Osteopathic Medical Student with Asperger's Syndrome

[sjagan1]

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[pathologyDO]

Hi everyone! I am a 2nd year Osteopathic medical student who started going to therapy last March for deep trauma and personal stuff adversely affecting my academics. As it turned out, I had undiagnosed Asperger's Syndrome for nearly 25 years of my life. I was misdiagnosed as ADD in 2nd grade. Even though things improved somewhat with medication and academics/behavior problems were easily resolved, it was deceiving. Silently, Asperger's Syndrome, depression, PTSD, and anxiety were slowly destroying me. I struggled invisibly. However, no counselors, teachers, and people saw what it was. My family was not very welcoming to me either though they sacrificed so much for me.

In medical school, people were clearly able to deduce I had Asperger's and after roommate troubles pushed me over the edge in March 2014, therapy slowly but surely connected me to the answer. Though it has been a very slow/huge struggle opening up to important people like clinicians and understanding myself, I still comfortably passed my classes (including OPP and the History and Physical Examination with excellent scores in humanistic domains) and I know I am going to do extremely well on level one of boards. My academics/work ethic were powerfully compensating; Also, so was my otherwise very genuine/incorruptible personality (never did drugs, alcohol, or any of those trouble making stuff), lack of pure mental breakdown, and "mildness" of my impairments. I was spared from the worst of life's crises and the worst forms of abuse possible from people growing up. I was in an Independent study pathway at medical school where I was spared from a lot of classes to keep track of/attend. As long as I write stuff down, I am able to keep track of things like deadlines ( I have incredible written recall).

I nevertheless wonder how I can best make use of resources to help me when clinicals start. How can I make the "life" things less of a minefield? Asperger's Syndrome can't be cured but so much of the root causes and symptoms can be reduced through therapy, doctor's care, support, and medication.

The doctors at my medical school know I have Asperger's and they are totally not worried about me being able to be a good doctor. But how much more do I have to do to ensure that my function in all aspects is up to the mark? Academics is only one part of Medicine. It can only compensate so much.

EMDR therapy
Journaling
Yoga Therapy
Bible Support group ( I am a christian)
A few friends
Clinician Support
Very supportive Family

I am not on medications, have no signs of depression, PTSD, and anxiety (they have been going away rapidly). I will be going for a sleep-study next week and I will be seeing a neurologist/psychiatrist for more evaluations even though things are heading in the right direction.

What else will be critical to success in the future as a physician in training and as a physician?

First off, congratulations on making it into medical school and succeeding this far, despite your troubles.

But...I'm not sure what exactly you're asking? I didn't find anywhere that you mentioned specific problems you're having, all I read is that you survived 25 years with aspergers, have done well in medical school so far, your professors believe you're doing fine, you have a good foundation of knowledge to use for step I and clinic, etc. etc.

What problems do you have? Obviously social interactions are harder with Aspergers, but what specific problems are you having?

 

[sjagan1]

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[HoboCommander]

You can pick a field like pathology or radiology where you don't have to interact as much with people.

 

[sjagan1]

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[Stagg737]

Wow, that's a lot of questions/issues to bring up at once, but it's great to hear that you've made it this far and have been successful. Hat's off to you sir (or ma'am?).

For the neuro/psych thing, are you talking straight psychiatry or neurophys which focuses on psych disorders? If you're talking about straight psych, I'd say it's probably not a great fit because of the issues you stated in parts 2 and 5. Most psych patients would probably struggle with a physician who needs them to repeat themselves a lot. If you have difficulty distinguishing between what's normal vs. not normal you may miss important cues in their tone of voice, body language, etc. in a patient's case, a skill that I think is probably more essential in psych than in other fields. Other than that, there are plenty of fields which you can thrive in. To add to patho and rad, have you considered anesthesia?

For number 6, I'd say that everyone struggles with this in one way or another. Once you're in rotations, I'd just be straightforward with them. Say what you have and tell them your concerns, but also make sure they know you want to be challenged and will bust your butt. Some of them will probably be jerks and couldn't care less, some may become great mentors. Either way, I think being honest and having a positive attitude/outlook would be beneficial.

Final thought, I'd recommend giving meditation a try. I've had several professors teach our classes throughout my education, and it can be really helpful in clearing and recharging your mind. It can be tough to learn, but if you do it right, it can really help with focus and feeling more energetic throughout the day. Worst case scenario is it doesn't work and you wasted 15 minutes. Not usually the end of the world.

Hope some of this is a little useful and that you're able to continue getting better/improving your situation. Good luck with everything!

 

[sjagan1]

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[Shaggy102]

Hey Brother! There's an endless road for you to discover. Maybe a reason why all the doors are "closed", is so you could open one that leads you to your perfect road. Endocrinology seems pretty interesting 🙂 Stars can be fun. I know how you feel man, it's like a house of cards, one blow from caving in.

 

[pathologyDO]

Even though my problems are getting less, here are a few.

1. My brain just has chronic songworm. It plays songs over and over again. I wish my brain could be "100%" quiet. My focus can be better even though it already is strong in many respects (I am a singer and piano player with perfect pitch).

2. Sometimes, my brain struggles with short term memory (it is not impaired) but my brain in group interactions and even when clinicians are talking tries to focus on other thoughts, feelings, and other "random stuff" (not inappropriate or concerning). As a result, I miss parts of oral instruction when someone is trying to show me a procedure, giving directions, or if they are talking fast or saying a whole bunch of things at once (Urinary catheter or IV placement). I really struggled being a medical scribe and learning how to do very fast short term multitasking in University of Maryland School of Pharmacy whose chief mentor gave me very hard times equivalent to "attending who grills you every step of the way and judges you every step of the way). It was traumatized by that experience. I would forget things people my age or in class said would say I would have to make them repeat unnecessarily (which I know is VERY bad in Medicine where there is no room for that)

3. I still struggle with anxiety and I wonder how much can therapy get rid of it all together. Is medication of any sorts necessary? Do all people with Asperger's Syndrome have to have medication? One of my group faciliators said that even though things are clearly getting better, I still should see a neurologist/psychiatrist for a cognitive/emotional evaluation to see if medication is necessary.

4. Which specialties and rotations will best fit me in your opinion? I always wanted to do something with neuro/psych and Endocrine. Those are my three favorite subject and strongest ones I am passionate about.

5. How do i determine if mistakes or imperfection are due to typical human error or coming from Aspergers'/mental illness? I struggle with what is normal vs not normal in many respects.

6. How can I work with my "higher-ups" in clinical medicine to challenge me to be the best physician I can be while at the same time being understanding and tayloring based on how I am (even with optimal treatments, I will always have strengths and weaknesses). I am not asking for "special sympathy or easiness". I value being challenged and growing from criticism. At the same time, I want to ensure that they are on my side and will be helpful in every way possible. I can't do this alone.

7. I don't have serious sleep issues but I know they can be better. I am going in for a sleep study on Monday. How can I tell if I am getting excellent quality peaceful sleep that is nourishing? Even though my sleep has been improving tremendously, I think there is a way to go on that.

How much exercise do you do? Lifting weights, cardio, etc?

The bolded items are things that I believe shouldn't be solely attributed to Asperger's and could all be vastly improved with exercise. I also struggle with the things you listed, and I'm pretty sure lots of other medical students do as well. From experience I can tell you that regular exercise will help a lot with these things, so if you don't already, you should try to start doing 30+ mins of any exercise 4 days a week.

As far as clinical years, you will have to be able to work with a superior that may or may not like you. Its best to go into any situation open-minded to the fact that someone may be really nice, or you may not get along with them - as is life. The best way to cope with this is to learn ways to destress, and try not to take criticism personally (and this could be hard for someone on the spectrum because it requires putting yourself in the preceptors shoes).

Btw, did you say it was a professional that diagnosed you with ASD? Many of the things you're talking about sound more like ADD, your original diagnosis.

 

[sjagan1]

Hey Brother! There's an endless road for you to discover. Maybe a reason why all the doors are "closed", is so you could open one that leads you to your perfect road. Endocrinology seems pretty interesting 🙂 Stars can be fun. I know how you feel man, it's like a house of cards, one blow from caving in.

That's what I LOVE about Endocrinology and the brain. They are puzzles always waiting to be solved and understand how it all works mechanically! Knowing where the "key lesion" is and what is compensating. Pituitary, Thyroid, Pancreas, Adrenal Gland, Hypothalmus, Parathyroids. It's all cool.

 

[sjagan1]

That's what I LOVE about Endocrinology and the brain. They are puzzles always waiting to be solved and understand how it all works mechanically! Knowing where the "key lesion" is and what is compensating. Pituitary, Thyroid, Pancreas, Adrenal Gland, Hypothalmus, Parathyroids. It's all cool.

 

[sjagan1]

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[pathologyDO]

Alright, this further insight does sound more like ASD.

It also sounds like things are going very well for you though 👍👍👍

I say just keep working on getting some of you weaknesses taken care of and you will be fine.

You are not defined by ASD, so you should never let your situation confine you to a field, just because said field has less social interaction. If you made it this far then I doubt you will have any serious problems in whatever field you choose.

Good luck

 

[Stagg737]

Sounds like you've got both realistic plans and are doing well with getting better. I've struggled with mild depressive issues, so I'm always happy to hear when people overcome stuff like that. Glad the yoga/meditation stuff helps too! I've found the more one practices it, the easier it becomes to refocus and destress quickly.

As for endocrine, I'm afraid I can't give much advice as I'm in the middle of that system right now, I'm definitely enjoying it though and I don't see any major issues that would prevent you from pursuing it if that's what you want!

 

[costales]

How do i determine if mistakes or imperfection are due to typical human error or coming from Aspergers'/mental illness? I struggle with what is normal vs not normal in many respects.

When you're on the wards, if an attending/resident says you're wrong, then you're wrong. Correct it and move on. It's not personal. Don't obsess over it. Don't psychoanalyze yourself over it. The most important thing is you have gained new knowledge - that's the whole idea.

 

[Neverbot]

This whole thread. I'm so happy to see this because I have Aspergers as well and I need to be reminded that it will not bar me from what I want to do with my life and that there are other people with Aspergers who are successful in med school. You're awesome and I wish you all the success.

 

[sjagan1]

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[MrChance2]

Honestly, you seem to be doing well and have a very realistic grasp everything you talked about. Regarding some of your memory shortfalls and such I would remember that you are in medical school and more is being asked of you than probably any other program in existence. People sometimes can't pay attention to complex new tasks all day everyday as is asked of medical students. I would be surprised if most medical students have not felt the same way.

Regarding Aspbergers management, if you believe it to be an issue maybe see a psychologist, not so much to "cure" you but to have someone knowledgeable that you trust to bounce things like this off as they come up in your day to day life. I'd be careful not to overdiagnose yourself. I obviously can't diagnose you but it sounds like things are working out for you pretty well.

 

[sjagan1]

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[sregrub024]

This reminds me of my favorite bible verse, Genesis 15:9.

I always refer back to this when medical school seems tough.

"The Lord answered, “Bring me a heifer three years old, a she-goat, three years old, a ram three years old, a turtle dove and a young pigeon.”

I hope you can find courage in knowing that Hoshana in the highest, peace be upon Him, appreciates your sacrifice.

I like to think the 3 symbolizes the 3 tenets of osteopathy. Mind, body, spirit.

 

[Tortaspie]

I also have aspergers disorder. What specialty are you considering going into? I have been considering radiology or possibly path but I keep hearing the job market for path is horrible.