Let me start off by telling you that I am a warrior, a protector, and a healer. I am an Army Veteran. I’ve worked as an EMT, completed a bachelors degree and 2 years of medical school, plus I’m raising a family. I’ve achieved amazing things, but I have never been defeated like I’ve been over these past few years.
Honestly, I was less stressed in Afghanistan. Medical school is worse than my deployment experience.
It’s not easy to share this so bear with me. When I finished undergrad, I decided to be a doctor. So off I went. Completed my sciences at a local community college, volunteered at hospitals, and worked as an EMT to beef up my resume for med school applications. I got all my applications in then boom, I was deployed to Afghanistan. I was recruited to deploy with Military Police as a combat medic. During the first few missions I was scared for my life. After that, I became numb to that fear and just focused on making sure I was able to save my guys’ lives if we were attacked. The stress was incredible, but I had their back and they had mine. In an unsafe country and a future filled with uncertainty I felt secure because we supported each other.
Once I was home I started medical school and I was SO excited! I was finally living out my dream. I’ve always been able to make friends with no problem and I’ve always done well in school, so I was good to go. I am not the traditional medical student. I’m 30 with a family and it turns out my life is very different than my peers, so I isolated myself. The course material was incredibly difficult for me. I struggled. I barely passed some exams and always wondered if I would make it to the next course. I worked so hard to do well, but couldn’t hack it. I was just in awe at how much more intelligent everyone else around me was.
This was it, I had put all of my eggs in this basket and my basket was falling apart. I cried almost every single day. My family was there to support me but no one could understand what I was going through. Or so I thought. I never really opened up to other medical students because they seemed so smart and were doing well. It was bad. Here’s the worst part: I thought it would be easier to die than continue living like this. I started to see a therapist and we identified that I was persistently depressed and passively SUICIDAL.
I know I’m a strong, intelligent woman. But medical school broke me down.
I’m in my 3rd year now and have realized what is most important to me: self care, my family, and close friends. I can’t help others at my own expense anymore. I get that I’m learning information that will save peoples lives and I need to take it seriously. Believe me, I do. Yeah, I get nervous that I will be pimped and not know the answer to a question or do bad on a test again. But I am DONE letting that stop me from living a life I love. Regardless of my transcript and test scores, I will be an amazing doctor! I already make a difference in people’s lives and will continue to do so.
I hope other med students can learn something from my story. You are all amazing! Please take care of yourselves.
Pamela, thank you for standing up for us. It means the world.
Suicide is an occupational hazard in medicine.
Here’s how to stop training doctors like Navy SEALs
Pamela Wible, M.D., is a family physician and author of Physician Suicide Letters—Answered. Contact her (confidentially) here. Photo credit: Shutterstock.
How did you decide to change. Was it through therapy or meds or both? Did you just decide one day to stop trying to be perfect? Would love to hear that part of your story
Let me start off by saying that I still struggle every single day. I haven’t figured it all out, but I am making progress. And to answer your question, YES. Yes I decided to stop trying to be perfect and accept that I will land on my feet. Accept that I am only one person and deserve to have time to take care of myself.
I have always maintained my physical health – exercising 6 days a week, eating healthy, and sleeping about 7 hours a night.
What I have been overlooking is every other aspect of my life.. my mental health, emotional health, and spiritual health. Mentally, I am using guided meditation every day and limiting the amount of information I take in. This includes things like checking my e-mail only one time per day and studying less to let my brain actually absorb the information I am learning. Emotionally, I am focusing on the relationships that make me happy and terminating the ones that use up my energy. Spiritually, I need to belong to something bigger than myself. I have found this to be helping others achieve their own health and fitness goals.
As far as the medications, I have not tried any although they have been recommended by my psychologist. I don’t know if I will, that is a hard pill for me to swallow. I pride myself on being very strong and that makes me feel weak. Admitting to all of this makes me feel weak too, but that is the first step in my healing process.
Thank you for reaching out.
I’m so happy that you were able to realize you don’t have to be perfect to be happy. I know it’s very hard to deal with everything you have going on in your life. It hard to keep balance in ones life. Learning to rid yourself of toxic people in your life at such a young is a noble thing. I’m old enough to be your mother and I am just learning how to do that in my life. I applaud you for being able to do this for your well being.
I’m happy to hear your making time to care for yourself.
I also very proud of you for sharing your story. I know it could not be easy.
My son was a 3rd year med student. He was also in the Navy on the scholarship program. He had just graduated ODS on May 6th. Upon his return from R.I. where we watched him graduate. He spent Mothers Day morning with me. He took his own life later that night. I never saw his depression I was totally blind sided. He was my only child. His father died when he was 15 so I’ve now experienced death twice within 9 yrs. I wished my son could have realized there was help available. I wished he could have realized like you to cut toxic people out of his life. To realize he needed to take time to help himself. My son knew depression ran in our family but couldn’t reach out for help. I know you said meds are a hard pill to swallow. I pray you are able to heal yourself without them. Please don’t be totally anti meds should you find your unable to fight the depression on your own. The pain my son must have been in those last days all he did was pass his pain on to his stepfather & Myself. If you ever need someone to listen to you please reach out to me. firstname.lastname@example.org
It devastates me to hear of the loss of your son. I am so sorry for the pain he felt and the suffering you are now enduring.
My story is very similar to his. I too lost a parent about 9 years ago and have a strong history of depression in my family.
I think the best thing we can do to heal is to raise awareness and let other students/doctors know there is another way out. Lead them to get the help they need. They can find happiness again. They don’t have to be miserable.
Maybe we can spare other families from having their lives shattered. Through this outreach we can pick up the pieces and find meaning in our world again too.
My heart goes out to you.
Thank you Michele,
My son Sean had to be in such pain to end his own life. After his father passed away I told him if it wasn’t for him I would have ended my life. He told me he would never take his own life. I guess I took that as he would never do that ever. Every time I saw him he always seemed so happy. I don’t know if I’ll ever be able to move on from his death. Anytime I deal with his medical school and their lies they tell it makes me so upset. His school says they want to change the school but if you ask me I say they want business as usually.
I am sorry for your loss of a parent 9 years ago. I’m sure that was extremely hard for you. After Sean’s father died he took on the role of my protector. He was always there for me and always went to events with me. I know he may not have wanted to some of them but he knew that I wanted to so he did it for me.
Please if I can ever help you in anyway. Please reach out to Pamela for my contact information.
Michelle, I am proud of you. When you speak of other students, it is fake. You are the honest one. You should be proud of yourself. Do the best you can and remain fearless. Medicine will fail the world if it continues in the present way. You can help change it. Feel free to call me or email me anytime. 619-564-0931.
Doctors Against Corporate Slavery on Facebook.
Thank you for reaching out, Asha.
We have to let other students and doctors know that it is okay to have these feelings. That it is okay to talk about it because they are not alone. They may be vulnerable, but they are not weak. They have the power to get through this and support each other.
We can face this together.
Exactly how I feel.
Michelle, as a patient of Dr. Pamela Wible’s I applaud you! Congratulations on finding a way to create balance in your life so that you can walk your path to becoming a wonderful doctor, and a member of our much-needed healing community! Remember that as you walk your path, there are many of us out here cheering you on! We will need you when you’ve completed your studies and we eagerly await meeting you to share our lives with you!
Completely agree! I thought Iraq was less stressful than medical school and I was also a non traditional medical student at 30 years old with two kids. I remember days in med school when I wished I could just put on a uniform and get shot at. I didn’t realize how depressed I was until I graduated. I’m glad I’m not alone☺️. Thank you for writing this!
I’m not in med school. I’m in nursing school and I feel the exact same way. I always “joke” that I would rather be back in Iraq being shot at and everyone just looks at me like I’m crazy. School for me is extremely difficult because where in the military we are working as a team, school is me working with me , myself, and I. No one else to blame for failed exams or not getting the information down. It’s crazy hard, but I know it will be worth it. Thanks for sharing your story.
Michelle, keep your head up. You’re one of the good ones. Nobody should ever be afraid, ashamed, or embarrassed to tell it like it really is. And by the way, antidepressants helped me channel my anger. They’re not all bad. Just know your meds and the side effects of said meds.
I’m very curious how the Dell Medical School of the University of Texas at Austin will handle the First Year stress. Begun with a large grant by the Dell Foundation, the school seeks to train a new generation of physicians who are trained to access massive volumes of digitally-searchable data, which data is under constant revision as new science is discovered. It may be unnecessary to memorize as much junk in the future, because we can look it up and learn about it as we go, in the connected world. Conversely, the self-imposed autism of spending two years memorizing stuff, to get up to speed where one is thought qualified to exercise some medical thinking, may prove unnecessary…as the student could work with real (or simulated) patients and learn obscure elements of anatomy and physiology on-the-run.
This will be an interesting experiment to watch.
Let’s hope it is successful. The basis of medical education needs to be revamped. Antiquated model. The new med school is still locked into much of the old model to be accredited so not sure how much wiggle room they have. The med school of the future should be designed by med students not politicians, bureaucrats, and administrators. That I know for sure.
Look no futher than Case Western Reserve Medical School which has been doing it right since about 1952. First 2 years are pass / fail. And classses 6 half days per week. Once laughed at, Case has produced healers in all manner of arenas: from Community health to Chairman! All with the biggest bent arrow non traditional programs of any.
As for revamp and remodel… Google is great ; but if you can’t ask the right questions, even Google can’t provide the right answers/ direction/ guidance. Bottom line: it’s a combination of memorization and learning and new technologies
Awesome! Let’s all model what’s working.
Dear Michelle, I I admire your strength and it reminds me of mine as well. I was stationed in a very dangerous place on Oct, 23, 1983 when the 2 terrorist attacked and killed 220 Marines 18 Sailors and 3 Soldiers among others. I never asked for help and thought I could just work through it all. Pre-med, then Caribbean School of Medicine followed by Family Medicine. I smoked, drank off duty of course but the word spread that I “had a chip on my shoulder”. My mom passed away during my Intern year and I believe that was when the depression really manifested it self strongly. I isolated my self from anyone else and began to use alcohol fairly heavily. I had a non pass in a rotation and the program director simply fired me in 30 days. I have never been able to recuperate from the residency experience and it wasn’t until years later that I finally received a diagnose of PTSD.
Amazing what we do to human beings and expect them to carry on without complaint. We are truly in the dark ages in mental health care.
Amazing. I sat in a conference room today with 130 doctors, heart racing, nauseous, sad. I was having flashbacks to fellowship, where one of my colleagues had her foot broken by an attending for not holding the flouro pedal down long enough. To quell my discomfort, I looked up the symptoms of PTSD. Then I recalled a comment a PHD administrator made to me once: “. You don’t have PTSD. I have worked with vets and prisoners of war. Now they have PTSD. You have no idea what that is like.”
I am still ashamed.
Hi, Michelle, Here’s some words from an old doc (class of 1988). Thank you so much for being courageous and sharing your feelings of vulnerability. There is absolutely nothing wrong with you. I remember those days–we all felt that way. The truth is that attendings know that we don’t know it all. Any physician worth his or her salt who is honest will say that we have just gotten more comfortable making decisions in the face of uncertainty. I was just talking to the Chief of Urology a few days ago, and I showed her an ad showing an overwhelmed medical student. She said, “The last time I felt like that was last night. I had a really tough case.” The ad itself was dated to 1965, so whoever is giving you crap was an overwhelmed medical student back in the day–or is full of crap. In my class, I remember one student who worried out loud more than anyone else about having a hard time with the material. It turned out she was the valedictorian. So don’t criticize yourself and keep an eye on the prize. I was just and average medical student, and since I graduated, no one has ever asked me about my grades. Never. I have gotten every job I applied for, because in the real world, who you are matters more than letters on a piece of paper. It sounds like you are someone who can be trusted with lives.
One more thought–there is a saying, “What’s hard is soft and what’s soft is hard.” What that means is that the content that you learn, the data, has very short shelf life and we all have to constantly relearn things that we thought we knew. That’s just the nature of science. Your mastery of the “soft things,” your values, your character, and interpersonal skills, will last you your entire life.
By the way, I’m a psychiatrist who used to be a GP (changed fields at age 40), so I have all the appropriate scars, and am still standing. You will be, too. I promise, medical training may pass like a kidney stone, but it will pass.
I got a good laugh out of training passing like a kidney stone! 🙂 Thanks for sharing – you have made some really great points here. At the end of the day it matters how we take care of patients, not how many multiple choice questions we can get right.
What an incredible and inspirational story! I have been a nurse now for 25+ years and am completely in amazement as to what I’ve learned about Doctors and Med student suicide. The medical field is a stressful place to be just on a good day. You never know what will come your way and you not only have to be at your best to treat/diagnose patients, you are expected to be on top of it! If not….the fear and stress of the outcome can be overwhelming. There are lives at stake and of course the “legalities” that go along with it! I, as a nurse can sleep and go to work rested, but our doctors or residents don’t always have that opportunity ie; being on call or working non stop for >24 hrs. I commend and have great respect for all of you ❤. I struggle with my own depression and issues and have always been so passionate about my role as a nurse, but I felt a calling to do it long ago. I came across this incredible knowledge on fb because I’m friends with a couple of doctors I worked for and am amazed and shocked! I’m proud to be a nurse not only to my patients, but also the docs! Kim
Thank you for being there—for all of us!
I had severe depression during medical school to the point where there were sections of classes and rotations I could not recall anything from. I had two more episodes during residency. At the time it was treat with medications 6 to 9 months then off. This only resulted in relapse. Antidepressants, therapy, and lots of support saved me. Finally being kept on medication persistently and understanding this was as much a disease as my diabetes requiring lifetime management has kept me stable. Use everything available to get better and stay alive and then thrive. Been practicing 30 years now!
I am so happy to read that you were able to reach out and get the help you needed. I have learn since my son Sean’s death he wanted to get help but couldn’t justify time off from clinical. I wish Sean had reached out for help. I wished more students would reach out for help. If they need medication take it because your right it’s no different then a diabetic needing insulin for life.
I am so happy for you and your family that you are still here 30yrs later. Maybe you can share your story with more people. I know society needs to change their thinking of mental illness too
Thank you so much for opening up and speaking the truth.
I left medicine during residency partially because I could no longer bear the hippocracy and imbalance it caused in my life. It’s often left me though with feelings of weakness because I was not as strong as the others to carry on.
I know you’re an amazing doctor and person in general. Again, thank you for not keeping quiet.
I don’t look at you as weak because you left medicine. I think it took you great strength to realize you couldn’t be happy being mistreated. I am sure the stigma of walking away from medicine in our society was very difficult. Unfortunately being a doctor in this country holds a higher status in society then other careers.
However, as a parent who’s son Sean committed suicide this past Mother’s day. I would have rather had my son walk away from Medical school and still be alive. I would rather him be a teacher, trash man, or whatever he was happy doing. Then feeling trapped in Medical school and owing the Navy time. He was in Medical school on a Navy scholarship. I realize society puts being a doctor really high up in society. However, what they fell to realize is how much debt comes along with that degree. How medicine is now more about making money that quality of care. All because they are run by big business.
I have nothing but respect for you walking away from medicine. It took you great strength to do that for yourself.
It boggles my mind that people found medical school to be more stressful than serving in Iraq or Afghanistan. I never was in the military, so I can’t compare. And I don’t mean to make light of your experiences. It’s not that way for everyone, though. I didn’t find medical school to be all that stressful. Busy and challenging? Yes. But I mostly enjoyed it – a lot. In fact, it is one of the favorite times of my life. Maybe I’m weird because I went into surgery- I loved our q2 trauma call. It wasn’t until residency that I burned out.
It depends on your environment for sure. Some schools are way better than others and some people find med school less challenging than others. Highly variable experiences. I do believe that medical education could be more humane and it would benefit us all.
I think it depends on the school as to the type of experience you may have. I also think it has to do with how isolated you feel. If your the type of student like my son Sean who really didn’t have to study. However most of his friends had to student really hard. Which looking back now I think he felt alone. Even though I talked to him or texted him he always made it seem like thing were good.
I don’t think your weird it’s just the experience you had. Maybe some of your fellow classmates were struggling and you never knew. Maybe if students were all able to express their feelings you might have been able to help one since you were doing so well.
Please don’t use the word burned out. Burned out implies you gave up, you didn’t have motivation, and you were exhausted. If the medical field would change and care about medical students, residents, and physicians as far as making sure you all got proper sleep, spoken to with respect. Maybe you would have felt the same way in residency as you did in medical school.
I know it sounds crazy, right? That’s the whole point of me sharing my story – to boggle minds. Here’s the thing.. in the military there are tons of soldiers that have my back. I have never been alone. I have always had support and back up. My experience with medical school is very isolating. It is the luck of the draw who you are going to get to teach you, both in the classroom and in clinical training. This is why our experiences have been very different from one another. It’s possible that you are more resilient, but it is also possible that I have had a lot more negativity in my training.
I am glad that you had a positive experience in medical school! But why did you have to endure “burn out” in residency? As Cheryl said, it shouldn’t be that way. You and your time should be treated with respect always.
I wish she had identified the reasons she felt suicidal. My guess is that while she was in the military someone always had her back. When she hit the wards she discovered that nobody had her back. All the weight from above and the side was hers alone. The military knows they have to take care of their men. Business doesn’t care at all. Military says we take care of each other. Business says I will eat you for lunch. I do not care about anyone but myself. This is why we are falling apart. No morals. It is every man for himself. Life without honor. Business people say helping others is only for profit. The military understands we must stand together. Stop the for profit model and all this can change. Health care is a right for every human being not a privilege. Stop the oligarchy. Stop the entrenched two party system. This is political as much as it is economic, as much as it is personal.
Thank you for commenting, Elizabeth.
I felt suicidal because I put everything I had into studying for exams and still could not get good grades. We are told time and time again that if we do not get good grades and don’t do well on boards that we have a slim shot at getting a residency. It seemed black and white to me. No matter what I did it was never good enough. I sought out help, got a tutor, and joined study groups. Nothing got me to where I thought I should be.
I get how it sounds to some people – “Wow, you felt suicidal because you got bad grades.” Thats why it is hard for me to share. It’s not that simple though. I have put my heart and soul into the military. My dream to to treat soldiers, to give back to them because of the sacrifices they make for this country. I’m pretty good at it too! I have served for over a 1/3rd of my life – it runs in my blood.
I want this so bad and thats why I am so hard on myself. Yeah I have been treated negatively by my school, by professors, and during clinical training at times – but I am my worse enemy when it comes to negative thoughts. All I want to do is help and I just feel like a failure.
I hope this helps answer your question.
Military eats their own people and do not care for them when they no longer need them. Look at the Pentagon back in the 1990s trying to denied the Gulf War Syndrome and Agent Orange during the Vietnam War. In addition, you had ex-military people like President RonaldReagan, President Bush, Sr., President Bush, Jr., and various Republican politicians like Senator McCain, Bob Dole trying to deny or cut veteran medical benefits since the end of World War II.
Compared to medical school, the military apparently does better.
There was also a story a couple of years ago, when an American Army General got tired of soldiers complaining about suffering from PSTD and put it out on Twitter or on his private email that they need to suck it up and move on. The next thing you know, he had to put in his retirement papers when his soldiers and the Pentagon found out about his remarks. That general was luckily he was not a mental health doctor in the military medical corp. His patients would have torn him apart for being so insensitive.
I would have to disagree with you Elizabeth. There was a movie called The Invisible War about the problem of rape in the US military that has been going on for who knows how long. The many rape victims never got support from their support from their fellow soldiers and many of them ended up being kicked out of the military while their rapists were allowed to stay in and be promoted.
That happens in medicine too. Rapists stay and victims are thrown under the bus.
Thank you for sharing your story. I was working at a veterans hospital several years ago which was a privilege. What impressed me was meeting with some returned servicemen who did not have PTSD.
Scientists have long wondered,how does a bee fly? Similarly,there were people at the hospital, with the normal range of feelings and interpersonal interactions, who did not have PTSD, despite having been through some really terrible, life-threatening traumatic experiences in warfare.They survived the war, afterwards they were also surviving the peace and return to “normal life”.
Michelle – you are strong and amazing and medical culture needs you!! You’ve done awesome work!!!
I’ve gotten certified as a coach in part to be able to help health professionals deal with what we medical educators know can be a sick culture of pressure with no relief. I offer my services pro bono to med students and other health professions students (it was a nurse who said of nursing education “we eat our own”).
If I can be helpful, or if you know of anyone who might like to explore a coach as an option, please contact me.
Thank you for sharing your story!!
With all due respect, the military does not always have your back. In 2012, there was an independent film titled The Invisible War about the hidden, systematic, widespread of rape of both female/male soldiers in the US military that was hidden for decades and the military covering it up just the like the Catholic Church’s sexual abuses. Those military rape victims went to their superiors for support and did not get anything except retaliation and were forced out. Just saying.
Although I’m not in Medical School, I’m so glad the issue of excessive stress and depression among advanced degree students is being brought up. I’m a PhD student and am struggling with issues almost identical to Michelle’s. And I can confirm from my own experience that being an older student with a different background certainly exacerbates the problem. I’d also like to add that being a PhD student rather than a med student has another added stressor for me: the uncertainty. Uncertainty about results of my experiments, about funding for my research and livelihood, about about getting a job after graduation etc., all of which just pile on to my misery. I sincerely hope that med students with stress/depression issues take some comfort in the fact that if they do reasonably well in school, they are well on track to become doctors and get well paying jobs. For us on the other hand, no matter how hard we work to excel in grad school, the future still seems to be totally up in the air. Sorry for rambling but I just want to say thank you to Pamela and Michelle for bringing up this issue. I’ll try and take Michelle’s advice and practice better self care. Lending my moral support to everyone going through this!
Michelle- I admire you for recognizing what was happening and taking controll to overcome the depression and high expectations you put on yourself. Medical school is tough enough to go through – especially if you feel isolated. I was fortunate to be in an environment where we really all helped each other to get through. No cut throats – at least in our group of 30 (out of 90 students) My limited exposure to current medical students seem to suggest that some schools do a better job at alleviating the undo stress. My daughter is in UF Dental – their program to assign a second years as a mentor (a ‘big’), and the dean addressing the incoming class that they all belong there – helped diminish the feelings that every other student must be smarter and better. The atmosphere is that the school is cheering each student on to succeed. More than 50% of her class are unconventional students too. So I think each school could learn from each other how to help their students succeed without jeopardizing their own mental health. My husband and I are both physicians – and the saying goes…the top of the class and the bottom of the class both will have an MD after their name! Two more years for you- and clinicals are so much more interesting. Your experience as a medic will make you comfortable in that setting. It sounds like you will be an amazing doc.
My name is Jenna Smith, and I am a reporter with UCF Knightly News. I am doing a story of the overwhelming stress of studies as we approach finals week. I saw your story and was immediately drawn to it. Would you be interested in letting me interview you for our newscast about your experience with school stress? Y
Thanks you for your consideration, and have a great day!
Sure Jenna! Will call you in a bit 🙂
Michelle, first of all just let me say that you are indeed a strong and intelligent woman. I don’t even know you, but I can interpret that through your chosen life path – the military, a tour of duty in Afghanistan, a family and medical school. People who choose to pursue such endeavours are not weak nor unintelligent.
Your story seemed to echo my own in a way. I heard a lot of uncertainty and assertions in your writing – almost as though you were uncertain of your assertions and felt it necessary to justify your struggles in medicine. I could be wrong of course, but that is what I sensed.
I too entered medical school feeling excited and accomplished. I had achieved much more than my family; I was a bit of a trailblazer in a way.
But, I entered medical school carrying the weight of many childhood traumas, a violent sexual assault, the death of my sister… honestly I could add to that list but yes, clearly, many traumatic experiences. I had struggled with anxiety from young age. I also had a few episodes of PTSD – or perhaps it’s been chronic! Hard to draw a line between chronic PTSD and chronic anxiety, if that makes any sense!!
I realize now that those former traumatic experiences and my history of PTSD made me susceptible to further retraumatization and triggering of PTSD/anxiety by medical training. Medical training is traumatizing at baseline – even individuals who have no prior history of trauma or mental health issues are traumatized during medical education and exhibit trauma associated symptoms.
I discovered that in fact my depressive and anxious symptoms were also in keeping with trauma associated disorders. Again, a difficult distinction to make.
I had a difficult time teasing out these issues because I also reasoned that I was a really tough chic!! I had been through so much more in my life and survived handily… what the heck was wrong with me that I couldn’t get my shit together now!! I was wrong… the same things that made me tough also made me susceptible to retraumatization in medical school.
My story may not be your story and I certainly do not want to make assumptions, but I could not help but notice the similarities… perhaps some food for thought.
Do not ever let anyone or anything shake that belief in yourself – you know your own story and your own strength better than anyone ever could! Nobody else gets to make that decision for you.