Depression and hospitalizations

[sartorious]

This is, very briefly, my story.

I went to a very competitive undergraduate school. I was depressed as an undergraduate, hospitalized more than once, and had to withdraw.

I finished with a 3.5 cumulative (surprisingly) and a 2.9 math/science.

I did all my pre-meds as a post bacc (including re-doing a few terms of this and that), and got a 3.8. I got a 37 on the MCAT.

I was honest about the depression and the hospitalizations. It didn't keep me from getting into a good med school.

That's all, really. Of course there many details, and everyone is unique. I just wanted to offer my experience if it's any comfort to anyone (particularly those trying to figure out how to address hospitalizations, mental illness, and time off in their essays).

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[Law2Doc]

This is, very briefly, my story.

I went to a very competitive undergraduate school. I was depressed as an undergraduate, hospitalized more than once, and had to withdraw.

I finished with a 3.5 cumulative (surprisingly) and a 2.9 math/science.

I did all my pre-meds as a post bacc (including re-doing a few terms of this and that), and got a 3.8. I got a 37 on the MCAT.

I was honest about the depression and the hospitalizations. It didn't keep me from getting into a good med school.

That's all, really. Of course there many details, and everyone is unique. I just wanted to offer my experience if it's any comfort to anyone (particularly those trying to figure out how to address hospitalizations, mental illness, and time off in their essays).

Congrats, and good luck. But bear in mind that "getting in" isn't really the endgame. Many people succomb to depression (and lots of related substance abuse) in med school. Some would argue that if you already have these tendencies, med school may not necessarilly be the best place to be. I had a prof who certainly did. Make sure you have a really good support system.

 

[sartorious]

Hello. it has been several years since my original post above and I wanted to add an update.

I graduated from medical school this past May after four years. I received a pretty well known graduation award (which will remain unnamed for the sake of my anonymity). I started my residency in internal medicine a month or two ago. So far I'm very happy with my choice of program, though of course being an intern, and a new one at that, is no walk in the park.

I am proud of my accomplishments both as an individual, and as an individual with depression, which I consider a chronic (or at least, relapsing remitting) condition in my case so far.

While I was a med student I saw my psychiatrist twice every week, except during my surgery rotation where we went down to once a week. I had my good times and my rough times in med school, in college, in life... I expect that pattern to continue. The best advice I ever got was from an attending I hardly knew and have never seen since. She said, "sometimes, when you think you can't go on, you just have to push yourself a little harder and you will find you can do more than you thought." It's true. Have faith in yourself, even when others may not.

 

[deleted307836]

Congratulations on your success, sartorious! And thanks for the update -- I'm sure many will be glad to see at least one person who has succeeded after being open about mental illness. This issue comes up from time to time on the pre-allopathic board. I'll try to link to this thread the next time it does.

 

[ejw5075]

Congrats

 

[GoldenHorizon]

Hello. it has been several years since my original post above and I wanted to add an update.

I graduated from medical school this past May after four years. I received a pretty well known graduation award (which will remain unnamed for the sake of my anonymity). I started my residency in internal medicine a month or two ago. So far I'm very happy with my choice of program, though of course being an intern, and a new one at that, is no walk in the park.

I am proud of my accomplishments both as an individual, and as an individual with depression, which I consider a chronic (or at least, relapsing remitting) condition in my case so far.

While I was a med student I saw my psychiatrist twice every week, except during my surgery rotation where we went down to once a week. I had my good times and my rough times in med school, in college, in life... I expect that pattern to continue. The best advice I ever got was from an attending I hardly knew and have never seen since. She said, "sometimes, when you think you can't go on, you just have to push yourself a little harder and you will find you can do more than you thought." It's true. Have faith in yourself, even when others may not.

It is no coincidence that I found this post. I struggle with anxiety and depression, yet am unmedicated and not seeing a psych. However, I have been inspired to continue my own endeavors to study and eventually practice medicine when I decided that I would not let a chemical imbalance hinder my plans to enter into medical school. I hope I will be posting a similar success story to people on SDN who are going through this as well This kind of thing makes me proud

 

[roaringtiger]

It is no coincidence that I found this post. I struggle with anxiety and depression, yet am unmedicated and not seeing a psych. However, I have been inspired to continue my own endeavors to study and eventually practice medicine when I decided that I would not let a chemical imbalance hinder my plans to enter into medical school. I hope I will be posting a similar success story to people on SDN who are going through this as well This kind of thing makes me proud

Is having anxiety/ depression a hindrance to getting into medical school? I would think it would be a motivating factor and adcoms would look at it favourobly?

 

[PSYCHDR40]

Awesome, thanks for sharing!

 

[wholeheartedly]

I think this is a great post and thanks for the update. Congrats on your success!

I think the most important thing when dealing with something like this is to be honest with yourself about how it's affecting you and your life, and how it could influence patient care. Then be proactive addressing it.

The people who seem to get into the most trouble are the one's who try to pretend there isn't a problem when there is one. It seems like a lot of people in medicine think they need to be emotionally tougher than everyone else and deal with this stuff on their own due to stigma or bravado. The OP took initiative and sought help which is great. I haven't been through the medical training process but I get the impression a lot of people in medicine could benefit from having someone to just vent frustrations to without fear of being judged.

For people that do deal with these issues please do like the OP and talk to someone.

 

[wholeheartedly]

Is having anxiety/ depression a hindrance to getting into medical school? I would think it would be a motivating factor and adcoms would look at it favourobly?

There seems to still be a lot of stigma with mental health issues like anxiety and depression in the medical field.

Anxiety can be beneficial to a point. Studies have shown that as a motivational or performance factor it looks sort of like a bell curve, with anxiety on the x-axis and performance on the y-axis. Too little anxiety and you aren't motivated at all, too much and you become overwhelmed and paralyzed by it. A moderate amount is best for peak performance.


I doubt depression would be looked on favorably by most. People who suffer from depression lose interest in things they used to enjoy and have difficulty focusing. I think medical students and doctors have much higher rates of suicide than the general population so putting an already at risk group into an academic or career path that seems to increase risk further probably isn't something adcoms want to do.

I'm sure there could be ways to put a positive spin on it if it's something they have overcome/successfully managed and gained good insight from, but it would be a challenge.

I don't agree that it's always a negative though, the OP is a good example. I bet he (she?)'s learned a lot of useful tools that can benefit others based on personal experience.

 

[sartorious]

Hello,

It has been several years again. I haven't been to SDN now in a few years (since maybe my intern year?). But I checked my gmail and behold my old username/password was there.

For anyone who's interested, here's an update:

Residency was hard, though mine was a benign program overall. I had more than a handful of days when I regretted ever going into medicine, wished I could quit, contemplated different ways of getting out (or switching to radiology??), felt dangerously close to a public meltdown... But that's just me. I knew it would pass. At no point did I seriously contemplate suicide, which may sound like a dubious accomplishment, but to me is an sign of clear progress.

I finished my residency in June and am now working as a hospitalist. 3 nights a week and making mid 200k's, living in a city... Enjoying having time to talk to my patients for the first time in a long time... Enjoying having the time and money to dress up and go out and laugh with my friends and feel attractive rather than spending all my time in garbage-bag scrubs and a white coat covered with dirt/blood and what I hope are coffee stains. I am appreciating this phase of my life while it lasts. I'm still prone to the "what's the point of it all" blues and general (shocking!) lack of discipline when left to my own devices... Prozac helps. So do my friends. I'm happier and more relaxed than I've been in a long time.

I know there are people out there similar to me in various stages of training / despair What can I say? I guess the same thing I say to myself periodically: Don't be so hard on yourself, you are better than you think.

 

[TactFR44]

Hello,

It has been several years again I haven't been to SDN now in a few years (since maybe my intern year?). But I checked my gmail and behold my old username/password was there.

For anyone who's interested, here's an update:

Residency was hard, though mine was a benign program overall. I had more than a handful of days when I regretted ever going into medicine, wished I could quit, contemplated different ways of getting out (or switching to radiology??), felt dangerously close to a public meltdown... But that's just me. I knew it would pass. At no point did I seriously contemplate suicide, which may sound like a dubious accomplishment, but to me is an sign of clear progress.

I finished my residency in June and am now working as a hospitalist. 3 nights a week and making mid 200k's, living in a city, enjoying having time to talk to my patients for the first time in a long time, enjoying still being pretty enough to turn heads when I go out (and having the time & money to go out). I am appreciating this phase of my life while it lasts. I'm still prone to the "what's the point of it all" blues and general (shocking!) lack of discipline when left to my own devices... Prozac helps. So do my friends I'm happier and more relaxed than I've been in a long time.

I know there are people out there similar to me in various stages of training / despair What can I say? I guess the same thing I say to myself periodically: Don't be so hard on yourself, you are better than you think.

These are the kinds of stories that more students should know about. You are definitely not alone my friend and your post really hit home for me. I hope that I can one day share the same success that you have earned. Anxiety and depression are a tough cookie that people who have no experienced them tend to not really understand the complexities of what it can do to an individual.Glad to read this into my long night of MCAT studying. Hope the best of luck to you in your future endeavors in medicine.

 

[crazy87]

Hello,

It has been several years again. I haven't been to SDN now in a few years (since maybe my intern year?). But I checked my gmail and behold my old username/password was there.

For anyone who's interested, here's an update:

Residency was hard, though mine was a benign program overall. I had more than a handful of days when I regretted ever going into medicine, wished I could quit, contemplated different ways of getting out (or switching to radiology??), felt dangerously close to a public meltdown... But that's just me. I knew it would pass. At no point did I seriously contemplate suicide, which may sound like a dubious accomplishment, but to me is an sign of clear progress.

I finished my residency in June and am now working as a hospitalist. 3 nights a week and making mid 200k's, living in a city... Enjoying having time to talk to my patients for the first time in a long time... Enjoying having the time and money to dress up and go out and laugh with my friends and feel attractive rather than spending all my time in garbage-bag scrubs and a white coat covered with dirt/blood and what I hope are coffee stains. I am appreciating this phase of my life while it lasts. I'm still prone to the "what's the point of it all" blues and general (shocking!) lack of discipline when left to my own devices... Prozac helps. So do my friends. I'm happier and more relaxed than I've been in a long time.

I know there are people out there similar to me in various stages of training / despair What can I say? I guess the same thing I say to myself periodically: Don't be so hard on yourself, you are better than you think.

Thank you for sharing your story over the years. It is inspiring, and I know that many pre meds and those in medical training struggle with depression/anxiety just like a large percentage of the U.S. population. I think your words will serve as a great example and hope for those of us in need of some.

 

[Elscy]

Thank your for sharing your story. Mental health played a large factor in my decision not to go into medicine via the traditional route. Your story gives my hope that I can succeed.

 

[Law2Doc]

Hello,

It has been several years again. I haven't been to SDN now in a few years (since maybe my intern year?). But I checked my gmail and behold my old username/password was there.

For anyone who's interested, here's an update:

Residency was hard, though mine was a benign program overall. I had more than a handful of days when I regretted ever going into medicine, wished I could quit, contemplated different ways of getting out (or switching to radiology??), felt dangerously close to a public meltdown... But that's just me. I knew it would pass. At no point did I seriously contemplate suicide, which may sound like a dubious accomplishment, but to me is an sign of clear progress.

I finished my residency in June and am now working as a hospitalist. 3 nights a week and making mid 200k's, living in a city... Enjoying having time to talk to my patients for the first time in a long time... Enjoying having the time and money to dress up and go out and laugh with my friends and feel attractive rather than spending all my time in garbage-bag scrubs and a white coat covered with dirt/blood and what I hope are coffee stains. I am appreciating this phase of my life while it lasts. I'm still prone to the "what's the point of it all" blues and general (shocking!) lack of discipline when left to my own devices... Prozac helps. So do my friends. I'm happier and more relaxed than I've been in a long time.

I know there are people out there similar to me in various stages of training / despair What can I say? I guess the same thing I say to myself periodically: Don't be so hard on yourself, you are better than you think.

Congrats on your great accomplishment. However I want to reiterate my initial word of caution to others from back when this thread was started. Sartorius showed what is possible, but that doesn't mean that for everyone it is wise. This is a path where you will be isolated, sleep deprived and physically and emotionally pushed. Make sure you are mentally in a very good place before you start. For every person like the OP, you can bet there are stories of people with not such happy results. Ive seen some. Make sure you really know what you are getting into and that you aren't biting off more than you can handle.

 

[Goro]

100% concur with my learned colleague. Medical school is a crucible, and I've seen it break healthy students. All should approach this with eyes wide open.

Congrats on your great accomplishment. However I want to reiterate my initial word of caution to others from back when this thread was started. Sartorius showed what is possible, but that doesn't mean that for everyone it is wise. This is a path where you will be isolated, sleep deprived and physically and emotionally pushed. Make sure you are mentally in a very good place before you start. For every person like the OP, you can bet there are stories of people with not such happy results. Ive seen some. Make sure you really know what you are getting into and that you aren't biting off more than you can handle.

 

[Apoplexy__]

I love this thread.

That's all.

 

[crazy87]

I have recently looked into mental health treatment and its effects on medical licensing. It looks like some states just ask "do you have a condition (mental or physical) that will prevent you from performing your duties?" But other states specifically ask about any mental health treatment (depression, anxiety, ADD...). Also, apparently hospitals can ask these questions too when you're applying for privileges. I am a pre med so I am just getting this info online. Some of the things in this thread are worth a read: http://forums.studentdoctor.net/threads/physicians-with-mental-illness.481898/

 

[KPZ]

I have recently looked into mental health treatment and its effects on medical licensing. It looks like some states just ask "do you have a condition (mental or physical) that will prevent you from performing your duties?" But other states specifically ask about any mental health treatment (depression, anxiety, ADD...). Also, apparently hospitals can ask these questions too when you're applying for privileges. I am a pre med so I am just getting this info online. Some of the things in this thread are worth a read: http://forums.studentdoctor.net/threads/physicians-with-mental-illness.481898/

Do they do any follow up to validate this? I mean, I would think that you could just say no. Certainly you don't want to be dishonest, but it seems like it's really none of their business and borderline unethical for them to even ask. There is no requirement for mental health disclosure in other jobs other than the military and it's illegal to discriminate based on medical history anyway... Basically it comes down to whether or not you can perform your responsibilities, not what you're struggling with behind the scenes.

Hello,

It has been several years again. I haven't been to SDN now in a few years (since maybe my intern year?). But I checked my gmail and behold my old username/password was there.

For anyone who's interested, here's an update:

Residency was hard, though mine was a benign program overall. I had more than a handful of days when I regretted ever going into medicine, wished I could quit, contemplated different ways of getting out (or switching to radiology??), felt dangerously close to a public meltdown... But that's just me. I knew it would pass. At no point did I seriously contemplate suicide, which may sound like a dubious accomplishment, but to me is an sign of clear progress.

I finished my residency in June and am now working as a hospitalist. 3 nights a week and making mid 200k's, living in a city... Enjoying having time to talk to my patients for the first time in a long time... Enjoying having the time and money to dress up and go out and laugh with my friends and feel attractive rather than spending all my time in garbage-bag scrubs and a white coat covered with dirt/blood and what I hope are coffee stains. I am appreciating this phase of my life while it lasts. I'm still prone to the "what's the point of it all" blues and general (shocking!) lack of discipline when left to my own devices... Prozac helps. So do my friends. I'm happier and more relaxed than I've been in a long time.

I know there are people out there similar to me in various stages of training / despair What can I say? I guess the same thing I say to myself periodically: Don't be so hard on yourself, you are better than you think.

Thank you so much for sharing your story. Getting through depression is really all about perseverance, and it's great to hear stories like this! Keep us posted!!

 

[crazy87]

Do they do any follow up to validate this? I mean, I would think that you could just say no. Certainly you don't want to be dishonest, but it seems like it's really none of their business and borderline unethical for them to even ask. There is no requirement for mental health disclosure in other jobs other than the military and it's illegal to discriminate based on medical history anyway... Basically it comes down to whether or not you can perform your responsibilities, not what you're struggling with behind the scenes.

If they asked if the physician had any conditions that would put a patient at RISK then most everyone who's been treated for common things like depression, ADHD, anxiety could definitely say no, i think. But if they (the State) asks more specifically "have you ever or in the last 10 years been treated for any psychiatric condition" I think the person would have to answer truthfully or risk their whole career by lying. unfortunately from reading online it seems they can and do ask questions like this depending on the state. Then once you answer "yes" you have to send over your medical records and go before the board, blah blah. Guy in the link I included in my other post from Ohio I think had a really horrible experience with this. One of my questions is whether hospitals can also ask this and whether that would have an affect on your licence or just that hospital....

 

[KPZ]

If they asked if the physician had any conditions that would put a patient at RISK then most everyone who's been treated for common things like depression, ADHD, anxiety could definitely say no, i think. But if they (the State) asks more specifically "have you ever or in the last 10 years been treated for any psychiatric condition" I think the person would have to answer truthfully or risk their whole career by lying. unfortunately from reading online it seems they can and do ask questions like this depending on the state. Then once you answer "yes" you have to send over your medical records and go before the board, blah blah. Guy in the link I included in my other post from Ohio I think had a really horrible experience with this. One of my questions is whether hospitals can also ask this and whether that would have an affect on your licence or just that hospital....

Yeah I just read that thread... I can't believe the stigma among health professionals. There's really no excuse for that. Someone shouldn't have to disclose a psychiatric condition unless it is truly a risk such as schizophrenia or borderline personality disorder. Things like anxiety, depression, and even bipolar 2 shouldn't have to be disclosed, putting completely competent and functional physicians in an uphill battle for their career. Mood disorders are frequently misdiagnosed as well, and medical boards should know that, so that's really disconcerting.

 

[ChE04]

Yeah I just read that thread... I can't believe the stigma among health professionals. There's really no excuse for that. Someone shouldn't have to disclose a psychiatric condition unless it is truly a risk such as schizophrenia or borderline personality disorder. Things like anxiety, depression, and even bipolar 2 shouldn't have to be disclosed, putting completely competent and functional physicians in an uphill battle for their career. Mood disorders are frequently misdiagnosed as well, and medical boards should know that, so that's really disconcerting.

I think it's less of a stigma and more of a concern about a person's overall well being. Physicians have one of the highest rates of suicide in any profession. Just like if you have a serious heat condition you probably shouldnt be out running marathons.

 

[KPZ]

I think it's less of a stigma and more of a concern about a person's overall well being. Physicians have one of the highest rates of suicide in any profession. Just like if you have a serious heat condition you probably shouldnt be out running marathons.

Maybe that has something to do with these requirements being a deterrent for seeking help? Do they also ask about sleep disorders or any of the myriad health conditions that are negatively influenced by stress? Are physicians required to report traumatic events throughout their career that may negatively affect their well being or emotional state?

The problem leading to suicide is probably not that too many people being treated for depression are getting licensed. It probably has more to do with the extreme demands of medical students, interns, and residents. A change in curriculum or at least culture would do wonders more than reconsidering (or creating an environment where it is possible to reconsider) a competent individual's licensing due to a bout of depression, former eating disorder, or a bipolar 2 diagnosis, for example.

 

[Law2Doc]

...
The problem leading to suicide is probably not that too many people being treated for depression are getting licensed. It probably has more to do with the extreme demands of medical students, interns, and residents. A change in curriculum or at least culture would do wonders more than reconsidering (or creating an environment where it is possible to reconsider) a competent individual's licensing due to a bout of depression, former eating disorder, or a bipolar 2 diagnosis, for example.

I assure you the extreme demands of schooling and training don't end when you graduate and become a licensed attending/clinician. That's when the liability risks become your own and you become the place where the buck stops. In training you always have a backstop. Your screw ups are team screw ups, not individual failures. Lots of failsafe mechanisms to catch things residents miss. Not so after training. Lots of people see their hours go up after training because they have to double and triple check things to not miss something once there's not another layer of defense. Also in some practices, the new attending bears the lions share of call to "pay his dues" so you still might be spending lots if nights at the hospital. So no, I think a change in curriculum would just let people get further down the rabbit hole, with a greater investment of time and money, and more to lose before hitting them with both barrels. The answer is really to know yourself and what you can handle, and be in a very good and strong mental place before you launch into this career. It's really truly not for everyone, and sometimes things we think we want aren't good for us.

 

[KPZ]

I assure you the extreme demands of schooling and training don't end when you graduate and become a licensed attending/clinician. That's when the liability risks become your own and you become the place where the buck stops. In training you always have a backstop. Your screw ups are team screw ups, not individual failures. Lots of failsafe mechanisms to catch things residents miss. Not so after training. Lots of people see their hours go up after training because they have to double and triple check things to not miss something once there's not another layer of defense. Also in some practices, the new attending bears the lions share of call to "pay his dues" so you still might be spending lots if nights at the hospital. So no, I think a change in curriculum would just let people get further down the rabbit hole, with a greater investment of time and money, and more to lose before hitting them with both barrels. The answer is really to know yourself and what you can handle, and be in a very good and strong mental place before you launch into this career. It's really truly not for everyone, and sometimes things we think we want aren't good for us.

That would be the "culture" aspect I'm referring to...

Additionally, this response doesn't address the other questions raised. You're saying "know what you can handle." A person who has suffered from an illness in the past may know they can handle this. This doesn't illustrate why someone who was previously diagnosed, or misdiagnosed, with a mood disorder would need to report it, and have to answer to it for the rest of their career.

 

[pluto101]

Someone with a disorder that is being successfully managed and is in remission should be allowed to pursue whatever they want, so long as they are aware of the risks of relapse and have both a plan and the resources to deal with any potential relapse.

It doesn't matter what the disorder is.

And yet, for some reason, mental health disorders get far more attention and scorn.

It's insulting to our ability to manage our illness. It's also an indictment of a system which will accommodate other disabilities, but not provide access to mental health counseling.

 

[Law2Doc]

...This doesn't illustrate why someone who was previously diagnosed, or misdiagnosed, with a mood disorder would need to report it, and have to answer to it for the rest of their career.

Simple-- none of these requirements are about YOU. Medical boards and credentialing and oversight are all there to first protect the patients and second protect the hospitals. That you are confident you can handle it really doesn't factor into their analysis. They just want to know enough of your mental health history so they don't get accused of negligent supervision if some foreseeable event they should have foreseen occurs.

 

[KPZ]

From reading the other threads linked on here, it really sounds like an appalling system. Anyone can have a full on psychotic break at any point, or become addicted to drugs, or go through a traumatic event, or get any serious illness that would impair their ability to function, regardless of whether they've had a depressive episode in the past or not. An environment created by health professionals to discriminate against people for a diagnosis that may not even be relevant is simply appalling.

 

[QofQuimica]

From reading the other threads linked on here, it really sounds like an appalling system. Anyone can have a full on psychotic break at any point, or become addicted to drugs, or go through a traumatic event, or get any serious illness that would impair their ability to function, regardless of whether they've had a depressive episode in the past or not. An environment created by health professionals to discriminate against people for a diagnosis that may not even be relevant is simply appalling.

The stigma against mental illness is definitely there in health care, and it's significant. If you have a diagnosed mental illness, better you should know about the existence of this stigma up front rather than being surprised by it later on. Also better that you should go into this career with your eyes open to the fact that it may make you worse. As L2D said, someone who is functioning fine before training may get into training and break. It happens. And if you go to medical school, you will almost certainly know someone it happens to. Hopefully that someone won't be you.

FWIW, I agree with you that the culture of medicine does much to promote the breakdown of a healthy psyche in trainees. Unfortunately, changing that culture is not easy, and every time people try (ex. implementing work hour rules), there are unintended consequences (ex. new grads being less prepared to join the work force as independent practitioners, less ownership of patients, etc.)

 

[Law2Doc]

...

FWIW, I agree with you that the culture of medicine does much to promote the breakdown of a healthy psyche in trainees. Unfortunately, changing that culture is not easy, and every time people try (ex. implementing work hour rules), there are unintended consequences (ex. new grads being less prepared to join the work force as independent practitioners, less ownership of patients, etc.)

I second this. Changing culture is problematic for several reasons. First, the current culture isn't "broken" -- MOST people trained through our system do fine and become very sound doctors, Second, as I alluded to above, we live in a litigious society and any culture change that helps some doctors but isn't aligned to the expectations and safety of the patients can never happen, third as Q suggests, trying to fix things doesn't always net the consequences desired. Residency duty hours changes are a perfect example. In an effort to make things more humane and decrease medical errors, we moved from a call system to a night float system. sound good on paper but I think the consensus of those of us who worked in both systems was that you are actually LESS tired having a 30 hour call every few days followed by a post call day, than doing a 6 day string of 13 hour night float shifts. Sure in theory you have eleven hours each day to sleep before your next shift, but it just doesn't work out that way and by the end of the week the interns are stumbling around the hospital like the undead, unlaundered and unshaven, eyes half shut. And studies are suggesting errors haven't gone down to boot, mostly because increased numbers of handoffs are more of a problem than tired residents. And training decreases because to cut down hours it means you have to nix a lot of the morning conferences and didactics, and not let them go in on some of the cool cases, just to get these people out of the hospital on time. So good intentions, very bad result.

that's why someone outside saying let's change things inside is not going to get a lot of love -- we've all seen the backfires, more often than the successes. There are more moving parts and interests than you are appreciating. While I think some improvements to culture could occur, I think they need to benefit the patients first and foremost, and those on this thread much lower on the list. And hospital and risk management and insurer interests have to be in there somewhere too. Saying healthcare should change it's culture to look after the mental health interests of it's future practitioners probably tries to put those interest too high up on the list, because its only a small minority that the current system is not working well for, and it only views the issue from one set of eyes.

 

[QofQuimica]

Personally, I greatly preferred night float to 30 hour call. I like staying up late and have no issues with sleeping during the day. There is also a lot less administrative BS that goes on at night, and I get paid an extra night differential to boot. But you are probably right that I'm in the minority, which no doubt is why I don't have tons of my colleagues vying with me to become nocturnists.

FWIW, I agree completely that handoff issues are a huge problem. In fact, I'd argue that the danger of handoffs to patients greatly outweighs my personal schedule preferences to the point that I'd rather suffer through 30 hour calls than accept more (invariably bad) handoffs. I can't begin to say scientifically how many M&Ms are related to handoff errors, but my anecdotal experience is that handoffs are a contributing factor in the majority, if not the main cause.

On that note, it's 6 AM, and time for bed. Nighty night, SDN.

 

[KPZ]

At this point the argument has veered off topic entirely. You keep picking asides to argue against when my standpoint is that every doctor who ever goes to a psychiatrist should be able to do so in confidence and not be stigmatized their entire career. Not going to argue red herrings here.

 

[Law2Doc]

At this point the argument has veered off topic entirely. You keep picking asides to argue against when my standpoint is that every doctor who ever goes to a psychiatrist should be able to do so in confidence and not be stigmatized their entire career. Not going to argue red herrings here.

Actually it's you who suggested a "cultural change". Which is why we are explaining that cultural changes don't come easy and frequently have undesirable consequences. Not really a tangent, a direct response to your post. And again, it's not really about YOU. Everything is driven based on patient care and liability issues. In general, things an be made better for you as the clinician if they are aligned with one of these twin goals but not in contradiction to them.

 

[sartorious]

Wow it's been another 7 years or so since my last update. I wonder if Law2Doc is still around I got tired of big city life and moved to a highly underrated (imo) flyover state. I ice fish a lot now with my husband, and am working on my pilot's license. Still a hospitalist, with a lot more autonomy working for myself in the midwest than in my previous life. Daydreaming about continued gains in crypto that will let me work only as much as I want to within the next few years. But even if that doesn't happen, doing fine.

Middle aged and overweight now, hah. Still very prone to depression + ennui. Still taking prozac off and on... That is, I skip it till I feel like I have constant mood-flu, which takes about 6 months, then I'm back on for a while till I fall off the wagon again thinking I don't need it. You'd think I'd learn, but at this point I'm ok with my pattern. My depression is much less intense/volatile than I was when I was younger, so I feel fortunate.

Since covid hit I switched my occasional in person therapy to an app service called TalkSpace which I really like. The older I get the more I agree with Law2Doc in a way... things worked out fine for me, but they probably would have worked out fine too if I'd dropped out of pre-med/ med school and done something totally different. It's very hard to say if net satisfaction would be more or less.

I've de-escalated in terms of conventional ambition quite a bit over the years, and surprisingly never regretted it or felt ashamed. I mean that. That's not because I'm impervious to the opinions of others by any means -- it just was a lot easier than I thought it would be. Good luck to all you young people getting started. In terms of depression, I think many people mellow with age, so hang in there.