2.26.2008

Forgetting Learned Helplessness

Behavioral scientists developed an animal model for depression. The model works on the premise that if you repeatedly expose an animal to a noxious stimulus that it can not escape from, the animal will become desensitized to the pain and basically become depressed. Usually it's performed with rats on an electrified grid. It is called the "Learned Helplessness" model. Many medical school professors have deemed it necessary to move these experiments into human trials...more specifically, they're trying their methods on us, the medical students.

This is my informal declaration to the investigators:
Over the past 18 months, I have been provided so much noxious stimulus in the form of crushing debt, sleep deprivation, impossibly difficult exams, stupid busy-work assignments, painfully boring lectures, and excruciatingly drawn out small group exercises that I have achieved a level of Learned Helplessness the likes of which I have never experienced. I actually hit the bottom of that depression before the end of last semester. I pretty much had given up hope of ever being more than mediocre. I was doubting whether I was worthy of the admission that my institution had even given me. I wondered if I would even want to go back to this grind. I even looked into transferring back home, but the chances were slim given that my application would basically state "I am a miserable med student 3 hours away from everyone he cares about, unable to strike a balance between the demands of medical school and the desire to put the pieces of the former life that I had built up over the past 24 years back into shape."

I took my winter break to look long and hard at what was happening to me. I realized that I had pretty much just reached the end of my wits focusing on how miserable I was and that was distracting me from everything at school. Instead of focusing on studying, I was thinking about being unhappy which lead to some very inefficient studying. Instead of going to lecture, I was laying in bed thinking about how much lecture sucked. Instead of focusing on doing my best, I was focusing on how I hard everything was. I looked around at my classmates and several of them were going through the same thing that I was. I told myself that things had to change this semester, that I had to make more room for the things outside of medical school because all of my free time is going away in a few short months when I hit the wards. I told myself that I have to make my study time as efficient as I could.

So I've been working at it. I've been diligent about paying attention to my girlfriend. I've been good about calling and talking to my parents and brothers and friends whenever I still have the time. I've even managed to fit in a few days of skiing in here and there. I put myself ahead of the curve on my last set of exams instead of on the back side of it. I almost feel like I'm back on track, or have I just learned to forget my helplessness?

12 comments:

Anonymous said...

Hey, I am a second year med student in Kansas City. I can sure relate. There is no two ways about it, medical school sucks! We are taking our Endocrine final tomorrow and they have literally given us know time to study for it. Yesterday, they had us out doing physical exams on school kids. Today, we had a pathology practical that was so awful, I want to puke. And now I am trying to go through 6 weeks of lectures in about 4 hours. And a faculty member has the audacity to say "enjoy your evening". I hate this place. It sucks. There is no mercy and no logic. I am dead tired and am falling asleep right now just going through my lectures. I hated it the first year and I hate it now. And I really hate the bastards who run the program they are so out of touch. But I won't let these bastards win! I will be a doctor...

Anonymous said...

Oh, and the "know" above should have been "no". This is what this crazy med school has done to me. :-)

Bostonian in NY said...

I'm going to call you Jayhawk.

Jayhawk,
If you google "medical school blows" my blog is the first one that you hit. It sucks, and I use this as my own little public therapy session and I pray that the administration/anyone that I know doesn't find it, because you'd pretty much instantly be able to peg exactly who I am when you know where I go to school. Anyway, I hope that you find some sort of catharsis that helps you get through this. You're almost through the crappy part of medical school, soon you'll be so busy on the wards that you won't even miss your former life or the sun!

I just hope that some pre-med stumbles across this and takes a moment to think about his/her decision to go to medical school a second time before incurring $250k in debt.

Anonymous said...

"I just hope that some pre-med stumbles across this and takes a moment to think about his/her decision to go to medical school a second time before incurring $250k in debt."

Well well! Here I am, your wide-eyed pre-med! I've spent the good past three or more months obsessively reading blogs (like yours) to get an idea of the profession and the education. Actually, I've only stumbled across your blog today and I've scoured it for anything related to your reflections on your medical school experience. I'm pretty sure I've exhausted most other medical student and practicing physicians blogs and to be honest, I'm still suffering an intense agony in deciding if I should pursue this... career... life... path... thing...

As much as I would like to think these blogs are helping me in making a decision, I am beginning to feel as if they're creating more conflict than relief. What I mean is that it would be a lot easier to make this decision under a "cloak of ignorance". That's the truth anyways, right? From what I've read thus far (a fuzzy conglomeration of rants, bitching, and "it's worth it after all" type posts), there seems to be no one universal dictum concerning the worth of pursuing a career as a MD in today's health care climate. Everyone has their own perspective, shaped by their own personalities. It's a shame that we can't personally know how it's like without going on through it ourselves... Where's that damn crystal ball?

I do appreciate people like you who openly share their thoughts and experiences out in the open. They're an invaluable insight to say the least.

In the end, it will have to be my choice. The way I see it now (naive, but not quite as naive as before), it's a matter of whether or not I am willing to contend with all the negatives that come with medical school education and medical practice (Medicare RVU's killing primary care [I really want to work in this field... I really do. But not under current conditions...], defensive medicine, malpractice lawsuits, bureaucratic interference in the patient-physician relationship, stupid HMOs and insurance companies, projected decrease in physician incomes, bad personalities in patients as well as physician co-workers, depressing patient encounters, witnessing social injustice, witnessing apathy, hell - witnessing the dark side of human nature, and just plain not being able to practice the kind of medicine you want). Oh and add to that what I perceive to be a really involving/consuming work life (do physician make bad spouses and parents?). Gee, that's a lot to consider there... But then again, there's just no job out there that can compare to what an MD is privileged to do and the perks they receive (personal and monetary).

Oh, by the way, not to brag or anything, but I am blessed to live in a state where public medical school tuition is on the order of 20-30k for the entire ordeal... so I wouldn't have to worry much about debt. Still a big decision, regardless of the monetary investment, don't-ya-think?

Best wishes on your journey as you tackle the impossible and come out the victor.

- Stupid Undergraduate Student

Bostonian in NY said...

Premed dude/dudette-

You're making a HUGE decision about 4 years of your life and being as informed as possible could quite possibly save you much of the suffering that I've put myself through. I made the choice in a relative vacuum and I'm spending hours writing posts about being depressed. It's not so much school as the requisite isolation from my family and friends that got to me.

That being said, medical school is nothing like the practice of medicine and if the dems are elected things in medicine will change greatly over the next decade. I don't know if the problems of today will necessarily be the problems of tomorrow. I take the view of medicine as a job and not a way of life, but in my current situation, it's a way of life and a desk job that is taking my money, my life and my soul away from me. Once I'm in the clinic, I'm 200% sure that I'll be a happier person, even if I will be the lowest person on the totem pole and completely useless...atleast I'll be doing something other than reading.

And just to put $20-30k/yr of tuition, my home state school has tuition of $14,000, living frugally on about $20k for a cheap apartment, food, health insurance and a car that's still $34,000 a year that I'm dumping into my education, and considering the 5% annual increase in tuition it would likely be up to $40k by the time I graduated bringing me to a total of about $150k in debt which would end up around $250k in repayment after 20 years...still not a cheap proposition.

Jayhawk said...

Hello Bostonian, Jayhawk here.

This week is better because I am on Spring break. After last week, I need it. I will take this week for attitude adjustment and then a few days to prep for boards. I am a middle aged guy with a wife and kids, so I come to this with perspective from a former life. Don't get me wrong, I DO want to be a doctor, it is just that I don't buy that medical education has to work the way that it does. I know there has to be a better way and the establishment just assumes this is the way it has always been and thus is the way it should continue. Pure stupidity and BS if you ask me. I will say that the system is really cruel and heartless. Maybe one day, as physicians and alumni, we can use our dollars and influence to affect some change. Our school is proud that they have a 30% contribution. That seems ridiculous to me. That means that 70% aren't and I can tell you why they aren't too. Because they feel like they paid their dues and the school didn't do them any favors. Anyhow, just rambling now, but you understand what I am trying to say. Unfortunately, too many docs, graduate and move on and forget about the hell of medical school. So it is up to us to not forget this horror and do anything we can to affect some change, even if it is small. I have already vowed then when I train others, I always do so in a "spirit raising" manner. None of this condescending pimping that is so prevalent. Some people really enjoy making fools of others. Sick. That is all I can say. Other professions wouldn't tolerate this abuse, and I don't think we should either. So remember this time and try and do something about it when you can. If there is enough people fed up with it, then maybe it doesn't have to be hell for those who follow us. Those like our kids and our friends kids. Okay. Enough rambling.

BTW - You are so right about the Dems. I am listening to Hillary ramble on right now about how she is going to FIX medical care. That is really scary. Ugh. I could go on here too.

Anonymous said...

to stupid undergrad:

if you can, read HalfMD and LongRoadtoMedicalSchool blogs.

also, there's a date coming up called Match Day. If you can visit your state med school on Match Day (husbands, wives, parents often go) it might help you.
MAssachusetts 2007

- i'm not a student; i just work here.

Jayhawk said...

So Bostonian, are you a year one or two? Things getting any better?

Bostonian in NY said...

Jayhawk,
I'm a second year as well and my life is pretty much set to craptastic for the next 2 years and 3 months. Sure it's not going to be all horrible, but everywhere I look there's some other soul-crushing endeavor that I have to take on. If it's not some small group problem based learning activity, it's my weekend being shot because I have to study and look at a vagina/some balls for 3 hours on a sunday morning. Or it's an entire year of having people tell me when I have free time to sleep/eat/see my family.

In all seriousness, things are getting worse but I've become so accustomed to it that I've pretty much decided on keeping a status-quo level of emotional involvement. Med school crosses a fine line that makes me uncomfortable, it now intrudes on my personal life. Want to celebrate the birthday of your girlfriend of 6 years...too bad, you have mandatory clinical orientation. Want to celebrate your own birthday, here you get to hold the retractor for an extra 3 hours today oh and you have overnight trauma call! I say great...bring it on. There's a good deal that you blindly accept by signing your name on the dotted line...but it's my fault for signing and I'll suck it up. I didn't want to enjoy my 20's anyway.

Jayhawk said...

Bostonian,

Bro, I feel your pain!!!

Did I mention I even stopped going to class? Yeah, I noticed my grades actually went up when I didn't have all the time wasted crap to do like drive time to school, downtime between classes, talkative classmates, etc. I live a good 40 miles from the school and since we are a systems based school we are finished with anatomy, micro, and histo for the the year. All of the lectures are online, so I just listen at my convenience. Half the instructors read their notes anyway and I can do that at home at twice the speed. The other half of the instructors go way too fast to follow and by listening online I can stop it when I get lost and regroup. Because we are systems based and anatomy, histo, and micro labs are finished for the year, I fortunately don't have as many REQUIRED attendance events. I dare say that this has made things a bit more tolerable. At least temporarily for the next month or two. Anyway, hang in there.

I will never understand how the bastards really expect anyone to learn this way. There has go to be a better way. I've got friends at other med schools also and it is the same shitty thing there too.

Jayhawk said...

Bostonian, Jayhawk here again. So when do you take boards? I finish up regular academic coursework the next couple of weeks. I even CELEBRATED my final path lecture this week. I never thought this crap would end. After this, we have three weeks of integrative lectures that are supposed to sum up the last two years of lectures. Yeah, right. It is kind of their idea of a board prep. What is funny is that attendance is optional, so no one actually goes. Everyone just stays home and prepares for boards. So actually it will be nice to only have to study for once without putting up with the obstacle course they call medical school. Anyhow, buddy, I hope it is getting a notch above craptastic.

Bostonian in NY said...

Oh man, I'm about 36 hours away from another pound me in the ass session from Renal path examination. The exam questions are so detail oriented that I've completely lost the forest for the angles of the carbon-carbon bonds in the dna of a particular tree...I kind of want to gouge my eye out. I take my boards on the 23rd of June after another 6 weeks of class and exams here. I'm literally counting down the days...I put a counter on the front page to remind me of how long I have to sit in the library...something like 80 days.

Anyway congrats on finishing up path, and good luck with your "review"...I'll be suffering through endocrine, derm and occular path while you're slogging through Kaplan...

What's your plan of attack?

I'm going to give myself 3-4 days for every system, and a couple extra for the random stuff that defies categorization (general anatomy, psych, stats...etc) with 1 slow day per week for catch-up/simulated exam/fly-fishing/sanity retaining activities and 50 random Kaplan questions every night before bed. I'm hoping to finish all 3000 questions before the exam but we'll see, my optimism rarely out-paces my laziness.