The Psychology of Insecurity

I'm in California. Just kidding.  Now I'm in Pennsylvania.  But I started writing this last Friday so there's that.  Pretend it's Friday.

Tomorrow, I'll still be in California.
But MONDAY.
Freakin' Monday, man.  We will all be back in school.  All 270 (er, 250-something now) of us, displaced first years of 2017 shoved into the role of semi-less-confused second years, passing the gumshoe-doe-eyed-deer-in-headlights baton to the class of 2018, wandering around with our little lunch pails with Tupperware and our backpacks on just one shoulder and new shiny Staedler Fine Point markers in 80 colors like it's the first day of school for the 19th time in our lives.  Have you ever thought about that?

We've done this rodeo show now FOR NINETEEN YEARS (give or take).  If you're of the post-baccalaureate variety like myself, twenty.   TWENTY YEARS I have packed my little boxed lunch..maybe your mom has...eh, maybe your mom still does, I don't know, and packed my backpack with new 3-ring binders getting progressively more ginormous and done my homework and marched/sprinted/driven to school.

Twenty years I have been a student.  K through 5th, then junior high, then high school, then college, then add a year because I sucked at physics and all things science and had to remediate a ton of classes and trade in a Drama Major for a little certificate of "You Are Smart Enough in Vague Science Prerequisites!" then first year of medical school and now second year. 

On August 1st, 2013, I packed up pretty much everything I owned and coalesced it into two large suitcases and drove with my best friend Zack to the Long Beach International Airport in California.
I remember throwing out a decent pair of running shoes because otherwise I was going to pay an overweight baggage fee and in my irrational and anxious brain, it made sense to avoid 50 dollars by tossing a pair of 40 dollar shoes.  Right, I'm dumb when I'm nervous.  Anyways, I remember we ordered wine at this wine bar in the airport because this was the start of our lives.

Zack, my Best Man Friend.  Taken the day we got the hell outta dodge and went to medical school!  Long Beach, CA.

It didn't serve so much a celebration as it was a sigh of relief.  The threat of having to sleep in Hyundais to save rent money or the fear of stagnancy in a non-English speaking city bordering Mexico or the insecurity of "I want to be a doctor.  I'm not a doctor.  I need to be a doctor." of every waking moment and permeating every dream and every email that dinged on your phone.  For us, it was an alleviation of the omni-present anxiety that embodied everything I initially feared about a path towards medicine-lifestyle ambiguity, plans that operate on a schedule negligent of time or day or weekends or people that I want to be around, being at the whim of the demands of standardized exams (of boards, of grades, of tests that compare me to my peers).

It was a relief that I could get away from the life I was living.  Granted, I don't have much room to complain.  I have a so-so ultra-private boring middle class Roman Catholic family that sometimes convenes for holidays, sometimes we don't.  I had a job and (usually) enough food.  I had an overpriced apartment sorta near the beach and I paid too much for gas, but damnit, I could buy that gas if I wanted to.
But every day I drove somewhere (usually work because I suck and was single), I punched my time card at HealthNet, I stared out the window and I remembered just outright sobbing when I failed Physics for the second time in the row, and selling my clothes on Ebay in college in order to register for Remedial Calculus because UC Irvine just charges so dang much.  I remember this as I lived my perfectly normal mediocre life and all I wanted was to live with impetus, to live with purpose. To be present somewhere with the implication that what I was doing would one day be more important that just myself; more than being self absorbed into my own needs for "when is lunch hour?"  "When are accounts payable reconciled?"

I recently asked a first year, "What are you most afraid of entering school?"
The response was one that was familiar, one that I can bet money on is ubiquitous too all medical students, irrespective of year, to some degree.  His response was, "to have underachieved."  And when I asked for expansion on that, he explained that he was aware much of this was an intrinsic and vague sense of an expectation of excellence-an idea that were he not to achieve success in any capacity, that he would be letting someone down.  This self-imposed sense of obligation to others, to be the best because in his/your/my mind, there is disappointment at stake.

And I cannot tell you how many times you might feel that way.  Maybe your sense of insecurity will be far more transient than mine; perhaps you have a better sense of self-worth and capability.  But even now, having "survived" first year, if you will, having passed (usually barely) all markers of academic aptitude, having somehow managed to not totally hate everyone and everything and hide 24/7 in the Anatomy Lab (although I do that now and again), I still feel in jeopardy of just undoing everything.
It happens often. It happens when I eat lunch and everyone seems so fraternal and happy.  I'm not a depressive person; if anything I overcompensate with this zeal and zest of "HI HOW ARE YOU la de da de da?!"  But I worry that I will always be on the cusp of failure; that the person they tell stories of being "so close" but just couldn't hack it will be me.
I'll get over it.  Probably when I'm 20 years into actual  clinical practice, I'll get over it.  But should you see me stoic, or quiet, it's not because I know what's going on.  Usually, it's because I'm too afraid to divulge that I don't, and so it's easier to remain silent ninja struggling student until I feel I'm at par.

But Monday, Monday is the last day of the first day of school.  Ever.  It's over man!  Moving forward is just a bunch of lectures that will blend together until Christmas, when Boards panic probably sets in.  Then that gets enmeshed in some second year senioritis purgatory when you just want the year to be done so you can go prove that you can maybe be 1/2 of a Doctor and then you're thrown into the ThunderDome of Rotations.

There are a myriad of things to freak out about.  I guarantee I've tried them all.  But there's not a whole lot you can do about it.  First years, I'm talking to you.  Benzo's, sure.  But more importantly, the management will come with experience.  I could sit here and indoctrinate you on the BEST STUDY METHODS OF ALL TIME, the books to buy, those to avoid, but really, I'm ancient in my ways.  Confused about the information in a lecture?  There's the magical thing called the internet; use it! There's your peers; utilize them!  And lastly (but importantly), utilize your professors.  They have office hours for a reason.  Think logically and thoroughly....if you can't come up with the conclusion on your own, go to the person designated to help you (read: 'help,' not 'spoonfeed.')  I assure you, putting in the initial effort prior to eliciting the easy answer will make you a better medical student, a more independent thinker.  You will walk away proud of what you know, confident in your ability.  Start becoming your own greatest resource by forming a reservoir of knowledge.

Art makes me feel less like a psychopath.  Find what makes you feel less like a crazy person and I promise you, the school stuff will come more easily.  No xanax required.

An anecdote: There was a time where I just didn't.  Get.  Histology. I just didn't get a gosh darn thing.  Wanna know why?  I'd never seen normal cells before.  Nope, a major in Drama will not give you ample histology exposure with a microscope.  So to see structures from anything but a gross perspective was just the worst thing.  And I recall trying to tell myself "Veronica, this is a Brunners gland.  Brunner's glands look like this." And all I saw was purple and pink and coils and some white space.  And I just couldn't do it.

And I'm up in 3rd floor, parked by a window with my laptop.  There's this histology quiz in 45 minutes.  And I am beyond panicked.  It's almost apathy...but worse somehow.  Like, I've heard everyone complain about how they "really wanted that 5/5" and I'm just a mess inside because for ONCE, I'd like a 3/5.  Maybe a 4/5 on my best day ever.  But no, it's not happening, because I'm having a hard enough time discerning a nucleus from cytoplasm.

And I hear the familiar shuffle of one foot just slightly slower than the other, and I turn around, and it's Dr. McGuinness.  The McGuinness that somehow narrates with his eyes closed, like he memorized the cadaver in his sleep and delivers his tutorials like the Gettysburg Address.  And he asks, "What's wrong?"

And I'm there with my bag of Trail Mix and laptop and lack of any histological foundation and I just LET IT GO.  I couldn't stop it if I wanted to.  Hot tears are just pouring out of there like woman going through menopause that ran out of Milano cookies.  And of course, because I can't handle the truth of admitting I don't know anything, I say "There's too many raisins in this Trail Mix."

Needless to see, there is resolution to this ultra-pathetic story.  What I learned was 1)If you don't get it, it's cool.  Chill out.  Don't blame it on the raisins.
2)Ask for help!  But make sure you've tried.  Nobody likes when you sit there sobbing into your bag of assorted nuts and look as hopeless as you feel.
3)Understand it's normal.  To varying degrees, you'll get stressed.  Go running. Eat a whole pizza.  Eat a whole pizza and THEN go running.  Whatever makes you feel better, just do it.  Far better than being distracted by feelings of your own inadequacy.

Until then.  I'll let you know I'm still afloat.  Stay afloat.
Remember: don't blame the raisins.  They won't help you, but your colleagues and faculty will.
Maybe even me.  Maybe.  Just don't ask  about Brunner's glands.

Sand over Gland. (Corona Del Mar, California).

Advent of Year 2

Hiatus is over.

I'm notorious for excessively lengthy prefaces.  Perhaps this is because much of what I choose to divulge as your bright and shiny DO Blogger is so poorly defined by the parameters of three paragraphs and a clever header.  And so, like time and time again, I'll word vomit until you elect to stop reading.

But hopefully, you don't.  Hopefully, you are the right person, at the right time, reading those choice words.  Hopefully, something strikes a chord with you, whether you are like me, closing the curtain to first year summer limbo and entering second year; whether you are beginning your journey into the entering DO class of 2018 from whatever life event or academic segue that brought you about this way, or whether you are a curious onlooker, wondering if "it really it all they say it is."

In personal matters, I have news for you.  Miss Williams is getting married.
Jokes on you though: Miss Williams is my mom.  (We share the same surname).  Ironically, everyone is getting married.  Like...everyone. My best female friend just jumped on this bandwagon about two weeks ago. Don't roll your eyes just yet, this isn't to be followed by some sour-laden statement like "I'm just sitting here becoming a doctor, you all go on with your life milestones." I haven't met my mother's fiance yet; in a way, I have trepidation about the whole thing.  It has much less to do with the introduction of a new man (the only man?) in our small little circle of Williams' widows and singletons than it does with the fact that it is a very existentially alarming thing to see (recall) that medical school and all of its gravity and levity and trivialities and legitimate concerns and drama or mundanity are not the center of your life (all the time, anyway) or that of others  In the end, it's you within it, again, in this bubble that removes you from the ongoings of normal people, and when it's over, you have the blessing of an institution to rejoin it (albeit sleep deprived, you are qualified.  You are something. You are someone). Everything else, marriage included, must be malleable to the shape of your academic career.

But it is funny, in a way, to remember that people can mark progress, and personal growth outside of school with events and celebrations that don't pertain to "I passed this exam" or "I placed out of histology."  It is silly that I sit here, on the phone with my mother, a fellow single woman for as long as I've been alive, and briefly talk details of what is typically one of the biggest days in someone's life as a mere calendar event-in some ways, an inconvenience.  Because the topic progresses from "How exciting!" to "When?" to "Who?" to "But not around boards, right?" to "But yes, around boards" to "In that event, it is not feasible; I cannot go."

And that doesn't bother me so much, an inability to attend my only parent's first wedding.  It frightens me a little more that this mutual decision is one made so nonchalant, like that I can't order pizza in because the coupon expired.  Like this is just another exam.
For that, I will always have a distaste for the jail that is professional school.

But last night, I attended the gala (I'm just going to call it a gala...all things dinner and dance will hereby be known as Gala) for the Masters in Biomedical Sciences graduates.  Many of whom, in attendance, will be joining the Doctor of Osteopathic Class of 2018.  And I couldn't help but be so...excited.

Excited for them.  Excited for you, should you be one of them.  Excited that, regardless of what your acceptance means to you (maybe you have adopted the attitude of "it's about time" or "Thank God, I can spend the last bit of my 400 dollars in the bank" to "I have a life.  I am defined."), you are becoming Someone.  You have always been someone.  But now, someone (some school, really) has publicly declared they trust you with the knowledge and professionalism and genuine humanity that constitutes the intelligence and benevolence truly needed to be a physician.  I have always been of the mind that you cannot have medicine without an interest in people-all people.  Does this limit everyone to Family Medicine?  No.  But it does set a very nice stage for your approach to patient care in any capacity or specialty-not solely your aptitude but your concomitant desire to see and work for the improvement of their quality of living of others at what occasionally comes at the expense of your own. 

I am excited for you.  If you are like me (which I understand would make you eccentric, odd, a hot mess on occasion, verbally overbearing, etc), your acceptance to medical school means you never have to sleep in your car again.
It means you never have to park behind an Albertson's lot during summer school.
It means you never have to make a decision between money and food or education.
It means you can have all of those things.
It means that, you are given the opportunity, one that 8000 people this year sought out just like you, to sit in a seat 270 were priveleged with, to prove (not because you ought to, but because you want to) that you are working for the betterment of your immediate society and the advancement of a medical and scientific one.
It means that, you are assured a spot in Ginsburg, which is of the utmost insignificance, but more importantly-MOST importantly-you are assured a degree, pending your unrelenting hard work and dedication, lots of pots of coffee and occasional cynicism and sometimes missed marriages and tests instead of birthday-a degree that lets you physically CHANGE others.

You can CHANGE them. Most times, it will ideally be for the better.  It may be preventative, and life saving.
It may be defensive with intervention, and no one's lives are for the better.
But you CAN change them.  You are one of the few professions in the world where you can utilize your mind and your hands together, and you can feel for disease, you can think for curative measures, you can instruct and teach and palpate and feel and improve.  You can do this, and someone believed in you enough to grant you the greatest opportunity- a medical education.

And you will forget this at times.  You will be tired, and annoyed. You will be upset, and cranky.  You will say things you don't mean to your colleages and your friends at home, to your spouse or your children.  It will be mentally and physically demanding in ways (unless you've been to medical school before) that you have not experienced before.  It may not be "harder" than labor, or more "difficult" than an Iron Man, but it will be tough.  And it will be tough when you enter your second year, when you remember all those nights that melted into mornings, all those exams you could have cried over because, yea, damn right they dictate your future. That one scantron says "Yes, collect 500 dollars and pass Go, be a DO."  Conversely, it can say: Stop.

Work hard.  You will.  When you think you've worked hard, work a little harder.  Work as hard as those 8000 applicants worked to get where you are fortunate enough to be today.  I am excited for you; never forget how excited you were the day you read a header that began with

"We are pleased to inform you."


xo,
V