The Existential Crisis of a Second Year Medical Student

As someone who never intended to be a doctor growing up, I struggle with this crossroads at times where I am losing the side of myself I find most precious and dear. I worry about losing the girl who loves creative writing, reading fiction, watching political discussions, and contemplating the philosophical complexities of humanity and how we fit into this strange world.

My interests go far and are certainly not limited to science or medicine. I could have chosen many professions, but of them all, I most preferred becoming a doctor. Perhaps my reasons are the same as others, for the cliché reasons of wanting to help my patients. And I find the functioning of the human body amazing. Studying medicine is useful both in practice and in my own life. Mostly though – I am inspired by the pain of the human condition and how I can play a part in using my knowledge to take that pain away.

I began the second year of medical school feeling confident in my abilities as a student. I excelled academically and knew how to study for exams. Reproduction and Endocrinology Module set me off on a good start for second year and certainly helped for my first rotation in Ob/Gyn. Multisystems Module felt like the academic time to tie up loose ends, build on previous concepts, and reminded me that microbiology is more complicated than I realized. I had a great run and ended up with a distinguished performance award for pre-clerkship didactics. The first year and half of my medical school career were some of the best times of my life. I figured out a routine and thoroughly enjoyed my free time. I stayed close with friends and family and got to spend time in my favorite area (northern Virginia ie home).

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Jessie and I at her wedding!

My last real break this past winter felt like more work. I spent the majority of my time packing my entire apartment into storage amidst construction due to a flooding/molding issue and catching up with friends in the area before heading out to San Diego for rotations. I spent a few days in Sacramento (Andrew’s first trip to California!) for Jessie’s wedding – first time I was a bridesmaid. I learned about how American weddings normally go and got to wear a beautiful dress and take part in their beautiful wedding. Jessie and Andrew (her husband is also named Andrew) had a lovely ceremony and amazing New Year’s wedding party.

USUHS is unique in that we go out on rotations halfway through our second year of medical school and postpone Step 1 exams until after our “clerkship” rotations (Ob/Gyn, Surgery, Pediatrics, Family Medicine, Internal Medicine, Psychiatry, and an elective). 3.5 months in San Diego for Ob/Gyn and Surgery was the longest time I have been away from Virginia.

The first few weeks of Ob/Gyn, I was insanely enthusiastic and enjoying learning. As the days continued, I began feeling the enthusiasm wane a little as my days consistently dragged longer, as I was missing home, as I felt like I was never good enough. Being a medical student at a teaching hospital is being at the bottom of the totem pole. Some doctors want to help you climb up and others will stand on you and ignore you. Ob/Gyn in San Diego consisted of 5 weeks: complicated obstetrics, labor and delivery, reproductive endocrinology and infertility, gynecology, and oncology. I loved getting a taste of everything, but it was exhausting switching teams weekly. As soon as I felt comfortable, I had to start all over. The program director was amazing and the experience was great to start out with as Ob/Gyn exposed us to the wards, surgery, and clinic.

The next 10 weeks were surgical rotations: cardiothoracic surgery (I held a heart – it was cool), ENT (great life experience), and general surgery. My existential crisis pretty much compounded itself during surgery when I began questioning whether I fit into medicine as a culture. I enjoyed my weekend trauma shifts, met inspiring people, and did awesome things in the OR. Something just didn’t click though.

During my time in San Diego, a beautiful friend of mine from college took her life. I think about her in waves of mixed emotions, and sometimes I find myself falling apart at the thought of the world losing such a lovely person. It got me questioning the purpose of life and what I want to get out of it. San Diego represented this new phase in my life where I no longer felt confident in who I was as a person anymore. I survived because of the beautiful weather, my amazing USUHS classmates, and my mom.

On days I question why I wanted to become a doctor, I try to remember what brought me to this moment. When I feel like a failure, or feel exhausted, or wish I did something else with my life, I try to think about the superficial struggles in life that tear us apart. The little things keep us going, but the little things are also enough to break us down.

I define myself by my academics, life choices, dedication, compassion, need to learn, and by my desire to change the world. I want to be a writer, but I don’t know how to write anymore. I want to be a doctor, but I am only beginning to understand what that entails. I want to stand out, yet I find myself hiding as if I am ashamed of being caught, of people thinking that I do not belong in this field because I question it. Is it bad to not love anything enough to want to do it for more than 12 hours a day every day? Is it bad to say that by throwing myself into one facet of my being, I feel like I am losing the rest of who I am? I try to take a deep breath at the end of each day – both the good and the bad – to reflect and remind myself that I am in a microcosm of medicine that is but a small piece of my career and future. I may not be the philosopher or writer I once hoped I would become, but I cannot lose the humanities side of myself and part of me that is so deeply engrained to love my patient more than I love medicine.

I might not enjoy new uncomfortable situations, but I constantly find myself doing things I never planned to. I sometimes think I crave challenges just to prove to myself that I am capable. That probably factored into my choice of commissioning into the Air Force (one of the best life decisions I have ever made). The military forces me to experience the world in ways I never would have otherwise.

Anyway, the existential life crisis continues. Throughout medical school, I assumed I would pursue psychiatry, but I am definitely considering pediatrics. I beyond LOVED my pediatrics rotation at Walter Reed, and it reinstated my faith in medicine. For the first time throughout my rotations, the faculty and patients made me feel like I belonged in medicine, which is a beautiful thing. I had never picked a baby up before nor changed diapers, and now I am pretty much pro at both (nursery week was my favorite). It is funny to think back at the cardiothoracic surgeon attending who kept calling me a pediatrician, because he said I was “too nice to be a surgeon.” Pediatricians definitely won the prize for most friendly field thus far.

So that brings me to now – I am currently in Omaha, Nebraska during this transition to being a third year medical student. Family medicine has been treating me well, and I love being with the Air Force. As opposed to the San Diego experience where I questioned if I should be in medicine at all, Omaha is giving me time to figure out how and where I fit in because the options are endless.

Pretty sure existential crises are healthy parts of introspective awareness. I have been doing way too much thinking this past year and could not figure out how to get it into words, so I appreciate anyone who took the time to read my stream of consciousness written on a late Sunday night.

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From Montgomery to Nashville to USU Orientation

As a COT-graduate, I had been entirely too sleep deprived. Right after the graduation festivities on Friday, everything still felt rushed with the campus bustling and people all over Morehouse Hall exchanging goodbyes and luggage. Andrew and my dad helped me pack my belongings into my dad’s car (well, the car that said “Distinguished Visitor” on the license plate – I learned from one of the administrators that the Air Force views SES as equivalent to 3-Star Generals and the Army generally views them as the civilian equivalent to 2-Star Generals. Makes me proud!). 

I had the opportunity to show my dad and Andrew downtown Montgomery when we grabbed lunch in The Alley near the Riverwalk. I scarfed down a bacon cheeseburger like nobody’s business. My dad bought wine, and we celebrated my accomplishments/survival. I mostly celebrated the ability to see my family and go home and sleep (you’ll notice this theme of SLEEP will come up frequently). After lunch, we picked up Charlie (my 2006 Honda Accord) from the shop with her new battery. McGriff’s Auto Shop proved to be a great spot right next to Maxwell AFB (suggestions for future COT-goers who have their batteries die…I heard of a number of individuals with this problem, probably because we had to leave our cars unattended for a few weeks). Beware of politics if you mention you’re in the Air Force though. The guy working at the auto shop certainly had his opinions about “Barack Obama negotiating with terrorists” and I prefer to steer clear of such conversations with strangers, namely to avoid political affiliations with the military. Remember: whoever the President is, he/she is your Commander in Chief!

Once we got back to base (I’m beginning to rock the car salute), we all decided to take a power nap in the Fairchild suite my dad and Andrew were staying at. Originally, Andrew and I planned on driving to Nashville after dinner as a pit-stop on the way home – we both have friends in Nashville and have never been to Tennessee. However, this power nap turned into a 4+ hour affair. Neither my dad nor Andrew wanted to wake me up, and I am grateful they didn’t! After waking up, showering, and having a cup of coffee, I was finally ready for dinner. At this point, it was sometime after 9pm, and we set out back to The Alley. My dad and Andrew were both very impressed by Montgomery, and I attribute that to my tour guide skills of downtown. Enjoyed some Mexican food, some margaritas, and some good old-fashioned conversation.

Blurry photo of Andrew at El Barrio in Birmingham, Alabama

Blurry photo of Andrew at El Barrio in Birmingham, Alabama

My dad’s flight went out Saturday morning, and Andrew and I headed for Nashville a couple hours after. Because of traffic, our 4-hour drive turned into an 8-hour drive (somehow there were 4 accidents on the one highway we were taking). We managed a pit-stop in Birmingham, Alabama, and to the suggestion of my Alabammer flight mate, we went to El Barrio, a fantastic Mexican food place in the downtown area that had A+ breakfast burritos. Very cool ambiance. Several hours later, we made it to Nashville! Andrew treated me to the Marriott with a view of Vanderbilt Stadium. 

View from our hotel room

View from our hotel room

Soon after, Ben – a William and Mary friend who I knew through Project Phoenix (a tutoring/mentoring organization), APO (a community service organization), and math/science classes, currently getting his education degree at Vanderbilt – picked us up for a driving tour of Nashville and dinner at Five Points Pizza. If I was a Yelper, I would have given fabulous ratings. I never realized what a small city Nashville was, and it has so much Southern character. After dinner, the three of us went to Andrew’s friend’s place. His friend is managing a band in Nashville, a great city to kick start a music career. His friend, also named Andrew, took us bar hopping and gave us a variety of scenes – from underground bars to Broadway street. Music was everywhere. The streets were absolutely packed. I have never seen so many bachelorette parties in one location! 

Broadway Street in Nashville, Tennessee

Broadway Street in Nashville, Tennessee

After our half-day in Nashville, Andrew and I had to make the drive back home Sunday morning, which was really painful due to traffic and poor pit-stop experiences, including a gas pump in Knoxville that kept going after my tank was full, resulting in gas spilling over onto my feet. Eating at Cracker Barrel eased our hanger – don’t judge, I’m a huge Cracker Barrel fan.

Once we made it back to Northern Virginia, I had this brief existential moment when I realized I had changed. COT definitely had a greater impact on me than I expected. I have this huge appreciation for being home as well as being with the individuals I care about. I also appreciate time to sleep (which I should hold dear to my heart before medical school really picks up). It’s time to prioritize what I value most in life. Spend less time on the things that don’t matter and more time on the things that do. I’ll try to maintain the school-life balance to the best of my ability, but I want to be a qualified physician and will do what it takes to get there. Wish me luck 🙂

I have been attending USU orientation for the past three weeks, the first two designated for Military/Brigade Orientation and the latter week for Academic Orientation. Military Orientation was a little like COT 2.0 with more direction and without the screaming. We had some lectures relevant to the military and mostly filled out paperwork and completed online training programs. Orientation provided ample free time to get life in order. It was a fabulous time to catch up on my social quota with friends and family in the area and to catch up on much-needed sleep. Academic Orientation this past week introduced us to the USUHS curriculum, mostly focusing on the pre-clerkship period in the next year and a half. We had a lecture for our first module, Fundamentals, which basically provides a foundation for the rest of the modules and is Pass/Fail (no honors, unlike the other modules).

I’ve been spending lots of time with my fellow USUHS Bravos and the one amazing USUHS Alpha (I’m clearly still in COT-speak. We have been staying in touch with our fellow Bravos – a few of us went out to U Street when a Bravo from Philly visited last weekend. And our flight commander sent us a final Bravo Bombers morale memo to motivate us for the next stage of our careers). All in all, my classmates seem awesome. Everybody is friendly and always willing to help each other out. Faculty members thus far seem fabulous, both engaging and caring for their students. I am a balance between excited and terrified to embark on the next stage of the journey. Somehow I am already swamped with readings, an essay, online quizzes, and a massive to-do list. First day of medical school is tomorrow! Although I feel quite unqualified, I see my first patient this week and am doing a home visit with a classmate on Wednesday. And so it begins. Ready, set, gooooo!

Happy Belated Memorial Day

I had the well-timed opportunity to get a tour of Walter Reed National Military Medical Center on Memorial Day. It felt quite patriotic! An Army child psychiatrist in his fourth year residency at Walter Reed showed Andrew and me all around the hospital and the campus (which is why networking at conferences is a big win). The hospital is amazing – albeit quite confusing to navigate. Afterwards, I got to show Andrew my soon-to-be USU academic buildings.

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On a similar note (I wish I had posted about this earlier), I had also recently toured the Pentagon for my father’s promotion ceremony to SES (Senior Executive Service) in the Department of Defense. It was the first time I have been to the Pentagon since 9/11. I met a couple generals, some of my father’s friendly colleagues, as well as the Assistant Secretary of the Army (for Financial Management and Comptroller). Quite the surreal experience. Our tour guide gave the family great insight into the history of the Pentagon, and the September 11 Memorial was really well-done.

With father and brother at Air Force Art Gallery for my father's promotion ceremony to SES

With father and brother at Air Force Art Gallery in the Pentagon for my father’s SES promotion ceremony

Logistics

I frequently get asked how my military life plan works, so I want to clear up confusion from the start:

– 4 years of medical school at Uniformed Services University in Bethesda, Maryland (you can also opt for the HPSP scholarship and go to a civilian school, but I preferred USU)

  • 1.5 years classroom followed by 2.5 years of rotations nationally and internationally at military hospitals for all the branches. School is year-round.

– 4(+) years of residency

  • I am currently leaning toward psychiatry, but 65% of matriculating medical students change their mind by the end of medical school. If I do psychiatry in the Air Force, I will likely end up in San Antonio, Texas or Dayton, Ohio for my 4-year residency.
  • I could also squeeze in a General Medical Officer (GMO) tour before residency. The civilian equivalent is a general practitioner. Very common for Navy, but I do not anticipate doing it myself.

– 7(+) years of active duty service

  • Do my time as a military medical doctor. Will get deployed from time to time, but usually assigned to military bases in the U.S. unless I choose to be abroad.
  • If I serve for 20 years of active duty, I can retire in my forties!

– 6(+) years of reserve

All throughout, I do not have to worry about tuition or fees, insurance or malpractice, and I am a paid military officer. Wins all around.