Can I Be A Depressed Doctor?

Ever since I wrote about how going for therapy was my biggest gift to myself*, I’ve met with a few medical students to talk about the topic of mental health. Many of them were worried about their ability to make it through med school with their illness. Many were worried about the viability of a career in medicine with depression.

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When I was a student, there was a rumour that students with mental illness would be excluded from the course. We were informed by our senior students, and they by theirs, and thus the rumour was propagated.

This may well have been one of the biggest reasons, besides financial accessibility, that I took so long to get help for my depression. (In case you’re still wondering, the rumour is false, as rumours are wont to be.)

The reality is that depressed medical students are often high functioning in nature. It’s the reason they get away without help for so long. It’s the reason their colleagues will say, “But we never knew.”

I got through most of medical school without therapy or medication. But I didn’t get through it happily, and I wish I had found help earlier. I’m still not sure if my brain has recovered from the years of deprivation.

Now that I am more open about my mental illness, I have met more doctors – young and old – who are open about theirs. We don’t advertise it, but if it comes up, we don’t shy away from it. So I can confidently tell my young friends that yes, you can be a depressed doctor. But try to be a depressed doctor in remission.

For medical students (and doctors!) with mental illness, I recommend finding a treatment team sooner rather than later.

Find a good psychiatrist – even if, for financial reasons, it means you find a government psychiatrist. Or maybe a really good family physician. If they suggest medication, take them religiously. Don’t be the stereotypical non-compliant doctor-patient. And, as hard as it may be, try to accept your role as a patient when you step into your psychiatrist’s office. Maintain involvement in your own treatment, but put some trust in the expertise of your doctor.

I don’t advocate pharmacological therapy on its own to my patients, and so I don’t recommend it to my friends. Therapy is another costly but valuable part of managing mental illness, and one I have found to be invaluable. Once you are a doctor, you’ll be able to afford it. As a student, you may need to pull some strings, put your name on a waiting list, or open up to your parents for funding.

As a doctor with depression, I have days that I can’t get myself out of bed. I have relapses. I have colleagues I trust, but I have days that I second-guess that trust, and days that I feel alone. I have days that I can’t connect with my patients, and days where the connection is too intense and I just want to cry.

I have not yet had days where my patient-care was compromised. But I am always on the lookout. And I know that my psychiatrist and therapist will step in if they think that is the case. This is also why I told my HoD – not for sympathy, but because it is important for her to know. Just as we know about our colleague with diabetes, in case he has a hypo and collapses at work.

I also know that I will never sign up for shift-based work like in the ER, because I don’t think my neurochemistry will be able to handle that. Being on call is hard enough. Some of my colleagues accept multiple shifts in a weekend so that they can have a greater total of uninterrupted weekends. I know that I can’t do this, because I know that my mood takes a dip.

Managing mental illness as a doctor has been challenging. Sometimes I stumble. Sometimes I fall. Sometimes I lie in the dust awhile before I get up. Sometimes, someone helps me up. But the more I strengthen my support systems, the less frequent the falls become.

We are not cookie-cutters. I cannot say that some doctors/medical students will not decide to leave the profession because they feel it is incompatible with their illness. But that is a decision that should only be made after careful thought. Probably also a decision that should not be made while experiencing a major episode.

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Whatever you decide, don’t be driven by internalised stigma. And remember: you are not as alone as you feel.

*Strangely enough, the post in question has disappeared from my blog. A few of my posts mysteriously disappeared a few months ago. Quite annoying. 

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FAQ: Will I Get Into Med School?

Ever since I first posted tips for applying to medicine (in South Africa) in 2014, I have received multiple questions from aspirant medical students.

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The hardest to answer (and thus one of the most popular) is DO I STILL STAND A CHANCE? – usually prefaced with the person’s failure to achieve the desired grades for medical admission, or some other stumbling block. Continue reading “FAQ: Will I Get Into Med School?”

Overview: A New Study About Selection Criteria at South African Medical Schools

So many questions on this blog pertain to admission to medical school in South Africa. I’ve written a few posts about it, but at least once a week I get a question I can’t really answer.

Stethoscope, compass and blank notebook Continue reading “Overview: A New Study About Selection Criteria at South African Medical Schools”

Another Song for Medical Student, Interns, and Basically Everyone

I heard this song for the first time as I was driving to my New Year’s Day call on Friday. Apparently I’m the only person in the whole world who hasn’t heard it, but WHATEVER okay.

I wept a little.

THIS is what I want to say to people. To the new interns who are hopefully going to realise this year that medicine was the right career for them; but who will certainly meet many challenges this year.

Medicine is hard and you’ll be expected to be super-human, never to have broken wings, never to feel like you can’t go on.

Remember that for every person who expects you to motor on without a wink of sleep,  without any debriefing after a difficult resuscitation, there is another who will lend you their wings when it’s hard.

Look for them. Look for us.

Find the people who will support you when your day or week or month is shitty.

And when your wings are working… please help someone who needs them.

A Song for Medical Students, Interns, and Basically Everyone

By now this is an old song, but I remember last year I thought: this is the song I want to dedicate to my class.

I don’t know if I’ve always followed its advice. Have I grabbed every opportunity to LIVE? Perhaps not. But I’ll keep working on that.

I keep saying this about medicine: it is when we learn and experience that we come to grow through this profession.

If you’re about to start medical school: grab every opportunity.

If you’re about to finish medical school: grab every opportunity.

If you’re somewhere in-between: grab every opportunity.

No matter where in your journey you are: make it one helluva ride.

Tips For New Doctors: Things To Do During Your Last Summer Before Internship

Yesterday was the one-year anniversary of finding out that I had passed my final year of med school; and on Friday a new group of young doctors was born. I’m so excited to welcome them as my colleagues!

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As I write this, I’m sure that most of them are in a deep slumber trying to catch up on all the sleep they missed out on this year. I am jealously thinking about the summer holiday they have ahead of them, so I made a list of things I think one should do before starting your first official job as a doctor.

1. SLEEP

If you don’t sleep a lot during your last big holiday I might actually disown you.

2. Do what you’ve been dreaming of all year

In my case it was spending the festive season with my family; for others, it was traveling. DO IT NOW. You deserve it.

3. Declutter

Chances are you’ll be moving into a new place – maybe even a new city! Instead of chucking everything your own into boxes, spend some time going through the detritus of your life and getting rid of things you don’t need or don’t use. Haven’t worn that all year? Chuck it. It’s the age of minimalism – dust is gross and moving companies are expensive. If it’s old and gross throw it away; if someone might still use it, donate it to a charity shop.

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Some awesome articles here – click for source.

Continue reading “Tips For New Doctors: Things To Do During Your Last Summer Before Internship”

Collectibles For Your Trip Around The World

In just a few days, the Fall 2015 class of Semester at Sea will embark on their once-in-a-lifetime journey around the world. They will be the first to sail on the new Campus, the World Odyssey, and I may admit to some jealous-sea. (#sorrynotsorry)

A very clear memory for me about SAS was the weight of cost during all the excitement of seeing the world. It was a monumental effort to go on SAS at all, and I wanted to walk away with something tangible I could remember, but that wouldn’t leave me broke. As people wiser than me often remind me: it’s the experiences you bring home that matter most.

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I went on SAS fully intending to buy a lapel pin at every port. Cheap, small, and so very Rotary International. I did not for a second think that I would have trouble finding them, but I could not find one in Burma/Myanmar OR India OR Ghana. (Some of my fellow SASers did. Lucky bastards.) Continue reading “Collectibles For Your Trip Around The World”