Wednesday, March 30, 2005

if it were easy....

i haven't written in a few days, and it hasn't been because i didn't have anything to write. i guess i've been trying to figure out what topic i'd like to blather on about, without having to resort to writing about the same ol' shit that everyone else is on. thus, there will be no long rant on terri schiavo.

so instead i want to talk about mental health, substance abuse and physicians. i go to a psychiatrist and at our appointment the other day, she gave me a copy of the action report for the california medical board. this was because last time i'd seen her, i'd mentioned i was interested in maybe applying for a student position with the CMA. the one i wanted to do the most had to do with physicians that are addicted to drugs or those with mental illness. i didn't end up applying cuz i ain't got no time, but i was happy that she remembered something i have an interest in.

substance abuse and mental health are a very touchy issue for me, given that i'm going into a field that is ok with these diseases in anyone but the people in the field. i have a strong family history of drug and alcohol abuse on both sides, and have been very afraid for a long time that i'll somehow find myself an addict. thus far, that fear coupled with a very low amount of alcohol dehydrogenase has kept me clean, but i still worry about it plenty. and while i'm seeing a psychiatrist for ADHD, which could reasonably be considered more of a neurological disorder, i still feel weird about admitting i go to the crazy doc and take mind altering drugs every day. i don't keep this info secret, but i do worry that one day that frankness will bite me in the ass.

seeing the action report scared the shit out of me. physicians lose their licenses for DUIs, petty theft, depression-all sorts of stuff that for anyone else would be just a little misstep in life. lots of drug addicts in there, injecting themselves and writing illegal scrips. the list was long.

so how did those poor docs find themselves losing their licenses? my carpool partner wondered how many of them were just bad people, and how many were good people that found themselves in a bad situation? i said i figured most were the latter. i say this because i can totally see how it could happen, especially in the last month or so.

it's apparent that our class isn't doing too well right now. i'm willing to bet 2/3 of us fit the clinical description of depression. i've been pretty sad myself, for a myriad of reasons, but mostly just because of all the stuff i have to do every day. i'm constantly tired, waking up early after staying up late, not studying effectively enough to satisfy my perfectionist psyche. after going to lecture and lab for 8 hours a day, i come home and try to shovel in more material, in hopes that i'll actually get higher than a 71 on this next exam.

it's not that i can't hack stressful situations- i once worked 21 hours without even noticing it and spent 3 years on call 24-7 (EEG techs aren't too plentiful, even in LA). most of the people in my class that i've talked to feel the same way. the problem is that we do all this with so little instant gratification, which our generation has gotten used to. we won't see the results of all our sacrifices for another 3 1/2 years, when we match. until then, we study our asses off to barely pass, doing all sorts of community service and club stuff in our spare time to look better on paper.

this last part is especially true for DO students. as a 4th year recently told us: "why should residency directors pick you when they can pick an MD?" she was trying to tell us that we have to go head first into what we love, and start early. but some took that as proof that we're all destined to settle into primary care, because that's what everyone expects of us. that is, unless we find some way to walk on water before match day.

so now we mope. we cry. we tense our shoulders and walk with them hunched over, staring at the ground. we're depressed, and what is to stop us from self-medicating?

nothing, really. we were told in a recent lecture on opiates that medical personnel abuse oxycontin and fentanyl like it's going out of style. the stigma attached to getting help for mental health issues when you're supposed to be a paragon of health causes a lot of us to look to a way of forgetting it all for a little while. we have counseling at school, and they tell us to get help if we feel out of control. they even say that they'll get us into treatment for addiction if we tell them we have a problem, but how many are comfortable risking their education to ask for it?

we're supposed to just suck it up, right?

it all comes back to that stupid cliche we've seen over and over on ER: we are expected to be perfect, but we can't live up to it. being at the pinnacle of society, more hardcore than the regular people is why we want to do this job in the first place, but we still hate to find ourselves the victims of our own hubris. i could get into a whole rant on that, but for now i'll just leave it.

in other news, i'm getting braces! the invisalign ones! straight teeth is something to be happy about.


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