Psychotic Medical Students

Doctor D gets lots of emails from students considering medical school.

Hey, if the practice of medicine is your dream then you should go for it, but be forewarned it isn't sexy or glamorous like on Grey's Anatomy. It is years of drudgery in which helping patients and feeling awesome about yourself will be the exception rather than the rule.

But I pray to God you never go totally off your rocker and spend your precious days off making videos like these:






Doctor D has more relevant material than silly parodies of parodies of parodies, but unfortunately not the time to post it right now.

He's also about 2 months behind on answering AskAnMD emails. Feel free to chastise him the comments!

I Hate Medicine!

Last week Ella the Med Student wrote brilliant and thoughtful advice on how to be happy in medical school: You need to love medicine.

Now Doctor D has a confession to make:

I hate medicine! Medical school was the worst 4 years of my life.

There, I said it! It felt good to let it out.

But before all of Dr. D’s medstudent fans rush to unfriend him on facebook they should know this: Doctor D not just a good doctor. He is a frickin’ amazing doctor!

How is this possible?

They look so pleased just to be in a hospital!
Doctor D isn't in any photos like this.

How I Learned to Stop Worrying and Hate Medicine:

Ella classified medical students based on their love for medicine with the “miserablites” at the bottom. They are the ones in medicine with ulterior motives. Therefore they hate school from the first cut on the cadaver. They don’t fit in with other medical folks. They don’t like studying diseases or treatments. They can’t wait for medical school to be over.

Yup, that pretty much describes D in medical school!

Young D took one of those aptitude tests administered by the college career counselor. It said that his personality was an awful fit for doctoring. He was warned.

So why did he do it?

Medical School With Ulterior Motives

Doctor D’s ulterior motive for studying medicine was that pesky humanitarian impulse. D loves people. As a student young D worked in homeless shelters and volunteered in 3rd World countries—not to pad a resume for med school, but because he actually liked doing those things. Young D asked himself, “Self, what work should you choose that allows you to help suffering people?” Since D had the book smarts everybody suggested medicine.

On day one of medical school D realized he wasn’t in Kansas anymore. He was surrounded by highly driven people who absolutely loved spending 18 hours a day studying pathophysiology and pharmacokinetics. Ella enjoys kicking back with Robbins Pathology while sipping her coffee in the morning. God bless her crazy ass! Doctor D’s trudge through Robbins was about as enjoyable as the Bataan Death March.

D’s secret fantasy in medical school was that one day he’d go in and give everyone the middle finger and drop out. This thought was the only real pleasure he had for most of med school. It kept him going when times got rough. Every miserable day D told himself, “I’ll quit tomorrow.” He came close to doing this about a hundred times, but never pulled the trigger.

Doctoring with Love and Hate

So D became Doctor D, and lo and behold he was right: All this dull medical science he forced himself to learn is useful—it helps sick people get well, and D really enjoys his job!

The actual practice of medicine allows for amazing connection with other human beings. A caring doctor during the worst and most painful day of your life is really useful. Doctor D always gets along well with patients. One reason Dr. D connects so well with patients is that he never really did connect with other medical folks.

Some doctors love studying diseases and reading the latest medical trials—quite a few retired docs do this years after they’ve seen their last patient. That’s cool and all, but it ain’t me. If Doctor D lost his medical license tomorrow you can bet he wouldn’t read another sentence of medical literature again!

"Yeah, I don't like school either, but some things are worth the misery."

But Doctor D does keep up with all the info on the escalating arms race between diseases and medicine and he'll treat you with just as much skill as the next doctor. In some ways D sees himself as the purest form of doctor:

Some doctors battle illness because they are fascinated with the weapons or with the battle strategy. Doctor D fights because he believes in the cause.

So take courage you med school miserablites—you sad souls who don’t like biochemistry or fit in with your anal classmates—here is hope for you yet! You may yet become a fine MD who loves this crazy job in a way those medical types could never imagine.

PS: If any of you med students do decide to go out in a blaze of glory by telling "the man" to stick it up his rectum and burning your student ID please email Dr. D your story because he would love to live that moment vicariously!

An informal AskAnMD poll:

How many of you medical people actually like medicine vs. those who use medicine for ulterior motives like Dr. D?

How many of you patients would care if you doctor wasn’t actually fascinated with your disease and your medicines?

Will Medical School Make Me Miserable?

Part II of ongoing series: Should I Become A Doctor?

Great question from a potential medical student:

"I got accepted to med school for 2011, but I am scared to commit to this decision. Will medical school suck all life out of me, leaving me passionless, tired and with no ambitions?"

For this question Doctor D called in a consult! Doctor D recruited a real live medical student! Ella the Med Student is a brilliant blogger and a winner of the coveted Big D Award!

Ella's Advice:

Medical school is difficult. It takes tons of time. It's stressful. It is a huge commitment. It's competitive. It is also a million other wonderful things.

Everyone in medical school has essentially the same experience, the same course load, the same time schedule, etc. Yet, you will hear very different opinion from students about their medical school experience... ranging from "it was the worst time in my life" to "this is so much fun!"

The MAJOR factor that contributes to the differences in student's experiences in medical school is why they are there.

"Why am I here?"

Let me describe a pattern I have noticed among medical student. I think there are three main groups of student attitudes about medical school. I'll describe them here...

Ella’s Taxonomy of Medical Students:

The Good

The happiest students are those who are enjoying the journey. They actually love medicine, love the material they are studying, love the lifestyle of continued learning and a high-paced academic environment. Of course, many have other interests and families, but to them medical school is not an obstacle in the way of those things. Med school is an awesome part of their life.

"I'm happier than a pig in mud! Medical school is Awesome!"

Personally, I love reading my huge Robbins pathology book with a cup of coffee in the early morning. I love going to lecture and participating in clinical problem solving. I feel a rush every time I am in the hospital, I talk to my patients for too long, and my brain is always coming up with ideas for projects and research. I look forward to residency and my future career, but I am in no way miserable in school. I absolutely could NOT imagine being anything other than a physician... it took me so much work to get here that I am actually in bliss all the time. I know this sounds weird... but I know a lot of other people like this. If you ask them about medical school, they will describe it just like I have.

The (sort of) Bad

The second group of people are those that like medicine just fine, and it came to it as a reasonable choice. They worked hard in undergrad, and are all around strong academic students. To them, medicine is more of "a good field to be in" but not "the most amazing and only possible career on the planet." They could have been attorneys or engineers or business entrepreneurs or stock brokers and would have been just as happy. They do well academically, but are a bit blase about medicine... often eager to get home, eager to skip extra discussion about a disease or patient, and tend to be a bit frustrated with the rigmarole that comes with medicine. This doesn't make them less of a physician, but they do not enjoy the ride of med school as much as the first group. They are "putting up" with med school... and looking forward to getting out so they can have a family, a paycheck and a steady schedule.

The Ugly

The third group are the Miserablites. They hate medical school. They are barely hanging on by a thread academically, and they are socially and academically absent. They are caught up in the idea that that are in the wrong spot. They've realized that medicine is a lifestyle that doesn't end after medical school... and they expect that stress and academic/hospital nonsense will be a theme in their lives forever.

Some miserablites ended up in medical school because of outside influences. They felt pressured to do something "worthwhile.” Their heart wasn't in it... but they either didn't have another readily identifiable passion, or they felt their other passion didn't hold enough weight.

Other miserablites came to medical school for the money or lifestyle, and quickly figured out that those reasons are not sufficient to motivate you through the insanity of medical school. And they also figured out too late that being a doctor usually doesn't make you rich. 90% of doctors are not free of financial obligations. Student loans, malpractice insurance, etc. make the life less than glamorous.

The miserablites are those who, as you say regard medical school as "sucking all life out of me, leaving me absolutely passionless, tired and with no ambitions." I can tell you I have NEVER even one day felt this way about medical school.

Search Your Soul!

So, you have a lot of thinking to do. I would really consider what this commitment means, and how it will effect your goals. You have already identified some gut feelings about whether this career is a good match for you. I really think you owe yourself, your wallet, your future family, your happiness and your overall sanity some real hard soul-searching.

If you decide not to go into medicine, there is NO SHAME in that!

There are a million other things you can do which are just as rewarding. And if you do choose medicine as a career, choose it because it is best for you. It is indeed a wonderful life, but only if it is the life you really want.

Good luck!

What do you think? Doctor D always loves hearing your thoughts in the comments.

Patients: Would you care if your doctor enjoyed learning medicine?

Medical Students: Where do you fit in Ella's Taxonomy? Any of your Miserablites want to explain themselves?

Go on over to Ella's blog and admire how awesome she is!

Should Fear of Patients Keep You From Medicine?

The first of the series: Should I Become A Doctor?

A confused premed writes Doctor D for advice:

"I really want to be a doctor, but I have a fear of sick people. I don't mind needles or blood and guts, it's just people being physically sick that I am horrified by. It's the only thing holding me back from applying to Medical School. Is this something you think I can overcome?"

Excellent question my young friend!

The good news is that you aren't the only person who feels discomfort in the company of ill people. Many people feel this way to some extent or another. Ask any chronically ill person and they'll tell you how often people squirm in their presence. If you want to be a doctor you will eventually need to work comfortably around sick folks, but first lets examine why people feel this unease...

Why would you be horrified by sick people?

1) You're afraid you will catch their disease.

I suppose this is an understandable concern. But many illnesses aren't contagious and most of the others can be easily prevented with proper hand washing and immunizations. Doctor D has caught more things from his preschooler than he ever caught from patients!

But... I suppose there is always a small chance you will catch a bad illness from practicing medicine. If you aren't willing to take this risk then you should probably stay away from medical school.

2) Ill people remind you of your own frailty and mortality.

If you want to blissfully imagine you will live forever in perfect health the existence of illness in others is a painful reminder of reality. If fear of sick people is an extension of your personal dread of death then by all means stay away from medicine because every day at work will terrify you.

Believe it or not, a lot of narcissists with the this issue are drawn to medicine because they want the MD as a status symbol. They leave medical practice when they realize that the presence of suffering kills their hedonistic buzz. Good riddance!

3) Ill people make you uncomfortable because you feel their discomfort.

Human beings are social creatures. We all to some extent experience the world through the experiences of others. When we are around people who suffer—if we are at all feeling persons—we tend to feel a small amount of their pain.

This is Empathy, and empathy has motivated some truly amazing people to choose medicine as a career. Rather than avoiding the ill because of the sympathetic pain they feel, many empathic people want to help those who suffer.

If you are disturbed by ill people because you feel their pain, then you can become an understanding doctor goes the extra mile to help. We need more doctors like this.

If this is you, then you could have the makings of an excellent physician!

"Trust me kid, I'm more scared of you than you are of me!"

Disclaimer: Empathy Can Be Handicap Too!

If you feel so strongly for ill people that you turn into a puddle of ineffective mush when confronted with the suffering of another person then you aren't much use. Sick people come to doctors for help, and sympathy is an extra—a good extra, but only if it comes with professional help and skill.

Can you calm your emotions enough to think clearly and help people who are suffering greatly?

Also, empathetic doctors tend to get burned out. It's wonderful that you feel for your patients, but you have to realize that disease always wins in the end. You will lose a lot of patients. You will be unable to cure a lot of diseases. If your motivation for being in medicine is helping people's suffering you will have a lot of days you want to just give up. This is called compassion fatigue and it is the bane of kind doctors everywhere.

Can you keep doing your work with sick people and still care even when you lose again and again?

If you can maintain your empathy despite these obstacles you may just find that your initial anxiety around sick people made you into an even better doctor!

What do you think?

Patients: Would you be comfortable seeing a doctor who still sometimes feels uncomfortable around sick people? Would you go see our young premed once she graduates from medical school?

Med Students and Doctors: Have you ever overcome a dread of ill people?

PreMeds: Dr. D loves bringing premeds to the hospital and answering their questions about medicine. He always gives it to them straight about what it is really like to go through the training and then practice. So send him more questions!

Should I Become A Doctor? -The Series

Future doctors write Doctor D for advice:

• Will I Be Sexier With An MD?
  

• Should Fear of Patients Keep Me From Medicine?

• Will Medical School Destroy My Life?

• Will I Get Rich As A Doctor?

• What If I Hate Medical School?