Sunday, May 22, 2005

remember when things were hard?

Earlier this semester, things were hard. I shared part of what I was experiencing because I felt I needed to let people reading along know what was going on in hopes that it’d explain the sporadic knitting posts.

The truth is that at the point of that post I had just gotten news that I had failed components of the cardio system and I needed to take a re-test exam to show that I did know the material. It was a major hit – emotionally and mentally I was exhausted, and the knowledge that all of my studying hadn’t helped me get through an exam was just too much. It was our first system back for the spring term, and I worried that it would set the tone for the rest of my classes; if it could happen once without warning, it could happen again.

I made it through the retest with flying colors, and changed how I was studying and reviewing the material for other systems. Now my second year is (essentially) over, and aside from one grade that we’re all still waiting on, I passed everything.

When I wrote the “hard” post, I got in touch with my own doctor; things weren’t right with me, and I wanted to either know that I would be okay eventually, or that I needed help (in one way or another). My doctor watched as I struggled through my first classes in medical school, and suggested that perhaps it was time for medical intervention when I all but stopped sleeping. Weeks went by where I averaged 3-4 hours of sleep a night, partially because I was so wound up with anxiety that I wasn’t able to calm down, and partially because every time I fell asleep I’d wake myself up again with dreams of being in the gross anatomy lab, usually during an exam.

It took several months and three rounds of different types of medication before I found one that let me sleep and return to functioning as a human. I hated the idea of drugs, and was incredibly disappointed in myself for how I was handling med school. No one told me that it might affect me like this, and there was no way I could ever talk to my classmates about how things were really going – not only was it a sign of weakness, but I thought for sure someone would comment that perhaps I wasn’t cut out for being a doctor.

Over the summer between my first and second years I gradually, with quasi-doctor approval, stopped taking the meds, and on my own returned to feeling like myself. I wanted to start my second year off with a different mindset, in hopes that I’d be able to remain myself and make it through in one piece without disruption in sleep, or emotions.

It took the cardio exam to show me that things just weren’t right again. My sleep was off, and instead of not sleeping I was sleeping all the time – but waking up tired. My anxiety levels were back up, and my own interventions didn’t feel like they were working. I got in touch with my doctor again, and let her know that I needed help; there was no way I was going to get through the rest of the year in the state I was in. As much as I hated how I felt and hated (hated hated hated) the idea of needing drugs to feel human again, I recognized that there was a place for them, and that I couldn’t do it on my own.

Slowly, with a return to meds and knowing that I could step away from it all if I wanted to, things improved. It’s been several months since I felt as awful as I did then, but now, studying for boards, aspects of how I felt after I tanked the test are back. My own anxiety is getting harder and harder to keep at bay. The national boards are a big deal, and not everyone who took them last year passed them. I hope that what I am studying is what will be on the exam, but there’s no way to tell – some years they focus on a few areas, other years those same areas have only one or two questions!

I am okay, and will be okay; the place I’m in now is very different then where I was my first year, or even this January. I am not sharing this for pity, or sympathy, but rather because no one told me that it was a possibility. Early on in our medical training it’s assumed that we are super-human, and that we may never again be the patient; the truth is that I’m human. The good news is that the days I regret deciding to enter med school pass quickly, and I’ve heard that once I’m done with this round of boards (absolute worse case scenario is that I fail the ones in June and have to take and pass the set in October) things lighten up a bit.

I’m still knitting (the body of the striped sweater is done and I'm taking bets on if I'll have enough yarn for two full length sleeves), and happier things will still make it in today – but for now this is where I’m at.


Anonymous Cara said...

I've suffered with anxiety and panic my whole life (well, since I was thirteen - at least that's what I remember.)

I currently take a low dose of SSRI, and an occasional Xanax when necessary (flying, Bruce concerts.)

It was VERY difficult for me to take medication. VERY. It took a bout of anxiety that was so bad I thought I might need to be hospitalized to realize that it was probably a good thing. (Note, no one else thought I needed to be hospitalized, but that's the beauty of anxiety, isn't it?)

I find your post very interesting, especially in because you are studying to become a doctor. What if a patient displayed all the symptoms you are displaying? Would you encourage them to take medication? (I'm not being snarky - I'm really asking.) Knowing how you feel about taking medication - and therefore knowing how your patient probably feels about it (I mean, really, the whole anxiety thing comes from perfectionism and control issues - so it's really, really hard for people like us to admit they might need help) would it change the way you would address the issue?

Thank you for your post. It's interesting to see the human side of doctors. I hope you're feeling better soon. Anxiety BLOWS. I've been pretty anxious myself lately, and it really just sucks. No other way to slice it.

11:59 AM  
Anonymous Bridget said...

I hope your anxieties are alleviated soon and that you have time to rebalance yourself over the summer. I can only imagine the strain of being in medical school. You seem to be in tune with when to ask for help, which is great. Keep your chin up!

12:50 PM  
Blogger Lorette said...

It's really hard for ANY of us to ask for help, not just doctors. Having said that, doctors do seem to have that extra layer of denial that we could have medical problems (I'm a doctor, and can say that!). In my second year of medical school, I went through what in retrospect was an episode of major depression. I just wasn't smart enough to ask for help, and somehow made it through it in spite of myself.
In answer to Cara's question (not snarky at all!), I would certainly offer a patient medications when indicated, but the key is giving the patient the correct information and education to make the appropriate decision. I've found over the years that just saying "I think you have this, take these pills" isn't destined to get the patient involved in the decision process enough to buy into what you're recommending. You really have to teach them enough about the different options to pick the right option for them.

Anxiety is really OK. It helps to identify things that make us uncomfortable or that we need to change. It will get better as you go through this, but you've chosen a career that is destined to cause you anxiety. There will always be that feeling that you don't know enough, but you do learn to accommodate that after awhile! Email me anytime you need moral support!

5:50 PM  
Blogger J. said...

yep, Lorette said it and I agree although I am not a dr.... (yet). I think that making informed choices about ourselves is really important. When I went through a major depression in university I needed to resign myself to the fact that the meds would help. Being given choices by the people in my ife who were helping made a big difference, I made the choices based on their advice but was never forced to do anything. It made it easier for me to say ok to taking meds becausse I said all things that you are saying.

It sucks right now ut you are so close and you can make through, your right the worst that will happen is that you will have to take them again. Life will go on regardles of the outcome. Okay I have to leave the moldy apartment for my moldy classroom.

Be well and remember to take some down time to take care of yourself, knit, eat chocolate, bubble bath, whatever works.

6:07 PM  
Anonymous Nikki said...

You're not alone. I've dealt with bouts of depression for the better part of my life, but it took me literally years to come to grips with the idea of taking meds. I finally decided that I couldn't live like that anymore, and I've now been on meds for almost 5 years. Maybe someday I'll get off of them for good, maybe I won't. But I'm me again, and life is manageable (95% of the time, anyways!), so to me it's worth it.

I definitely understand that desire not to appear weak - despite the fact that I'm known in my class as a huge advocate for people with mental illness, almost no one knows about my depression. I hope that eventually, I'll get comfortable enough to tell more people, because I think I will discover that I'm not alone. It's hard to be the first one to speak up, though.

Keep your chin up. You're not alone.

11:00 PM  
Anonymous Cordelia said...

Thank you so much for posting this honest and open post. I'm guessing it was hard for you to do, so I wanted to let you know how much I appreciate your honesty. I'm a graduate student, and although I don't have to memorize the entire human mechanism, "regular" graduate school is equally a process of "this is your dream, and it's hard, and you have to know when & who to ask for help." This will sound silly, but thank you for sharing.

12:12 PM  
Blogger Stitchingmum said...

Thank you so much for your candour and honesty - it makes us all feel human, especially those of us who share your intense 'dislike' of the meds. For me it was a case of post-natal depression with my third child, and was very hard for me to accept what was happening, after having already given birth to and raised 2 babies with no hint of depression. Now as an adult first year nursing student (also continuing to deal with the breakdown of my marriage and raising 3 kids under 8 on my own) the anxiety and fatigue of that time creeps back at times,and the lack of sleep is starting to have its effect. After reading your post I've had to consider going back to my doc and having a chat with her about my options, after all, I am only human. Thank you again.

7:49 PM  

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