Editors’ pickMed

What I Saw In Medical School

“I See You Even When I Sleep” — Self Portrait

What I Saw In Medical School

Introduction

Medical school, #metoo, and the real time story of a woman moving through it.

When I was in medical school, I was told by someone I thought of as a mentor that there was very little she could do to advise me, because there was no one like me on the planet. This was over drinks at a neighborhood bar, after I’d opened up a little bit about my history and daily issues in medical school as an older student with kids, with the hope that I could find solutions that would make me fit in a little better. She told me that no other person she could think of had been accepted to a second U.S. medical school after having failed out of the first. Nor could she remember any other medical student in her time as a physician, professor and advisor who’d also been through homelessness and foster care; who’d been a sex worker, a rape survivor, a domestic abuse survivor, a mother of two kids on the spectrum, a wife, and someone with chronic health conditions.

Her assessment of my unique situation was mostly correct. Certainly, I’ve met many, many people in medical school who have shared some of my past circumstances — homelessness, foster care, neglect, abuse, domestic abuse, rape, random violence and motherhood — as well as traumas that I can’t even comprehend of, such as escaping war as a refugee, or facing the life threatening illness of self or child while in medical school. Those people got through medical school and some of them thrived, so I took that into consideration when looking for reasons that I wasn’t performing well, or connecting with classmates. But no, I’d never met anyone who’d had as many traumatic life experiences as I seem to have, at least not in medical school, and I chalked it up to being older.

However, I have never seen myself as irredeemable or damaged, just a body working to make its best thoughts into realities. I tend to see my life, which would obviously include trauma, mistakes and tragedy, as a primer for what to avoid in order to generate successful outcomes. Experience really is the best teacher, and I try not to give experience much more gravitas than that. So it was somewhat disturbing to me to hear how much my experiences set me apart, and set me up for failure.

Over the next year, we talked about the fact that my ACE score is 9, and statistically speaking, at 49, I should be dying of cancer and diabetes right now, not trying to save my little sliver of the world. We talked about my intense and “unrealistic” idealism and expectations, and how that reflected on my intelligence and stability, or people’s perception of it. We talked a lot about sociopathy and narcissism in the context of medical students and doctors. (In retrospect I think she was trying to see if she could diagnose me with an Axis II personality disorder.) We talked about PTSD and its impact on being a high-performing human.

We talked about what was wrong with me, because, and I found this to be true the entire time I was in medical school, talking about what was wrong with the system of medical education and medicine was seen as a form of playing the victim and abdicating personal responsibility. If I was stressed, failing, inflexible, angry, exhausted, depressed — really, anything other than grateful to be in medical school, and expressing that gratitude by being successful — then I needed to fix it by myself, because it was entirely of myself. Those emotional states and attitudes were the only things I had control over, not the precipitating factors that I’d identified as causes. So her advice to me, and I think it was sound, was to find a way to be more flexible and accepting, and less a victim of the circumstances I’d signed up for.

When I was ultimately suspended and kicked out for reasons I‘ll discuss in my next post, she told me that this was understandable, too. “No one, not me, not anyone, could have gotten through medical school if they’d been in your situation.” She didn’t advocate for me as I went through that process, and I (probably correctly) took that as a comment on her faith in me as a physician, and maybe even as a person. She told me to “go home and sleep.” And after trying and failing to appeal, that’s what I did for a few weeks. It was better than sitting with the feelings of isolation, humiliation and shame that I had no way to process yet. And I was genuinely exhausted.

Eventually, I rallied. My family and I managed to land pretty gracefully from my fall from the pinnacle of educational opportunity. While my husband packed the house, I took our kids and Great Dane on a five week drive across the country, and tried to reframe a devastating event in all of our lives into an adventure. Because not only had I lost a dream, $340,000.00 and 98.67% of my idealism, my husband had lost all the time and energy he invested in being the primary caretaker for the kids that could have been used working on his career, friendships, and hobbies. My children had moved two and three times, away from friends and schools and neighborhoods they loved, for this singular pursuit of mine. For the first week of the trip, I let them trade off sitting in the front seat so I could hold their hands as they wept for what was lost, and then for the rest of the trip, I encouraged them to spend that time dreaming new dreams for what would come next. I promised (and delivered on) a trampoline, good schools, a projector, a place big enough for them to have their own rooms, extended family, movie nights, game nights, security. And when they slept, I practiced not dreaming, not anticipating, not ruminating, just focusing on the road directly in front of me.

With help from one of my closest friends, we bought a beautiful home in a great school district, in a community of friends who love and protect us fiercely. We got kittens to keep the dog company and my depression at bay. And so now, I’m currently a stay at home mom who’s using a new-found artistic ability to paint the things I saw in medical school — both the people I love and events that rocked me to my core — as a way to process what happened to me. The adjustment hasn’t been seamless, but I have more patience and compassion for myself than I ever have before.

And I’m coping, too, by hanging onto gratitude like it’s my only friend in the world, because medicine taught me that success is how I express gratitude, and I need to succeed for my family and for my very life right now. It’s between success, or the kind of existential crisis that can lead to suicide, and often does for medical students and doctors, as well as people who have lived through profound trauma. I’m not going down like that. My kids are not going down like that.

I’m finding, though, that the key to success might not be gratitude in and of itself. It might lie in how I define it:

Are my children and husband content, to the extent that I can provide that for them?

Am I engaged in a mission that utilizes my life and my narrative in a good and useful way, a mission that can be completed to my satisfaction?

What happened to me is something that’s been legally settled, and that was traumatic in its own right. The mental hurdle I had to jump over to call a lawyer after getting kicked out of medical school the second time was both small in its pragmatism, and emotionally insurmountable. Had I only listened to that first mentor, I doubt very much that I would have had the courage or confidence to challenge the “wisdom of my betters.” But she was not the only mentor I had, and I wasn’t left alone in those meetings with administrators, or at my appeal hearing. I had another mentor who had known me for 20 years. He was my first boss in research, and is a fierce advocate for underserved populations and educational opportunities. Having a witness to what I went through, who understood the culture of medicine and had the privilege to name aloud its injustices, gave me commonality to many other people who are medical students and doctors. It also gave me a deeper understanding about my situation and limitations, and those of the medical community. I still have a role to play in the healthcare and wellbeing of marginalized people, even if it’s not the one I thought it would be.

A few weeks after I submitted my request for settlement to the school, the Harvey Weinstein story broke, and the #metoo movement started. This last year has been full of strange coincidences for me, but having aspects of my narrative reflected back at me through a collective cultural shift in our thoughts about agency, victimization and power has also given me some courage and hope. Not a lot, though. As a child of the late 60’s and 70’s, I’ve lived through enough of these kinds of movements to see how cyclical and sometimes cynical they are. But it’s been important in that it’s again shown me that I’m part of a larger community, and that some of my experiences in coping with what happened are pretty common.

For instance, right after I left school, every time I tried to explain what happened, the words tumbled out of my mouth, and to me, they sounded like paranoid delusions of persecution. I could not, and sometimes still cannot, believe that it happened. Every time I told the story, I would have to refer myself back to the recordings of conversations that I’d taped with administrators, texts and emails that I’d received from classmates, conversations I’d had with people who’d been there with me, and convince myself that what I said was true.

It was so uncomfortable and traumatizing that I stopped talking about it at all, unless directly confronted for an explanation of what happened. Instead of going to therapy initially, I started painting what happened, because a picture really can be worth a metric ton of words. I started posting those paintings on Facebook and Instagram, and friends from medical school started calling me, sometimes for the first time in years. Because they know my story, know the whole of me, they were able to give me the profound gift of an informed and gentle perspective on myself. They’ve implored me to speak, write, to move forward, and to fight.

The story, in any case, now has a life of its own, and now I’m in the process of figuring out what exactly to do with it. I’m not going to lie — as a deeply private person who cares deeply about the wellbeing of her children, I’m terrified of the prospect of being public, and thus vulnerable. I understand that there are many different and legitimate sides to this story, but in none of them have I been, or will I be, a victim. In all of them, I’m human. Over the next little while, I’ll be telling my side of it, in my own words in this weird little blog, I think mostly for the friends and family who have waited for a year to hear me tell it. My hope is that the people who read it, even if they don’t know me, hear their side of it, too.

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Thanks for sharing this, you are awesome !

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