I Told Them to Take Care of Each Other

This fall I had the privilege of working with a small group of first year medical students at Case Western Reserve University as a “case-based inquiry facilitator.” For two hours every Mon-Weds-Fri morning I coached my students as they read through and analyzed real medical cases. Through my role as a facilitator I helped them to tease out the basic science information and medical facts that they needed to learn about from each case.

There are four things which really stand out as I reflect back on my experience:

1. I had no idea that I would get to know my students as well as I did and care about them as much as I did in such a short period of time.

2. After working with these young adults I have so much hope that our future will be full of brilliant, compassionate, and doctors (and they will be the ones taking care of us as we age!)

3. I learned that I truly love teaching, even when it’s not at a patient’s bedside.

4. I felt really old as it was almost 20 years ago (1999) that I was in their shoes!

Working with my group brought me back to a time when I was "over the moon" enthusiastic about becoming a doctor--when I dedicated every waking moment to studying and learning about medicine--when my attending physicians would actually ask me how I could start out every morning so “perky” and always appear to be so happy to be at the hospital--before I became depressed and burned out and down-trodden. I was given the gift of remembering that I once had their passion and energy and drive!

Although I am still passionate about my field of neonatology and love being able to take care of my patients and their families, a lot of stressful things have happened in my life over the last 20 years! It’s not been unusual for me to question why I became a doctor, bargain for a “normal” life that does not require working nights, weekends, and holidays, and mourn my time away from my kids when they were babies and toddlers. I've contemplated quitting more times than I can count.

Through the years I’ve watched my physician friends and colleagues burn out too. Some have become withdrawn and depressed, some have turned to alcohol to cope, and others have had to leave the field of medicine entirely. It seems that almost everyday there is a new story of a medical trainee or physician in the U.S. committing suicide and I’ve learned that my risk of committing suicide, as a female physician, is close to 1000x higher than the average American middle-aged female.

So at the end of my block of time with my students, I tried to warn them about what was coming (stress, burn out, risk of suicide, etc.) without scaring them too much. My final words to them were a plea that they promise to always take care of each other. I told them that if they are ever worried that one of their former group members is struggling, even if it’s years or decades from now, that they reach out to check in and be there for him or her. I asked them that if they ever find themselves personally struggling with sadness, depression, feelings of hopelessness, etc. that they reach out for help (and that they will always be able to reach out and find me, even years down the road, if they need help!) And I asked them to always remember the time that they shared together this fall, including the excitement and passion and love that they have for medicine at the present time.

And then, like I normally do, I cried. And then I tucked all 8 of my medical students away in my heart forever…