Hi Pamela,
I’m a medical student in the UK. Though I’ve only been in med school since September, it has already taken its toll on me. Before I started I was so in touch with my emotions, spirituality, and nature. Now I feel so empty and desensitized. I hate that when faced with the horrible circumstances of another person, I just don’t feel anything anymore. How can I overcome this? I so badly want to tap into the vibrant me from 6 months ago!
Before starting medical school, I was a curious and loving young man. My life hadn’t been plain-sailing: I had been through my parents’ divorce as a young teenager; I had suffered bullying in a hostile school environment, and I had come out of the closet as gay. All of these things sound quite monumental for a young person to go through, but nothing prepared me for the agony of medical school. You see, when my parents divorced, I was sad, I cried, I grieved for the family life I would no longer have, and I recovered. When I was bullied at school, I was hurt and upset, but knew they were wrong which gave me strength. And when I came out of the closet, I was bursting with emotion: of anticipation, excitement, terror. All of these experiences were by no means pleasurable, but I FELT them, and that’s what made me feel alive. They were painful, but they illuminated the happy times in my life and made me a stronger and more empathetic person as a result. I looked into people’s eyes and could sense their pain a little more because of my own personal experiences, and enjoyed feeling connected to their lives. I was spiritual. I would pray and meditate and marvel at the beauty of nature and humanity around me. I was genuinely excited for my life, the people I might help. I wanted to be intimate with people, rejoice in their success, and feel the pain of their sorrow.
Then I entered medicine.
From the first few days, I could tell something wasn’t right. I entered this profession with the intention of becoming a healer, yet, when I looked at my lecturers, I mainly saw didactic scientists, not healers. I looked around me and saw egotistical, power-hungry students. Many were concerned with status, competitive to the extent that they all wanted to outdrink each other on boozy nights out and have the most sex out of our whole group. They wanted to be the best at everything: in their exams, and in their personal lives. Yet no student has ever spoken with genuine concern and feeling for patients. When I organized a talk by two individuals suffering from HIV, hardly any of our class turned up—I’m talking about 2-3% of the students. When I asked some why they did not attend, many just didn’t care. “We don’t need to know it for our exams,” one said. “I don’t think I’d get anything from it,” smirked another. I was aghast by how little they cared.
At this point, I really questioned the establishment of which I was becoming part. Even with the brightest soul and the best will in the world, it is hard to survive in an environment at complete odds with our own intentions. This soon took its toll on me. I felt like I was in a constant battle to retain my care, my love, my empathy. But I feel like I am losing.
While the challenges in my life were at times very painful, medicine has caused me to feel something I never imagined could be so bleak—nothingness. It is quite astounding actually how little I feel nowadays. I have lost my libido (In fact, I have been convinced I was asexual for a time), and I feel numb on a daily basis, like a nurse has injected some local anesthetic into my heart which hasn’t worn off. Nothing seems to bother me anymore. After cadaveric dissection, nothing is gruesome, the boundaries by which I could operate on someone without feeling any hesitation are endless. There’s something about hammering a ribcage open with a chisel on a deceased old lady that breaks down those barriers for you, and they can never be built back up. In addition, disease and death are talked and laughed about in such matter-of-fact ways that they’ve become boringly dull to me. No longer am I heartbroken for the cancer patient, or devastated for the young mother who died in a car accident, because I feel nothingness. We are only ever taught about the scientific basis of afflictions, never the emotional or spiritual impact on both the patient—and ourselves.
My spiritual life has suffered too. No longer do I appreciate the world around me with the overflowing gratitude I used to hold. Instead, I just wallow. I am strongly considering dropping out of medical school to pursue another path, not because I detest the vocation, but because I am scared I am losing pieces of me that I will never get back. I am scared that after only 6 months, I am just a vessel with no life and that I will never feel what it feels like to feel ever again. I am scared I will never have another tear fall from my eye. Is really worth sacrificing my soul to this profession? I feel ripped apart.
Please let me know if there are any ways to cope with this torturous predicament.
With much love, even though it is so hard to gather from a numbed heart,
Luke
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Luke,
Join our teleseminar this Sunday (scholarships available for med students)
You are not alone. Med students all across the world experience the dehumanizing effects of medical training. The basis of our education is a flawed reductionist medical model that views the human body as a machine—a bag of parts to be conquered. Reductionism (the opposite of holistic medicine) leads to mind-body-spirit disintegration. Consequently, you are losing connection with your heart and soul—the reason you went into medicine—the purpose of your very life.
Loss of meaning, loss of self, leads to pain. Pain leads to self-medication with alcohol, drugs, sex—anything to numb oneself and distract from the loss of soul. Sustained numbing leads to permanent numbing and an inability to connect with oneself or others.
What can you do to overcome your loss of self? My best advice:
1) Keep a clear and unwavering focus on your dream—the original vision that led you to medicine. Read your personal statement daily. Hang it all around your house. Never allow anyone to steal your dream.
2) Surround yourself with inspiring mentors—other physicians who are living their dreams in medicine. They will guide you in the right direction. Avoid advice from cynics and naysayers for they are wounded too. I will totally get you into our mentorship group. Contact me here.
3) Maintain your physical health. Exercise, eat well, sleep. Balance your intellectual pursuits with time to relax and be INSIDE your body. I highly recommend weekly massage to help you remain present with yourself. The benefits are not just physical. To care for others, you must first care for yourself. Massage is a great way to learn how to receive care and to form a therapeutic relationship with a trusted healer who can help you through medical school.
4) Maintain your emotional health. I believe all medical students should receive weekly counseling with a professional (not a friend, not a spouse). If you feel sad, cry. Tears are cleansing. When humans bottle up their trauma with no outlet, they become numb, detached, sick.
5) Maintain your spiritual health. Whether you meet with your church pastor or meditate at an altar in your home, devote time at regular daily or weekly intervals to spiritual self-care or you will lose connection with your soul.
6) You must be well to guide others to health. By caring for yourself, you will not only help patients; you’ll help your classmates and teachers heal. They are wounded too. Be a beacon of hope for them. Even if triggered by your joy, they’ll be less likely to injure you with their pain. They need you.
7) When you are resourced and well, you will once again be able to look into people’s eyes and be a sacred witness to their suffering. You will experience true intimacy which means “in to me see.” For patients to see inside you, and for you to see inside them, you must be inside your body.
Blessings to you on your journey . . .
Love,
Pamela
Want to heal your soul? Attend our next retreat!
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Pamela Wible, M.D., was named one of the 2015 Women Leaders in Medicine by the American Medical Student Association. Dr. Wible is the author Physician Suicide Letters—Answered. Need a letter answered? Contact Dr. Wible.
Great advice. Medicine needs people who feel what is happening to those around them but the process is dehumanising. To those would need to be doctors of the future. I was a medical student in Scotland 30 years ago and it saddens me that the destructive process continues. Keep hold of your dream. Protect yourself . Choose your specialty wisely. You Will be able to change medicine but to really make impact get over the hurdles to achieve your dream and vocation. Do it gently to yourself. Find a mentor to talk with you I can’t believe I went through 5 years of training with no one ever asking me if I was ok? What a way to treat a young person. You have spoken up,well done. You will be a dr to be proud of
We need a holistic medical education model. Thankfully the public and others are seeking this type of care and public pressure will mount to lead us all to a more sane and humane medical education model—for the benefit of all.
I like the curriculum at Whole Health Education which is offering certification for completing their courses. I do wish doctors had more training in whole health.
Here’s the education I received in whole health during medical school & residency: In medical school my instructors made fun of me for eating healthy food. In residency I’m caught giving patients recipes for kale salad. I’m sent to the office, reprimanded for not getting approval from the patient education committee.
Luke,
It is …. in reality…. a very tough job, one has to learn to embrace a positive helpful detachment and develope a thick skin arround your heart and emotions. You dont have to join your colleagues, there is a definite place for a gentle professional approach, also depression may colour your view of others. It may be that the severe and significant challenges you have had over the past few years have resulted in a clinical depression.Please ask the student GP service for an urgent medical appointment and to refer you to councelling services. Early intervention, reflection and time out could result in you enjoying a wonderful future. There is a place for all types of personalities in medicine… are you a body mechanic or a people person. Medicine needs and requires both types of doctors. Take some time to get real proffesional help.
Kind regards J
No. She is not depressed. She is not overcome by the “Severe and significant challenges.” She has been let down and turned off by the egos and self-centered attitudes of her medical school peers.
I am not pursuing medical school after having had the same experience with pre-med students in undergrad. I knew at least 15 of them and I despised how impersonal they were (without exception). They could talk all day about the money, the prestige, what kind of surgery they were going to do, but became lost for words when I would interrupt their monologues with a question about humanistic motivations, how they planned on incorporating pro bono cases into their practice, or what they thought about social inequalities in access to care. These are the same students that went to Africa for a week, played doctor with a stethoscope, got an Instagram selfie with a native child, and came back to the States acting like they were god’s gift to man.
I am happily pursuing a career in a different branch of healthcare where I can retain my soul and not be eaten alive for it.
Yes! I wish I had read this in medical school. My third year, I got so incredibly ill that I could not function. I had complete adrenal shut down from the stress. I saw an amazing holistic psychiatrist that has a practice model similar to Dr. W’s. She suggested weekly counseling, better eating, exercise, and massage. My life has changed so much for the better. I’ve always been an optimistic, eye on the goal kind of person, but this training and profession really does get to you…Even the strongest and most positive among us. Thanks for the advice!
I suggest you go into research or another profession. It isn’t going to get any better. It took me 13 years to finally quit and go into parks and recreation management. I found that much more enjoyable than working with patients suffering from terminal lung disease.
RE disillusioned physicians.
You are not alone.
As a solo FP for the last 12 years, I find myself fortunate to continue to love what I do every day.
I charge all practicing physicians to try to find the joy in what they do and transmit this to the physicians behind them as well as help and protect other health care workers/professionals.
The “overfocus” on the money, and generic management styles, has the downside of dehumanizing all of us.
However, at the end of the day, healthcare is only the following –> a doctor, a pt, a closet-sized room, a light, and now, a computer.
Enjoy your choices.
Dr Matt Levin
Solo FP since 2004
Residency completed 1988
Luke,
I liked your comment about your classmates:
“Many were concerned with status, competitive to the extent that they all wanted to outdrink each other on boozy nights out and have the most sex out of our whole group.”
It reminded me of my med school days and my classmates. Unfortunately, many don’t outgrow this need for status and competition. Many use drinking and sex to cover the pain that soul crushing medicine can cause. I do continue to work in traditional medicine, and my colleagues can be the most difficult part.
As you take care of yourself, keep a soft heart for the others who don’t know how to care for themselves.
I do believe you have depression. Depression has lack of feeling – (anhedonia), not necessarily tears and emotions. Please get some help. I graduated in 1970 from medical school, from psych residency in 1975. Worked at it for 39 years. It was hard. I am still very interested in people’s health, which of course is intimately connected to physical well being, but if I “came back”, I would most definitely choose another avenue such as naturopathic, ayurvedic, dietary (WFPB – whole food plant based), Chinese medicine -. I looked into it about 15 years before I retired, but realized the costs were too great to make that change then – so did the best I could to be as helpful as possible and stay sane. I really feel the medical field as it is now has been corrupted by monetary interests, so sad, as I was so eager to do it as a child – ah well! Still passionate about it in concept.. Please please please do seek help – and know there are other avenues for healing people if you like. You sound like a wonderful person. I hope, Pamela, that you will allow this on your site. I so respect your strength and what you are doing.
Hello, Luke:
I went trough similar situation in my own medical school- which was about 16 years ago…
Studying, passing tests during medical school was easy for me, always was, because I could handle it by simply putting my own brain to good use. Other things were worse. Fatigue and sleep deprivation was a challenge- and it still is until this day because whatever was said about “getting used to sleep deprivation” is just straight baloney- as my body testifies since after 16 years of practicing I still get exhausted after working 24 hours straight. Somehow, despite of trying to suck it up during my medical school and residency my efforts were all in vain-I still need to eat, sleep, pee and poo- as every other physical body on this earth. Physical exhaustion always won- it slowed my brain down, made my reflexes and speech slower,and made me feel like a looser, really (until I started seeing through the bull that is).
Emotional exhaustion was another thing- I came to medical school wanting to heal, to make someones life better. Instead I entered rats race environment. I was in shock how egoistic and downright abusing people, suppose to there to teach me were. I got confused and angry: my upbringing did not prepare me as to how to handle such, lets just say “highly egoistic” individuals. I made one decision then: NOT ever become a person like this myself. I promised myself that I will not join the herd, but stay respectful and considerate to others to the best of my human ability. I followed my pledge for years now- and it helped me to remain sane even 16 years later.
There was a time that I became emotionally numb myself during my training. It happens when you get exposed with more emotional pain that you can possibly take. In order to keep personality intact, emotions get “bypassed” for a while. The emptiness comes and all feelings are distant- both the good and bad, and the Zombie like state state starts. I felt like a robot then, and nothing made sense to me- I could no longer make patients feel better because I felt nothing myself. I was lost, really. Speaking about libido- who has it after not sleeping, not eating and not peeing? It is normal body response to abusive environment- functions not essential to survival simply shut down.
Why did I not quit? Not because I was so gifted then, as to be able to see and understand what was happening to me at age of 23. It was simply because my specific personality did not know how to quit :)- and still pushed me forward even when everything else seemed to go to hell.
My Zombie state did finally go away. Why? I thought about it- meaning I used my intellect in attempt to understand where is this mess I was in coming from. After some time it occurred to me it is coming from…my own unfulfilled needs.
See Luke, I am HUMAN, just like you are. One with a soul and feelings and zero desire to use another human being for my own benefit. My body needs food and rest and regular intervals and gets slowed down after 12 hours of non-stop work. I also have this illogical deep need to be nice to others and for my job to be meaningful. During medical school and residency I could not get those things… and so I switched into survival mode of Zombie state. I started feeling much better when I found a job where I can be nice to people, and my body does get the much needed rest and nutrition. I found the right environment for myself, for my own specific set of personality features, and so I can thrive as a person. Feeling like you are going trough hell in medical school is I think quite normal human response to malicious environment- but it still does not mean that being a physician is not for you. It only means that you personally reject such environment (being the one of medical school)- and not the occupation itself. It is still possible to find work environment that can fit you just right after training- it is just not easy to find- I had to go looking for it.
I also decided to let all of those who tell me to be “more resilient”, to go straight to hell…really , please.
I also decided to let all of those who tell me to be “more resilient”, to go straight to hell…really, please.
Great. Love it.
I sympathize with Luke. As a student nurse I learned not to feel my feelings. This was a detriment to me and those I loved. Eventually, I reconnected and now am able to share what I have learned and have taught plus much more in my soon to be published e-book, At Eden’s Gate Whole Health and Well-Being Revised and Expanded Edition being offered by WestBow Press.
Make use of the excellent suggestions in Dr.’s response!
Best wishes, Luke. You will make a wonderful physician if that is your calling.
Evelyn
Here’s to Your Health!
evelynmmaxwell.com
RE Disillusionment in Medical school
1) I am the son of a doctor. While medical school was difficult (went to Jefferson Medical College in Philadelphia), I was fortunate as I never went through the disillusionment that you appear to be suffering through. I suspect it was a combination of things: support from my family, friends in the same place that I was (although not at my medical school actually). Our attrition rate was not that high, but mostly in the “speed up 5 year group” who took an accelerated undergrad group.
2) Since I grew up in a medical family (my father was the first in his family to go to college, graduated 1947), I never thought of my experience as dehumanizing, although I’m clearly aware that it could be.
3) I was on the receiving end of challenges from several preceptors and residents who attempted to knock me down, but challenged the resident (for sending me into a research project that was a red herring) as well as 2 attendings who tried to bust on me on rotations with misplaced comments in evaluations that could have hurt me.
Advise you to look as far ahead as you can to where you want to be, as a physician. Try to find some mentor who is doing this work, and spend some time with them.
Also as a thank you to Pam for bringing this out.
You would be welcome to see primary care in action if you get to the states, esp Pennsylvania.
Dr Matt Levin
Solo Family Medicine.
Western PA
Medical school graduate 1985
Family Medicine residency grad 1988
Solo since 2004
Well done, Pamela. I enjoyed this post. I have had to keep my own beacon of light shining to even get my voice out about the chronic pain-epidemic (aka PAINDEMIC) in my recent book release. Granted, I am still on my journey to lead people to better ways of helping others with chronic pain. Sadly, the road frequently travelled in pain medicine can be lucrative, but it does not follow my conviction of “do no harm.”
A friend of mine told me he was afraid to say “I love you and I need you” for fear of being judged as too needy or as pressuring her to commit and would leave the relationship. If those two people actually deeply care for one another it’s vital that they share that with each other so that they can have the rare gift of a special and precious relationship together. If the feelings are one sided because he is emotionally or sexually incapable of that intimacy please don’t get caught up in a dysfunctional situation. Be kind in moving on, don’t say or do things you will later regret just to hurt them, talk with friends and family and possibly so you don’t bottle up all your feelings. Time and open communication with friends and family that care and finding peace with the Lord if you are a christian with slowly heal you even if you are convinced things will never get better. Don’t let your parents force you into a vocation you don’t have a passion for…it’s your life and becoming a doctor requires a huge dedication and hard work not to mention will occupy many years of study and dedication. You owe it to the human beings you will hopefully be helping to genuinely care for them, and have their health important to them because most people can instantly tell if my doctor is into what he is doing or just going through the motions. When you are doing something you love and get genuine fulfillment from that occupation you definitely know it in your heart and soul. If it’s not there it isn’t fair to yourself or the patient. This posting went off topic but I was trying to explain your conflict about having or not having a passion for being a physician and a passion between two people by comparing the two. Are you ok with your sexual orientation? I hope so. It would be awful to live a lie your entire life and I think that faking you are straight just to fit in with society not to mention if you marry just for appearances..not fair to your wife unless she is bisexual, very open to that lifestyle and she would be happy with that kind of marriage. If being gay is your truth and are happy with it don’t feel bad…it’s fine. To each his own. I am not bisexual and could never be married to a man who isn’t hetrosexual or thinks swinging is cool. It’s just not for me. That’s my truth.
Lots of errors there, yikes.
Science does not have to drive out compassion. Every scrap of everything you learn (well maybe not every scrap, that “apneustic center” stuff was a bunch of malarkey) may help someone someday and you can still be in it to become a real healer and/or researcher no matter what the rest of the student body seems to be into. The folks who DID show up for your HIV presentation will all go on to do great and compassionate things, and so will you.
Dear Luke,
There is so much that all of these people have offered you as advise. Yes, there is emotional overload, and there is definitely separation required to be a physician in order to remain objective. That’s a good thing because we, as patients, need you to remain level headed in critical situations.
As a patient, a pro px now and a chronic pain patient (not on opioids), we can be complex. We can not fit the mold, and that can be frustrating for both people because you can’t fix us and we still need help. Those other 98% that you have described will probably be happy pushing through 24-32 patients per day with problems like needing shots for their travels or an assessment of their twisted ankles.
You don’t sound like that kind of guy to me. You sound like someone who wants to develop a relationship with the patient. That is a long, hard journey for both parties. You mentioned setting up an HIV presentation. That’s awesome, and you educated 2-3% of your class. That’s 2-3% who might recognize an immune disorder in a pediatric patient or understand the susceptibility of an HIV patient to sepsis when they see them in the ER with a fever, confusion and a high heart rate.
Remember, you can only save one life at a time. If right now that life is yours, save it. You are worth it.
Also, you treated the two HIV patients when allowing them to share their stories. That is cathartic for them. It brings meaning to their suffering and their stories. That night, you were a doctor.
If you have any time at all, I would encourage you to do two things. Please visit the website, mycounterpane.com . There are so many people sharing their stories of chronic illness on that site, and you would ve amazed at the strength of the human spirit to keep going. Second, we need more docs in hospice and palliative medicine because it is the practice of medicine to achieve better quality for the patient’s life. I wish you the best of luck.
This may seem a bit callous, I had a pretty brutal life before a hypercompetitive medical school and surgical residency and fellowship, yes I can see the most gruesome things, and tragedies, and not blink. My sense of humor is so black, very few people laugh at my jokes.
But there is a silver lining , I can concentrate on doing the technically correct thing, and its not a human, its an abdomen, I can withdraw life support, with the same emotional level as writing the OR schedule.
But when it comes to interacting with patients and family I can care deeply and Interact humanely, my human interactions are not in the same part of my brain as my technical side. They are separate.
Or as the Russian proverb states: those who cry at funerals should not become undertakers”….. I agree with all of the above but when doing a trauma laparotomy turning the patient into an abstract concept helps.
Or, we need to believe in things that are not true to feel good about the world. Religion continues for a reason.
Holistic care is not related to spiritualism. Holistic care is more than a band aide though. It is essentially a perspective which implements lifestyle into the medical practice. For instance, a broken bone is better treated with more than just a mend. Lifestyle can effect how well the mend works.
If a doctor tries to talk to me about spirits, I won’t want that doctor around me and it will make me feel threatened by incompetence in the field because this person is promoting a placebo as an objective solution. Who’s “feelings” matter more?
Dr. Wible,
I’m not a physician and I just stumbled upon your web page by accident. I appreciate reading your Insight on so many different topics especially the one I’m patient profiling. I also think it’s a crying shame that so many positions and aspiring Physicians commit suicide because to me they’re the ones who have a heart and they want to do the right thing and uphold the Hippocratic oath. I’m a registered nurse and was trained in the military and have been treated like garbage because I was injured on my job 20 years ago and had two with no choice, go on workers comp and I have had the worst care but I’ve had some good nurses as well as good Physicians. I hope Luke continues our there’s dream and tells himself just get through this and do what you got to do to get through to get that dream accomplished and after you’re done in your graduate that’s when you can apply your feelings and treat patients with their dignity and love that you want to give to them. I wish him all the success in the world. It’s hard being gay in the medical field and I know I seen the abuse people suffer from it!
Sincerely,
Jeffrey J. Lepre
Great advice. A lot of information about medical schools. This one is very helpful for us.
Modern Medicine is reductionist medicine that reduce the human existance to just physical body no other planes of existence is considered….it was intentianlly designed that way to reduce humanity to just the mortal body.