HEY. I realize that it has been a good long while since I’ve posted anything. Second year is insane! But because I didn’t want to deprive you of my incredible prose (lol), I carved out a little time to try to get out what’s been on my heart lately.
Can we talk about perfection for a second? This is something that I feel pressure to achieve every. single. day. There is a pervasive culture of perfection in our society, so imagine all of that funneled down into the culture of a bunch of overachieving, type A med students who spend a lot of time together. Our worth and our success and our value is in large part determined by how closely we achieve perfection, and that can mess with your head. I see it in our professors, I see it in my classmates, I see it in myself. We all want to be perfect, no matter what. And thinking about this has raised a lot of questions for me – is this important? Is this necessary? Is this healthy? Is this human?
Is this important?
I actually think it is. Medicine is a field that necessitates attention to detail, and the well-being and lives of our patients often ride on our ability to achieve perfection. Small mistakes can have devastating consequences, just like small adjustments can have drastic benefits. It is so important for us to pay attention to everything – they teach us this: how to watch body language, how to pick up on subtle clues that could be easily overlooked, how to ask the right questions and do the appropriate tests and perform the correct exam. If we miss a step or don’t ask a certain question or interpret lab values wrong, the end result isn’t always great. This is why medical students are allowed to do very little on the wards, and why, once we graduate with our M.D.s, we all still have a minimum of three years of training left (COOL).
Is this necessary?
NOOOOO. (One more time for the people in the back: NO). It’s just not. Think about the kinds of people that med school typically attracts. I don’t have to look any further than the mirror to see a stereotypical med student: driven, perfectionistic, a little (or a lot) type A, persistent. This is who we are. These are the kind of people that go into medicine. Internally exerted pressure for perfectionism is already a part of many of us. Externally exerted pressure for perfectionism is unlikely to change ever. So what gives? I think we need to be more gentle with ourselves. I think we need to assert the fact that medical school is a world of unattainable perfection: we will never know everything. Not now, not ever. In these last few months, life has thrown me some major curve balls, curve balls that have made me feel like one of the only things I have control over is my performance in school. Even so, I have continued to learn how incredibly important it is to be gentle with myself. It’s okay to take a walk and clear my head. It’s okay to take a night off from staring at my computer. It’s OKAY. It’s okay to want to be the very best I can be, while still giving myself space to breathe, still loving myself when I make mistakes, still allowing myself to be human.
Is this healthy?
I think competition can be really healthy, and so by deduction striving to not make errors or mistakes is an inherently good thing, and can also be healthy. But, for example, I’ve watched myself and others beat themselves up over getting one question wrong on a quiz. We are learning much of this information for the very first time, and at a ridiculously speedy pace, and somehow getting all but one question right isn’t good enough for us. This can be healthy in that it motivates it, it pushes us to work hard, so that when that question pops back up again, either on an exam or in actual patient care, we get it right. However, this is also, in a very real way, SO unhealthy. I have been so frustrated with myself for getting that one question wrong, when in reality, me learning from that mistake or misunderstanding is what’s ultimately going to make me a better doctor.
Is this human?
Second year is kind of a brutal year in med school. Step 1 looms closer every day, the blocks get shorter and faster with no breaks in between, and the senioritis/desire to not be in a classroom anymore gets super real super fast. This year is draining and exhausting and, to a certain extent, dehumanizing. I feel like a robot approximately 79% of the time, and I have to remind myself on a very regular basis that I am not a machine but a human being. It is so easy for me to see why the rates of depression and anxiety and other mental illnesses are so high among medical students – we are human beings attempting to operate like machines, all while trying to outcompete all the other human beings acting as machines. Med school can be really quite enjoyable, but there is also a dark side to med school, a side that we try to ignore a lot of the time, a side that we deal with because one day this is all going to be SO worth it. Interestingly, med school has taught me more about humanity than any other experience in my life so far, but this same experience has also been the biggest threat to my humanity. I have learned more than I thought possible about suffering, vulnerability, humility, empathy, and healing since starting med school. Concurrently, I have learned more than I thought possible about working yourself past your limits, about being so test-focused that we forget all about why we are here, about depriving myself of basic human needs – exercise, rest, human interaction – so that one day I can champion the benefits of exercise, rest, and human interaction to my patients. The irony of all of this has not been lost on me, and sometimes it amuses me to no end, while other days it can be rather discouraging. In the end, I think med school tries really hard to take the human out of us, while simultaneously bringing out the most human parts of each of us.
If I’ve learned one thing in the last almost 2 years (WHOA that’s gone fast), it’s that I will never be perfect. I think a lot of us (including myself) often view physicians as gods who can do no wrong, but when we get right down to it, we’re just as human as the patients in front of us, and reminding ourselves of our humanity, in the midst of trying to achieve perfection, makes all of this much simpler:
I am a human who will, one day, finish a long, arduous road of extensive training, and I’m here to do my best to make you healthy again or to keep you healthy. And if I can’t do that, I will do my best to make whatever life is left in you the very best it can be.
I am a human, and so I won’t promise perfection because to do that would be to put myself on a pedestal above you, my patient, to claim that I am superhuman when you are not.
I am a human, and I will be authentic, I will be real, I will work as hard as I can to serve you well, and I will make sure that your humanity, just like mine, isn’t lost in the middle of disease and chaos and illness and fear.
I am a human who will champion you right on through all of my strengths and all of my shortcomings.
I am a human who will never give up on you, because you will make me better at my job.
In order to do all of that, I’m going to be working hard forever – now as a medical student, in the rest of my training, and as a full-fledged attending. That’s what I signed up for, and that’s what I’m showing up for. But sometimes we can all use a good reminder that this isn’t about us, and we need to shift our focus. My #1 goal in life should never be my ability to achieve perfection – it should be serving my patients well, and while that ALWAYS includes precision and critical thinking and teamwork so that we can get as close to perfection as possible, it also necessitates realizing my errors, acknowledging my mistakes, and retaining a very, very strong sense of humility in a profession that can easily replace that humility with pride. In my opinion, there is much more danger to my patients in me exuding pride – believing that I am perfect – than in me embracing humility – knowing that I am not. I will come much closer to perfection through humility than I will ever be able to through pride.
Here’s to replacing studying to achieve perfection on exams with studying to achieve healthy patients and saved lives. Here’s to replacing stress with determination. Here’s to being something more than robots, something better: humans. Here’s to working hard to achieve the highest bar of all: not one of perfection, but one of service.
And with that, back to work.