To My 2008 Self:
Congratulations, you’ve started medical school! The dream you have had since you were nine years old is finally coming to fruition. You’re going to be a doctor! Just … not in 2012, when you think you’re going to graduate. In 2018. I’ll get to that later. For now, let’s chat.
The thing you’re about to do is hard. Like, really hard. Harder than you’ve ever imagined. They say that medical school is like drinking from a fire hose; I’m here to tell you that I’d rather drink from a fire hose any day. You are going to be tested in ways you never thought possible, and I’m not just talking about the paper-and-pencil exams you’ll be taking. You’re going to question your intelligence, your willpower and your stamina. You’re going to wonder if you’ve made a terrible mistake by going to medical school. It’s okay; everyone has these thoughts. This is all normal. It’s really not fun, but totally normal. Don’t worry, though, you find some amazing people in your class who will help you stay sane — whether that’s studying in the anatomy lab until 2 a.m. or eating an entire pizza with you as a study break (I’ll leave that choice up to you). Regardless, these are people you’re going to be friends with for the rest of your life. There’s something about being in the trenches of medical school that bonds people together.
Medical school has some really great parts. But, as you can probably imagine, I’m not here to tell you about those. I’m here to talk about something even more important: your health, your well-being and your life. You haven’t had the easiest road, but I know you feel like you’ve gotten your depression and anxiety under control. Here’s the thing: you haven’t. Medical school is going to do its best to break you — and trust me, it will come close. It will steal everything from you — your physical health, your mental health, your sense of self and, eventually, your will to live.
It will start with anatomy and physiology, which, sorry to report, you’re going to fail and have to remediate over the summer. Then, you will have some social shake-ups and break up with the boyfriend you moved from home with. You’ll start dating someone in your class. Then, he’ll break up with you and that will throw you for another loop. You will get physically ill from the stress and the lack of sleep. You will be exhausted all the time. Thinking you can stop this tidal wave before it hits the shore, you’ll start seeing the school psychiatrist and a therapist. Slowly, medications will be added to your regimen until you’re taking so many drugs it’s surprising that you’re awake at all. The worst part is that you still won’t want to be awake because being awake is emotionally and physically painful. You will try to keep a smile on your face for your friends and family, but when you get home, the tears will come, and you’ll fall into bed without studying (again). The guilt will be unimaginable. Finally, things will get so bad that your favorite professor will pull you into her office and ask if you’re okay. You’ll sit silently and then burst into tears because you’ve been walking around with this weight inside of you that is too much to bear. You will say, “I never thought medical school would be fun, but I never thought I’d wish I would get hit by a car every day while walking to class.” That afternoon, you’ll sign the paperwork to take a leave of absence until the following year, and, just like that, you will no longer be a medical student.
Then the real depression will set in.
It’s not like you were really going to class by the end of this, but, without the semblance of some schedule, your life will slowly deteriorate into a cycle of waking, sleeping, crying and sleeping again. You will forget to eat, and, eventually, you won’t even care that you’re not eating. You won’t shower. You won’t be able to bring yourself to see your friends because they’re all still in medical school and you are not. You will be scared that you won’t find a job to support yourself but you also won’t be sure that you even want to stay where you are. You can’t decide if it’s better to stay and tough it out for a year until you can go back to medical school or if you want to pack it in and go back home. You will feel like a complete and abject failure. You will convince yourself that without the purpose of becoming a physician, you are worthless, that you have nothing to offer the world and that, really, the world might be a better place without you. You will return to old coping mechanisms, none of which are healthy, and you will realize that you can go days without seeing anyone but your cats. The loneliness will be interminable, made worse by the fact that your family and the few friends you still have keep saying how much they love and support you. You will despair because you simply cannot connect with anyone. And, one night, it will all be too much.
You will write a note. You will count the pills. You will lie in bed and cry. And then your mom will call and save you. She will convince you from 1,300 miles away to call a crisis line. Then, things will happen very quickly. The police will come to your apartment and you will be more concerned with the fact that you haven’t showered in three days and now you’re seeing other humans than you are that the police are there to make sure you aren’t going to kill yourself. Everything will feel surreal as the cops trundle you into the back of their police car and take you to the emergency room. You start to cry and you won’t stop for four days. You will be admitted to the psychiatric unit and it will be as if all the feelings you have been holding are pouring out of you in the form of salt water. Other than that, I am going to leave you to experience those four days for yourself. You need them to start the healing process but they are only the beginning. It will get better.
I wish that I could save you from this trauma, but I cannot. What I can do is tell you this: You will convince yourself that you aren’t supposed to be a physician. You’ll even get another degree entirely and try your hand at being a working professional. Of course, you’ll work in clinical research so you still have one foot in the medical world. After six years, surprising no one but yourself, you go back to medical school. It will be a different school and will be like a different world. You will still be scared that the world will drop out from under you again. (Sadly, that feeling never really leaves.) The experience from 2008 will feel both inexorably part of you and like it happened to someone else. Here’s the other thing: It will light within you a fire to defend others from the crushing blows of depression and anxiety, especially in medical school. You will share your experiences candidly to show people that it is not a sign of weakness to need help and that you can return from the depths to realize your dreams. You will have a friend, in whom you see so much of yourself from what you call your “former life,” that you are terrified, and you will help her realize her need to take a leave of absence to keep herself healthy and safe. All of this will be healing, and slowly, you will put yourself back together.
Before you know it, you’ll be a mere nine months from graduation with your residency application written, your audition rotations scheduled and your degree so close you can almost feel it in your hands. You’ll still be worried that the bottom will fall out, that you will lose your footing and fall deep into the pit again. You have become a different woman in the almost-decade that has passed since those events, and within you lies a strength you did not have last time. I’m not saying that it won’t be hard. You’re still going to fail exams and wonder if you’ve made a terrible mistake by coming back to medical school. But you also will give yourself grace around your failures and know that you are under no obligation to hate yourself for shortcomings. You will shed tears, but the friends you will make in your class will gather around to bolster you with baked goods, kind words and hugs. You will not lose yourself to medical school this time; instead, you will become more “you” than you ever have been.
Love,
Your 2017 Self, MS-IV
Writer-in-Training
Rowan University School of Osteopathic Medicine
Alison Toback is a third year medical student at Rowan University School of Osteopathic Medicine. Prior to that, she graduated from Drexel University with a BS in Biological Sciences and an MPH with a concentration in Epidemiologiy and Biostatistics. When she isn't studying or running around a hospital, she enjoys spending time with her husband and daughter, knitting, and eating dessert. She has a blog entitled Simply A, where she writes about medicine, motherhood, mental health, and other things that don't start with the letter M.