A Heavy Decision

Second year of medical school- one of the hardest for many reasons. The academic load (along with persistent chugging of life) during first year of medical school was greater than I could have imagined; when I transitioned to the next year I didn’t know more could be added to the plate. I was overwhelmed- sleep-deprived wondering how I was going to make it through. The mountain peak of graduation completely obscured from my line of site.

A still, small voice whispered in my mind. It was a familiar phrase that would offer a shallow comfort. Only difference during my second year as opposed to the first was how loud it became. Gradually increasing in decibels to the point where it could not be dismissed as a fleeting thought.

“I can’t do this.”

I was tired of feeling all stress- fear of failure, pressure of success, and the growing frustration of no one outside of medicine understanding my struggle. Too much weighed on me, and when the kitchen got too hot I wanted to abandon ship. I didn’t realize all I signed up for, and it felt too hard- I wanted to quit. I could be anything I wanted to be other than this.

My escape would be fantasizing about the joy of being a schoolteacher. In fact, when I was applying to medical school I had decided my back up plan would be teaching if I wasn’t accepted into any programs. Never mind the reality of being a teacher carried its own burdens. In my imagined life of freedom, I would live an abundant and fulfilled life as a schoolteacher. Being a teacher was my paradise- a mental relief from the life of a second-year medical student.

Florescent lights in an ever-bright study room would snap be back to reality and I would continue reading about the topic of the day- preparing for the next set of exams (which always seemed to keep coming). I didn’t want to study anymore. I didn’t want to sacrifice anymore. I didn’t want to put in the effort anymore. I wanted out.

By God’s grace, I made it to graduation. Medical school behind me, residency on the horizon. I was glad it was over; focused on enjoying this time before the challenges of residency became my reality.

Fast forward and I am in residency- the same thought runs through my mind. They creep up under the similar pressure I felt in medical school, except itnow persists. When I am finishing inpatient notes well into the night- at times even past midnight just in time to catch a few hours before waking up the next day at the crack of dawn. When my head is spinning with learning points, patient load, learning the nuances of insurance and liability, board-studying, meeting the expectations of everyone around me- exhausted, drained, and hesitant to reach out- that is when I hear:

“I can’t do this.”

Sometimes, there are moments where I get a little jolt that will fuel me for a stretch of the race. I remember an encounter with a black woman in an elevator- she looked at me in anticipation, hopeful that someone who looked like her (understood her) would be her doctor. It served as a a reminder that representation (as lightly as it may be used) still matters. Experiences like (whether small or large) are like wood- wood thrown into the fire of my drive fueling me to move forward for one more mile- temporarily forgetting about that whisper.

As you can imagine, the cycle continues, and would have continued if it had not been for the wisdom of a trusted counselor. She challenged me to address something I had been avoiding.

I was avoiding a decision. Since undergrad up until now I was avoiding a decision. Avoiding my sense of ownership in this journey. I was comfortable reacting to everything around me, placing blame on all things external for how I felt- absolving myself of accountability for choosing this path in the first place.

Toying back and forth with “should I quit?” “should I commit?” was taking an emotional toll; I couldn’t keep doing it anymore. Either decide to stay or decide to leave; regardless of the side of the fork I chose, stick with it and accept what comes (using wisdom to discern what can be changed and what can’t). There is a saying - “If someone wants to stay, he will look for 100’s of reasons to do so. But if someone wants to leave, she will only need to find one reason to go.” No need to torture myself anymore with a decision only I could make.

Can I be real though? There are aspects of medicine that, simply out, are huge burdens. There are reasons why medical students are statistically more depressed once they graduate medical school compared to their counterparts who pursued other careers. There are reasons why physician burnout is so pervasive and why compassion fatigue is a growing concern.

It is real out here, and there are enough reasons for someone to walk away should they choose to (and in all honesty I would empathize deeply). Peace is priceless, and medicine isn’t the only meaningful way to serve.

As for me? I needed to decide for myself- this day- how I was going to move forward. Will I continue to torture myself oscillating between resignation and progression? Was I going to entertain wanting to quit with needing to stay on a regular basis- easily swayed by the tides of a clinic day, patient load, endless list of notes, bureaucracy, politics, nepotism, capitalism, or fatigue? Or was I going to finally decide?

When I realized how I was adding more frustration to myself by avoiding the decision, which by extension meant I was trying to avoid accountability, I decided to make a change. I chose to stay.

Yes, there are many reasons to leave and many reasons to stay- either decision would be okay and either path would have been supported. But for myself, as for now, in light of the pains and the joys, I have decided to stay.

What are your thoughts? I don't know where you are in your journey, but regardless of your decision, know that you are supported.

Until next time, stay well, carry gratitude and compassion in your heart, and remember the best is always to come.

All the best always,

-minorinmd