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 29 (Saturday, May 31): Until Next Time, India + Budget + Bucketlist

Woke up around 8:30am. I felt like sleeping in, but Lauren and I planned to get breakfast at 9am. I wore my red with green vines Fab India shirt. We walked down with Taniqua. I vlogged Taniqua signing her name in the book for the last time and then Lauren getting food. Breakfast: one toast, two pancakes, omelet, and tea. Alvian was there too. Lauren walked with me to vlog the library. Taniqua asked us to buy Orbit gum for her with 50 rupees. We peeked into the library café and at first glance thought they didn’t sell gum, but it was on the counter. I can faintly picture seeing gum in my memory of ordering food at the café, so I felt bad that we didn’t take the chance of going in. Drew inspired me to purchase a maroon-colored Kasturba Medical College t-shirt at the Manipal campus store. I had around 1000 rupees left. We said goodbye to the library by taking individual pictures with the Manipal sign.

IMG_1589Back at the hostel, I gave Taniqua her 50 rupees back. It was around 10:30am when I returned to my room and hardcore packed. I thought I wouldn’t finish on time. I gave Taniqua some Ziploc bags when she came over around 11am. I checked my room several times, took out the trash, and finished packing all my bags around 11:45am. We were supposed to be ready at 12:05pm, so I was cutting it close. Taniqua and I visited the small snack shop on the ground floor of our hostel to use more rupees. Lindsey and Ashley were already in the lobby with their luggage. I purchased a Tropicana Orange Juice and Lipton Iced Green Tea with Lemon and Mint. I brought my luggage downstairs, turned in the room key, and rolled the suitcase to the bus.

Taniqua and I sat in the very back. The tiny air-conditioned vent above made the ride more bearable. I updated this journal and listened to music on my iPod. I relished the Indian scenery for the last time. I was pretty productive, but started to get a headache towards the end of the drive.

Arrived at the Mangalore airport and our flight itinerary were checked twice by army-like men standing at the doors. Alvian suspected he was discriminated against when the guy only told him, “no smoking inside.” We went through the baggage scan and check-in. In line, Sesen pointed out a half Indian and half Caucasian family. The little girl was beyond beautiful. We parted ways with Dr. Raj, Paul, Ashley, and Rachel because they were on a separate flight. I shook Dr. Raj’s hand and thanked him for everything. Sesen teased him about emailing us his whereabouts (he’s going to Poland for a conference) and he said no one reads his emails anyways. I hugged Rachel and Ashley and waved goodbye to Paul. We went through the carry-on scan and body check. Sahanna and Sesen needed to empty their bags because of metal. The bathroom at the terminal was surprisingly really nice and could have been mistaken for one in the US equipped with modern toilets, toilet paper, soap, and hand dryers. Only when Lauren and I returned and raved about it, did the others go too. We boarded and I sat in seat 11B, one row away from first class. One of my personal goals on this trip was to engage in conversation with a stranger on the airplane. It didn’t quite work out on the way here, so I was hoping I would have a chance on the flights back home. I believe we have so much to learn from one another by just talking, and the prospect of learning new things from another person’s perspective excites me. The first flight was unsuccessful. For food, we got an Indian-styled chicken and pepper wrap that was surprisingly very good, a mini water bottle, and tea. I love the plane’s tea. I wonder what kind it is. People told me it’s just black tea. I napped for 15-minutes towards the end of the flight.

We had a 9-hour layover in Mumbai. Hopefully the time passes by fast. We had the opportunity to see the airport from the outside, and it is gorgeous: peacock design, uniquely shaped trees, water fountains, Indian flags, and white designed ceilings.

IMG_1597IMG_1600We went to a restaurant called The Square for food. Sahanna and I shared a vegetarian platter and lava cake.

IMG_1607IMG_1609As we were leaving to go through customs and immigration, we ran into Anna, Lauren, and Taniqua as they entered the restaurant. The interior of the airport could have been mistaken for a mall!

IMG_1611I bought a green silk scarf that came with bangles for my mom and a small wooden elephant keychain at a store called The Lotus. They accepted US dollars, so I paid with 530 rupees and 5 dollars. I think I have an obsession with buying elephant figurines. Sahanna played the first X-Men movie on her laptop to pass the time at the gate. Anna, Lauren, and Taniqua eventually came to our terminal and hung out. Anna wanted to take a couple pictures and was sent on a mission to buy soft drinks for Sahanna and Lindsey. I went with her because I was in the mood to walk around. We checked out a tea shop. Anna bought me Slice mango juice because I spent all of my rupees.

IMG_1624Slice was sold at the Italian fast food restaurant on the 2nd floor Manipal cafeteria, but I never had a chance to buy it. I was excited to finally try it and it was good! Everyone was right in that it tasted better than the Mazza brand. Lauren and Anna split a chocolate brownie with their last rupees. Back at the gate, I transferred Dr. Raj’s pictures to Alvian’s flashdrive for him and organized my pictures on the computer. We hugged and said goodbye to Lauren and Taniqua as they headed to their Amsterdam flight. Then, we found out our gate changed. We walked further down and parted with Anna when the paths forked.

IMG_5724We boarded the flight and I couldn’t sit next to Sahanna and Lindsey because the flight was full. I sat in the middle section of the aircraft in the third seat of a four seated row. I tried watching X-Men: Origins, but I fell asleep. The guy to my right at one point was almost leaning on my shoulder while he was sleeping. Vegetarian lunch: Indian food, watermelon, cantaloupe, papaya, tea, bread roll, and water. The woman to my left started a conversation by letting me know something is leaking from my backpack (water). We talked for a good half hour about India, studying, Mysore, medical school, education, her visits to the US, her son in New Jersey, the difference between taking care of elders in India and the US. The flight landed and she patted me on the shoulder saying she’s not sure if we’ll see each other on the next flight. I told her to have fun in New Jersey and she wished me good luck in my career. Aw, so nice. I started watching a movie called Serendipity when she started the conversation with me. Fun fact: that’s my favorite word and the actress in the movie said it was hers too, so I was intrigued to watch the movie. It’s about a woman that believes in fate and plays with a man’s heart by saying that they’ll part ways and if fate brings them together, it’s meant to be.

Landed in Brussels and went through a bag and body check. The workers ordered Sesen to unwrap her hair and she was reluctant at first, but complied in the end. We went shopping for Belgian Chocolate, but the price was exorbitant. We bought food from a café.

Boarded next plane to Newark. I got an aisle seat – woohoo! I was in the middle section of the aircraft again in a four seated row. Two people are in my row, but no one sat immediately to my right. I finished the movie Serendipity, and watched Silver Linings Playbook and Love Actually. I let a guy in the left section borrow my pen to fill out customs forms. Snack: flakes made of peas. One meal: Indian-style wrap and chocolate ice cream bar.

IMG_5743I slept for brief periods. Listened to Bollywood songs and read the book, Quiet.

Landed in Newark. I kind of wish I had window seats for the transatlantic flights, but I guess that’s something to look forward to on my next international trip. Went through US customs and retrieved luggage from the belt. A police officer was walking around with a sniffing dog. I was so scared the dog would find my cashews and force me to throw them away, but everything went well. We re-checked the bags and took a shuttle bus to our terminal. Bought food at Starbucks: turkey and cheddar sandwich and strawberry and banana Naked juice. At the terminal, I talked with mom and Arif on the phone and updated journal. Sahanna’s extension cord started a conversation with a family of four. He asked us how India was. He said he’s really curious about the Pakistan dividing moment. We parted with Sesen because she’s headed to DC to surprise her mom. I told her I am so glad I met her on this trip.

Boarded plane. This plane was a little larger than the ones that typically fly into Columbus. It’s two seats on either side of the aisle, but normally it’s two on one side and one on the other. My seat was 11A and I asked the man in seat B, “can I get in there?” And he jokingly said “no.” That’s when I knew we’d have a good conversation. I let a couple minutes of silence pass, while I updated the journal on my iPhone. Then, I asked him “were you in Newark?” He said “yeah. You?” Me- “India.” He said “wow.” Told him I’m on this flight with three other students that studied abroad in India for one month. He asked how it’s different there. I said it was a humbling experience and reminds me to not take things for granted, like toilet paper. We talked about OSU, my future career plans, his home and family in Newark, job in Columbus, Chinese food, skiing, and his summer plans. He was very talkative, which was nice because I can cross off conversing with a stranger off my traveling bucket list. We talked the entire flight. I periodically would look out the window and he would bring me back to conversation. He flies back and forth between Newark and Columbus every two weeks or so and mentioned he needs to plan out his flights like two weeks in advance to avoid high prices. I asked him what city he preferred. He said Columbus, mainly because of the traffic. He said it takes him 15 minutes to drive to work whereas in New Jersey, it takes a little more than an hour and you need to use public transportation. I said “yeah that’s added stress to the day.” He said although Ohio has no mountains or bodies of water, it’s a nice break. He said “for example, at home, I need to mow the lawn, weed, install various things, and do housework. But in Columbus, I can eat dinner, drink a glass of wine, watch TV, and relax.” Haha. I asked if it’s difficult traveling back and forth. He didn’t really complain and enjoys the change in scenery. We talked about his daughter, who is a senior in high school and he expressed his concern about her choosing a college. I offered to help if she is interested in Ohio State. I gave him my BLF business card (haha quite possibly the first time I have ever legitimately gave one out) and he gave me his. I couldn’t have asked for a better way to end this once-in-a-lifetime trip. So surreal and so blessed.

IMG_5746 IMG_5751Money Spent
Cost:
Program Fee         $1,800
Air Ticket               $1,400
Personal                   $400
_____________________
Total cost               $3,600
Profit:
Wolfe Scholarship $2,500
Personal left             $100
_____________________
Spent:
Out-of-Pocket        $1,000

Bucketlist for India

  1. Ride a rickshaw & capture it on video
  2. Ride a camel
  3. Ride an elephant
  4. Ride the citibus
  5. Buy kurtis/saris/salwaar kamis
  6. Go to the beach
  7. Experience a “discotech”
  8. Make a local friend
  9. Go to a temple, perferably on a mountain
  10. Keep a blog and/or diary
  11. Try vlogging!
  12. Watch a Bollywood movie
  13. Eat on a banana leaf
  14. Drink tea
  15. O-H-I-O pic anywhere and everywhere
  16. Selfies anywhere and everywhere
  17. Try all food
  18. Watch a religious ceremony
  19. Handwash clothes
  20. Take lots of pictures and videos
  21. Go to the circus
  22. Purchase a Manipal t-shirt
  23. Explore the Manipal Anatomy & Physiology Museum
  24. Cross a busy street as a large group
  25. Try some Indian pastries at a bakery
  26. Take a picture with a monkey
  27. Eat/drink something mango flavored (be careful of raw fruit)
  28. Take a bucket shower
  29. Listen to Bollywood songs
  30. Wander and maybe get a little lost around a familiar place in a large group