On March 4, 2015, JAMA Psychiatry published an article entitled “Depression and Suicide Among Physician Trainees: Recommendations for a National Response” calling for “[a] national commitment to support residents and fellows throughout the challenges of medical training.” However, we believe that the term “physician trainees” should also be inclusive of medical students.
Friendship is a powerful force that offers one celebration in one’s happiest moments, and solace in one’s most difficult times. Just as when two ducks meet to chat about their respective plights and offer each other support, medical student groups foster the same collaborative environment where students exchange ideas, challenge each other, and ultimately grow into better and more competent physicians. This important ideal binds all living things and gives them the strength to tackle life’s toughest obstacles.
I am a medical student, yes. I am also a survivor of sexual violence. With the recent Columbia University commencement, the surge of articles surrounding the narratives of Emma Sulkowickz and Paul Nungesser prompted me to reflect on this latter identity. When histories of sexual harassment at my school emerged last November, my survivor status edged its way into my path toward doctorhood. I know I will always carry the mark of my trauma with me, and I am learning how I will better empathize with patients because of it.
As medical students we’re told over and over to treat the whole patient, emphasizing unity of body, mind and spirit, recognizing the things that make us unique: upbringing, culture, values and beliefs. But on the way to achieving this holistic view of our patients, we often lose ourselves in the process. Barraged with metabolic pathways, pathological markers and exams, medical school tends to become a zero sum emotional game.
For most medical students, the third year of medical school is their introduction to life in the hospital. This results not only in exciting learning opportunities, but also emotional tolls — grief, fear, anxiety, exhaustion — that can lead to serious problems including burnout, depression, and anxiety.
There is another reason wellness is now stressed so heavily in medical schools, and it is one that is not often talked about — physician suicides. As many as 400 physicians commit suicide each year. That is equivalent to four medical school classes who take their lives every single year.
One of the things that I have struggled with most in medical school is depression. Not learning to recognize, diagnose or treat it, but actually dealing with the effects of this condition. I soon realized that this problem is much bigger than myself, and needs to be talked about openly. This is my story.
Within the next three years, ketamine, the popular club drug referred to as “Special K,” may replace the current generation of antidepressant drugs. By substantially reducing the latency of antidepressant effect, the use of ketamine as an antidepressant may hold promise and is in fact in Phase 3 trials for FDA approval. But, how does ketamine work to alleviate depressive symptoms, and how does this approach fit with our current understanding of depression? Do we currently understand depression?
Have you ever spent a night curled up in a ball of blankets rocking yourself, tears streaming down your cheeks, just wishing you could go to sleep and wake up a couple of months later? As a teenager, I had more of these nights than I did nights of restful sleep. There was no particular trigger. I had an idyllic childhood, growing up in a quiet suburb with a loving, supportive family.
Egg shell coat: / Tread softly, / Quietly. / To not crack the illusion / Of knowledge, / Bold aspirations.
It has been a little over two years since Kaitlyn Elkins, a second-year medical student at Wake Forest, took her own life. Her death stunned friends and family, who had been largely unaware of her protracted struggle with depression that was ultimately revealed in her suicide note. Kaitlyn’s mother, Rhonda Elkins, dedicated herself relentlessly to advocating for mental health awareness before succumbing to her own grief, committing suicide one year later.
“Neuroanatomy lab exam. You’ve got this. You studied hard. You’re good at anatomy, you know that. Okay, found a tag you definitely know. Start at the one you know. You’ll be okay.” It’s the way I try to start every exam. I try to talk myself up to push away all of the negativity slowly flooding my brain. Anxiety is a tough card to be dealt, especially in medical school. There are only so many ways to cope with the mounting pressure.