Wednesday, May 30, 2012

Before beginning my first year of medical school I had promised myself an ongoing memoir of that first year. It seems I am a liar. Two weeks to the finish line and I have just begun, likely using writing as a more respectable method of procrastination than say, watching old cartoons. In truth, this is the first moment I feel inspired to say something other than a melodramatic complaint. First year is an experience much like I imagine war is: so singular, so grandiose, so awful, that not even a person with the most eloquent tongue could ever truly explain it – so now, ladies and gentlemen I’m going to try.

Med school: not a place anyone is ever prepared for. Before it began, I had imagined an obscene amount of work and memorization. That part, as best as I could, I anticipated, but the rest, the intangible darkness that slowly strokes its victims with notes of sadness, self-doubt, and hopelessness until all that exists is despair in a shell of one’s former self, that friends, I was as prepared for as getting hit by a train. Not only are you hit by the train, but you are expected to maintain enough composure to climb into said train.

One of the professors during the orientation week compared medical school to drinking out of a fire hydrant, the water signifying the information we are asked to learn. We will discuss what I believe to be the deadly flaw in modern medical education at a later time, but for now we shall briefly address the workload. It is a lot. More than you can imagine; more than I can imagine, because even right now at the end of my first year I did not learn all that I “must” have learned by this point. There were many days that I was certain the information was increasing my intracranial pressure. But that is inevitable and ultimately conquerable, unlike the smoke monster, also known as interpersonal relations.

Fellow med students are both the cause of and solution to most of medical school life problems. So let’s begin with the fact that one must have friends and support, and sadly there are many moments where one would rather crawl into a damp moldy cave and become a troglobite than have to speak to another soul in one’s class. Even more sadly those moments dominate class time. School is hard, obviously, and each person reacts differently to the stress. Some turn into aggressive beasts, others cry incessantly, others turn into hermits, and others still, become sociopaths. At any given moment nearly half of the class indisposed with some psychiatric ailment, although no one will admit that. Admitting it would mean responsibility of ameliorating the illness, and that is an unacceptable amount of energy directed away from studying.

Being in medical school is like being in a zoo for psychiatrically disturbed animals that all have to share one large cage and have a limited amount of food, so they quickly turn on each other. The worst aspect is it is absolutely impossible to successfully avoid people for more than 2 days. There is always something: small group, a mandatory class, a standardized patient encounter or simply commitments to a study group that at this point I am displeased I joined. So here I am, an only child with traces of avoidant personality disorder and social anxiety, permanently forced to be with people who can only make matters worse.

At this point dear deader I’m sure you’ve asked yourself about my supposed lack of complaint, but indeed I am not complaining because now, unlike many points during the year, I am happy to be a med student and I do not feel a heavy woe.  I am simply divulging the ugly truth of all medical education, no matter the country or the year.

Along the way, in my deep focus on academics I had lost a big part of myself, the most important part: my soul. It was taken, but I did nothing to resist. But that is the inherent nature of the thing. When attempting to not drown in a yearlong tsunami with only a poorly constructed raft at one’s rescue it is easy to lose sight of anything but the next approaching wave. Everyone and their mother speak of the importance of balance.  However, that is possibly the most useless advice ever uttered because the only way to have any understanding of that balance is to completely lose it. So now, near the end I finally approach that balance and gain back my soul, my joy and interest in things. Being in medical school is like being depressed. I went through the motions with duty but had no real emotions attached to anything. Except the occasional outburst of crushing sadness or sharp anger, I was numb. And now, as I am approaching the shore, I feel exponentially more joy in the things I used to love before.

This place changed me. It has at times made me much more, and at times much less myself. And now I do not know what I really am, just that I’m different.  There came a moment during studying a very long lecture on the pathology of bone cancers, that the slides, x-rays and cases are not just theory. Each of those is a real person that has suffered from the disease and the sadness of that truth is overwhelming. 

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