Silent Sufferers – Mental Health in Medicine

In the event of cabin decompression, an oxygen mask will automatically appear in front of you. Place it firmly over your nose and mouth, secure the elastic band behind your head, and breathe normally. If you are traveling with a child or someone who requires assistance, secure your mask first, then assist the other person.

How many times have we heard a flight attendant say the above statement, with its true meaning being lost amongst the cacophony of busy airplane? In order to help others, we must first help ourselves. Studying and practicing medicine has more to do with selflessness, than selfishness. It is about the personal sacrifice for something bigger than yourself- a daily exemplification of our pledge to abide by the Hippocratic Oath. We dissolve any image of normal with that of exceptional because “if medical school were easy, anyone could do it.” We can’t escape the everyday challenges that accompany being human: family, love, or the sense of belonging and worth. However, do we practice what we preach to our patients? In times of need, will we seek help? More often than not, we opt for the embodiment of perfection and maintaining a “stiff upper lip,” yet we hide and cry in the bathroom where no one can see.  Everything is or will be “fine,” is our mantra. All we must do is speak it into existence. But we hesitate and are afraid to do for ourselves what we ask of our patients…to be unashamed, open, and vulnerable.

It is 2019, and there’s still an ongoing battle to combat the stigma that surrounds mental health. Like “Voldemort,” we dare not speak its name in the context of ourselves as medical students, out of fear. What will my classmates think? What if residencies find out? How will my family look at me if they knew I was in therapy or taking medication? I am a medical student – I’m supposed to have it all together. Will they still be proud of me? Ours is a community of silent suffers. You’d be hard pressed to find one amongst us that doesn’t know a fellow classmate that has crumbled under the weight and burden of the white coat. We were their confidant, shoulder to cry on, provider of comfort cookies, fried foods, and alcohol. We managed to get them through the crisis while keeping our own head above water and the curtain separating the front and back of the house firmly affixed to the wall. We understand that if we drop that veil, we expose an unfathomable truth; that we’re just ordinary people, being asked to do something extraordinary, for a profession that demands so much of us

I see a therapist not because anything is wrong at the moment but because I know life happens. I’m living my life and with that comes stresses and obligations that have everything and nothing to do with my choice to pursue a career in medicine. I go to therapy to learn how to be my best self, to understand how I reason through problems or how I can better emphasize my strengths and decrease my weaknesses. I’ve learned how to tackle the guilt of not being as involved in the lives of my family and friends as I once was and reconciling that I have to be selfish, not only for me but for my future patients. I’ve learned how to feel comfortable with asking and verbalizing the type of support I need from the people I love. Compartmentalization might seem easy, until you find the “noise chatter” in your head so deafening, you can’t get a decent night’s sleep.

Silence and stillness can often be the toughest to achieve when you are trying to get it all done in twenty-four hours; pay rent, buy a subscription to USMLE Rx, eat healthy, watch all your lectures, exercise, and practice your clinical skills. Also, how do you grapple with the feeling of appreciation, that you finally are fulfilling your dream of medicine, but recognize you don’t always enjoy the process?  How and where do you learn the techniques to make the abnormally normal of medical school just that more manageable? As medical students we have to learn how to maximize our time to produce the best results. I look at therapy as a tool for gaining my maximal potential, not as a reservoir for the weak or broken. I try and stay steadfast to the belief, that I can’t ask of others what I am too afraid to ask of myself. If I can’t recognize when and how I need to care for myself, how can I care for others?  I can’t ask someone to love me, if I don’t love myself. I can’t ask my patient to be vulnerable and open, if I’m too afraid to feel the uncomfortableness that comes with speaking and living my own truths.

Many of us laugh or use self-deprecating humor in moments of stress or struggle as a coping mechanism. To laugh at ourselves is a way of admitting we need help without the accountability of follow through. But we don’t have to take the easy comfortable route. We don’t have to be Academy Award winning actors and actresses, that smile knowing full well, that what we really want to do is scream. We can choose to recognize and ask for help, not because it makes us weak but because admitting so is our attempt at making the best version of ourselves possible.  We can head towards vulnerability and we can choose to prioritize ourselves and self-care above self-neglect, embarrassment, or shame.