Continuing the theme of posts I’ve written in years past, this one talks about the weirdness of having a self admitted mediocre student being called exceptional. I remain, quite honestly, mediocre at many things, but somehow clinical medicine clicked with me, and allowed me to become better than mediocre. 

This post was written halfway through medical school! Enjoy!

It’s a lovely word, exceptional. Makes you feel all warm and fuzzy inside, gives you this idea that you’re something more, something above and beyond, raising your self image to dizzying heights.

It’s something I’d never heard till I got to college. Through my middle school, my report cards would read, “Can do so much better if he’d apply himself” or “Capable of so much more.” In college, I started hearing the word smart, or even gifted applied to my name. I convinced myself that I was actually just gifted, and the fact that I’d done two years of college level Biology, Physics, General and Organic Chemistry in high school had little to do with the apparent ease with which I achieved academic success. So, I coasted through college on autopilot, passed out in nearly every class with my legs sprawled out on the seat ahead of me, working through experiments, projects and exams in fractions of the time of the rest of my class, never seeing the frustration on their faces as I did these tough tasks with obvious ease. I tried to explain that I’d done it before, but I didn’t try very hard. I enjyoed the mystique the achievements gave me, enjoyed the feeling of being seen as gifted and smart, and I loved hearing from the people around me, professors, peers, and the people I taught that I was exceptional- sometimes in words, or sometimes in just the way I thought they saw me. So, I remained oblivous to the trial and the tribulation that is hard labor of the mental kind. I graduated mangna cum laude, with college and departmental honors and sundry pats on the back from the world.

I then moved onto medical school convinced in my little mind that it’d be the same thing as college, that I’d be able to sleep through my classes and still outshine everyone else. The first day of medical school, as they explained that we’d be dissecting on one day and studying the other, my small group was told we had a study day first. So, I floated around the library in this vast new building unsure of what the heck to do with myself. I opened my Netters, and promptly passed out with my face in it, drool leaking from my open softly snoring mouth onto those glossy perfectly drawn images of the anatomy we were to learn. The next day, during cross teach, when the other half of our group who had dissected taught us, I experienced what it’s like to feel like an idiot for the first time in my life. There were terms flying around I’d never heard of, gray structures that looked identical to my naive eye being distinguished from one another all the while I tried desperately not to throw up my breakfast. I was like a fish lost in the desert, totally out of my element. Slowly, I got the hang of it, but that first two months I learnt to feel like a fool and began to downgrade my estimate of my own intelligence. I still didn’t study, since I’d never learnt how to; hoping instead that somehow magically I’d survive. I did survive anatomy, and felt much more comfortable during Biochemistry (since that was my major in college) but my self esteem was about the lowest it’s ever been in the first two years of medical school. I’d gone from an honors student in college to an average or slightly above average medical student. The swagger and arrogance of my college years remained as a thin veneer to hide the fear and insufficiency I felt on most days, with my peers the equivalent of linebackers to my metaphorical ninety pound weakling being kicked in the face with the sand of anatomy, phyisiolgy and pathology. The sense of meaning, purpose and power I’d felt in college, the heady sense of strenght, and the knowledege of where my path was leading was replaced by a never ending gnawing self doubt that nibbled at the foundations of all of my choices, questioning why I came to medical school, what it was that I hoped to accomplish and fear that the Siphysian task of learning all this material would never end.  Nearly every day I experienced at least moments of dread, fear and anxiety, feelings that I wasn’t cut out for medicine, that I was in the wrong field. I’d heard that it would get better, but the future was so far off, with such daunting obstacles between me and it that there were days I nearly despiared of my goals.

Somehow, I managed. I passed my Boards, and did fairly well. I began my rotations, jumping into psychiatry where I had always done well in my boards and my classes. I found my strengths again, talking to people- a skill that had nearly atrophied in my two years of social isolation, finessing out the details of their conditions and trying to match their symptoms with this whole set of diseases I’d had stuffed into my brain over the last two years. I guess some of it stuck, because I was doing quite well by the end. The soft skills I had discounted in favor of my so called intelligence in college, of conversation skills, charm, courtesy, politeness, and reading people began to show their worth as I searched to find them under the haze of biochemistry formulae and physiology concepts. So, I started hearing the voices again (not the schizophrenic kind), those of my attending physicians and my residents, telling me that I had skills, that I could be of value in medicine and I could be a good doctor. I spoke to a resident yesterday, a self described hard ass who ‘didn’t kiss medical student’s asses’ who said the magic word to me- exceptional. She called me an exceptional medical student, not so much for my fund of knowledge, but for my abilities with people, for the confidence to ask questions and try things, and most importantly the confidence to give it a shot and be totally wrong- something I have in abundance.