Fear as a now third year medical student

It would not be a trial of our faith if our faith was not actually tried. Trials are essential, obviously, but how much of a trial can it really be if all the time we feel His guiding hand and Comforting presence? Can those really be considered trials?

Today I am officially a third year medical student. Reflecting over the last two years, I want to take a moment to write down my thoughts. As a missionary, when the Spirit said I would be going to medical school it was a huge relief. I had struggled up to that point to really know what to do with my life. I knew I wanted a good career, a steady paycheck, a job that I loved. I knew I wanted to work outside the home, make a difference, help people. But I didn’t know exactly what that looked like for me until that moment in Virginia. And when I got home and got to work researching and then putting into action all that would be required to be accepted into a medical school in the US I had multiple moments of doubt. Heavy doubt. But I pressed on because they were never heavy enough to stop me. I never once experienced a single moment where the Spirit took back his words. And I gave God plenty of opportunities to change his mind about that one. The requirements to be accepted into a medical school seemed to me almost astronomical, impossible. It seemed like something I could never accomplish. But I pressed on and I picked away at the list of requirements until I was past all of them.

When I was accepted into medical school, I felt no rush of relief, no shift in my world. I felt no inclination to call everyone I had ever known and tell them. I felt conflicted. I got into a medical school. I had accomplished the asinine amount of required hours of service, the ridiculous amount of leadership experiences, the confusing and annoying hours of physician shadowing. I had passed all my classes through the doubt, the struggle of never feeling enough, through losing my brother just before my midterms. I had collected letters of recommendation and told my family I was pursuing a degree in medicine. And yet… as I listened to the voicemail that told me I had been accepted I felt… nothing. Surprise maybe. But the school was not my first choice. I had always had doubts about the direction of medicine. I didn’t know what the next steps were. So I shifted back and forth like a child does on their feet while waiting to meet with the principle after punching a kid on the playground.

It wasn’t until I talked with my bishop, Michael Thueson, that I realized my emotions – I was struggling with my acceptance to medical school because to me at the time it felt like I no longer had an option. I felt like now that I was accepted, I was required to attend. The moment he said, “You still have a choice, you know,” that the world seemed to clear up like it does in those allergy medicine commercials. I remember thinking about what else I would do. Did I want to pursue a masters and Psy. D.? Did I want to go into education instead? Nothing was right until I decided that Yes, I would accept PNWU’s offer and go to medical school. And I started again down the road of the asinine list of requirements once you get in. Medical appointments, getting my finances in order, finding housing, accepting a loan, coordinating vaccinations, and the list went on and on and on. There is something comforting to me about having a list of things that I can check off. I love check lists. I love marking those boxes. Check, check, check. Done.

Along the way I was honest with myself that I struggled to be going to medical school because a) I did not feel intelligent enough b) I would rather have been married and starting a life in the traditional sense with someone and c) I have always been afraid of failure. No one in my family has been to medical school. I do not have any siblings, parents, aunts or uncles who are physicians. I do have a brother who successfully graduated from law school – but everyone has always known he is intelligent. He is the most intelligent person in our family and it came as no surprise to anyone when he decided to go to law school or when he graduated from said law school and accepted a position in the US military.

I moved to Washington state full of hope that I could succeed at something like that too. And what commenced were two years of absolute hell.

The system of medicine in the United States is broken. Healthcare is a joke and doctors everywhere are making mistakes and are exhausted and getting sued. What people don’t realize is that healthcare training in the US is also broken. If you want to be a doctor in the U.S. you have to be a good student. You have to be willing to sacrifice your family relationships, your sleep, your sanity. You have to be willing to take on new emotional distress and struggle with your sense of what it means to be a human being. You have to accept new medications – I can’t number the amount of people in my medical school class who since started school have started medication for ADD, Depression, Anxiety, Panic disorders, PTSD. And while the view on mental health is largely shifting for the better in America, it still a hushed topic and people don’t talk about it – this is especially true in the training of a high power field like medicine. We are constantly comparing ourselves to each other and in order to do that we cannot admit to weaknesses except to our close friends or in the hush of bathroom stalls or quiet corners in bars. Add to this the sheer magnificent amount of information medical students are required to learn and you have a recipe for breakdown. They have a fancy name for it though: Burnout. They don’t call it what it is: the results of a broken system no one is willing to fix.

We press on. I press on. I started an antidepressant, an anti anxiety med, I work out three or four times a week, I read my scriptures every day to try to find some meaning behind the distress of the day to day. And I cry and rally, cry and rally, cry and rally. I place motivational little quotes around my living space, my locker, my desktop background. I try to talk to my siblings and loved ones about my feelings, always with the understanding that none of them can completely understand because they have never experienced it. They can sympathize to a certain extent, but unless you have been to medical school you can’t understand. And unless you have been to medical school and failed almost every test but still passed each class, you can’t understand. And that is incredibly frustrating. And you start to shift into this mindset where this is your life now. Where when people say how lucky you are or how intelligent you had to be in order to get into medical school it’s a white comment thrown out in a snowstorm without guiding ropes or illuminated lights. It’s background noise. It’s white noise. It’s nothing.

I have never been the kind of person to kill myself to get an A. In high school I worked over part time and spent most of my time at my job. I struggled to get my homework assignments in on time. I attended one football game and two school dances. I had one friend I called close. I fell asleep in class because I was working the day before and stayed up late to finish only the needed assignments with only the necessary effort to pass. I had more important things to worry about – like putting food on the table and making sure my little sister had someone with her at parent teacher conferences. I was in the debate team because I needed something at school that I felt I could be a part of that was bigger than myself and it gave me a safe space to argue and raise my voice where it was appropriate. In college I took extra credits every semester and worked in order to learn everything I could about everything and also eat. If the choice came down to getting more than six hours of a sleep a night or getting over a 90 on an exam, I chose sleep. I turned down a lot of social engagements, kept to myself, did not stray too far from campus. My grades stayed in a happy range of B+ to A – and I was content with that. If I put in the extra work I know I could have gotten better scores – the same was true of my high school days. But I wanted to be able to sing in the kitchen and make cookies for a neighbor, to read until midnight in bed, to get up early and go to the temple, to watch a movie with my roommates if I wanted. And I did those things.

And this is perhaps a part of the reason I was a little surprised when I was accepted to medical school. Not too surprised mind you, the Spirit of God had told me I would be going. But still. I do not consider myself the kind of student you would expect to get into medicine.

Which is a contributing factor to the fact that I have struggled, and struggled, and struggled to pass almost every single one of my medical school classes. The first semester was the hardest of course. There is nothing that can be compared to constantly being tested (so many tests) and constantly failing them as a medical student. Everyone has been saying how amazing it is you got into medical school – you hold yourself already to an impossible standard – you are surrounded by incredibly intelligent and amazing people, over 100 of them every.single.day. – you’ve never actually failed something at school before. But to be successful in medical school when you aren’t a genius takes fortitude. If you aren’t good at it already, the environment forces you to get good at picking yourself back up, moving on, getting to the next class, the next test, the next practice clinic patient. You put a smile on, no one has to know you failed that, and in time you pass the class regardless because they give just enough back to make your scores pass.

And so after two academic years of picking myself back up off my bruised ass at least once a week, I am now studying every day for the first step of my national medical boards. And I am constantly asking myself, “Did I learn anything the last two years?” Because instead of seeing that failing score on the computer after a test or three a week, I see it multiple times a day as I take practice question sets and take the national COMSAEs which are practice boards at half the size.

It is made worse of course by the idea that the score I get on my boards will dictate the specialty I’m expected to aim for. “Keep practical about where you can actually get to” they say. Because after two years of mental, spiritual, emotional, intellectual, physical exhaustion, it isn’t enough that you have to push through and get one HUGE TEST OUT OF THE WAY but you have to do it with enough success to make something out of it on the other side.

This is not the worst of it for me however, as grim as it sounds.

The worst is that I feel so alone.

I have always been more alone than I feel others are. Perhaps my perception is off. But I have never had a group of friends that I called mine. I never had more than one or two people in high school or college to spend time with that mattered to me. I’m not married, I don’t have kids, I don’t want to spend every moment with another person around me. But I don’t want to be lonely.

And while I have always felt particularly alone in the physical sense, I have with rather few exceptions always felt close to God. He sent me on this path and he has been with me. And in the last two years time again he has reminded me of his love and support. And when I thought about quitting medical school at least once a month in the first year, it was never the right thing to do.

But I did struggle. And I struggled HARD. Medical school has been very, very difficult for me. My week is six days of waking up between 3 and 6, studying until 8 and 10 and starting over again. I break for breakfast, I study during lunch, and break for dinner. But I don’t eat like a normal person – I never have – but rather I inhale my food so when I decide to stop studying for the amount of time it will take me to eat my dinner I am studying once more in less then five minutes. No longer did I feel it appropriate to go to bed early without finishing my studies, to read a book in the middle of the week, to take a day off of studying and go to the wilderness. Why? Because I couldn’t even pass my exams. In high school and college I could pass with an easy 80-85+ easy with what seemed to me very little effort. If I paid attention in class and did the assigned reading (mostly), when test day came I could swing a passing score with what felt like minimal effort on my part. Looking in maybe I worked a little harder than others but it didn’t feel that way to me. And yet in medical school, I have felt like I have killed myself day after day after day … to fail every.single.time. And that kills me.

I have thought time and again, God if you sent me here, why aren’t you helping me? And if you are helping me and our combined efforts are getting me a failing score, what did you send me here for?

I could not say how many times I have thought that exact thing. I couldn’t count it. Innumerable times.

And the worst is board study. Seeing those failing grades with increasing incidence. Feeling like He is letting me fail. Doubting my faith over something that does not seem like it should be big enough to make me doubt when I feel like my faith has been so strong. After 29 years of struggle and doubt I have come to a place where I believe strongly in the love of a God who knows infinitely better then me. I have come to a place where I fall to my knees with gratitude at trials. I have pulled myself out of trenches, jumped from heights with my eyes wide open, have leapt with my arms outstretched to him, time and again and have developed for myself what I feel is strong faith. And yet I doubt Him. In this week, in this trial, I doubt. And that breaks my heart.

I went to one of our instructors at PNWU who is a new faculty member and a Mormon and cried in his office. After several minutes of trying, I finally voiced my concerns. How could something so small, in the grand scheme of things, make me doubt so much? How could simply worrying about not passing a national exam make me doubt the reality of a Being I have served and loved and thought I have known for over 29 years? Even on this cool blue morning as I type these words my eyes fill with tears and the keyboard is hard to see. My spirit is aching.

I don’t want to fail. I want to be a phenomenal doctor. But if I have come this far only to fail, why the have I struggled to make it this far in the first place? Why if it comes to the point where I fail my national medical boards, did I not stop after that first semester when it was so hard, so dark, so terrible that I drove myself to a cemetery to cry huge, ugly, gut wrenching sobs in my car in a location where no one would question my sorrow?

And still He is quiet. And that is the worst part.

I took a COMSAE and passed after intense prayer. That was several months ago. In the last eight days I have taken four more and have failed all of them. With each subsequent fail I have tried to pray and humble myself before the Lord. To recognize to myself and out loud that I am nothing without him. That I cannot find success relying on my own intelligence, my own strength. And yet? In that moment after my last score came up on the screen? A failing score. A failing score. A failing score.

How can I still be this shocked and devastated by failure after two full years of it?

Because it feels more final. More than the others, it feels like I have actually failed. 

It is getting so much harder to pull myself back up, to sigh but put that smile on my face, to talk to other people without wanting to shout what a failure I am proving to be, to put my hand in the hand of a God I feel has left me alone to my own inadequate devices.

Dr. Wilson reminded me that even the Savior of the World questioned his heavy trials. “I don’t want to do this,” Jesus said in the middle of the garden. Even God’s prophet of the restoration struggled to see God in his trials. “Where are you?” Joseph Smith questioned from the jail cell. I am not alone in these feelings. If God saw fit to allow His Son and Prophet to feel he had left them, why would He not let me feel so?

Dr. Wilson said He takes us to the places where we will be stretched the most, to the point where it becomes necessary for us to truly question, in order to see if we will stay faithful. It would not be a trial of our faith if our faith was not actually tried. Trials are essential, obviously, but how much of a trial can it really be if all the time we feel His guiding hand and Comforting presence? Can those really be considered trials? It isn’t until He has taken us beyond where His comfort seems to reach us, that He sees if we will choose to remain with Him. When it would be the absolute easiest to turn away – when we truly question if He exists and if we matter to him, when it seems the only answer is leaving him. When we really say to ourselves, I don’t actually know if this is true, if he is real, if anything I have believed is true. Those are the real trials. The real defining moments.

Like I said, I’m afraid to fail.