickly win over to explore the most personal aspects of their life.  But with this patient, something was different. There was a tangible shift, a testament to my growth as a medical student learning to follow subtle cues, unafraid of where they might lead.

This experience stays with me as a reminder to approach each patient with curiosity, to linger in pauses, and to meet them where they are—wherever that may be. Ultimately, becoming a physician means building the kind of trust that invites patients to unburden themselves, transforming health care into an opportunity for care and connection to converge. Listening is not just about hearing symptoms; it is about creating a space where unspoken struggles find room to emerge. Sometimes, it is in these quiet spaces where healing can take its first breath.

 

[Featured] Image courtesy of Emilio Blair

The road less travelled

Published by Ayesha Khan

“Two roads diverged in a wood and I-
I took the one less traveled by,
And that has made all the difference.”
‘The Road not Taken’ by Robert Frost.

‘The Road not Taken’ is a poem by Robert Frost, where he talks about the impact of making different choices. The poem has stuck with me as I believe it resonates with my choice to specialize in family medicine – unknown to more than half of the medical graduates in my country, Pakistan.

In Pakistan, becoming a doctor is a dream that many parents have for their children. It is considered noble, and it ensures a relatively stable income in the economic stagnation that we face. But when it comes to making a choice of specialization, many fields that are well established in the rest of the world are unheard of, underdeveloped and underrated in Pakistan.

‘Family medicine’ – I heard the words for the first time from my sister, who had a friend who decided to pursue the specialty at Aga Khan University Hospital (AKUH) in Karachi, the pioneer institution and one of the few places that offered fellowship training in the discipline. Her class fellows were astonished. “But she was a very bright student, why did she go into family medicine?”

This astonishment stemmed from young aspiring graduates, who found sub-specialty and super-specialty to be lucrative options for a postgraduate degree. Anyone settling for a mundane field like primary care would mean that the person either lacked talent or motivation. While they mourned the waste of a good brain, the 15-year-old that I was back then thought this field might be for me as perhaps they choose not-so-bright people!

Years later, as a fresh graduate from medical college, the only additional information about family medicine for me by then was that my sister’s friend had moved to Australia after her residency.

Internship at AKUH followed, and I didn’t get a slot in family medicine as they were taken up by high achievers in the selection tests. My first desire to become a ‘generalist’ came in a specialty clinic while seeing a patient with multiple comorbid conditions. As soon as the patient would utter a new presenting complaint, I would do my referral form, making duty like any efficient intern. By the end of that consultation, I had referral letters made to endocrinology, cardiology, pulmonology and orthopedics.

Post-internship, the real dilemma came. The time to decide my area of specialization had arrived. As JK Rowling said, “There is an expiry date to blaming your parents for the decisions they take for your life.” For the first time, this had to be a decision that I made for myself, and there would be no one to blame if it did not go well.

I finally made the choice after two years. In those two years, I questioned what I wanted to do for the rest of my life. The answer came after doing short stints at community-based family medicine clinics in early 2018. The chance to see the grandmother for her osteoarthritis, the daughter, a new mom, for her postnatal check and the grandson for his well-baby check was immensely gratifying. And in 2019, there I was in the residency program at the same AKUH.

A journey began that was nothing short of a roller coaster ride. Though I thought that it was a well thought out decision, doubts were created by those around me every day. From my aging, innocent parents who found it hard to explain ‘family medicine,’ to relatives, to colleagues who would comment on the field having no scope. From seniors of internship year who would sigh with disbelief, “Family medicine, c’mon,” to well-wishers who would tell me that it is still not too late to change the specialty. Amid these doubts I somehow made it to the second year of our residency. The comments continued…“It’s a very small club. There is no growth. You won’t be saving a life like we do, is that satisfying?”

At the threshold of completing my four years here, I have realized that choosing the road less traveled has really made all the difference. Had it not been a small club, shy residents like me would have been lost in the crowd. I’m grateful for all the mentors who recognized my strengths.

We are a better version of ourselves than how we came in the first year – that is growth to me.

And yes, it’s satisfying since we save lives by taking time out to talk to our patients about prevention of disease. It may not sound heroic, but the impact of these small talks can mean a better tomorrow for the population, a whole generation.

To quote JK Rowling again,

“It is our choices, Harry, that show what we truly are, far more than our abilities”

The choice I made four years ago was the best I have made this far!

 

Image Credit: (Two roads diverged in a wood” (CC BY-NC-ND 2.0) by Nguyen-Dang Tung)

Saving Lives

Published by Aaron Davidson

Beating the chest, emergency surgery, stopping the bleed,
The obvious ways to save a life, that which we all agree.
Picture a doctor saving lives–what first comes to mind?
The ER doc, the trauma surgeon, surely the first to find.

But we often fail to see beyond in more subtle ways,
How other doctors save lives through different displays.
The patient with chronic back pain, feeling death the only solution,
Relieved from misery by a single spinal fusion.

Another with mental illness that can’t help but think the same,
So let’s not forget psychiatrists who deserve plenty of fame.
And a teen with acne feeling ashamed of himself,
Yes, that dermatologist did more than just help.

These are lives saved that we often miss,
For all doctors save lives–let’s remember this.
Treating all patients with equality and respect
Holds a much deeper meaning and a profound effect.

But it’s not just doctors who hold the tools to do so,
For every person saves lives, though it might not always show.
Acts of kindness, floods of love and care,
You never know if someone needed you to just be there.

As doctors and as humans, let this all sink,
For saving lives is more than what we might think.

 

Poetry Thursdays is an initiative that highlights poems by medical students. If you are interested in contributing or would like to learn more, please contact our editors.

The Bridge We Build

Published by Leanne Peres da Silva

In halls of sterile light and steel,

Where pulses echo, hearts to heal,

A quiet truth begins to rise—

Care can’t be measured by device.

 

For every chart, each test result,

There lies a gap, a hidden fault,

Where voices lost, unheard, remain—

A silent burden wrapped in pain.

 

From city streets to rural lanes,

Health divides in unseen chains,

A mother waits, her voice denied,

As walls of care grow far and wide.

 

For in the spaces where we fall,

We search for voices but fail the call,

Yet far too often, eyes are glazed,

As charts and numbers leave us dazed.

 

Despite the needs that linger near,

The call for change will never disappear,

Where time is short and tasks remain,

The human story bears the strain.

 

So may we strive, with open hearts,

To see the whole, not just the parts,

For true connection, clear and bold—

We must challenge norms and break the mold

 

May we learn, through heart and mind,

That health is not for one to find,

So doctors must unite, together fulfill—

A healing bridge, a shared goodwill.

After the Match

Published by Lori-Anne Noyahr

we dozed on a mattress
rattling overtop the yellow line,
dreams buzzing to the
arrival of each subway car.

how hard we fought to
wake together, and
walk among hundreds
on this cold palate
of concrete, between the
pointed teeth of buildings,

unclear if in these shadows
we are sheltered, as
mouthbrood roe, or simply
waiting, to be consumed.

 

Poetry Thursdays is an initiative that highlights poems by medical students. If you are interested in contributing or would like to learn more, please contact our editors.

A Summer of Reflection

Published by Abdullah A. Memon

7AADMaxilla 3DAssay planning

As the summer countdown began, there was both a sense of thrill — excitement to learn from and be around someone I admired — and a weight of expectation, both from myself and from those I’d be working with. These emotions are familiar to most embarking on the journey of medicine, where the promise of growth comes hand in hand with the pressure to rise to the occasion. I honestly hoped it would be filled with the kind of moments you can’t get from books alone, the kind you’d tell the grandkids about. Little did I know, it would be that and so much more.

What I thought would be a summer immersed solely in the science turned into an unforgettable bench-to-bedside journey, bridging the OR and the lab. One memory I return to often is the first time I was standing in front of a fibula free flap being procured for a maxilla englufed by cancer. As the initial cuts were made, I couldn’t help but tilt my head back and forth, blinding myself as the bright OR lights reflected off the glistening fascia. I hoped no one noticed, or else they might have wondered what was going on with me. This was nothing like anatomy lab where everything was preserved and muted, set against the background of pungent formaldehyde. Here, every structure was alive, and every movement had purpose, solidified by the smoke from the Bovie carrying the smell of burning flesh into the ether. Every experienced spread of the Scanlon, every purposefully ligated vessel, and every nerve sacrificed overrode the whispers of uncertainty while reflecting the harmony between art and science. What a profound privilege it is to work on the human body in real time.

The tumor immunology lab, though quieter, offered its own rewards. I felt it to be a space for reflection and deep introspection, where the implications of what was seen in the OR could be understood and expanded upon. There was pure excitement in reducing number-assigned tumors to mere fragments, preparing them for the creation of cell lines. It was often easy to forget that these same tumors in the OR were intertwined with the very essence of a patient’s life. What made being in the lab special was the beauty in some days being filled with discussion on the stochasticity of science, while others were more about the rawness of life as we experience it. It was this balance that made being here such an enriching environment, one where both the cells and us humans cultivating them could thrive.

From the blue drapes that mosaicked over a patient to the whooshing of the glass shield within the confines of a culture hood, each environment demanded its own sterility. I came into the summer looking for something grounding — a sense of direction, maybe even confirmation that the path I was on still made sense. I hoped that if I committed fully, asked the right questions, and paid close attention, something meaningful would take shape. But medicine and its pursuit, I learned, is rarely linear. Rejection and setbacks are necessary evils. The OR taught me that precision is only part of the equation; the lab reminded me that science fails much more than it succeeds. Through both, I came to see that sterility is not just physical: it is in our approach, our assumptions and our desire for control. I was reminded that the true reward in this work is not in meeting expectations or in crafting a perfect story in a predefined way; it is in uncovering the raw, unfiltered truth, no matter how it challenges or surprises you. Maybe this applies to life in general, but for me, it all started here. And as the summer sun set all too soon, I found myself reminiscing on the great experiences with even greater people — memories I will carry with me and reflect on for years to come.

Featured images courtesy of Abdullah A. Memon

Counting Down

Published by Michael Nguyen

I stepped into your home in a short white coat

You asked me what year I was in

I answered, I asked you how your day was

You told me, “it is as good as it gets!” (smiling)

As you count down the days

I think to myself (nervously)

We both are counting down the days

But the way you’ve chosen to peer at future days is

One I will never forget

One we will count on

One that will prevail 

 

Poetry Thursdays is an initiative that highlights poems by medical students. If you are interested in contributing or would like to learn more, please contact our editors.

The First Day

Published by Kristen Anderson

From great violence burst that first guttural wail of life. Gurgling with fluid, peach fuzz slipped into gloved hands. Your head was still moulded by the birth canal as we fit your wee yarn cap. Your mama is a warrior; you’ll see her battle scar one day and will hardly believe that it was through this fine passage you slid into life, spluttering with indignation to have been woken so abruptly from your nap. How your papa squeezed your hand, gazing once more into his mother’s eyes. Time coiled past and present through downy curls. 

You were so untouched by the world that you weren’t sure how to cry; your mouth opened and closed around warbles of sound. You were pruned as fingers after a long bath, for you’ve been floating these nine months.

How soon you’ll crawl, then run and climb. How soon these abstract splotches before you will morph into Mama and Papa, their shapes shifting through all the memories of your childhood, shrinking as you grow until you find one day that they were little more than children, the years long gone by. You will struggle to hold onto the last tendrils of a youth slipping ever further out of reach – but that is ages away, for a time when you have aged more than the caterpillar cocooned outside our window. How soon you will explore all your parents long to show you, will weather all they long to shelter you from, and the lifetime of today will be but one day of many.

Perhaps we’ll meet again under the glow of the operating room lights. You will hold your new world in your arms and will wonder that she has your father’s eyes, opening into this brief, shared glimpse of eternity. But for now you are bundled, a bundle of joy, delicate and blinking. What a beautiful day it is, this day I share with you.

The Physician CEO Advantage: Why Leadership Training Belongs in Medical Education

Published by Kush Savsani

Healthcare is inherently a high-stress field, requiring constant adaptability, critical decision-making and steadfast resilience in the face of unpredictable challenges. Effective leadership in this environment demands a unique combination of skills: the ability to navigate regulatory changes, leverage medical advancements, address complex patient needs and ensure organizational stability. Physicians, who operate daily within these high-stress settings, are uniquely equipped to lead in such demanding environments. Their firsthand experience enables them to understand the pressures faced by healthcare teams as well as the intricate balance between clinical priorities and financial considerations. This blend of expertise positions physicians as strong candidates to drive healthcare organizations toward success in an ever-changing landscape.

Physicians bring a unique advantage to the Chief Executive Officer (CEO) role in healthcare organizations (HCOs). Their deep understanding of clinical workflows and workplace culture allow them to make informed decisions that optimize efficiency and improve quality of care. Studies have shown that physician executives are more likely to utilize evidence-based research emphasizing quality metrics and patient outcomes to support their decisions. Large hospital systems led by physicians in 2015 were found to have higher US World News Ratings (USNWR) and bed usage rates than hospitals led by nonphysicians without a significant difference in financial performance. Led by their clinical expertise, physician-CEOs can champion initiatives that improve care coordination and reduce wait times, ultimately leading to a more positive and effective healthcare system for all stakeholders.

Since the COVID-19 pandemic, we have seen a greater number of physician-CEOs in top hospital systems. Physicians and clinicians in HCO management have proved to be more effective in crisis situations. During the pandemic, when hospitals experienced the most strain with regards to capacity and resource-allocation, physician-led systems were associated with better organizational performance, higher rates of patient satisfaction and improved capacity utilization. Since the pandemic, we have seen a rise in physicians taking on the CEO role in large hospital systems. In 2019, before the pandemic, USWNR’s Hospital “Honor Roll” listed 21 top hospitals, 13 of which were physician-managed (physicians on the board) and six of which were physician-led (physician-CEO). After the pandemic, the 2023 honor roll lists 23 hospitals, 15 of which are physician-led, demonstrating a clear increase in physicians filling the highest role in hospital system management.

When asked about what attributes of physician-leaders might account for better organizational performance, former Cleveland Clinic CEO Dr. Toby Cosgrove answered, “credibility … peer-to-peer credibility.” Certainly, the professional experience of a physician within the healthcare industry can give them more credibility with hospital staff. Many physicians already possess the essential qualities of a great leader, as these are learned skills given their role in the healthcare team. Their training gives them experience in crisis management, multi-tasking, and managing cognitive biases.  However, the leadership style that most physicians practice may be less compatible with the necessities of executive positions in healthcare organizations. Dr. Victor Dzau, president of the National Academy of Medicine, argues that “physicians have traditionally been trained in ‘command and control’ environments as ‘heroic lone healers’ who are collaboratively challenged.” So how can we bridge this gap to create better physician-leaders? Despite the extensive education provided to medical trainees, there seems to be a lack of a formal education on fundamental leadership skills. There are at least 60 MD/MBA dual degree programs in the US. However, beyond this, it is essential for medical schools to incorporate formal leadership training into their curricula with emphasis on holistic thinking and systems interventions rather than command and control styles. Regardless of whether students choose to pursue formal education in business with an MBA program, all physicians are thrust into the world of leadership and would surely benefit from formal training.

While fostering physician-leaders who can rise to CEO positions is valuable, the true impact of leadership training in medical school extends far beyond the executive board. By equipping future doctors with the skills to effectively manage teams, navigate complex healthcare systems, and prioritize patient-centered care, we can achieve positive change throughout the healthcare system. Specifically, leadership training can directly improve care coordination, leading to better patient experiences and potentially reducing medical errors. This can then translate into improved patient outcomes and increased healthcare system efficiency, ultimately contributing to greater financial stability. Investing in physician leadership early in one’s career, whether in medical school or residency or as an attending, is not just about individual career advancement; it’s about building a stronger, more effective healthcare system for all.

Bridging Personal and Professional Perspectives on Mental Health Medication

Published by Jacob Murphy

As medical students, we spend years preparing for the daunting hurdle that is the summer between the third and fourth year of medical school, a twelve week stretch in which you prepare for USMLE Step 2, perform at your highest caliber on a sub-internship in the specialty of your choice, and craft your application to residency. Accordingly, as I approached this part of medical school myself, I expected its accompanying level of academic stress. I had not, however, prepared for what coincided with this time. 

I have navigated obsessive compulsive disorder with recurring episodes of major depression for the better part of the last ten years. These symptoms provided me with a baseline level of distress, but they were always manageable and had never before required urgent intervention.  This changed throughout my USMLE Step 2 study period. The isolating nature of exam preparation, with day after day of solitary study hours, created the perfect storm.  What began as manageable discomfort spiraled into overwhelming distress. For the first time, I found myself in a depressive episode which felt insurmountable.

Despite having taken my first steps into therapy a few months prior, I was overwhelmed by this current episode and desperate for relief. I found myself contemplating medication for the first time in my life, and as I began my fourth year of medical school, I prepared to begin an SSRI for the first time. First, I did as all good medical students do and turned to research, hoping to set my expectations appropriately.  I found reassurance in matter-of-fact descriptions of mild, transient changes. It, however, was not long until I also read about widely variable rates of insomnia, fatigue, weight loss and more, leaving me struggling with uncertainty. To top it off, I did as all bad medical students do and read SSRI horror stories on Reddit. My quest for clarity had only clouded my judgment, leaving me more hesitant than ever before.

At an impasse, I voiced my apprehension to my girlfriend, who reminded me of the obvious solution to see an actual psychiatrist rather than rely on a sea of PubMed abstracts. When I met my psychiatrist, months of pent-up anxiety and analysis immediately poured out of me. She validated my fears with candor, acknowledging the frustrating trial-and-error nature of SSRI prescribing. She addressed my concerns, stating that I would likely only need a modest dose; sexual side effects, while real, were often more manageable than anticipated; in her anecdotal experience, weight gain concerns were largely overblown. I was convinced and began an SSRI.

The initiation was largely unremarkable until my dose increased about a week in, when my fears quickly materialized with unfortunate precision. I experienced sexual side effects, appetite reduction and weight loss, daytime fatigue and nighttime insomnia, and on top of it all, worsened anxiety.  In my final clinical rotations, I felt like a shell of my former self, unable to conjure the engagement and competency that I had developed through years of training. To complicate things, the medications were working. The calmness in my mind brought relief I had not experienced in years. Desperate for guidance, I confided in two friends who I knew were also on SSRIs.

My friends’ responses brought comfort quickly, as they told their stories of starting medications with the humor that typically accompanies awkward tales of adolescence. Our conversations also revealed something unexpected. While mental health conversations are increasingly normalized, candid conversations about medication experiences related to mental health remain rare, still shrouded in stigma. Four months into treatment, I find myself living in profound relief from years-long mental struggles.  My side effects gradually faded into the background, and I found myself thriving in ways I hadn’t thought possible. Yet even as I celebrated my own progress, I couldn’t shake my friends’ observations about the persistent silence surrounding medication experiences, a conversation which echoed a larger truth about our profession’s unfinished journey toward true openness about mental health treatment.

With the steadily rising tide of SSRI prescriptions and the well-documented prevalence of mental health conditions among health care workers, one may expect the process of beginning medication to be easier to navigate.  Yet my struggle to embrace this treatment, despite my position as a medical student on the cusp of graduation, reveals a telling paradox. This disconnect between my professional knowledge and personal hesitation suggests a crucial gap in how we approach mental health medication. My experiences demonstrate the strides we have made in destigmatizing conversations around mental health, and outline the meaningful work required to extend this openness to conversations around treatment.

How can we better shepherd patients through the challenging early weeks of SSRI treatment? Adverse effects remain the primary reason patients abandon SSRIs, particularly during those crucial first weeks. Moreover, patients rarely volunteer information about their struggles, making active solicitation of side effects essential. What if we conducted more frequent check-ins during the initiation period, particularly in the critical first month? What if we set better expectations regarding the potential for side effects to be life-disrupting rather than mild, temporary inconveniences? Would we then have a greater impetus to engage patients in shared decision-making about the timing of treatment initiation and help patients choose, when possible, less demanding periods in order to weather the adjustment phase? By aligning treatment initiation with patients’ lives, we might forge a path toward better adherence and improved outcomes.

Adherence to these medications has fundamentally improved my quality of life—a gift that I hope others are able to receive.  I persevered only because others who had walked this path before me offered their stories and support. For this reason, I share my medication experience, in hopes that shared experiences will push down stigma and empower trainees that so often find themselves as patients.

Image Credit: Depression” (CC BY 2.0) by Ryan_M651

Code Blue

Published by Natalie David

Baby powder, body odor

Dark red blood, pale white skin

A mother’s cry, a baby’s silence

 

 

Image Credit: “Baby Feet” (CC BY-NC 2.0) by Joseph D’Mello

Poetry Thursdays is an initiative that highlights poems by medical students. If you are interested in contributing or would like to learn more, please contact our editors.