On my PBS tour, I had lunch with health blogger James Clear, who is studying for his MCATs and wants to go to medical school. James and I have been talking about his desire to go to medical school for a while. As a successful entrepreneur with a strong sense of self and a calling to medicine, James once asked me whether I thought it was possible to go through medical training without getting your spirit broken. I told him I think it’s possible. It’s hard. But possible. As I wrote about here, it’s easy to wind up with PTSD after your medical training. But if anyone has the mettle to survive medical training unbroken, it’s James.
But I thought I’d call in the troops to help support James as he embarks upon this journey. To build a support team for James, I introduced James to my friend Aviva Romm, who I met about six years ago, right after I had left my conventional medical job (read this blog I wrote about Aviva here). At the time, Aviva was midwife, a published author, and a faculty member of Dr. Andrew Weil’s integrative medicine fellowship at the University of Arizona who decided to leave behind her flourishing career in order to go to medical school. When we first met, Aviva was a medical student struggling to keep her soul at Yale Medical School. Having survived the journey, Aviva is now an amazing physician who works at Mark Hyman’s integrative medicine center.
When I asked Aviva if she had any words of wisdom for James, she wrote the following letter, and it’s so beautiful I wanted to share it in case there are any other aspiring medical students out there who want reassurance that it’s possible to become a doctor without getting your spirit broken.
Take it away Aviva!
A Love Letter To Aspiring Medical Students
I don’t know that you can avoid exposure to potentially traumatic experiences in medical training. But I think you can avoid being traumatized in a permanent way. In fact, I think feeling the trauma in the system actually helps us understand and transform it. Yes, there is a lot of potential for trauma. I embraced the experience and found very low levels of trauma for myself, but I witnessed a lot and certainly experienced some myself.
During your medical education, there are some great people who will be your faculty and senior residents, and you will learn some of the best aspects of humanity from them. But there will also be many overtired, underfed, undernourished, and broken people in white coats. And there will be many mean rule followers and perpetuators who are in positions of authority. It can become a toxic soup. In the process of trying not to ingest the toxicity, you can also feel exhausted, drained, and traumatized. The process results in a lot of insults to the human spirit that you will both experience personally and witness happening to others. For example, you’ll watch physicians treat patients and residents badly, yet you are not always in a position to stop it. For those of us who are sensitive, seeing it is also feeling it, so even if you avoid the misbehavior personally, you experience trauma by proxy. It’s sort of like feeling helpless on a playground when another kid is getting bullied, but you know you’ll get beat up, too, if you step in.
The process requires a lot of spiritual personal choices that can wear on the soul. It can be crushing even when you do it unconventionally as I did.
I went in intact and am now intact on the other end — stronger, wiser, clearer. But it has taken a year to heal from interpersonal insults and anxieties. I got sick more in the last two years of my residency than in my entire adult life put together. I mean that literally. I got a kidney infection and was told I might need to be hospitalized. At 45, I took the first antibiotics I’d had since I was 14-years-old, yet I still kept working even when I was sick because I was told I had to keep working or “pay the consequences.”
I missed family weddings. I missed my friends’ important life events. That kind of separation from self and community is, in itself, traumatic.
In spite of all that, I am so glad I did it. Now that I have those respected credentials behind my name, I get to help heal a very ill system with beautiful peeps like Lissa.
You have to really want it, know why, and be clear about who you are when you go into your medical training. Hold the truth, hold the love, hold the healing — more good comes your way when you’re in that space. Eat well, sleep when you can. Have good love in your life. Be kind to yourself. And keep the faith.
I hope this helps…
Aviva said it so perfectly that I have little to add. But the one thing I would add is a reminder that you always have choice. In my medical training, I made the mistake of feeling like a helpless victim most of the time. It left me feeling very powerless, and that powerlessness led me to tolerate sexual harassment and blatant physical abuse without reporting it to those who might have done something to stop it. I too stood by as I witnessed others being tormented because I was afraid I’d get in the line of fire if I stood up for my values. I failed to stand up to protect the patients I saw disrespectfully being called “GOMERS” (Get Out of My Emergency Room) by my superiors. If I had the chance to do it all over again, I would not sell out my personal integrity the way I did. I hope you will find within you the strength to stay in choice, to realize that nobody is keeping you there at gunpoint, and to stand tall and courageous in devotion to your values. (Tweet-worthy!) The only way our system will start to heal is if people like Aviva (and YOU) enter the system, emerge out of it unbroken, and unite, arm in arm, to heal our beloved profession and protect the lineage of the healer that called us to serve in the first place.
You can do this. I believe in you.
With love and faith in the future of medicine,