For those with ADHD

[vtucci]

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this may sound stupid, but i use lots of highlighters and colored pens when I study. For some reason, the colors keep me focused on reading. I also listen to music or play DVD's that I've watched a million time (like family guy) in the background. I've found that if I try to sit a quiet place and just look at a piece of paper I can't. But if there's something going on around me (you know, not a full on circus), it helps me divert my attention back. Also, I switch what I'm studying frequently. If I find myself drifting off on one note set, I immediately put it down and go to a new one. Also I study in short sperts (is that a word??). I'll do 30 or 45 min and then take a 5 min break instead of trying to go three hours.

and another problem for me are exams with lots of questions. I skip around on the exam. I start at the beginning and then I'll go to the last question and work backwards. Also, I'll get up at least once and use the bathroom or get some water.

LOL- I love highlighters. I use them to help me read and often highlight so much that people have remarked I should just leave the important stuff not highlighted. But they have to be blue, green or purple (orange and yellow are distracting to me). I also write in the margin for really important points.

I switch topics that I am studying alot too. And hop on SDN or e-mail frequently.

 

[AmoryBlaine]

Just a minor correction first, Amory- I graduated with honors from law school, not undergrad. Law school is way easier than most people think. We had one exam per semester so I all had to do was study for that (it was not the mental marathon that medical school is).

Also, ADD did not just creep up on me in medical school. It was very badly exacerbated by the anatomy block. My doctors always thought I had ADD and my parents refused to put me on ritalin when I was younger because of the perceived side effects (They had heard horror stories about it making kids like zombies). Up until medical school, I had adequate compensatory mechanisms (discussed below) to minimize the effects of ADD on my life.

With respect to your question, how can I be ADD and be a lawyer or do well in school? I am a little surprised. Based on your comment, why didn't you ask how any student with ADD or ADHD can be in medical school- didn't we all need to get good grades, take the MCAT and have clinical experience? There are four students with ADD in my class.

As psychiatrists will tell you, the DSM-IV is a guideline. There are more detailed tests (500 or 1000 question batteries) to determine whether a person has the condition. There are many very high functioning people with ADD. My psychiatrist treats exclusively doctors, lawyers, judges, professors in math, physics etc.

SYMPTOMS OF INATTENTION
a. often ignores details; makes careless mistakes
b. often has trouble sustaining attention in work or play[/B]
c. often does not seem to listen when directly addressed
d. often does not follow through on instructions;fails to finish
e. often has difficulty organizing tasks and activities
f. often avoids activities that require a sustained mental effort
g. often loses things he needs
h. often gets distracted by extraneous noise
i. is often forgetful in daily activities

I have had all of these to one extent or another. The most significant for me are items b, c, g, h and i (esp. item b).

However, as a high functioning person with ADD, I have been able to compensate for it for most of my life. I have unconsciously developed systems whereby I pay my bills the day I get them so I don't forget. Or, I put my keys in the same place every day so I don't lose them (I am still always losing my pocketbook when I go out though). I get easily distracted with noise in the form of conversations but not if it is music or TV (I can block those out like they are low-level background noise). I had forced myself to become organized almost to an extreme so I won't forget deadlines (I program it into my outlook with frequent reminders) and make lists.

With respect to academics, I took as many advanced placement classes in high school as I was permitted, worked full-time and managed to accumulate 2000+ hours of community service. In college, I worked, was president of more organizations than you could count and was almost a triple major (Yale does not let you do that). Ditto in law school. For post-bac, I worked full-time and took Chem and lab, Physics and Lab and Orgo with lab in one semester. What can I say...I get bored very easy. I need a lot of mental stimulation or I run into problems.

I love EM. I love the pace, the action. Everyone who has met me has told me that my personality is well-suited for it. I also love solving puzzles and challenges. The more tasks I have to do and the harder they are, the better I do on every task I have. I feed off this. As Miami-med indicated, my mind gets calmer in the middle of storm, which means I am an excellent crisis manager. Chaos does not do to me what it does to so many others.

No doubt about it, EM will require intense bursts of concentration for each case. That is not the same thing as an extended amount of concentration for only one activity (e.g., 12 hour transplant surgery). Think about it, being stuck at the operating table and not being able to move around- that really is my idea of hell. I am really worried about this for third year and forcing myself not to zone out. I am interested in doing as well as I possibly can in every rotation but I know myself and I start to get fidgety after an hour. I pace frequently. I like to move when I am thinking.

As far as infectious disease goes, yes it can be regimented. I would never want to be in a lab. However, I love figuring out the problem. It is like being a detective. That is the aspect of this field that appeals to me. Likewise with path (although, not enough personal interaction here). The most methodical field to me is surgery followed by ortho, anesthesia, rads, derm, ENT, urology etc.

My ideal job will be as a medical school professor, teaching clinical and pre-clinical students and then maybe serving as residency director in an EM program and seeing a ton of patients each shift.

We'll have to agree to disagree. The people I know with ADD are not fully-functioning people. They have major problems in academics and interpersonal relationships. They take drugs to function, not to excel. My point is that you can't have your cake and eat it to, if you have a psychiatric disorder that centers on innatention you can't act as if that can be spun into some sort of positive trait for a physician.

What if I were to say this: I really want to be able to bench 300 pounds. Deep down I know that I am gifted enough to do it. The problem is that despite years of weight training and protein intake I can only do 250. So is 250 my max? Absolutely not! I'll just see a Dr. and get diagnosed as having Actin-Myosin Dysthymia and he'll prescribe me some anabolic steroids. If I take those every day I can get to my 300 pound dream, but I need them, because I know that I am specially suited to be able to bench 300#.

 

[Miami_med]

We'll have to agree to disagree. The people I know with ADD are not fully-functioning people. They have major problems in academics and interpersonal relationships. They take drugs to function, not to excel. My point is that you can't have your cake and eat it to, if you have a psychiatric disorder that centers on innatention you can't act as if that can be spun into some sort of positive trait for a physician.

What if I were to say this: I really want to be able to bench 300 pounds. Deep down I know that I am gifted enough to do it. The problem is that despite years of weight training and protein intake I can only do 250. So is 250 my max? Absolutely not! I'll just see a Dr. and get diagnosed as having Actin-Myosin Dysthymia and he'll prescribe me some anabolic steroids. If I take those every day I can get to my 300 pound dream, but I need them, because I know that I am specially suited to be able to bench 300#.

I don't think you heard the OP. There reference to 'calm in the middle of a storm' is not an advantage. It simply means that the ADHD mind can (I promise) develop a greater capacity to focus in certain types of situation that is on par with the non-ADHD mind. A personality that, in the case of the OP is suited to EM, isn't defined by ADHD. There is no specific ADHD personality. This would be like saying that people with Psoriasis shouldn't go into internal medicine, because the 'psoriasis personality' isn't suited to a long differential diagnosis.

I won't bore you with my stories of punctuated study periods and exam cramming while walking in circles around the park, because I discovered that constantly looking up to see where I was going meant that I never zoned out. I could talk about how my grades dropped when constuction began by said park, and the distant beeping of the heavy equipment made me unable to continue. Just like some people with diabetes get their legs chopped off, while others turn their lives around and start running marathons, there is a range of responses to ADHD. I've never asked for drugs, special accomadations, or sympathy. I don't need anyone to hold my hand. What I, and people like the OP, usually want is simply to do find a way to adapt. When I find a way, I expect to be able to do what I've now proven that I can do. That doesn't change anything about the condition.

 

[vtucci]

No doubt about it Amory. A lot of people with ADD have a lot more problems academically and socially than I have had. Some have ADHD alongside it. Others have variants of ADD (i.e., ADD with oppositional disorder) and some have learning disabilities superimposed on their ADD. People are often not as forthcoming with the secondary conditions esp if there are behavioral issues with it.

That being said, I don't take Adderall to excel in medical school. I have been taking it so I can pass. I nearly failed anatomy and physiology block in medical school, which is what prompted me to seek help and I did not go to the administration with the thought of being put on Adderall. I wanted to identify the problem. After putting me through an extensive battery of tests, high functioning ADD was the conclusion of the expert panel they had me see.

It honestly did not occur to me that my ADD could be the problem because I had coped with it quite successfully before. I also never disclosed to them that my doctors thought I had it when I was young because I did not have the records of a formal diagnosis dating back that far. I thought I was having trouble because I came from a non-traditional background.

BTW- They never traded Adderall at my college for exam performance-- maybe I am dating myself by saying that but it is true.

I started working with a psychiatrist and taking the medication as prescribed and what do you know-- my scores popped up almost 20 points over night. I was able to sit through an entire class without surfing the internet, reading a different book, bouncing up and down and off the walls. This goes beyond just improving concentration. I know the drug can be abused and improperly used. A lot of people who improperly use it also suffer from a higher percentage of side effects like nervousness/anxiety etc. than true ADD sufferers.

I want to be the best doctor I can be and that means not getting overwhelmed by the volume of material and I will use the tools with proper guidance by my physician.

Miami-med is absolutely right-- it is not bragging to say that I get calm in a storm. That is how my mind works. I really settle down when chaos abounds. the ED is an ideal setting for me as a result.

Miami-med- I applaud your efforts. If you don't want to use medication or other therapies and your ADD is not preventing you from accomplishing what you want in life, I think that is great.

 

[thesauce]

I'm glad this thread got started because I want to ask a question of those out there with ADHD or ADD. I've always been under the impression that it doesn't exist. Here's what really got me pondering it:

My good friend from undergrad is probably the most unbelievably bright person that I've ever met (4.0 in Chemical Engineering and amazing at fuel-cell research). He once told me that he was diagnosed with ADD, but doesn't take any drugs for it. In lecture, he never "spaces out" like everyone else does. He sits there and listens for the entire hour and will stop the lecturer to ask intelligent questions, so you know he was following the whole time. We were in all of the same classes and he is the best verbal learner that I've ever seen.

So obviously he isn't "attention deficit." Recently, I spoke to a psychiatrist at my school about him and the conversation went like this:

Me: Could my friend have been cured over time (like maybe he had an "attention deficit" before I knew him and now it's all gone)?

Psychiatrist: No, once you have it, you have it for good.

Me: How it is possible to have ADD and have the greatest attention span the world has ever seen?

Psychiatrist: It can manifest itself in that way sometimes

Me: So the characteristics are either 1) someone with a great attention span or 2) someone without a great attention span. Everyone I've ever known, including me, falls into one of those 2 categories so how do you diagnose it?

Psychiatrist: It's tricky

It just seems like one of those TV evangelists or George W. Bush trying to sell you something.

I, myself, have a crap-load of trouble trying to pay attention to boring lecture material, but when I really need to come away from lecture with the material, I put in the extra effort and fight my tendancies to "space out."

So to those with ADD, I ask: How do you know that what you're experiencing is any different than what the rest of us are experiencing?

 

[vtucci]

Difficulty concentrating at times is normal.

Not being able to get through 2 pages of a textbook (even in a subject you really like) without hopping online, walking around the house or insert some other activity here, is not generally.

 

[thesauce]

Difficulty concentrating at times is normal.

Not being able to get through 2 pages of a textbook (even in a subject you really like) without hopping online, walking around the house or insert some other activity here, is not generally.

I just polled a group of students in the student lounge (4 students) and they all said what you just described is completely normal for them. None of them have been diagnosed as ADD or ADHD.

Any other theories?

 

[lil pook]

pardon me for saying...but exactly why is ADHD or ADD for that matter seen in a negative light?

anyone here who has it, or is very close to someone or perhaps many people with it, will tell you that it does NOT manifest itself the same necessarily in all people.

for example, i have a friend. bad ADD, horrible attention span, not terribly bright as far as books go, but a creative genius, and EXTREMELY intuitive.

i also have a friend with HORRIBLE ADHD who has an IQ of 145. never went to college, never had to. has his own alternative energy business making over 300 K a year.

another friend. Chemical engineer. amazingly smart. very creative. did great in school...just couldn't sit still.

see? its different for everyone....and not always a bad thing.

just because your mind jumps a lot and is super quick is not a bad thing.

personally, i find ADD/ADHD people so interesting and stimulating intellectually to be around. the ones i know are for the most part clever, witty, hilarious, intuitive, sensitive and quick as hell on their toes.....what's wrong with that i ask?

 

[VaEMTGuy]

So to those with ADD, I ask: How do you know that what you're experiencing is any different than what the rest of us are experiencing?

To thesauce, et al:
Your friend the psychiatrist is right, it is tricky. Presuming your friend's diagnosis was correct, we do have to remember that ADD/ADHD, like most quantitative traits, is not simply an all or nothing status. It seems to sit on a bell curve with some people experiencing much more severe symptoms. However, all exhibit their group of symptoms to a greater extent than the general population. Its the same things everyone experiences at some point but the difference is in matter of degrees. I'm sure there are plenty of people here who will talk about what that experience is like.

I just want to bring up two other points for you and the forum to consider.

For some people, short term attention, even up to an hour or so is not an issue. Especially if it is an interesting topic you might even see a sort of hyper focus where nothing else outside of the lecture matters. However, completing longer term projects, something that requires work over many days to weeks may be tougher to keep going without outside reinforcement. Also, getting started on projects, or starting too many may occur.

This brings up my second point, regarding maturity and environment. ADD/ADHD is something that changes with age. Maturing through adolescence can help attenuate it for some people as they learn to work around these issues. Further, some ADD/ADHD patients function very well in externally structured environments. So when working with a group or by keeping a rigid schedule for when to do work, they compensate for an innate lack of internal structure. A supportive home environment growing up where the parents make extra effort to teach their child these skills can come together to arm the person with such skills that most would never be aware that there was anything going on at all. Most of these people are very bright and once armed with the appropriate information, the successful ones will use this to compensate for any deficits.

I'm not out to change anyones opinions over whether this is or isn't a real disorder, I just hope I've presented some new factors to consider outside of simply whether or not to use medications.

Pax Vobiscum

 

[beefballs]

wait all this time I might be adhd, I just thought I was a dumbas$. Stick that in your ear and smoke it I am not dumb just diseased

talk about your lose/lose scenarios-dip**** or mentally ill

 

[Sombra]

I've been wanting to post in this thread for a while, but a few people at my school know my screen name, and there's such a huge stigma against ADHD that I held off. I finally realized I could just get a new screen name.

My story:

I've always been a daydreamer (my nickname as a kid was space cadet), and am frequently "lost in my head". It just seemed more interesting in there - although for the life of me, I usually can't tell you afterwards what I was thinking about. As a kid it took me 1.5 to 2 hours to fall asleep most nights, because I couldn't stop thinking. There were too many interesting trains of thought that kept skipping all over the place.

I went to a Montessori school through 3rd grade, where we had contracts. The contracts had lists of lessons we had to check off by the end of the week, but we could do them in whatever order we liked, at whatever pace we liked. This was absolutely ideal for me. I finished everything really quickly, was never bored, and got through most of the 6th grade material by the end of 3rd grade. So I loved school. Then I went to public school, and hated it. I hated sitting in a desk, I zoned out while the teacher talked, and I wasn't learning anything. I'd learned it on my own at Montessori already. In high school I took all the AP/Honors classes I could, but still zoned out a bunch, and ditched more than one day a week on average. I still got straight A's, but I had to have friends remind me to turn in homework whenever they turned in theirs.

College was way easier, because it was just tests. I went to class and then goofed off the rest of the time. At most I spent 1-2 hours a day studying (aka reading) in 20-30 minute spurts, maybe 3 hours right before a test. I usually tried to do the required reading, but as soon I read a sentence I would think of something I had to do, look up, or just think about. It took me like 4 hours off and on over days to read 20 pages, and I still wouldn't usually be able to tell you much about what I'd read right afterwards. (I LOVE fiction reading, however, and can get sucked into that for hours on end if the book is interesting) On tests I could usually reason out the answers by thinking them through, so I did okay even though I didn't know the subject very well. Oh, I had my IQ tested at that time, too, and was around 140.

Then I hit med school, and I couldn't think my way through tests (for the most part) - I actually had to know stuff. I HAD to read, understand, and remember. I had to pay attention in class, and sit for hours outside of class studying. I tried really hard. I repeated "pay attention" over and over in my head during lectures, but I'd still zone out (sometimes coming to to the words "and know that, because it will be on the test"). I made strict schedules for myself, but couldn't keep them. It was awful. I considered dropping out of school for a bit, because I just didn't think I could cut it. I went to a psychologist at school, and after a few sessions he suggested Adderall might help, so I started that after our first block ended. It has helped immensely, but I've still felt like a drug abuser, that it was a cop out, that I'm "cheating", and other negatives ever since. The main reason for all of those thoughts is I figure that if I got this far without needing treatment, there's no way I could actually have ADHD. (My brother has ADHD and he's your classic case, btw - he got Ds and Fs, then dropped out of high school, and is now doing pretty much nothing with his life)

Outside of school, I struggled to keep appointments (I had a calendar that I wrote everything on, but sometimes I just forgot). I often walk to some part of my apartment to do something, get distracted by something else, and then go back to where I was, completely forgetting that I intended to do something. I lose lecture handouts, and the ones I have are spread all over my apartment - in little piles on my floor, shoved into free spaces on my bookshelf, buried under other crap on my desk.

I love starting projects - paintings, stories, personal research, etc - but every time I lose interest partway through, and don't finish. If it's a required project I do finish, but the final steps are like pulling teeth, and I procrastinate doing them for as long as possible even though they're typically really easy and would take me less than an hour to do. I am so non-detail-oriented about some things that it's shocking. I can easily not notice something right in front of my face until someone points it out. But for other things I notice every detail - for instance, every single little typo in books irks me to no end. I worked for several years, and going to the same place, at the same time, to do the same thing made me want to shoot myself. I changed jobs at least every year, but the next one still sucked.

On Adderall, most of that has changed. If a phone rings in class, or someone near me talks, I'm still gone for the next 5 minutes, but at least now I can pay attention MOST of the time. I can focus on reading, and understand what I read MOST of the time. It's not perfect, of course - I'm still terribly disorganized - but I remember things better now, and am not struggling as much.

I know I probably sound like I'm going to make a terrible doctor from all of the above, but I know my strengths and weaknesses pretty well. I would rather quit med school than do EM, because I can't handle that many things and distractions at once and I know I'd wind up killing someone. I love puzzles and analyzing/thinking things through, however, and am pretty sure I'd do well in most of the specialties where I don't have to make a split-second decision. If I am allowed to take my time (minutes, rather than seconds) to think, I am really pretty exceptional (if I do say so myself 😛).

Sorry this is so long. There's so much more to say, too, but I left it out because I'm not sure most people are going to make it through what I've already written.

 

[lil pook]

OK.

first of all. i think it needs to be said that ADHD is NOT a mental illness. and for it to be viewed in that light is doing a disservice to those who have it. and i don't care what the criteria for 'mental illness' is at this time either.

remember 'back in the day' when homosexuality was viewed in a similar negative light? it was considered a deviation, or sickness, or abnormality, or what have you.

we need to realize that there is so much about the human mind that we havent discovered yet. how do you all know that ADD isn't actually a gift? like i said in my previous post, ADD people are different, they can be extremely bright....yeah, their minds operate at like lightning speed, but since when was that a bad thing? huh?

please stop judging these people and the different ways that their minds perceive things in a negative light. for all we know, in 100 years, 'normal' people will be wishing they had it.
🙂

 

[AmoryBlaine]

OK.

first of all. i think it needs to be said that ADHD is NOT a mental illness. and for it to be viewed in that light is doing a disservice to those who have it. and i don't care what the criteria for 'mental illness' is at this time either.

remember 'back in the day' when homosexuality was viewed in a similar negative light? it was considered a deviation, or sickness, or abnormality, or what have you.

we need to realize that there is so much about the human mind that we havent discovered yet. how do you all know that ADD isn't actually a gift? like i said in my previous post, ADD people are different, they can be extremely bright....yeah, their minds operate at like lightning speed, but since when was that a bad thing? huh?

please stop judging these people and the different ways that their minds perceive things in a negative light. for all we know, in 100 years, 'normal' people will be wishing they had it.
🙂

It is absolutely a mental illness. You take medication to control it and it harms your functional status. That doesn't mean that people with ADD are bad people. Saying it is not a mental illness is like saying people with common variable immunodeficiency are just "different."

I have medical conditions as well, I accept myself for who I am but I don't try to say that any pathology I have is just some wonderful variant of normal.

 

[vtucci]

I don't love the fact that it is classified as a mental illness either. Dyslexia is in the DSM-IV as well. I am not sure that any learning disability should be characterized as a mental illness or be listed in DSM-IV.

However, Amory does have a point. Once a condition starts affecting your ability to function, it is an illness. We are fortunate in that there is not as much of a stigma associated with ADD/ADHD as there is with other mental conditions (e.g., bipolar).

For the record, bipolar individuals can be extremely creative and amazing people. It is just that there disease (when uncontrolled) affects their ability to function in society to a much greater extent than an average sufferer with ADD/ADHD. Also, our society has become much more accepting of late of depression and some anxiety conditions.

 

[beefballs]

oh come on. quit being so sensitive, nothing I say is meat to hurt anybodies feelings, but I also subscribe to the theory that if you can't take a joke (especially on a silly internet site ) f-off. If you get your panties in a bunch because I make a few innocuos jokes (at my expense no less) then you need to venture out of your little coccon of rainbows and care-bears.

 

[lil pook]

😕

wow

 

[glp]

this discussion has convinced me that i have adhd.

 

[Tired]

this discussion has convinced me that i have adhd.

Really? Because it's made me wonder if these people should be allowed to get a medical degree . . .

 

[Miami_med]

Really? Because it's made me wonder if these people should be allowed to get a medical degree . . .

We will have to remember to exclude Tired from any future conversations about coping with illness. He is obviously absolutely correct in his assesment that people who can successfully complete work should be excluded from its tangible benefits due to a medical disorder.🙄

If this were a conversation about wanting special priveleges, extra test time, or changing the bar. I would agree. I think the standards should be steadfast. However, if somebody can meet those standards, the level of personal struggle involved to get there shouldn't matter, as long as the standards are met.

I can assure him that if he were knew me well, he would have no question that I had to deal with ADHD, and if he were one of my patients, he would never know.

 

[Tired]

We will have to remember to exclude Tired from any future conversations about coping with illness. He is obviously absolutely correct in his assesment that people who can successfully complete work should be excluded from its tangible benefits due to a medical disorder.🙄

I can assure him that if he were knew me well, he would have no question that I had to deal with ADHD, and if he were one of my patients, he would never know.

Oh, you misunderstand. My comment had nothing to do with your having ADHD . . .

 

[brianmartin]

So to those with ADD, I ask: How do you know that what you're experiencing is any different than what the rest of us are experiencing?

Because I cannot sit down and study for 4 hours straight (without stimulant medication), while others can easily do it. The interesting thing is, I can spend 4 hours playing music very easily, because it provides instant feedback. That's what ADD people naturally desire - instant sensory feedback, or some kind of affirmation that what they are doing in the moment is going to be resolved. ADD people are very good improvisers, and very skilled at living and working "in the moment" which is why EM is probably a good choice.

The ADD brain works incredibly fast. So fast, that it cannot slow down sometimes.

Here is a question, do you really think every brain works the same way?

It is absolutely a mental illness. You take medication to control it and it harms your functional status. That doesn't mean that people with ADD are bad people. Saying it is not a mental illness is like saying people with common variable immunodeficiency are just "different."

I have medical conditions as well, I accept myself for who I am but I don't try to say that any pathology I have is just some wonderful variant of normal.

::sigh::
You are failing to recognize the possibility that ADD merely represents one end of a continous trait distribution. A discrete, physical pathology is not the same. If you have Crohn's disease, you have a physical illness. That's not the same as ADD. Nobody said ADD was a "wonderful" variant of normal. Realize that everything is a variant of normal. We're all a little bit bipolar. We're all a little narcissistic. We all get depressed sometimes.

Not only that, we all tailor our actions to maximize our performance. Some people have to go out for a few drinks on the weekend to unwind. Some people need music to study. Some people take meds for their ADD. You adjust your sleep schedule so that it fits your internal clock. You find your own way to study. You balance your life oustide of school and in.

Your argument that people with ADD are celebrating their "disorder" is preposterous. We're simply responding to our own brain, assessing our strengths and weaknesses, and figuring out how to work with them. JUST LIKE everyone else.

Each one of our lives on this planet is incredibly short compared to the history of earth. And none of us are really that important in the long run. If you can take a drug for ADD that enables you to completely function in an academic and professional setting....I say take it. It's not a disorder, it's a function of the changes brought by modern society and specialization and what they require from the human brain.

 

[AmoryBlaine]

Because I cannot sit down and study for 4 hours straight (without stimulant medication), while others can easily do it. The interesting thing is, I can spend 4 hours playing music very easily, because it provides instant feedback. That's what ADD people naturally desire - instant sensory feedback, or some kind of affirmation that what they are doing in the moment is going to be resolved. ADD people are very good improvisers, and very skilled at living and working "in the moment" which is why EM is probably a good choice.

The ADD brain works incredibly fast. So fast, that it cannot slow down sometimes.
Here is a question, do you really think every brain works the same way?

::sigh::
You are failing to recognize the possibility that ADD merely represents one end of a continous trait distribution. A discrete, physical pathology is not the same. If you have Crohn's disease, you have a physical illness. That's not the same as ADD. Nobody said ADD was a "wonderful" variant of normal. Realize that everything is a variant of normal. We're all a little bit bipolar. We're all a little narcissistic. We all get depressed sometimes.

Not only that, we all tailor our actions to maximize our performance. Some people have to go out for a few drinks on the weekend to unwind. Some people need music to study. Some people take meds for their ADD. You adjust your sleep schedule so that it fits your internal clock. You find your own way to study. You balance your life oustide of school and in.

Your argument that people with ADD are celebrating their "disorder" is preposterous. We're simply responding to our own brain, assessing our strengths and weaknesses, and figuring out how to work with them. JUST LIKE everyone else.

Each one of our lives on this planet is incredibly short compared to the history of earth. And none of us are really that important in the long run. If you can take a drug for ADD that enables you to completely function in an academic and professional setting....I say take it. It's not a disorder, it's a function of the changes brought by modern society and specialization and what they require from the human brain.

See, I think you're trying to have your cake and eat it too. On the one hand you are saying that your brain is incapable of focusing on one task for very long without some sort of instant feedback. On the other hand you are saying that the trade-off is that you get some other intagible ability to improvise and think on your feet. I would love to see some data that say that people with ADD are better improvisers than the rest of us.

I don't know what year you are in school, but there is no field in medicine where studying is not important. There is no residency where you can just learn on the fly with "instant feedback."

Your last sentence is very interesting. So ADD is a "function of the changes" that "modern society" requires from the brain? I guess that "change" is the requirement that people learn alot of stuff. The argument that you seem to be making is that ADD was "underground" until people had to be really smart...

 

[Miami_med]

Oh, you misunderstand. My comment had nothing to do with your having ADHD . . .

Perhaps you are suggesting that anyone with differing opinions on politics, illness, or life in general should not be allowed to practice? I am definitely intrigued by the idea behind your proposal.

 

[lil pook]

thank you for saying exactly what i was thinking but couldn't find the right words to do so.

do you think 1 million years ago as we were evolving ,that sitting in classroom for 8 hours a day, or reading/studying all day long was a common function?

i don't think so.

society has evolved in such a way that people with this 'variant of normal' ARE at a disadvantage......but "mentally ill" they are certainly NOT.

 

[lil pook]

[QUOTE The argument that you seem to be making is that ADD was "underground" until people had to be really smart...[/QUOTE]

2 things about your statement:

1) ADD has always been around, yes. But, the learning environment in our society is structured very rigidly. Not everyone is a linear thinker, likes to sit still in one place for hours on end, or needs plently of time "to grasp" concepts. Hence, the "disorder" has surfaced in recent years simply because society today is structured in such a way that doesn't allow for these differences.

2) You are confusing ADD with being unintelligent. If you read my post a while back you would see that I have one friend with an IQ of 140, and another who is a successful chemical engineer. So now you tell me..what does having ADD have to do with being smart?

 

[Doctor Bagel]

Because I cannot sit down and study for 4 hours straight (without stimulant medication), while others can easily do it. The interesting thing is, I can spend 4 hours playing music very easily, because it provides instant feedback. That's what ADD people naturally desire - instant sensory feedback, or some kind of affirmation that what they are doing in the moment is going to be resolved. ADD people are very good improvisers, and very skilled at living and working "in the moment" which is why EM is probably a good choice.

Very few people can easily study for 4 hours straight without getting up, looking on SDN ( 🙂 ), staring at the floor, etc. That's the thing that sort of troubles me about the ADD diagnosis for some people -- you don't have a psychopathology because things are hard for you that are hard for most people. Yes, there are the attention super freaks in med school, but they're a variation of normal.

 

[Tired]

Perhaps you are suggesting that anyone with differing opinions on politics, illness, or life in general should not be allowed to practice? I am definitely intrigued by the idea behind your proposal.

Ironically, while I generally abhor your political standpoints, I find myself in agreement with most everything you have written in this thread.

When I (playfully) suggested that certain posters here scare me as physicians, I was specifically refering to two recurring points (neither of which, I believe, you have supported):

1) "ADHD is actually a good thing, because it makes the mind work so fast." People with 'special gifts' don't generally try to suppress it with medication. If you don't like the socially-constructed stigma associated with calling it a "mental illness", then frame it in terms of a Neurologic problem, or chemical imbalance, or whatever. But don't try to pretend like it's some wonderful trait, given how much people struggle with its effects.

2) "ADHD is crap, all med students get distracted when they try to study." Guess what? I also occassionally think someone called my name when they didn't, so all these stupid schizophrenics just need to get over it, because everyone has auditory hallucinations. And once I got a cramp in my leg and I just walked it off, so why are all these lazy "paraplegics" riding around in wheelchairs (you get my sarcastic point).

So don't be too paranoid Miami_Med, when I think you're full of it, I tell you straight out. Here, in my view, you're dead on the money.

 

[vtucci]

Because I cannot sit down and study for 4 hours straight (without stimulant medication), while others can easily do it. The interesting thing is, I can spend 4 hours playing music very easily, because it provides instant feedback. That's what ADD people naturally desire - instant sensory feedback, or some kind of affirmation that what they are doing in the moment is going to be resolved. ADD people are very good improvisers, and very skilled at living and working "in the moment" which is why EM is probably a good choice.

The ADD brain works incredibly fast. So fast, that it cannot slow down sometimes.

Here is a question, do you really think every brain works the same way?

::sigh::
You are failing to recognize the possibility that ADD merely represents one end of a continous trait distribution. A discrete, physical pathology is not the same. If you have Crohn's disease, you have a physical illness. That's not the same as ADD. Nobody said ADD was a "wonderful" variant of normal. Realize that everything is a variant of normal. We're all a little bit bipolar. We're all a little narcissistic. We all get depressed sometimes.

Not only that, we all tailor our actions to maximize our performance. Some people have to go out for a few drinks on the weekend to unwind. Some people need music to study. Some people take meds for their ADD. You adjust your sleep schedule so that it fits your internal clock. You find your own way to study. You balance your life oustide of school and in.

Your argument that people with ADD are celebrating their "disorder" is preposterous. We're simply responding to our own brain, assessing our strengths and weaknesses, and figuring out how to work with them. JUST LIKE everyone else.

Each one of our lives on this planet is incredibly short compared to the history of earth. And none of us are really that important in the long run. If you can take a drug for ADD that enables you to completely function in an academic and professional setting....I say take it. It's not a disorder, it's a function of the changes brought by modern society and specialization and what they require from the human brain.

Wow- I can't study for 30 minutes without medicine. Maybe I'll see you in the ED someday. 🙂

 

[AmoryBlaine]

2 things about your statement:

1) ADD has always been around, yes. But, the learning environment in our society is structured very rigidly. Not everyone is a linear thinker, likes to sit still in one place for hours on end, or needs plently of time "to grasp" concepts. Hence, the "disorder" has surfaced in recent years simply because society today is structured in such a way that doesn't allow for these differences.

2) You are confusing ADD with being unintelligent. If you read my post a while back you would see that I have one friend with an IQ of 140, and another who is a successful chemical engineer. So now you tell me..what does having ADD have to do with being smart?

Absurd.

1. How can you possibly learn medicine w/o "linear thinking," "sitting around in one place," or "plenty of time with concepts?" Dude, I'm sorry, the fact that you cannot concentrate on cell bio does not mean that you have ADD. I don't have ADD and I don't like to sit for hours on end either.

If you are incapable of sustained "linear thought" then you cannot be a good doctor. The two are mutually exclusive.

How could we possibly "structure" medicine to fit the ADD mind? This is like my previous example, but I'll try again. I'm actually a fantastic basketball player, but the NBA isn't "structured" to suit my slow speed and lack of coordination, so I think I should get special treatment.

2. ADD might not have anything to do with being smart, but it has alot to do with being a good doctor. If you can't focus, you can't be a good doctor. So if you are "really smart" and have an "IQ of 140" but can't study the material, guess what, you can't be a good doctor.

 

[vtucci]

Amory and Lil pook- you can learn pathology, pharm etc. all the topics for medicine without necessarily taking a linear approach but it is not the traditional way of doing things in medical school. For example, maybe you should try question books to learn information instead of reading a textbook.

People who have ADD do tend to be good at making connections very quickly (so it might be more curvilinear logic)- that is an excellent skills for physicians. I am planning on making a number of question books in fourth year for the pre-clinical years. I can't be the only one who learns by doing hundreds of questions. If anyone wants to help, PM me.

Also, Amory it is true that sometimes when you have 400 things being thrown at you at once, it helps us focus on what must get done now- helping prioritize and we are able to direct our complete attention to that item. The storm that actually helps calm the mind. 🙂

 

[AmoryBlaine]

Amory and Lil pook- you can learn pathology, pharm etc. all the topics for medicine without necessarily taking a linear approach but it is not the traditional way of doing things in medical school. For example, maybe you should try question books to learn information instead of reading a textbook.

People who have ADD do tend to be good at making connections very quickly (so it might be more curvilinear logic)- that is an excellent skills for physicians. I am planning on making a number of question books in fourth year for the pre-clinical years. I can't be the only one who learns by doing hundreds of questions. If anyone wants to help, PM me.

Also, Amory it is true that sometimes when you have 400 things being thrown at you at once, it helps us focus on what must get done now- helping prioritize and we are able to direct our complete attention to that item. The storm that actually helps calm the mind. 🙂

You're just making up your own disease...

From DSM IV

SYMPTOMS OF INATTENTION
a. often ignores details; makes careless mistakes
b. often has trouble sustaining attention in work or play
c. often does not seem to listen when directly addressed
d. often does not follow through on instructions; fails to finish
e. often has difficulty organizing tasks and activities
f. often avoids activities that require a sustained mental effort
g. often loses things he needs
h. often gets distracted by extraneous noise
i. is often forgetful in daily activities

 

[lil pook]

amory is just jealous of all you ADD people!!!!! 😀

 

[lil pook]

oh and one more thing amory...

i got news for ya....there is VERY LITTLE that we learn in the first 2 years that is 'conceptual'......just to clarify.

or perhaps you see hours upon hours of absolutely mindless memorization as really 'conceptual'? hmm.....

 

[Miami_med]

Ironically, while I generally abhor your political standpoints, I find myself in agreement with most everything you have written in this thread.

When I (playfully) suggested that certain posters here scare me as physicians, I was specifically refering to two recurring points (neither of which, I believe, you have supported):

1) "ADHD is actually a good thing, because it makes the mind work so fast." People with 'special gifts' don't generally try to suppress it with medication. If you don't like the socially-constructed stigma associated with calling it a "mental illness", then frame it in terms of a Neurologic problem, or chemical imbalance, or whatever. But don't try to pretend like it's some wonderful trait, given how much people struggle with its effects.

2) "ADHD is crap, all med students get distracted when they try to study." Guess what? I also occassionally think someone called my name when they didn't, so all these stupid schizophrenics just need to get over it, because everyone has auditory hallucinations. And once I got a cramp in my leg and I just walked it off, so why are all these lazy "paraplegics" riding around in wheelchairs (you get my sarcastic point).

So don't be too paranoid Miami_Med, when I think you're full of it, I tell you straight out. Here, in my view, you're dead on the money.

I stand corrected, and I'll let them defend themselves if they so choose. The real question is "how paranoid is too paranoid." 😉

 

[vtucci]

oh and one more thing amory...

i got news for ya....there is VERY LITTLE that we learn in the first 2 years that is 'conceptual'......just to clarify.

or perhaps you see hours upon hours of absolutely mindless memorization as really 'conceptual'? hmm.....

I agree that first year is total memorization. Second year has been more conceptual like with pathology (ok- not with pharm). 😎

Amory under the DSM-IV, you need 6/9, not 9/9 for ADD diagnosis- the three you highlighted may not be in the 6/9 for some people's ADD.

Everyone is different and will have different severity in their disease. If we have been higher functioning, we also often have compensatory mechanisms (i.e., are now obsessive about making lists so we don't forget anything, or putting the keys in the same place every day).

You have also missed the point that when there are 400 things coming at you, your attention for any one item only needs to be sustained for a short amount of time. Notice, I did not offer a 12 hour transplant surgery as an example of a time when I would shine. I am just better with multi-tasking because it allows small bursts of concentration instead of long, sustained effort.

1. often fails to give close attention to details or makes careless mistakes in schoolwork, work or other activities
2. often has difficulty sustaining attention in tasks or play activities
3. often does not seem to listen when spoken to directly
4. often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (no if oppositional behavior or doesn’t understand instructions)
5. often has difficulty organizing tasks and activities
6. often avoids, dislikes, or is reluctant to engage in tasks or activities that require sustained mental effort (such as schoolwork or homework)
7.often loses things necessary for tasks or activities (e.g., toys, school assignments, pencils, books, or tools)
8. often easily distracted by extraneous stimuli
9. often forgetful in daily activities

 

[AmoryBlaine]

I agree that first year is total memorization. Second year has been more conceptual like with pathology (ok- not with pharm). 😎

Amory under the DSM-IV, you need 6/9, not 9/9 for ADD diagnosis- the three you highlighted may not be in the 6/9 for some people's ADD.
Everyone is different and will have different severity in their disease. If we have been higher functioning, we also often have compensatory mechanisms (i.e., are now obsessive about making lists so we don't forget anything, or putting the keys in the same place every day).

You have also missed the point that when there are 400 things coming at you, your attention for any one item only needs to be sustained for a short amount of time. Notice, I did not offer a 12 hour transplant surgery as an example of a time when I would shine. I am just better with multi-tasking because it allows small bursts of concentration instead of long, sustained effort.

1. often fails to give close attention to details or makes careless mistakes in schoolwork, work or other activities
2. often has difficulty sustaining attention in tasks or play activities
3. often does not seem to listen when spoken to directly
4. often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (no if oppositional behavior or doesn’t understand instructions)
5. often has difficulty organizing tasks and activities
6. often avoids, dislikes, or is reluctant to engage in tasks or activities that require sustained mental effort (such as schoolwork or homework)
7.often loses things necessary for tasks or activities (e.g., toys, school assignments, pencils, books, or tools)
8. often easily distracted by extraneous stimuli
9. often forgetful in daily activities

So you have the other ones? The ones I didn't bold? You have those 6/9? Because then it seems that multitasking would be complicated by not listening, losing things, and being forgetful.

If you have time I really need a better explaination of this. I am still mystified as to why a disease with 9/9 diagnostic features that would harm a person's ability to multitask somehow confers as advantage in multitasking.

What is this mystical short amount of time that people with ADD can focus?

 

[Miami_med]

So you have the other ones? The ones I didn't bold? You have those 6/9? Because then it seems that multitasking would be complicated by not listening, losing things, and being forgetful.

If you have time I really need a better explaination of this. I am still mystified as to why a disease with 9/9 diagnostic features that would harm a person's ability to multitask somehow confers as advantage in multitasking.

What is this mystical short amount of time that people with ADD can focus?

ADHD doesn't make people think fast. However, most high function ADHD people do think very fast. This has nothing to do with ADHD, but for those who happen to have the advantage of fast thinking, it can overcome the disadvantage of ADHD. Some people will also develop a faster thought process as a compensatory mechanism for ADHD. In other words, learning to think fast avoids many of the pitfalls that come from not being able to stick to a single task for extended periods of time. The fast thinking is advantageous, while the ADHD is certainly not. There are plenty of slow thinking people with ADHD, and those are usually not the people on student medical forums.

The amount of time a person with ADHD can focus is highly variable, as the disorder is on a spectrum. Like all people, there is still variability depending on topic interest, understanding, and other factors. There is no *mystical* number. Also, just like a person with a fused joint can develop compensations that return some range of motion, a person can train the mind to develop compensatory focus mechanisms. In my case, these mechanisms usually come in the form of multi-tasking. I will give short bursts of focus to specific tasks. For example, I will walk when I study, or I will sit on SDN and ping pong back and forth between studying and a reply. This way, I do not spend to long on any particular thing. This mode of operation obviously lends itself more effectively to certain specialties in medicine (as the OP mentioned, transplant surgery probably not so much), but the ADHD has nothing to do with it. You could most assuredly train yourself to operate the same way, without ADHD.

 

[HyperDoctor]

Anyone a third year or beyond and figured out a good way to deal with this? All my rotations so far have let us go to sleep by midnight or 1 and up at 6 or 7 which isnt bad. Except I have OB and Surgery next and I know we dont sleep on OB (evidently going to the restroom is looked upon as lazy! But I am hoping those are exagerated rumors!!!) Wondering if anyone else had any recommendations?

Currently on Adderall XR 10 mg at 7 AM and 10 mg at noon. I have been taking the noon dose around 3 or 4 on call days, especially when afternoons are light. My psych gave me a script for some 5 mg regular adderall to supplement at night which I may try if it seems like I need it, but wondering if others had other ideas or things that worked for them!

(He also offerred to write a note saying I had to sleep for at least 5 hours a night, but I dont think that would go over well with residents or classmates for that matter! I guess it is always a fall-back if things are miserable.)

 

[Tired]

(He also offerred to write a note saying I had to sleep for at least 5 hours a night, but I dont think that would go over well with residents or classmates for that matter! I guess it is always a fall-back if things are miserable.)

Holy crap, if you try this and it works, please let us know. I'd so be willing to take a stab at that during Internship . . .

 

[HyperDoctor]

Sorry for the double posting, but I am currently having a rough time and am really glad I found this thread!!!

I was diagnosed in college with ADHD as well as LD. I knew from about 7th or 8th grade that I didnt learn like everyone else but my parents always blew off my comments especially since I always did reasonably well in HS. I finally got a second opinion from the student psychology office in college who referred me to a psych who diagnosed ADHD and recommended LD testing. My parents agreed to it just to "prove me wrong."

I totally struggled my first two years of med school. Every class except micro and immuno kicked my ass first year (not counting the touchy-feely ones 😎). Second year was better in general - I did well in path and OK in pharm, though neuro was again a real struggle. (Other small classes, psych, nutrition, lab dx, radiology were fine.) I did fine on Step I (right around the mean).

I am bummed about this year. I did not expect to struggle as much as I am. Psych and neuro went pretty well (shelf and wards), but medicine was much harder. I almost failed the med final - it was one of those exams which the moment I looked at it I knew I was going to fail or almost fail. I have had them before - the ones with really ambiguous, poorly wored multi choice questions where I really want to know "does the pt look sick?," or you have to select the disease that is not in your differential or the blood test that would be least useful in the diagnosis. Well, I barely passed. And I always got asked questions on rounds that were really hard - it seems like I always knew the answers to my teammates questions. Or had a different answer.

Peds seems to be going better, but maybe the residents think otherwise, and the shelf will tell the real truth.

I read all the time. Or at least I try to. It takes me forever and it can be hard for me to get started. But how do I know what to read about? I mean, how do I know I will get pimped about a pt tomorrow who is on the CHF service with DKA? (I knew all about CHF and the meds and studies and the trials and all that stuff cold!)

If any third or fourth years or beyond have advice, please help! I am frustrated. I know everyone goes through this, but it doesnt seem like it. And besides, who tells you "I actually feel brilliant and answer every question all the time?" Dont you sometimes wish your friends would tell you their secrets rather than be nice to you?

 

[HyperDoctor]

Holy crap, if you try this and it works, please let us know. I'd so be willing to take a stab at that during Internship . . .

I am sure my classmates would never let me live it down! And as you of course realize, internship I will have "real" responsibilities. Then again, I will only have to be awake when I have work rather than because some idiot working 12-hour shifts decides taking a nap at 4 AM is unprofessional and lazy.

 

[vtucci]

Anyone a third year or beyond and figured out a good way to deal with this? All my rotations so far have let us go to sleep by midnight or 1 and up at 6 or 7 which isnt bad. Except I have OB and Surgery next and I know we dont sleep on OB (evidently going to the restroom is looked upon as lazy! But I am hoping those are exagerated rumors!!!) Wondering if anyone else had any recommendations?

Currently on Adderall XR 10 mg at 7 AM and 10 mg at noon. I have been taking the noon dose around 3 or 4 on call days, especially when afternoons are light. My psych gave me a script for some 5 mg regular adderall to supplement at night which I may try if it seems like I need it, but wondering if others had other ideas or things that worked for them!

(He also offerred to write a note saying I had to sleep for at least 5 hours a night, but I dont think that would go over well with residents or classmates for that matter! I guess it is always a fall-back if things are miserable.)

Did you try talking to the dean of student affairs at your med school about it? He might be able to help.

Adderall is an amphetamine- just taking an extra 5mg will probably keep you wired on your surg and OB rotations so you don't sleep. However, that is not what the medication is intended for and that is really dangerous for any long term period.

 

[vtucci]

So you have the other ones? The ones I didn't bold? You have those 6/9? Because then it seems that multitasking would be complicated by not listening, losing things, and being forgetful.

If you have time I really need a better explaination of this. I am still mystified as to why a disease with 9/9 diagnostic features that would harm a person's ability to multitask somehow confers as advantage in multitasking.

What is this mystical short amount of time that people with ADD can focus?

Miami Med covered a lot of the points. But just to reiterate....

You do NOT need to have 9/9 to be classified as ADD. This is a spectrum disease. Some people will have a dominant one (or two or three) of the list below with others in varying amounts depending on the day.

For me, I am more 2, 7, 8, 9 with others to a lesser extent (and yes, Amory before you jump on me saying that I only mentioned 4/9 diagnostic criteria, I have each of the others in varying degrees. The four I listed are my more dominant features).

That being said, many of us, myself included, have developed coping mechanisms to minimize the impact of some of these traits. As I have mentioned, I will put my keys in the same place every day so I don't have to go searching for them. I do not bring a purse when I go out because I will (without fail) lose it. I can't tell you how many times I have lost an umbrella. I feel like the absent minded professor. I have become obsessive about organization so I don't forget to do things (and I would not say that I was good at this as a child/teen- this is a coping strategy that developed over time). I have pop-up reminders and sticky notes that I put places so I never miss a deadline for school/work etc. If I don't write it down, I will not remember it happened (this includes people's names, activities etc). I pay bills the very day I get them so I won't forget. I write copious notes when professors talk so my mind does not wander and I appear to be ignoring them-this also helps in not making careless mistakes.

The "mythical" amount of time that people with ADD can focus-- this is going to vary greatly by person. For some of us, it is an hour, for others five minutes, for some, even less than that. It also depends on what the subject or activity is. If it is something that we enjoy, we can usually focus longer. Granted, this is often true for all people. However, longer does not necessarily mean that they will get through their favorite activity in one sitting (even if it is their favorite movie, they might have to get up and do other things).

In terms of multi-tasking and whether ADD is an advantage.... I think there is huge personality element to this as well. For me, I know I multitask well. Is that because of or in spite of my ADD, I don't know. I tend to think that the ADD is just another element and is the reason why I don't get thrown when a crisis appears. Many people without ADD have no ability to cope with diaster or crisis. It freaks them out. It jars their neat, ordered little world. For those of us with ADD, our world (or mind) was not that neat and tidy to start with and we have had experience dealing with chaos so maybe that is why some of us can settle down in such times. I have been amused on more than one occasion when I have seen co-workers melt down/shut down when a crisis occurs. This is when I seem to shine.

1. often fails to give close attention to details or makes careless mistakes in schoolwork, work or other activities
2. often has difficulty sustaining attention in tasks or play activities
3. often does not seem to listen when spoken to directly
4. often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (no if oppositional behavior or doesn’t understand instructions)
5. often has difficulty organizing tasks and activities
6. often avoids, dislikes, or is reluctant to engage in tasks or activities that require sustained mental effort (such as schoolwork or homework)
7.often loses things necessary for tasks or activities (e.g., toys, school assignments, pencils, books, or tools)
8. often easily distracted by extraneous stimuli
9. often forgetful in daily activities

 

[Docgeorge]

I was Dx with ADD as a second year in med school. I had a hard time accepcting that diagnosiss. I wanted to anything but ADD, but it explained a lot about who I am and why i do the things that I do. I now take concerta in the am and shorty in the evening. I actually dont have a problem going to sleep while on my meds, so being on call has not been a problem for me. As far as telling people about my ADD, at first I was very secreative, I did'nt want anyone to know, now I dont care, if some one asks I tell them, or if I'm going to be working with someone and I feel that knowledge of my ADD will improve communication btw us I tell them. I've even told my soon to be PD that I have ADD, and she told me that it's not that uncommon for surgeons to have ADD and she does'nt see it causing problems. Over the years I've come to the conclusion that if someone takes umbrage with my ADD (or me for that matter) then thats their problem not mine.

Studying is a beast, I've re-written whole books. All of you guys out there in med school dont fret about these a$$holes who give you crap about about our unique way of thinking. I actually think that my ADD is of benifit to me. I love surgery and my add lets me hyper focus. It makes me very good in the OR. For the floor work I absolutely have to have a to-do list and patient cards. If I dont write down stuff that needs to be done on the floor it just wont get done. I've tried doing voice recordings on my PDA, but I found out that, I would just forget to review the recordings, and besides it took too damn long to listen to the whole message. I keep a small pocket note book for things that need to be done and I check it religeously.

I have to admit though that while I use the meds, i feel that they make my thinking more serial and less paralell. I'm not as creative on meds as I am off. Once I finish residency and fellowship I plan on D/Cing my meds, although my fiancee claims that she will divorce me if I stop taking them.

 

[AmoryBlaine]

I was Dx with ADD as a second year in med school. I had a hard time accepcting that diagnosiss. I wanted to anything but ADD, but it explained a lot about who I am and why i do the things that I do. I now take concerta in the am and shorty in the evening. I actually dont have a problem going to sleep while on my meds, so being on call has not been a problem for me. As far as telling people about my ADD, at first I was very secreative, I did'nt want anyone to know, now I dont care, if some one asks I tell them, or if I'm going to be working with someone and I feel that knowledge of my ADD will improve communication btw us I tell them. I've even told my soon to be PD that I have ADD, and she told me that it's not that uncommon for surgeons to have ADD and she does'nt see it causing problems. Over the years I've come to the conclusion that if someone takes umbrage with my ADD (or me for that matter) then thats their problem not mine.

Studying is a beast, I've re-written whole books. All of you guys out there in med school dont fret about these a$$holes who give you crap about about our unique way of thinking. I actually think that my ADD is of benifit to me. I love surgery and my add lets me hyper focus. It makes me very good in the OR. For the floor work I absolutely have to have a to-do list and patient cards. If I dont write down stuff that needs to be done on the floor it just wont get done. I've tried doing voice recordings on my PDA, but I found out that, I would just forget to review the recordings, and besides it took too damn long to listen to the whole message. I keep a small pocket note book for things that need to be done and I check it religeously.

I have to admit though that while I use the meds, i feel that they make my thinking more serial and less paralell. I'm not as creative on meds as I am off. Once I finish residency and fellowship I plan on D/Cing my meds, although my fiancee claims that she will divorce me if I stop taking them.

"my Attention Deficit Disorder lets me hyper focus."

Priceless.

 

[Doctor Bagel]

"my Attention Deficit Disorder lets me hyper focus."

Priceless.

I know it sounds wrong, but hyper focus is a well-established manifestation of ADHD. Weird, yeah, and maybe suggestive of a name change, but well accepted.

 

[AmoryBlaine]

I know it sounds wrong, but hyper focus is a well-established manifestation of ADHD. Weird, yeah, and maybe suggestive of a name change, but well accepted.

Can I see some data on that? I'm not trying to be flippant, but I am curious about it. To me that seems like saying, "extreme happiness is a well-established manifestation of depression."

 

[Ross434]

Can I see some data on that? I'm not trying to be flippant, but I am curious about it. To me that seems like saying, "extreme happiness is a well-established manifestation of depression."

Consider bipolar disorder - it's a problem with the mood regulatory system. Or diabetes - you dont have a problem saying "sometimes people with diabetes have low blood sugar ?? but sometimes they have high blood sugar?? Adhd is most likely a disruption to the system that controls attention. Attention isnt fundamentally disabled, it's just not modulated correctly. Too much attention in some tasks/areas, too little in others. It's out of whack, and the person has little control over it.

 

[AmoryBlaine]

Consider bipolar disorder - it's a problem with the mood regulatory system. Or diabetes - you dont have a problem saying "sometimes people with diabetes have low blood sugar ?? but sometimes they have high blood sugar?? Adhd is most likely a disruption to the system that controls attention. Attention isnt fundamentally disabled, it's just not modulated correctly. Too much attention in some tasks/areas, too little in others. It's out of whack, and the person has little control over it.

Once again, I wonder if you're trying to have your cake and eat it too. I'd really like to see some hard data that shows that people with ADD have better focus/attention in certain areas. I for one find it fishy to say that certain people need performance enhancing medication to study stuff they find boring but that that same disorder makes them better in the OR.

If the attention is "modulated incorrectly" than what about people who are awesome at the basic sciences but then suck on rotations. Do they have ADD in reverse?

I think it's easier to focus on "the Simpsons" than my Pediatrics textbook, does that mean that I have ADD too?

 

[Docgeorge]

You might. Here's an analogy that I like. There are Farmers and Hunters. The hunter gene (I say gene cuz of inheritabillity of ADD/ADHD) was an asset when we were huntergathers. Hunters are always scanning their environmet on the look out for both prey and other predators. You need to havehave situational awareness for you to survie. Situational awareness is picking up on a rustleing of leaves or seeing a sudden flight of a flock of birds from a tree or some one annoyingly tapping their foot during lecture. My mind is always scanning. Now when I find something that I deem/feel is somthing of priortiy (a woolly mamoth or a bleeding aneurysm) my brain shifts from scanning mode to lock on mode and I am able concentrate and pursee my objective with little regard for passage of time or sustinance. I'm also more likely to take risks when the risk/benifit ratio is in my favor. As an example I've read whole books in one sitting and stood through 15hr surgeries with out having to go pee or really preceiveing that I'm hungry. I cant choose what I can lock on to and what I cant. I cant make my self lock on to something that I dont find interesting. 6 hour vascular case I have no problems, 15 min tubal ligation I'm completely bored and time drags, and if I'm not on my meds my brain cycles through a million different things.

For farming (argrarian revolution) genes that select for high stimulation and risk taking are a liabillity. You need to be able to and pull weeds and plow the fields on a daily baisiss. You have to be a little risk adverse and be content with the day to day routien.

There have always been adders in the population. It was'nt a big liabillity as it today. You could make a fortune without having formal education or you could become a highway man or what ever. I believe that ADD really became a disadvantage with the german method of education that was introduced to the world during the late 1800 to the present. I thik that we are at a crossroads again now in civilization with the home schooling and montasori schools and the advent of the computer revolution. I think that my ADD is a disadvantage in the formal education process, but an assett in the real world if you learn to manage it correctly. My ADD made college and the first year and a half of med school a b!tch but it has allow me to highly successfull in Real Estate investment and development and it is so far it is an asett in my surgical endevors.