I went through most of today like any other medical student – in a massive rush. I had ten thousand things to do and knew that with the time I had, not everything would get done. Ignoring my throbbing headache and stuffy nose, I rushed around from class to meetings back to class back to meetings. When asked “how are you,” I answered with my proverbial, “I’m good! How are you?” and a cheery smile. I didn’t know how to be anything other than “fine.”
As my cold and cough worsened, and I admitted that I was probably sick enough to need antibiotics, I found myself in my white coat as a patient at an urgent care (the irony of which was not lost on me). When my doctor walked in the room and saw my white coat, he asked if I was a medical student. When I said yes, he chuckled and responded, “Ahh I remember medical school. That was a fake it ’til you make it experience. I’m sure it’s the same for you.” Though taken aback, as I started to actually think about what he said, I realized how much time I truly spend “faking it.”
Part of medical school is about “faking it.” It feels extremely uncomfortable to walk into a patient room donning your white coat and stethoscope when you barely know how to take a blood pressure. It feels completely unnatural to take a patient history when you know absolutely nothing about how to diagnose the patient’s condition. This kind of “faking it” is necessary – until you force yourself to be uncomfortable, you’re never going to feel comfortable.
The truth is that medical school is not supposed to feel natural. It’s not supposed to be simple and it’s certainly not supposed to be easy. The more dangerous ‘faking it’ that I feel occurs in medical school is pretending that it is easy. The fear of appearing weak or vulnerable to our peers, whom we respect and admire, and to a large extent, seek gratification from, determines so much of our behavior. The fear of appearing ‘squeamish ‘ prevents us from expressing when we’re uncomfortable in a lab or clinical setting. The fear of being anything other than perfect is why we answer “How are you?” with “good” even when that isn’t the truth.
This projection of the best versions of ourselves is not unique to medical school – in fact, with the rise of social media, most of us are projecting the best versions of ourselves to our social networks all the time. I’m sure we can all identify with the sinking feeling of scrolling through our Facebook newsfeeds or our Snapchat stories on a bad day – our ability to instantly compare our own lives to the ‘picture perfect’ projections of other people’s lives is disheartening, and it’s dangerous. The double standard we apply to our own lives in comparison to the falsehoods that are advertised to us makes us feel weaker than we are.
The truth is that “faking it” is not sustainable. A recent study published in JAMA found that 27% of medical students had depression or symptoms of depression and 11% had suicidal thoughts. Furthermore, only 16% of students who tested positively for symptoms of depression sought treatment (http://time.com/4591919/medical-school-depression-suicide/).
Physician suicide statistics are staggering as well – male physicians are 1.14 times more likely to commit suicide as the general male population and female physicians are a staggering 2.27 times more likely to commit suicide compared to the general female population (www.afsp.org). As a patient, when I meet doctors with little empathy (including today’s), I can’t help but wonder if the “faking it” is what made them jaded – because the problem with projecting perfection is that you begin to expect that of other people. Maybe the reason some doctors lose their empathy for their patients (or are unable to access it and showcase) is that the same empathy has not been afforded to them. I wonder that can be changed.
Medical school is too difficult to go through without compassion and vulnerability extended from you and toward you. My hope is that as medical schools increasingly prioritize student wellness, prevention of burnout, and student reflection, this “faking it” will be minimized and eliminated before students face serious issues of burnout and desensitization. Changing the culture of a profession is difficult, but I truly hope that the steps the medical education community is taking to support students will ensure that we all “make it” as empathetic, healthy, and above all, happy doctors.
And to my fellow classmates – I extend an open invitation for discussion , a shoulder to lean on, and an open heart, always.
Prerana Chatty is a medical student at Rutgers Robert Wood Johnson Medical School in New Jersey and recently graduated from Cornell University with a major in Biological Sciences and a minor in Creative Writing. She is greatly interested in narrative medicine and her primary creative medium is poetry. She is a strong advocate for reflection and humanism in the medical field. You can contact her at firstname.lastname@example.org