Max S.

Photo provided by Max S.

If you’re reading this, grief is a journey with no linear path.

Nearly four years ago, I lost my father after a long journey with cancer. He was an incredible human, an amazing father, and an even better role model. My journey with grief has not been an easy one – I have endured some of the most stressful times of my life during this process (going through medical school). It took me a long time to move on from the acute grieving process to a more integrated process I think out of fear. I feared that I would start to forget who my father was and how much he meant to me – I felt I would be moving on without him. In the process of transitioning from acute grief to a more integrated grief process, I have needed constant reminders that he is always with me, I will not forget who and what he meant to me, and that he is seeing everything that I am accomplishing right now. Getting into medical school five months after he passed away was an incredibly bittersweet moment. I Facetimed my mom from work and told her the news and while we were both incredibly happy, we had sad tears rolling down our faces. At that moment, I wanted more than anything for my dad to be there to hear this as well. Moments like this, birthdays, holidays, and stressful times often reawaken my acute grief. I cry, I ruminate on thoughts of my dad, I stare at pictures, I watch videos, and listen to music that reminds me of him. Nothing takes away the pain of not being able to share those moments with my father, but it has become a little bit easier with time. I think for me, this has been one of the hardest parts of my grieving process – how can I truly enjoy this moment without being able to share it with him? I often think of a specific moment my mother and I shared with my father a day before he passed – we were helping him get into bed and he had his arms around both of us and started singing a jingle; we all were just giggling in that moment. This is the last memory I have of my father before he peacefully passed away the following morning. I share this because ruminating on this memory used to absolutely wreck me. Sometimes it still does but more often than not, I find myself smiling thinking about him just being a goofy guy. Some say that time heals you – grief is not something that you heal from but rather you learn how to process the emotions that come along with it. 

My purpose in sharing my story with you is for you to know that grief is not a linear journey. It’s okay to sometimes feel lost during this journey. Grief is not something one gets cured of; it’s something that you live with forever. Sometimes days are tough and sometimes they may be easier. Important moments in your life often can feel bittersweet. For me, having an incredible support network including my mother, sister, brother-in-law, and amazing friends continues to help me throughout this process. I know that there will be future moments such as matching into residency and graduating from medical school where some of this acute grief will reawaken. I have learned to be more compassionate to myself in these moments and allow myself to feel the feelings fully. If you’re reading this, know that grief is a journey.

Max S., Fourth Year Medical Student

Q: How do you balance medicine and your personal life? 

A: This is a tough question because during medical school, residency, and then being a practicing physician, you will always have to make sacrifices. I think for me, simply being able to be efficient with my time has allowed me to balance my studies and my personal life thus far throughout medical school. That does not mean that I have not missed weddings, birthdays, or vacations but it has allowed me some semblance of balance throughout. This did not come without trial and error. I was fortunate to figure out how I study best through my master’s program, and this allowed a transition to medical school that afforded me some balance. As I mentioned, I chalk it up to being efficient with my time studying and that meant me being fully in the zone – minimizing distractions, having a rough outline of what I needed to accomplish (anki, question banks, etc.), and then when I was finished, I was finished (I would fully turn off when I got home). One thing that allowed me to fully turn off was physically separating studying and relaxing – I would only study at school while home was for relaxing. I think there is also the peer pressure in medical education to be always ‘doing something’ – I tried hard not to fall into this but that is easier said than done. When one of your friends is talking about this research project they are doing, it is easy to think to yourself well shouldn’t I be doing something like that. It is hard not to fall into this because we are always planning for the next step whether it’s residency, fellowship, or being an attending. That being said, everything is very individualistic – if you are shooting for a competitive specialty, maybe having a publication in the pipeline is beneficial. If staying up late and studying brings you peace of mind, do it. If going to the gym every day makes you feel good, do it. While it may feel impossible at times, there is a way to find balance in medical school and it is a choice you must make. I am not saying that is by any means easy, but it can be done, and I think it has provided me with a good headspace throughout this arduous journey.

Q: How do you cope with some of the more unique stressors of clinical training, such as night shifts, frequently changing environments, and balancing clinical performance with studying for shelf exams? 

A: This is a great question especially because I am a third-year medical student who has had to deal with all of these stressors. A lot of us as medical students have a type A personality and like to plan – I have found that during third year I needed to be much more adaptable to changing circumstances. Whether it was a rotation changing a couple of days before I was going to start and shifting my study plan, an unexpected 15-hour shift, or just transitioning from one rotation to another, it was tough. Time is unfortunately less of your own during your third year of medical school and it is somewhat helpful to lean into it – allow yourself grace if you cannot accomplish the set of UWorld after a rough shift and be able to be flexible with your study schedule. It is a tough balance third year showing up every day and being on while subsequently going home and being on again to study – this is hard, there is no doubt about it. For me, being positive about my rotations and trying to learn as much as I could helped me get through some of the longer days – if you go into the day with the mindset that ‘this is going to be boring,’ it probably will be. I tried to remember that I could learn something from every rotation whether it was something relevant for the shelf exam or even if it was simply that that specialty was not for me. I am not saying that I succeeded at this every single day, but it certainly helped when I did. It is difficult to balance things when you are no longer on your clock, but do not forget that this is tough, and you are doing the best you can. Allow yourself some grace because what you are accomplishing each day is an achievement.

Q: How did you cope with the loss of your first patient? 

A: Before I share my story, I would like to say that there is no one-size-fits-all approach to this. The first patient I lost was a bright nineteen-year-old – the patient had a host of medical issues, but this loss was unexpected. I was talking with the patient less than an hour before I witnessed the ED physicians run through the ACLS algorithm as they achieved ROSC. A couple hours later the patient passed as the family decided to make them DNR. The reason I am sharing a brief story about the situation is because it is what allowed me to cope with it – talking through it. After witnessing a code blue for the first time, I was overwhelmed with emotions, and I did not know how to process it. I took a minute to feel out what I was feeling and then gathered myself before going and evaluating the next patient in the ED. I think it is important to take time for yourself in these moments – it is okay to not feel 100% immediately after. While I may not have felt 100%, I was able to compartmentalize at the moment and transition to my duties. Later in the night, word came that the patient passed, and another wave of emotion hit me – I could also see this in my attending. After I left the ED at the end of my shift, I became overwhelmed with emotion thinking about what occurred and how tragic it must have been for the family. There is no doubt that what we witness as medical students and physicians is tough and properly coping with it is crucial. For me, I truly needed to verbalize my feelings and why I was feeling them – I was able to do this by talking to family and friends who know me best. Through this, I was able to come to terms with what I was feeling, and this allowed me to cope and heal bits at a time.

 

Several studies have revealed that medical students, physicians, and healthcare professionals experience mental health symptoms at rates significantly higher than the general population. Stethos[Cope] is a chapter of IfYoureReadingThis designed to help medical students and professionals cope with the unique stressors of medical training and change the narrative of mental health in medicine.

To read more letters and interviews from students, and to learn more about mental health in the medical community, visit the Stethos[Cope] home page.

 
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