In true medical school style, I’m going to present a case study, but with the following disclaimer.

The following case studies are completely fictional.

A 26 year old male and a 24 year old female both present to your psychiatric practice.

The male reports recent risk taking behavior- increased alcohol intake, numerous sexual partners, and ignoring “the things that are important because they get to be too much.” He also reports recent binge eating, decreased motivation and drive and less willingness to do work.

The female reports increased risk taking behavior of a different kind. She says that she ‘like the country song’ went skydiving, Rocky Mountain climbing, bull riding etc. She reports an increase in “retail therapy” in the hundreds of dollars as well as frequent trips to the bars so she can feel pretty and like a person again.

As they keep talking, they both report symptoms of a compulsive disorder. They report feeling pressured and forced into doing something that doesn’t always bring them joy. Fearing abuse, you question them further. They report shirking their “duty” for awhile, just so they can pretend they don’t have to do it- then experiencing guilt, until they return to their duty- resentful and angry.

Realizing that your typical medical interview’s gone to the dogs, you ask them what duty? And what do they do for a living?
Oh, they reply, we’re medical students.

At this point, you’re shaking your head at me and wondering if the glimpse into Insanity is talking about the case study or me… Read on.

While tongue in cheek and fictional, the stories above are amalgams of real people.  The point they’re meant to illustrate is the nature of medicine- medical school in particular. Everyone has coping mechanisms for dealing with life, and everyone has things to cope with. Medical school’s no different- we all have coping mechanisms and things that keep us sane. The only difference is the level of the assault on our sanity. Our sanity is assaulted on a regular basis, by a cycle of exams, recovery, scrambling to catch up, and exams again… There’s a constant stream of information coming at a medical student- things to learn, things to do and places to be. The stress is institutionalized in the way medicine is taught- and I’ll leave discussions of right/wrong to a later post. At the moment, it is- and it must be endured.

We all have coping mechanisms- some healthy, some not. For me, my coping mechanisms are simple. Exercise is a big one. One day a week is too busy for exercise. And that day I’m pretty miserable- I guess I’m addicted. But, a rowing class or a yoga class can have me walking out feeling like a million bucks.

The next big coping mechanism I use is escaping the rat race. We all feel the need to excel, to stand out. I (now more so than before) realize that studying for hours on end to learn specious detail isn’t joyful and exciting- and it’s not how I’m going to stand out. Instead, I choose to do things that make me stand out. Like my Masters in Bioethics, or a research project I’m doing, or a dozen other little things. They make me feel accomplished, without reducing my net self worth to my grades.

Family and friends are another great one.  I keep myself sane using the people who matter to me. My family, who I don’t see often enough. My friends, who I never really tell how valuable they are to me. For a lot of my classmates, I think their spouses and kids (despite how annoying they might be) are their best way of keeping sane.

Also, since if you know me or have glanced at the rest of the blog- the other escape that works for me is crazy stuff. For example, (if all goes well), I’m going flying next weekend. *The FAA/TSA probably won’t give me trouble. There’s no worry about a brown guy wanting to learn to fly right?*

And it’s not like med school has a monopoly on hard situations, so everyone ends up using coping mechanisms in life. I think the important thing is realizing that you do need to cope, and recognizing how you choose to cope. What say? How do you cope?