A calling

Medical school application season is upon us again – another round of personal statements to read.  They’re all BS. (Fine – 95% of them are).

You have the students who were inspired to become a physician by some patient while they were volunteering at the hospital.  Mind you, they were probably volunteering at the hospital in hopes of getting into med school (an unspoken requirement).  So which one came first?  Probably the latter.

Then you have the students who have family members who were sick and that’s why they want to become doctors.  I’ll buy that – sort of.  Everyone gets sick at some point.  But as a patient or relative of a patient, you don’t actually get to see what a physician does all day.  Usually it’s the nurse who takes care of you directly.  Plus, you’re not allowed to treat your family/friends.  But maybe it’s out of gratefulness and they want to pass it on to others who are ill.  I suspect they don’t get inspired to become nurses. I’ll give them the benefit of the doubt.

The ones who do know what it’s like to become a doctor usually had parents/relatives who were physicians.  They would say their relatives were their role models who inspired them to become doctors, too.   I’m willing to bet some of them are going into med school because their parents want them to.  Or for money/lifestyle.

Despite what they claim in their personal statements, most medical school applicants are probably motivated to pursue this career due to job stability, income, lifestyle, social status, etc.  Why else would they suddenly have a strong interest in dermatology or radiology?  Don’t get me wrong – I think they are perfectly legitimate reasons to go into medicine.  It is okay for it to be just a job – a means for living.

A very tiny group of applicants say they want to go into medicine because it’s a calling.  That they want to do God’s work and serve the needy.  This one is always hard for me to wrap my head around.  Maybe because I’m not a religious person.  But for some reason, out of all the applicants, they are the ones I am most inclined to believe.  Here’s why:

The Merriam-Webster defines calling as “a strong inner impulse toward a particular course of action especially when accompanied by conviction of divine influence”.

The fact of the matter is people have external motivations to go into medicine.  For those who truly believe medicine is a calling (from the religious type of applicant), that motivation is a higher being.  I respect them for it.  They recognize that it may not always be an easy, happy path, but they do it anyway.  But most of all, if they are as devout as they say, they aren’t lying like the other applicants.  It’s silly – we don’t lie about reasons to go into other professions such as business or law.  Yet in our personal statements for medical school, we have to say that we are going into medicine for some altruistic or inspirational reason.  Or else you’re a monster.  I just want to lay it out there.  You can become a doctor for whatever reason you want.  Just do good for your patients.


Celebrity suicides

We always wonder “Why?” when people die from suicide.

Usually the person in question is someone we know.  Someone we care about.  We wish to know why because we wonder if we could have prevented it.  Celebrity deaths feel different though.  Thousands upon thousands of people want to know why, even though few knew them personally.  It’s more out of curiosity.

I feel bad for the families of celebrities.  The media zones in on their grief.  Speculate on the reasons.  Create gossip to fill the tabloids.  I wish they would let the family members have some privacy.  Let them share when they are ready.

Treating hypomania

I know I talked a lot about hypomania in the last post, but this topic has still been swirling around in my head lately.  And here’s the reason:

I’ve had both manic and hypomanic episodes in the past.  Obviously we all agree that mania is destructive/disruptive to one’s functioning and ought to be treated.  However, I am not totally convinced that hypomania must always be treated.  I think a lot of my medical colleagues would disagree with me, but they also haven’t experienced multiple hypomanic episodes, some of which improved my life rather than worsening it.

The fact of the matter is in the natural course of illness (at least for bipolar 1 folks), hypomanic episodes usually continue on to mania, or lead to a downswing towards depression.  And I agree if you want to be totally safe and have the best chance of preventing the negative consequences, adjusting medications or practicing good habits such as maintaining normal sleep schedules is the way to go.

But what if hypomania makes me productive and happy?  Why would I want to give that up?  I could be part of that special group of people who just have isolated, “good” hypomanic episodes without crossing the line to more severe, undesirable ones.  Nothing bad will ever happen to me, right?  Then you have to argue with the docs that you’re not grandiose…

I like to think that I can tell when I’m becoming manic and will get help then (except I don’t, not always at least).  I don’t like medication.  Many of them give me side effects.  But I recognize I have to stay on them and get my regimen adjusted if I become manic or depressed.  I just wish doctors don’t insist on treating every single hypomanic episode like it’s some terrible, dangerous thing that must be squashed immediately.  Of course, not all physicians think that way, and my former therapist was very kind and let me go on a little bit before giving me a stern order to call my psychiatrist.  Anyway, I’ve got to stop here before I write an entire book on this topic!

Hypomanic? or just happy?

I always have a hard time with this.

Each spring, I come out of my winter blues.  My slump.  My mood brightens.  I have more energy.  I don’t feel like I need to sleep 12hrs a day.  I am more social and do my favorite activities again.  I just feel good again…about everything, including me.

So what’s the big deal then?  Well, if you read that last paragraph, if all of it were in excess or abnormally heightened, it would cover many of the symptoms of hypomania/mania.

This is where I get frustrated.  Who defines normal vs hypomania?  What I’m feeling right now could be my normal baseline – euthymic.  But how far up do I need to go, or maybe how intense do these things have to get before some doctor calls me hypomanic?  It’s not really fair when my psychiatrist sees me once every 3-4 months.  They don’t know my baseline.  And by definition, hypomania should not result in functional impairment (whereas mania does).  In my opinion, all I can say is I’m not depressed anymore.

In any case, I don’t think I care which I am right now.  I am just happy that I feel good again.


One year later…

I can’t believe it’s been one year since I started this blog.  (Thanks WordPress for the reminder!)

The first thought that came to mind was whether I accomplished what I wanted out of this blog so far.  I think the answer is yes.  (Okay maybe I didn’t quite hit one post per week, but I did manage >40 posts this year.)  I used it more like a diary to jot down things that were on my mind.  It’s kind of refreshing to be able to reveal my deepest feelings – the ones I can’t seem to tell my friends or doctors – while staying private at the same time.  There’s always that tiny voice in my head that’s paranoid someone will figure out who I am in real life, but then I remember I’m not that important.  Not that special.

Oh well.  Overall, it’s been an okay year for me.  Not the best, but not the worst.  I’ll try my best to keep going.  And thanks to all the people who drop by my blog from time to time!




What do I want to be when I grow up?

That’s what my advisor jokingly asked me the other day.

“I don’t know.”  That’s right – I still don’t know.

It amazes some of my friends that I am nearly 30 and still don’t know what I want to do for the rest of my life.  Many of them have gotten married, had kids, and have been at their current jobs/career for >5 years.  Most of us medical students are single, definitely have no time for kids, and have been in school forever still trying to decide what kind of doctor we want to be.

It’s like we’re developmentally delayed.  Like we aren’t real adults.  But we’ll catch up… someday.