it’s okay to not be ready.

Truth: most of my friends will be graduating from med school next year. 

I won’t be. Despite having (almost) four years of university under my belt, the very notion of being a doctor terrifies me. 

Instead of doing my final year, I’ll be doing a research year. With a bit of luck, I’ll be doing something in paediatric psychiatry, looking at somatisation disorders. 

Deep down, I know I’m not ready to graduate. I’m not ready to take on the big bad world, and that’s okay. I turn twenty-two this year, but I feel as if I’m only beginning to come into my prime—I’ve only had my driver’s licence for three months. I’m only beginning to get proper treatment for what has been an eight-year battle with depression and anxiety and possibly borderline personality disorder. I’m only starting to work out who I am and what I want and I know that I’m still a couple of years away from being comfortable enough to say I’m a doctor. 

Being a doctor is hard work. Long hours, overtime, and your work never leaves you. I come home from placement and think endlessly about the cases I’ve seen, if there was anything we missed, how I need to improve. And then there’s being an adult as well—budgets. Cleaning. Laundry. Remembering to send birthday cards. Plus there’ll be studying for places in specialty training schools and constantly keeping up with the new developments in medicine. 

I’m not ready for that. I spent most of my high-school and early university years avoiding people and relationships, finding myself unsteady on my feet. I don’t want to be like that as a doctor. I don’t want to be an adult without ever experiencing what it’s like to be a young person. I want to have late nights and do silly things and achieve my non-medical dreams. I want to have a life before I settle down to be a doctor. 

It’s taken me a long time to come to terms with this. Part of me believes it’s trivial to put my medical career on hold so I can write novels and ethics proposals. But on the other hand, I don’t want to be dead before thirty. I want to be well enough to survive medicine. Yes, I’m afraid, but at the same time, I’m proud of myself. 

I’m more than medicine, and I hope you are too. 

palliative care.

Last week, I spent a few hours in a palliative care unit. 

As medical students, we’re fixated on the living. What drug can cure that symptom. How surgery can remove the cancer. Where we can find a bed so that the patient with diabetes can have her complications managed. 

Rationally, we know that everyone dies. We dissect cadavers in our anatomy classes. We read about fatal diseases in our textbooks and see pictures of brain tumours and mangled hearts cut open. 

But still, we believe we can save everyone. 

The last patient we saw was a little old lady, pictures of her family on a pinboard next to her bed, fresh flowers on her bedside table. A blanket was drawn to her chin, and she smiled at everyone in the room, desperate for some recognition of her existence. I don’t know how much she knew about her prognosis; I doubt she knew what the doctors thought yet. 

To me, she looked well. To me, she didn’t look like a woman predicted to die within a fortnight.

I couldn’t look many of these patients in the eye as I walked through the wards, all I could say was a muttered thank you as I left one patient to attend to the next. I didn’t know what to say. I’m lucky. I haven’t experienced much death in my life. I’m yet to see a patient die or a patient code. I know these to be inevitabilities, but I still look at each patient with hope. 

Perhaps the hope to live isn’t universal. Perhaps, for those for whom death is imminent, the hope to live is replaced by the hope to die peacefully, in a way that is the least confronting and the least horrifying for their loved ones. Perhaps they want to stay as calm as possible, as coherent as possible, and without the pain that has plagued them for their entire illness. 

Perhaps medicine isn’t about operations and pharmaceuticals. Maybe it’s just about helping patients and their bodies survive, and die, in peace. 

how to save lives as a medical student.

1. Donate blood. One blood donation saves three lives. (In Australia, we’re not paid to donate, but I understand this is different in some countries. Regardless, giving blood makes a difference, and not enough people do it.)
2. Become an organ donor. You don’t even have to donate your whole body—you can select to donate certain parts if you need to keep your body intact for religious or cultural beliefs. 
3. Volunteer. Okay, so maybe volunteering won’t save lives (unless you volunteer as a first aider), but it will definitely make the world a happier, shinier place. 
4. Keep yourself well. As a medical student, the most important life you can save is your own. Engage with your peers. Take a walk outside. Try not to drink too much coffee (I know it’s hard, and that caffeine is liquid gold. But have you ever had eight cups of coffee before a clinical exam? Because you shouldn’t. If your heart rate is 130 bpm and you’re trying to interview a patient, you know you’re going to have problems). Have fun occasionally. Watch Grey’s Anatomy without feeling the need to comment on the fact that Izzie wears her stethoscope backwards or bemoaning the fact that surgeons are rarely as hot as McSteamy. 
5. Help the nurses on clinical placement. Sure, the doctors prescribe drugs and write management plans. But in hospitals, the only reason anything ever gets done is because we have amazing nurses. Ask if you can follow a nurse around for a shift. Not only will you get a work-out, but you’ll appreciate the sheer amount of work they do. And most nurses have brilliant communication skills—you’ll learn a lot. And even little things, like settling a baby while a nurse is tending to another patient or offering to find the doctors and get them to chart drugs for a patient can make a huge difference. 
6. Speak up. Do you think the registrar has missed something? Ask them if it they think it’s important. I was in ED the other night, and a girl was seizing and had a rash over her eye, and my reg hadn’t commented on it, so I asked if it was of significance. It wasn’t, but the reg explained to me what she was actually looking for. 
7. Talk to patients. Again, maybe you won’t directly save a life. But have you ever been in hospital? It’s a lonely place. Not all patients get flowers and family visiting them. Not all patients have friends to drop by and say hi. Approach them. Ask if you can clerk them. Ask them how they are. Go and say goodbye when they’re discharged. Smile at them. It might make a world of difference to someone. 
8. Take everything you hear with a grain of salt. Not everything your supervisors say will be right. Always double-check drug dosages. 
9. Learn because you enjoy what you’re doing. If you learn because you have to, or because you have to be a doctor, not because you want to, you’re doing yourself and your patients a great disservice. Not everything in medicine will be enjoyable. But my colleague gave me some great advice yesterday: “I used to take copious notes during every lecture, but I wouldn’t learn anything. The next semester, I brought a coffee to every lecture, sat back, and let myself enjoy what was happening. Sure, it was more work and I had to make my own notes later, but I learnt things better.” Engage with your learning. Approach everything with an open mind and fascination. 
10. Dream. Imagine what you could do and how you might change the world. It may be naive, but this is the greatest strength of being a student—we haven’t yet been jaded by the system. We can still find ourselves inspired by medicine—and from this, innovation is born. 

study habits of medical students.

Anonymous asked: hi… i’m a firstie and all this studying is getting a little bit over my head, i don’t know whether i should study anat, or physio or bio-chem, how many hours would be enough or whether i would understand certain topics if i don’t know the topics related to it. i am soooo confused. what’s an ideal time table n good habits for medical students to follow?

Hi anonymous! 

The first year of med school is always the scariest. There’s so much to learn and it’s completely different to anything else and it all feels out of context. Unfortunately, there’s no secret formula for studying medicine. (I wish there was. My life would be so much easier if I could learn via diffusion.)

My tips:

• Aim to do a little bit of studying each day, even if it’s just revising notes from the afternoon’s lectures or reading some anatomy. Little things add up, and you’ll be surprised how much you learn. 
• Flashcards are great for rote learning. I swore by flashcards when I was learning sociology and key symptoms, and you can pull them out at any time. I was clearly the coolest kid in surgery last year, whipping out my flashcards between cases. 
• Use colours. Bright colours can make even the most boring of notes more exciting. (I currently take a subject regarding administration in health care. I can only make myself study it because I’m allowed to use pretty colours for the titles.)
• Diagrams and pictures! Anything that is conducive to being in a flow-chart or diagram should be. It forces you to think about the information, and makes a great revision tool come exam time. 
• If you are going to highlight, write notes in the margins to summarise, otherwise you’re going to have to read the text again. 
• Have a to-do list and set deadlines (realistic deadlines, of course). Nothing gives you a greater sense of achievement than crossing something off your to-do list. 
• Give yourself a break occasionally. Go watch Scrubs. It technically counts as studying, right? 
• Talk about what you learn. Teach your goldfish anatomy. Interpret blood films for your computer screen. Get your friends to test you and have debates over the ethical issues of medicine. 

Those would be my tips for studying medicine—also, these are the things I wish someone had told me in first year. I almost failed my first mid-semester exam in med school because I had no idea what to study or how to do it, so I really hope these help you! 

med student depression, part deux.

See the previous post here. 

Anonymous asked you: hi, it’s me again. maybe i don’t have depression. maybe i’m just.. deficient in coping with things. i’m not happy with how i’m handling problems- i’m a pro at running away and freaking out later. is a simple thing such as random tears, negative thoughts and inability to handle daily stresses a warning sign big enough for a visit to the doc? i keep thinking and worrying about flunking, about dropping medschool….

Dear anonymous (and to anyone else experiencing a similar situation),

The short answer is yes, you are completely justified in seeking help. I need both hands and both feet to count the number of times I’ve seen doctors and counsellors and psychologists because I wanted to drop out of med school, because I felt like I wasn’t coping, and damn it, everyone around me was doing so well. 

Let’s be honest—med school is hard. I remember sitting in a lecture in second year, watching all the other students around me, and they were in perfect control of med school. They sat through lectures without falling asleep and without panicking about exams in two months and without being afraid of being judged, they took notes studiously and went home to their friends and family and lovers and siblings and maintained healthy relationships and seemingly flawless grades. It felt like I was the only one in a hall of hundreds of students that didn’t know how to make it through med school.

I spent an entire semester avoiding lectures and other students and hiding in the library because I thought I was crazy.

There’s something no one ever tells us about med school, and it’s this: we’re all struggling. I was having coffee with a colleague the other day, and he started to explain to me his struggles with depression, his excessive alcohol intake at the start of med school—and this is someone I’d always looked up to. Someone who, in my opinion, checked all the boxes: intelligent, kind, funny, surrounded by family and friends. And yet, he was someone struggling through med school as well. Very few med students wear their hearts on their sleeves—that’s why I keep this blog somewhat anonymous, because I’m still learning to let myself be vulnerable.

I suppose what I’m trying to say is that you’re not alone, and med school has the ability to make us our own worst enemies. But, at the same time, it doesn’t have to be the end of you. You don’t have to try and cope with these thoughts and feelings and fears alone. You, and every other medical student, every other health care student, every other person in general, are entitled to help and to have what’s going on validated. I can’t diagnose you with depression over the internet (or without a qualification of some sort), but whether you meet the criteria or not is irrelevant. You are allowed to seek help. You are allowed to talk to a professional and you are allowed to let them help you.

Please don’t struggle alone. Med school has no right to make you feel this way.

Take care of yourself and I hope you seek some help—talk to your family doctor or to your university health department.

My Life As A Med Student.

The second in a two part series entitled why they never should have let me pass pre-clinical years. This is also why I’m a medical student and not an artist.

Occasionally, my mind can’t take being serious and writing copious amounts of text, so instead I leave you with the first in a two part series of why they should never have let me pass pre-clinical years.

(Yes, this is what I tried to pass off as studying. Yes, I did almost fail that exam.)

an open letter to med school.

Dear med school, 

There are a lot of things I’ve sacrificed for you. I’ve given up sleep in favour of seven-thirty ward rounds and the excitement of having fifteen doctors ignore me every morning. I’ve said goodbye to normal relationships, finally acknowledging that not only do these need time, but most intelligent people recoil at tales of surgery gone wrong and how you scored your first PR exam. I’ve learnt to eat irregularly and infrequently, scheduling surgary snacks between studies and surgeons. I’ve discovered that caffeine is a food group and that one can survive for days on nothing but black coffee.

But I’ve also watched myself and my colleagues fall into your trap and be consumed by you. Sucked into your vortex so strongly that help seeking becomes an impossibility. Found my reason to wake up and take notes on ward rounds slipping from me, a descent matched only by my grades. I’ve been alone at night, numb and exhausted. Meetings with the faculty in failed attempts to make everything okay.

Dear med school, remember this: I will not give up. I will become a doctor, and I will become a good doctor. I will change this world, despite the obstacles you challenge me with. I will grow up and grow strong and dedicate my life to make sure that no one has to feel this low.

Once upon a time, med school was thought to sort the weak from the strong—I don’t believe this for a minute. Med school isn’t designed to set us up for failure, and nor should it. Call me naive for thinking I can change the system, but I will never stop believing.

Love, me.

(Source: bbeautifuloccupation)

med school and loneliness.

On my first day of clinical placement, I met a patient who was going to die. I found myself speechless. What do you say to a patient resigned to his own fate? To a patient with rapid-onset cancer and for whom living months longer than his prognosis is his achievement? Are there words for such a situation?

On my second day of clinical placement, the intern I was with made a MET call for a patient. I remember standing there, staring at the patient and the intern and the nurse and the ICU staff who hurried around him, taking notes and calling out words and terms I didn’t understand.

This is what makes med scool very lonely at times. There are so few people who understand what is involved being in a hospital setting, and fewer still to whom we can talk to about all the crazy that happens out on the wards. Our experiences are rarely shared and often difficult to articulate—how do you explain to someone how it felt to watch another human being struggle for their life? How it felt to be confronted by a patient with the same barriers to living as you experience each day?

But I think, most of all, we make med school lonely for ourselves. The business of medicine is a very small company. The friends you make to day are your future colleagues, the registrars your future consultants. We don’t want to show weakness. We’re afraid that, when we apply for internships and fellowships, someone will remember us and judge us, deny us a placement because they know us as the girl who couldn’t cope or the boy afraid to try.

Two months ago, I wanted nothing to do with medicine—I wanted nothing to do with life. It’s frightening, how easy it was to give up, to sink into my own loneliness, to hide from any form of companionship.

The hardest thing to come to terms with is that I wanted to end it all, and how close I came to that edge. I skipped out on clerking patients to go to the pharmacy and stare at the pills and potions, having given up on my own life. I glared at train tracks, trying to come up with a way of dividing my existence into reasons to continue and reasons to throw myself in front of the train.

I felt completely alone. I came to the conclusion that there was no one to talk to, because if I did, I’d jeopardise my entire future. And besides, everyone else was doing just fine—I should be coping as well. I was a failure.

I was wrong.

I broke down to my clinical supervisor and she broke it down for me: this is what you’re going to do to get your life back on track. This is what is going to happen next. I’m going to keep you on track and you’re not alone.

I told my colleagues what was going on. It turns out that I’m not the only one who feels alone and as if I’m not going to make it. I’m not the only one afraid my tutors think I’m an absolute idiot and I’m not the only one that feels this mountain is insurmountable.

Med school is lonely, but it doesn’t have to be. Reach out to your seniors, to your peers, to your colleagues. Med school can be amazing, but it’s not worth losing everything for, it’s not everything you are, and it’s not about suffering.

There is always help available.