This piece originally appeared in the Baylor College of Medicine medical student blog, Progress Notes, on June 19, 2018.
I vividly recall my first preceptorship experience at a community health clinic and my second patient, Ms. H. At the start of our conversation, to my surprise, she did not hesitate in sharing with me her entire psychiatric history, including past suicide attempts and newer sentiments of worthlessness after several romantic relationships had failed and overdue maintenance bills had accumulated.
Blind-sighted by both her level of trust in me and my unfortunate degree of inexperience at the time, I replied with the only thought I could muster in that moment: “…but you came here today, and we are so glad that you did.”
One of Ms. H’s comments stood out to me. She told me that she woke up every morning to first put on makeup and feel beautiful, and then to continue her quest to forge deeper relationships with others.
Towards the end of the encounter, my preceptor asked me why we could be reassured that Ms. H was not in danger of harming herself again (besides her diligent adherence to her medication regimen). I described what I had heard Ms. H say about feeling self-confident and motivated to connect with others, and this answer apparently hit the nail on the head.
In light of the culmination of my first year of medical school as well as recent tragedies pertaining to the suicides of beloved celebrities and healthcare practitioners around the country, I wanted to share Ms. H’s story and discuss several valuable lessons that it provokes. Here is my first prescription of advice to incoming students and perhaps seasoned physicians alike. There are unlimited refills, by the way.
While interpersonal relationships are the key to success in medicine at any stage of your career, you must always devote the most time and energy to improving your relationship with yourself.
We are fortunate in medicine that the product of our career success is quite often humanitarian benefit. The physician-patient relationship is, indeed, the most unifying among physicians. It should serve as your internal fuel tank to consistently push yourself beyond yesterday’s boundaries of knowledge and application. It should serve as your beacon of hope when the weight of your textbooks and impending exams feels insurmountable. And it should serve as your moral compass to remain courteous, professional, and humble even when you are only in your own company.
Peer relationships are also vital to thriving in medical school and the rest of your career. They should mirror the purpose of the physician-patient relationship to serve as your moral compass.
Yet, peer relationships are more constant than those we share with patients, so they shape us to a greater extent on a daily basis, most notably when we are not putting our best feet forward.
Moreover, medical school is competitive. Although the success of our peers does not diminish our own success in the long run, the pressurized academic environment can make it very hard not to compare ourselves to one another. You should seek to surround yourself with peers who command your respect based on their work ethic and good nature. It’s an exercise in humility to celebrate their achievements and purposefully view their talent as an incentive to cultivate your own.
Ultimately, the relationship you have with yourself supersedes both the physician-patient relationship and peer relationships. By asserting this, I do not mean that it’s most important to indulge in the moment or expend excess time seeking the elusive ideals of “balance” or “wellness.”
While it’s impossible to remain mentally sharp for every minute of the day, it’s essential to recognize early that physical health and emotional hygiene are, in fact, not subjective at all. For Ms. H, she prioritized feeling beautiful first before seeking the company of others.
For those of us in medicine, exercise, nutrition, sleep, reflection, self-encouragement, and at least one hobby and one friend outside of medicine serve to fuel the body and mind in tangible ways. Each of these is negotiable on any given day, often because medicine finds a way to rearrange our plans. However, each of these is non-negotiable over the years.
Our workday is long, but our years practicing in this profession are short. In the end, we are most capable of caring for others when we assume the best versions of ourselves.