Med School is not as Glamorous as you may Think | August 20, 2016 National Day of Solidarity to Prevent Physician Suicide

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http://espn.go.com/espn/feature/story/_/id/12833146/instagram-account-university-pennsylvania-runner-showed-only-part-story

A nice reminder for all social media users. I first came across this news story three years ago and even wrote a blog post about it. Out of the blue, my research PI (who is a psychiatrist) sent me this article at the end of my senior year and it elicited even stronger emotions. I felt compelled to start a draft, which I didn’t finish until now. A lot has happened in my life since then, but I was reminded again of this story as I attended the National Day of Solidarity to Prevent Physician/Medical Student suicide at my medical school a couple weeks ago.

Since the era of sending mail through horseback and the advent of phone calls, we have always portrayed the positive parts of our lives, but the difference now is that Instagram and other social media has consumed more of our day as we endlessly scroll past people’s filtered accomplishments, happiness, and picture “perfect” moments.

All of Madison’s friends shared some form of struggle, yet she still felt alone because social media didn’t match up with what they were privately saying. This really urges me to be real with people I talk to. I’m not going to pretend like I live in a world of rainbows and butterflies. No one lives a perfect life. This is what it means to be human. We are all in this together.

‘People are also often encouraged to put filters on their sadness, to brighten their reality so as not to “drag down” those around them. The myth still exists that happiness is a choice, which perpetuates the notion of depression as weakness.

As a family, they had never talked about suicide. Jim never considered it a real possibility — just the dramatic ending to someone else’s story. Jim feared that speaking about suicide would make its likelihood greater.

Bill Schmitz Jr., former president of the American Association of Suicidology, points out that depression does not have a one-size-fits-all prognosis. “The course varies,” he says. “In a way, it’s the same as cancer. For some, we might prolong life for months, for years. For others, it can be very sudden.”‘

  • These three paragraphs summarize the myths of depression and gets at the very root of mental health stigma in our nation. Yes, happiness is a choice, but when a person is suffering from a mental handicap, their brain chemistry has changed to where you are not in full control anymore. With that being said, depression is a real disease and not a personal sign of weakness. A lot of us want to please those around us, but we also need to be in-tune with ourselves. Your body is all you’ve got in this world; love it and take time to nourish yourself physically, mentally, and spiritually. The quote, “Speaking about suicide would make its likelihood greater” is similar to the sexual education dilemma. I think it’s important to talk about taboo topics rather than sweeping it under the rug because the more open we are, the more opportunities we have to help ourselves and others.

“It’s OK to not be OK. It’s OK to show people you’re not OK.”

  • Most important message I took away.

“I run because it’s therapeutic for me. Because every time I run outside, around my home, I am reminded of the beauty of the world, of which I often forget. Yet at the same time, I am fully aware of beauty — it simply saddens me because of reasons I have not yet conjured up. I suppose I am sad. But at the same time I am happy; and miserable; and joyful; and stressed out; and calm, and everything in between. I am everything. Every emotion, rigged in every format, and developed through every machine. I am numb but I am not.”

  • I can totally relate to the first few sentences as a runner, but the latter half is where the message is. We are all bodies of emotions and feelings. This is a very beautiful thing. Never feel alone in your thoughts and feelings because somewhere in the world, someone else is or has already felt that way. When you need help from yourself – tell someone, ask someone. We are all in this together.

Revisit my first post about this news story: https://journeyoflifeandmeaning.wordpress.com/2014/01/22/what-if-we-car…ore-loved-more/

Excerpt: “Make sure that whoever you talk to or come in contact with, that you are okay with how you made them feel with your words and gestures if that was your last day on Earth. Try to develop that deep connection with people so that maybe you can save someone’s life. This is a powerful realization for me. You don’t need an MD to save people’s lives – just genuine care for one another’s well-being by opening up, being vulnerable, talking deeply and loving thy neighbor.”

Developing a Healthy View of Social Media

Recently, I had a friend tell me that she didn’t want to take a picture because she was so concerned about being too fat and ugly. I hadn’t seen this friend in over a year, so I wanted some memories. This saddened me a lot and I tried sharing my perspective that you should never measure your self-worth based on numbers on the scale or what you see in the mirror. She wanted to be perfect. I said that’s not possible. She said “90% perfect then.” She even turned down entering in relationships because she said she didn’t want to disappoint them with her physical looks.

Let’s be honest. We are all affected by our outside looks to some regard. We can’t change this because our exterior is what others see first. I don’t want to sound like a perfect person because I am not. I still get very bad acne in my mid 20’s and I’ve been battling this since middle school. It’s been worse recently most likely due to medical school stress. My acne makes me feel less attractive, it takes me more time in the morning to make sure people won’t be staring at my acne rather than my eyes, and sometimes it prevents me from going out if I have a really bad breakout.

However, I think I am half way there to the wisdom of not caring what others think of you. As long as you are okay with the energy you give off to the world every day, it doesn’t matter what clothes you wear, what your face looks like, how fat or skinny you are, etc. I don’t untag photos of myself because “people might find me less attractive” and I don’t care if I’m laughing so hard in a picture that you can’t see my eyes. It’s all about the feelings of the picture – the happy emotions it elicits, not the way you look and the thoughts of what other people on your social media might think of it.

At the end of the day, I am happy with myself if I spread kindness, warmth, deep care for others, and positivity in the world. Think about the kind of energy you want to radiate from your soul.

National Day of Solidarity Lessons

  1. The osteopathic handshake is a hug. It was cute to see all the presenters hugging each other when they passed the mic and it reminded me of the hug fest we had during orientation week. As DO’s, we are known to be more hands-on and more open to expressing the caring touch. I really do believe in the healing power of touch and this is a huge reason why I enjoy learning OMM.
  2. Get enough sleep. Fun fact: 7.7 hours is the average hours we should be getting. I make this a priority and it’s been really helpful in keeping me awake and alert for school.
  3. Practice healthy selfishness. I love this phrase. Never ever forget to take care of yourself.

Med school is not as glamorous as you may think. I know I didn’t really think about what daily life was like for a medical student until I was one. I was just concerned about getting in, but the hurdles don’t stop there.

  1. You spend so much time staring at a screen studying that the next time you feel the sun’s warm rays or talk to a person about something non-medically related, you feel like a new person.
  2. All day, every day, even weekends and breaks, all you think about is studying. You feel guilty if you have too much free time. The material isn’t hard in and of itself, but there is so much content that it’s not humanly possible to master every detail. You keep striving to learn everything and fall short.
  3. You schedule to see your friends during the one free weekend after you take the block exam and before starting a new block the following week. You have less time to spend with family and friends outside of the medical world. You might miss important life events, like birthdays, weddings, reunions, graduations, etc. People might even move on without you… That’s one of the hardest things about this lifestyle. Non-medical people in your life might never understand what you go through and they move on because you can’t provide the kind of attention and time they seek. There are so many articles and videos out there about personal sacrifices people in the medical profession make (I do have something positive to say about this. See #6 in the “good things” list).
  4. You don’t get enough sleep because you are constantly wanting to study more and/or you have to get up early for another day of new lectures.
  5. If you’re away from family, you have to worry about managing life outside of school, such as cooking for yourself, expenses associated with eating out, cleaning, and other miscellaneous chores. You might experience being homesick.
  6. You put life on pause in a way. If you haven’t found your life companion, good luck dating and finding someone that puts up with your lifestyle. If you have found your life companion, wishing you the best during this challenging journey and may love endure, sincerely.
  7. Your apartment/room is a madhouse because you wait until exams are over to clean it.
  8. You spend your whole Friday, Saturday, and Sunday at the library/study rooms before a big exam.
  9. You’re constantly accumulating $200k+ debt while in school.
  10. You often let go of a few hobbies and forget about what truly makes you feel alive.
  11. You end up double speeding YouTube videos you watch for fun because that’s what you do for lectures.
  12. While you may see your non-medical school friends traveling the world, making money in a job, going out every weekend, getting married, having children, buying houses, and settling down, you’re concerned about passing the first two years of didactic learning, then rotations, then applying for residencies where you work long hours with modest pay, then finally securing your first position as a board-certified physician. By this time, you’re in your 30’s (older if non-traditional). While I’m not saying these things can’t be done simultaneously, it’s just more to think about and juggle.
  13. Medical school takes a toll on you. Four of my fellow medical students developed strands of white hair halfway through the year. You might experience feelings of depression, anxiety, and inadequacy.

Good things!

  1. You become close with your medical school classmates because of the shared struggle. With a small class size, you truly become a supportive family.
  2. You get to be a sponge as you soak in all this new information. You’ll look back and think “how in the world did I gain all this knowledge in four short years.” Learning is fun!
  3. What kind of career allows you to learn something new every single day for the rest of your life?? When I feel bogged down about studying, I step back and think how awesome it is that we have a wealth of information at our finger tips.
  4. Making new and exciting memories (e.g. unintentional twinning with my classmates and end of block gatherings with the whole class).
  5. I look forward to working out now because it’s the main release of my day. It feels so good to lift or run off all the stress you felt during the day. You just have to schedule it like you’re going to lecture. Hopefully this will prevent the med school 15 haha.
  6. I have a lot of classmates that have supportive significant others, even a few starting families. It’s not impossible. If you are privileged to have already found your person while in medical school and your relationship withstands the hardships, you know they are a keeper. Count your blessings for finding someone so understanding and patient.
  7. Medical school is a unique and special time. You only get to do this once. It’s four years where you really don’t have real responsibilities. Your job is to learn as much as you can. These four years will pass by fast, so make the most of it and slow down to be grateful for your daily opportunities.
  8. A long line of people would die to have your seat in medical school. In the 2016-2017 application cycle, 21,030 out of 53,042 applicants matriculated into medical school. That’s 39.6% acceptance rate. If you’re a medical student right now, be very grateful for this life-changing opportunity. Source: https://www.aamc.org/download/321442/data/factstablea1.pdf
  9. How lucky are we, as medical students and beyond, to have such a wide array of activities to experience and accomplish that’s worth documenting? Seeing your first standardized patient, volunteering at the free clinic, studying, OMM, taking Step 1, student organization events, conferences, presenting research, leading a health careers exploration camp for high schoolers, welcoming new students on campus, new friendships, field trips, wearing scrubs, holding human hearts and brains, learning new clinical skills, rotations, graduating, starting residency, etc. Follow my medical journey on Instagram: ghrellen where I explore what it means to be a strong female physician humanitarian 🙂
  10. When you learn about diseases that people in your personal life have and you start thinking about how it’s affecting them and possible treatment options: cystic fibrosis, immune thrombocytopenia purpura, GERD, lymphoma, Wilson’s disease.
  11. You become happy with very little. Sometimes, we go through such low points in this journey that we become more appreciative of the little things in life, such as having a free weekend off to spend with friends, breaking up the studying routine to get lunch with classmates, or taking a few minutes to be appreciative of nature outside the window.
  12. I normally go on a long run shortly after noon on Wednesdays, weather permitting. As 1st and 2nd year medical students, we have a lot of flexibility and decision-making power to choose how we spend our day. Of course, this changes in 3rd and 4th year, so I’m trying to be consciously grateful for this freedom while we still have it.
  13. At the end of this journey, we are in one of the most meaningful professions. In what other capacity do you get the chance to become so intimately involved in all spheres of another human’s life? We have the unique opportunity to save lives, reduce suffering, and love humanity every day.
  14. Remember, it’s not solely about the destination, it’s the journey – not only the journey of medicine, but the journey of life. We are in this space and time only once. Step back and be grateful for everything you have.

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I challenge you to live a #lifeunfiltered

~lntan

Day 18 (Tuesday, May 20): Lizards are Friends, not Food

(Name the movie!)

Woke up to the alarm at 7:15am. I remember shivering in my sleep, so I got up to turn off the AC in the middle of the night. Usual morning routine, but had some time to write in the journal before breakfast around 8:45am: roti-like bread and tea. Lauren went to buy some juice and graciously offered to get me some too. She got Tropicana guava, and Adam suggested I should get orange, which turned out to be a good choice. I made a mental note to buy something for Lauren next time. The juice hit the spot. That morning, I decided I would make orange juice a part of my daily morning breakfast routine.

We boarded the bus around 9:30am to travel to the Hirebettu tribal village.

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We toured their primary healthcare center and met the medical officer. She showed us around the small place, but it was difficult for the whole group to gather closely in one place to listen.

Then, we took the bus to the village community. We visited three families and heard about their lives and health conditions (esophageal cancer, diabetes/hypertension, history of fever – malaria watch). The weather was extremely hot and humid, which made it difficult to pay attention.

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Returned to Manipal and cooled down in room. I was trying to update my journal, but my eyes fell heavy so I succumbed to sleep at the foot of my bed. I set an alarm for 1:15pm because Lauren and Kelsey planned to go eat at 1:20pm. I woke up in time, but felt super tired. Lunch: barley rice, yellow rice, bean curry, my fave curry and jelly noodles in coconut milk dessert.

Class with Dr. Raj at 2pm: Unintentional injuries. He gave us his USB to download 250 pictures he took on his camera.

IMG_1077After class, we took an excursion to visit the ASARE center on the outskirts of the Manipal campus. It is a home for mentally challenged citizens of all ages. Their mission is to teach them how to be as independent as they can by making their beds, cleaning their room, following a structured day, and making arts and crafts.

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There was a boy with exceptional semantic memory, particularly with naming presidents/leaders all across the world. The director who was showing us around asked him who the president of the United States is. He took a minute and said “Obama”.

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Sahanna proposed the idea to see the Godzilla movie at 7:20pm or 9pm. They ended up seeing the 7:20pm one. Taniqua, Lauren, Kelsey and I didn’t go. We decided to check out Fab India.

Went back to hostel to exchange my backpack for a purse. As I walked in, I see a lizard between two side tables. It quickly ran underneath one of the tables. I met up with everyone in Lauren’s room and told them about the lizard. To calm myself down, I was ready to make peace and call the lizard my pet/friend. Taniqua insisted I let the front desk know about it. She talked to the lady for me, and they said they could handle it in two minutes. Taniqua went to the hostel store and Lauren waited downstairs. Kelsey came with me to my room. Between us two, we couldn’t locate the whereabouts of the lizard. A housekeeper knocked, and I let her in. I explained I saw it earlier, but not sure where it went. I showed her the area between the two cabinets because that’s where I last saw the lizard fled. She moved one cabinet, and I knew she found it by her swift motions of the small broom. She stabbed and swept the lizard out of the room, but not in one piece. Its tail came off and was wriggling around. I am not sure what she did with the lizard, but I graciously thanked her. Kelsey informed me that lizards release their tails as a safety mechanism – they can still run away if caught.

Kelsey, Taniqua and I caught tea just in time. Samosas with ketchup was served. After, we caught rickshaws to Fab India. I rode with Taniqua. When we arrived at the destination, Kelsey and Lauren were nowhere in sight. We waited by the road for a couple minutes, asked the Fab India worker and then waited some more outside. No arrivals. Taniqua prayed, which inspired me too also. Finally, we decided to catch a rickshaw back to Manipal to check if they returned to the hostel. Nope. Waited for an hour and decided to go back to the shopping complex after thinking that they should be alright since they have each other. This time, we shopped around. Fab India was a lot smaller than I expected. I saw one shirt I liked, but didn’t like the neckline when I tried it on. The other stores were very American. Checked out Nike to see if it costs less. Not really – between $20-25.

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Taniqua wanted KFC for dinner, so we went.

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I’m not a fan of fried foods, but I got a rice bowl with chicken. Wanted get a wrap with lettuce and chicken, but was hesitant of the fresh veggies. I didn’t want to risk becoming more sick. The chicken tastes just like the US, but the rice tasted like biriyani, which made the food spicy. I used three ketchup packets to alleviate the spiciness.

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We caught the rickshaw back and decided to check the cafeteria for Kelsey and Lauren. They walked out as we were walking in. They were holding drinks and bags. They said their driver didn’t know where Fab India was, so he kept driving. He took them to Udupi City, and they just ended up shopping there. Told them our story about how we worried sick. I asked them what they got. Kelsey got some fabric/tapestries and elephants. Lauren got more kurtis. Lauren had a Mazza drink, and that persuaded me to get one. Drinking more fruit juices makes me feel like I am eating fruit.

Went back to hostel, showered, washed clothes, uploaded pictures to computer and wrote in journal. I feel asleep in bed while writing around 12:30-1am.