At the age of 17, I had a patient close to death ask me how long she had to left live.
At the age of 18, I had to console a woman who just had a miscarriage.
At the age of 21, I saw my first patient die while I was helping the medical team who was trying to resuscitate her.
Just a month ago, I was given the responsibility to look after a high risk suicidal teenager.
These are just some of the many confronting experiences I have encountered. Unlike other university students, my role as a medical student doesn’t end when I walk out of the hospital doors. I take it home with me and it finds a unique place in my personal life. I spent hours wondering if Mrs A got her pain under control and how Mr B is coping with his new terminal cancer diagnosis.
Quite early in my studies, I have learnt that medicine is not always the utopia I thought it would be. In its raw, real form it is a formidable being with the power to consume you. In my third year, I was confronted with this reality. I experienced months of fatigue to the point where I struggled to get out of bed every morning. I struggled falling asleep and on the nights, I finally managed to snooze off, I found myself waking up to 10 times each night.
By then, I was finally coming terms to the with emotional toll medicine has had on me. I felt physically drained and mentally numb feeling no emotion whatsoever. It affected the way I was interacting with my family and friends. I found myself becoming more distant and apathetic. In the height of my burnout, just three years after graduating from high school, I couldn’t recognise the person I had become. She wasn’t the doctor I once aspired to be.
This negligence to recognise our human fragility has become ingrained into the culture of medicine.
Upon reflection, my burnout was almost inevitable given how the high-pressure environment and poor support network aligned. From day one of medical school, we are told to aspire to an unattainable level of perfection. From chapters and chapters of readings to overwhelming lectures and tutorials, never once can you drop the ball. The long emotionally tiring days don’t end when you leave the clinics, it is often followed by hours of study and sleep deprived nights.
This vicious cycle of poor self-care practise entraps many into a hazardous path. As students, we quickly learn to construct and maintain an indestructible façade of competence as we try to keep up or outcompete our colleagues. This negligence to recognise our human fragility has become ingrained into the culture of medicine.
One in five medical students and 1 in 10 doctors report experiencing suicidal thoughts in the past 12 months according to the National Mental Health Survey of Doctors and Medical Students. For a profession that is centred on caring for others, I wonder how and why we forget to care for ourselves and our peers?
It took a lot of courage and bravery for me to finally seek out for help. However, I chose to do it anonymously through Headspace. My reluctance to reach out for help openly is unfortunately quite common. Exposing your struggles in medicine, leaves you open to criticism. You fear being labelled incompetent and medical culture does not tolerate that. This judgment barricades individuals from seeking help. Cultivating a culture change in medicine to be more accepting of mental health in doctors is only one part of the solution.
The importance of self-care and good mental health practice is often neglected in medical education. Tools to adapt and develop coping strategies to the traumatic experiences we encounter fall often short. Ultimately, medical students develop behaviours and attitude that they carry for the rest of their career. There is a deficit of self-care education and skill development offered by institutions to ensure that their graduates are equipped to cope with the psychological distress that they are about to confront as junior doctors. Thus, it is naïve to assume, that tackling mental health at hospital level alone would resolve the epidemic we are now witnessing. The cycle essentially begins early in our career, often in medical schools.
It is naïve to assume that tackling mental health at hospital level alone would resolve the epidemic we are now witnessing. The cycle essentially begins early in our career, often in medical schools.
Creating a supportive environment within university where conversation is encouraged and support services are utilised can drive the change that we so desperately need. When self-care and effective coping strategies are emphasised and integrated in educational program, we can nurture a new age of medical graduates who are more self-sufficient and empowered about their mental.
Mental health in junior doctors is not an easy issue to resolve, it requires a multidimensional strategy that is also inclusive of future medical professionals. As I have progressed throughout my studies, I have learnt success in medicine hinges on resilience and self-care. It’s an art I am still learning to master as I grow into the doctor I dream of being.
Femy is a guest on Insight's look at why rates of mental illness are so high among Australian doctors and nurses. Watch the full episode of Critical Care here.
