The first time I truly felt capable of being a doctor, it wasn’t while actually working in a hospital. I was in the throes of my grueling surgery clerkship during the third year of medical school, historically the most difficult stretch for students due to the exhausting clinical hours and free time spent studying for board exams. I knew I was feeling burned out, but back in 2010, it was still a taboo term not to be spoken out loud by a lowly MS-III. You would always hear other doctors say things like, “how can medical students be ‘burned out’ when they haven’t even started the ‘hard part’ yet?” Feelings of resentment and shame starting creeping in whenever I talked to fellow colleagues who had not just figured out residency plans for the next year, but had elaborate machinations for the next five to ten years of their lives. Maybe I’m just not cut out to be a doctor, was the nagging thought in the back of my head as I made my way to Methodist Hospital’s ED on that balmy August night. I’d been living in Brooklyn with some close med school buddies, and we had just gotten notice that our friend Peter was in the emergency department. Walking in through the glass doors, we joked about what wacky hijinks may have landed him there. We thought maybe a stubbed toe, or at the most a fractured hand, since we had just seen him earlier at work. As we entered the chaotic ED, someone casually told us that he was intubated and that it “wasn’t looking good.” We were floored. From there, the rest of the night felt like an out of body experience. Just minutes after sitting down in disbelief, a nurse came in with an uncomfortable smile and said, “Yeah, you know, we did everything we could…but we just couldn’t bring him back.” She weakly shrugged before hurriedly shuffling off without another word.
We were in a state of utter shock.
Sitting in that patient lounge, staring off into space and engulfed in silence, my friends started weeping one by one. I was numb, unable to shed a tear, and again felt shame — why was I responding to this tragedy like an emotionless automaton? We looked at his body still on a hospital bed, and I flashed back to just hours before, strap-hanging on the R train on our way back from Sunset Park. I was the last person in our group to see him alive. My mind careened back to the hospital, and I saw myself start taking action. I took it upon myself to do things like hold his wallet and belongings for safekeeping, and to be the primary point of contact while his sisters traveled in from California. I needed to do something, anything in that moment to feel useful in a completely helpless situation. Looking back, it’s occurred to me that that was the first time I was able to function and make decisions under extreme duress, but it was also the cosmic straw that broke the camel’s back. In the following days, I woke up every morning detached and felt myself just going through the motions…slowly withdrawing and isolating myself away from friends, family, and most of the outside world.
I continued to go on like that for weeks and months, refusing to acknowledge how I was feeling. In the height of winter, it finally caught up to me. With hour long commutes back and forth from Brooklyn to the Bronx, I would step onto the subway in total darkness in both directions. I started to miss a day of work here and there, until it started happening with increasing regularity. The self-destructive behavior soon kicked into full gear and I eventually I wouldn’t even bother notifying anyone at work. My daily routine consisted of waking up, laying in bed paralyzed for a few hours, opening the door for the Grubhub or Seamless guy, and then retreating back into the room. This probably would have continued indefinitely if I wasn’t finally confronted by my faculty supervisor. It was only then, with my back against the wall, that I finally said out loud what I knew was true for months, maybe years: I was depressed. It could have gone many different ways, but where minutes ago she was angry about my failing performance, a look of understanding washed over her face as she encouraged me to get help. It was a major turning point. But even after admitting to myself that there was a problem, it was hard to talk to my parents about my mental health. Culturally, topics like depression and anxiety were rarely ever discussed openly in our South Asian community. There was always some shame attached, and it was sometimes taken as an excuse for failure. From my parents perspective, I was on the way to being a doctor, was completely “healthy,” and was blessed with an incredible life in the greatest country in the world…how could I possibly be depressed? I felt the full weight of the hopes and dreams placed on a first generation immigrant kid, and there was an underlying guilt that if I didn’t achieve that lifelong goal of being a financially successful physician, my parents journey and sacrifices would be all for nothing. I started therapy and took antidepressants for a few months, and started to slowly crawl out of the lowest depths of my depression and self-medication into a space where I allowed myself to cope in a healthier way. I also got very lucky —as I became more emotionally aware, I came out of my shell and asked someone out. Instead of hiding my baggage, I put it all out on the table on our first date. She saw me, she heard me…and we’ve been married for five years now.