Don't Despair...You Are Not Alone

By Anonymous

During the process of your husband’s pursuit of his dream, becoming a doctor, did you ever have a moment where you seriously considered he may not be able to push through and make it to the end?  Being a part of the LDWs facebook page has made me realize that a lot of medical students have these moments.  Moments where they question the decision they have made, question if they are strong enough to make it through whatever barrier stands in front of them, moments that shake the core of their relationships, with their spouse, siblings, and parents because this process has the ability to make them feel completely alone; how could any one not in medical school really understand?

This is the story of our moment:

My husband was a high honors student during his undergraduate training.  He was Phi Beta Kappa upon graduation, did well above average on his MCAT, and got accepted to his choice medical school.  MS1 and MS2 were okay for him.  He struggled in some subjects, not because he was not smart enough to learn it but simply because of the rapid pace to which learning was expected.  He did poorly on his first exams in medical school and quickly determined what he was doing wrong in studying and adjusted it and brought his grades up.  Many of his grades were average to high average, which was disappointing to him being used to being an honors student but I was proud he was keeping his head above water.  I watched him study all day into the night and he would still be studying when I was getting up for work at 5:00 am the next morning.  He conquered things that would have broken me.  He never failed a class. He never failed a standardized exam. The opposite was true in fact, he exceeded many of his peers on his MCAT, USMLEs, and eventually his Board Exam.

The conclusion of MS2 was celebrated.  MS3 and MS4 were supposed to be a great time. We never met anyone who dreaded his or her clinical rotations.  Everyone was excited to get into the hospital, experience all of the different rotations, and really feel out the process for what they want to be when they grow up.  His first rotations were Psychiatry and Neurology.  These rotations were fairly easy and although he had a tough resident that did not allow them to get away with not reading up on their patients, he got through and did well. 

His second rotation was Pediatrics.  His pediatric rotation was split into two 4-week sections.  The first month for him was outpatient pediatrics some of which was at a specialty hospital following up on pediatric oncology patients in the outpatient setting.  The second month was Inpatient Pediatrics. 

My husband came home from his first day on his Inpatient Pediatrics portion of his rotation obviously in a bad mood.  He began explaining to me the call schedule, expectations, ‘pimping’, and the pressure.  He was expected to be at work at 5:30am for pre-rounding 7:00am for lecture, round on patients for 6-8 hours, stay the night for his call shift, go to lecture at 7:00am, and round on his patients before leaving.  It was essentially a 24-hour call schedule flanked by two normal working days.  When he was explaining this to me my immediate reaction was this is something that everyone goes through and it will just take time to get used to it, just like it took time to work out the kinks in studying during MS1 and MS2. 

Within the next week, he began explaining to me how he hated being in the hospital and honestly did not like the actual job of being a doctor.  My husband loves science.  He is a scientist at his core.  He could have easily been a Physicist.  He was convinced he had made a huge mistake pursuing this career.  At this point I immediately went into damage control.  He had been working toward getting into medical school through six years of undergraduate and now was in the beginning of his third year of medical school and he was seriously talking about quitting.  We were sitting in the tiny living room of our one bedroom, 600 square foot apartment; me on a chair and him on the furthest end sofa from me.  He kept trying to explain to me that he could not do it any more.  He did not want to step another foot in that hospital.  He did not want to return for his shift the next day.  He had his knees pulled up against his chest with his face hidden in his knees.  In all of our time together I have never seen him cry like this.  I have never seen such desperation on his face or heard it in his voice like I did that day.  He was begging me for permission to quit. 

This initial conversation was short in hindsight.  I quickly called my husband’s father, who is a physician.  I demanded he discuss his feelings with his dad and that he get medication. He was showing clear signs of acute situational depression and I was heavily burdened by the idea of him feeling too ‘trapped’ in this career.  Two students at his school in other health science fields had committed suicide that year.  It was too common of a statistic. The debt burden, feeling of letting your loved one’s down, and feelings of failure do not mix well with the personalities that make it this far in this career.  I certainly never wanted him to feel like this was his only option.  After he called his dad and talked though things he made THE calls.  The first call was to his Dean followed by a call to his attending in his Inpatient Pediatrics rotation.  He explained that he was overwhelmed and wanted to quit medical school.  He explained to them that he was sorry and that felt this was a bad career choice for him. 

Our world was crumbling before my very eyes.  It is impossible to work up to this life for eight years and not have very solidified ideas of what life would be like.  All of our visions for the future were getting scrapped.  We were now in the situation where we had to figure out what he was going to do for a career to even begin to pay back his student loans.  His bachelors degrees were in Evolutionary Biology and Biochemistry, both of which are useless for actually making money.     

His Dean discussed his options.  They allowed him to get credit for his outpatient pediatrics rotation and take a month off from school.  We packed our bags and went home.  We left everything in our apartment and took some much needed time to really discuss what he wanted and where that would be taking us.  For most of that month I completely avoided discussing going back to medical school, even though it was constantly at the back of my mind.  I let him have the break he needed to not think about the hospital and bring the subject up when he felt okay discussing it.  That time came around a week before he was supposed to return to school. Small things during that month, like seeing a beautiful house or a fancy sports car, would remind him of the life that we had planned.  Going into medical school was never about the money but it was certainly hard to see how we would have anything nice trying to climb out of medical school debt with no usable degree for him. During that talk, we discussed possible specialties, the requirements of each, the interaction each had with patients, inpatient versus outpatient specialties, and the radiology and pathology options.  He decided to return to school.  He felt mentally prepared for it.  He never returned to that hospital or that city, until graduation.  He finished his Inpatient Pediatrics rotation and all of his following rotations successfully and went on to graduate on time and match to his number one residency program, where he works with patients daily. He conquered the 30-hour call shifts, the pimping, and the pressure.  He is a great doctor. Many of his peers had no clue what happened to him and we never discussed it.

The path to becoming a doctor is isolating.  Each and every flaw is self-analyzed during the process of just trying to get into medical school.  The medical school interviews criticize anything less than perfection, trying to ensure that they are picking only those students who they feel deserve it, from all their hard work during undergraduate, keeping those grades as high as humanly possible, doing the appropriate amount of volunteer work, research, letters of recommendation, being well rounded, and so on.  That’s the catch though.  We are all human.  We all need support. We all struggle.  The mentality of medicine is that perfection is the only quality that is acceptable.  Just know, perfection is impossible and if you have had one of these moments you are not alone and it is possible to come back from the brink and be okay, thriving actually. 

Signed,

Anonymous