Undertaking the feat of obtaining a medical degree is nothing short of monumental, but how we preserve our sanity amidst the strife and triumph truly shapes our experience. Today on the Osmosis blog, medical student and Osmosis Medical Education Fellow DianneMarie Omire-Mayor explores the harmful trope of “the tough physician” and how we can all benefit from asking for help.
A resident walks up to the nurse’s station, waiting amongst other residents for the attending to arrive and begin rounding on patients. She is just coming off of a grueling 24-hour on-call during which she dealt with 30 trauma victims from two multi-car pile-ups and lost a patient due to injury complications. As a fourth-year resident, she’s seen her fair share of trauma, but this particular day, it all seemed to just be too much.
Internally, she is dejected and exhausted, yearning for her bed and some much-needed rest and recuperation. Externally, she appears completely fine, showing 0 signs of fatigue. As the attending approaches, she makes a futile attempt at stifling a large yawn. Noticing this, her attending says, “Long night, doctor?” to which she replies, “Just didn’t get much rest. That’s all”.
The attending replies, “Rest? What rest? Back in my day, we worked 48-hour shifts with no breaks, no rest, and, most importantly, no complaints. You young ones don’t know how good you have it.”
The resident smiles and nods, thinking, “Maybe I just need to toughen up. It’s obviously not that bad if everyone else is surviving it.”
The myth of the “tough” physician
For decades, the medical field has been plagued by this perception of the “tough” physician. That is the physician who can withstand anything and everything. The physician who has seemingly unlimited energy is able to perform any task regardless of mental and/or physical fatigue. After all, doctors are superheroes, right? They do the seemingly impossible. They heal the sick. They fix the broken. They don’t faint at the sight of blood or quiver at the thought of trauma. They are always on the front line, ready and willing to serve mankind. Doctors are resilient.
Doctors are taught to put the needs of the patient before all else. To put personal biases and feelings aside in order to provide the best care for each patient they encounter. Doctors are taught to be empathetic while remaining emotionally distant from the situation, allowing for objectivity. They are compelled to place personal life in the background and patient needs in the foreground.
With this mentality, one would think that every clinician is objective, clear-headed and working in the pursuit of nothing short of optimal patient care. While this may be true at a surface level, there is cause for concern.
As medical students, we look to these physicians as an example of who we ought to be when we reach their professional status. But, are these practices that we emulate benefitting us in the long run? When do these doctors get time to deal with personal matters? Don’t those buried feelings still come to the surface eventually? Absolutely, and, often, negatively.
Why mental health matters
Mental health includes our emotional, psychological, and social well-being. It affects how we think, feel, and act. It also aids in determining how we handle stress, relate to others, and make choices. Maintaining proper emotional health and strength promotes productivity and effectiveness in work, school, and caregiving. Mental health governs how we interact with the world around us and the perspective from which we view hurdles we face.
Historically in the medical community, there is a stigma associated with receiving mental health services that prevents many from seeking help. They don’t want it to impact their careers and have colleagues look at them differently. They don’t want to be viewed as anything short of heroic. Medical students strive to emulate these historical standards placed by physicians who have come before them. These are the people we look up to and work tirelessly to emulate. Many medical students find themselves asking: If they didn’t need mental health services, why do we?
Maybe it’s not that they didn’t need mental health services, but that they just had a different set of tools they utilized to take care of themselves physically and emotionally.
Currently, during the COVID-19 pandemic, it is paramount for medical students to take care of their mental health. Routines are changing day by day, exams and rotations are being canceled, and clerkships have entered the uncharted territory of virtual learning. Many medical students have found themselves transitioning from continuous interactions with patients and classmates to existing at a desk for hours on end, alone with their studies and thoughts. Our worlds have been flipped upside down professionally, and for many, also personally.
In the long run, taking care of our health and well-being will make us stronger students and physicians.
Healthy habits, healthy mind
Maintaining mental balance while practicing social distancing can be difficult, but if done constructively, can lead to increased productivity and long-term wellness.
As medical students, we rely so heavily on our brains to help us think constructively and critically, sorting through clinical vignettes and differential diagnoses hour after hour. We know that we are supposed to eat a balanced diet and exercise regularly to maintain good physical health, but what about mental health?
How often do we take time to really evaluate our mental health? Are we happy? Sad? Stressed? All of the above? We often get so wrapped up in our studies that we fail to really acknowledge the emotional fluctuations that accompany trying to balance professional tasks with personal struggles.
Maintaining a clear, level head helps us to cope adequately with the stress that accompanies medical school and, while we each have different ways of going about this, the end result is the same: increased productivity and long-term health benefits.
Mental health resources for US medical students: 4 ways to seek guidance when you need to talk or just don’t know where to turn
- University/Institution Student Health Services: While hours of operation may vary, students may always seek help and support from providers and mental health professionals. Contact your institution for more information.
- Crisis Text Line: Available 24/7 throughout the United States. Text “HELLO” to 741741
- Disaster Distress Helpline: Call 1-800-985-5990 or text TalkWithUs to 66746 (Spanish speakers can call the hotline and press “2” for 24/7 bilingual support)
- Reach out to your local National Alliance on Mental Illness location for support groups and counselors in your area and crisis assistance 24/7.
If you are in crisis or you think you may have an emergency, call your doctor or 911 immediately. If you’re having suicidal thoughts, call 1-800-273-TALK (8255) to talk to a skilled, trained counselor at a crisis center in your area at any time (National Suicide Prevention Lifeline). If you are located outside the United States, call your local emergency line immediately.
About Dianne
Dianne Marie Omire-Mayor is a second-year medical student at Howard University College of Medicine and a member of the Osmosis Medical Education Fellowship program. She is originally from Washington, D.C., and intends to pursue a career in Orthopaedic Surgery with an emphasis on Women’s Health and Trauma. Dianne is an avid runner and works as a personal trainer during her free time.
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