Recent death in family...trouble with clerkships

[ECkayak]

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Hi everyone,

My mother died back in March while I was preparing for Step 1. It was a pretty big shock, she was in a coma for over a month so we never really had the chance to talk about death and all that stuff. I decided back then not to take time off, and went ahead with my original test date (actually pushed it back 1 week). I did ok, but it was a real struggle to stay focused and motivated. However, I had a few weeks off before my first clerkship and started feeling a little better. First clerkship went pretty good, at least clinically.

However, I'm now in surgery and starting to get run down. Besides the usual stress of surgery, I find myself staying awake at nights feeling like crap a lot. I don't have a whole lot of social support, and I'm starting to feel really lonely, and just overall tired. My mind wanders all over the place when I'm alone, and I can't really focus. I don't think it's showed so far in my work (I'm starting the fourth week tomorrow), but stuff is starting to pile up and I can feel my motivation starting to slip, and there's really no one whom I feel comfortable enough with to help me through this.

I guess my question is: what are some ways to get through this? I've seen the school's counseling service in the past for other issues, and it helped, but I have no time for that now. I'm too far in to take a LOA. Is it appropriate to ask for a day off perhaps? I don't want to screw my classmates, but I'm afraid that this sadness is going to start to show soon. Does anyone have advice, or has anyone been through a similar situation?

Thanks to anyone who reads this and replies.

 

[JohnnyExtra]

I'm too far in to take a LOA.

At my school, there is no such thing as "too far along." They make it clear that our health takes priority. I'm sure your administration feels the same way. Talk to someone.

I guess my question is: what are some ways to get through this? I've seen the school's counseling service in the past for other issues, and it helped...

Sounds like a pretty good start...

I'm afraid that this sadness is going to start to show soon

Again, talk to someone bud. The third year lifestyle isn't exactly one I'd recommend to my future patients. It's understandable that you may feel stressed out at times. Don't be afraid to ask for help if you need it. Now if you can tough it out, do that because it may save you a little time down the line...just not at the cost of your health.

I'm sorry to hear about your mom.

 

[Bacchus]

It doesn't sound like you "properly" grieved and just kind of pushed a lot aside/inside. You need to speak with someone. Your health is your priority.

 

[ECkayak]

Thanks for the replies.

I understand what you guys are saying, and I'm sure that I didn't grieve properly since I've never really cried over it, or gotten angry or any of the other stages. I just kind of accepted it and moved on. But I feel like, now, I would be letting myself down because I've managed to come so far. It's hard to explain, but I feel like I would be letting a lot of people down if I just decided I couldn't hack it anymore.

JohnnyExtra: I actually remembered that I used up all my mental health sessions already, so it's no longer an option through the school unless have them set me up with an outside provider. In any event, every hour of the working week is spent in the hospital, so it would really hard for me to get an appointment. Would an chief resident/attending look down upon a request for a spontaneous off day for such a reason?

 

[SiR99]

My suggestions would be:
1.) Tell your schools clinical administration so that they are aware of this. They will be able to tell you what options you really have with taking days off. Also, they may tell your attendings about your situation so that they understand what you are dealing with.
2.) Keep yourself as busy as possible. You will have a lot of sleepless nights, and it will just take time before everything is back to normal.

 

[88845]

Hi everyone,

My mother died back in March while I was preparing for Step 1. It was a pretty big shock, she was in a coma for over a month so we never really had the chance to talk about death and all that stuff. I decided back then not to take time off, and went ahead with my original test date (actually pushed it back 1 week). I did ok, but it was a real struggle to stay focused and motivated. However, I had a few weeks off before my first clerkship and started feeling a little better. First clerkship went pretty good, at least clinically.

However, I'm now in surgery and starting to get run down. Besides the usual stress of surgery, I find myself staying awake at nights feeling like crap a lot. I don't have a whole lot of social support, and I'm starting to feel really lonely, and just overall tired. My mind wanders all over the place when I'm alone, and I can't really focus. I don't think it's showed so far in my work (I'm starting the fourth week tomorrow), but stuff is starting to pile up and I can feel my motivation starting to slip, and there's really no one whom I feel comfortable enough with to help me through this.

I guess my question is: what are some ways to get through this? I've seen the school's counseling service in the past for other issues, and it helped, but I have no time for that now. I'm too far in to take a LOA. Is it appropriate to ask for a day off perhaps? I don't want to screw my classmates, but I'm afraid that this sadness is going to start to show soon. Does anyone have advice, or has anyone been through a similar situation?

Thanks to anyone who reads this and replies.

Hang in there! I've had similar circumstances. Just keep pushing and do your mom proud by staying strong. You will look back and be thankful you did. I know it's hard but channel all of these feelings into success and honor her that way.

 

[evilbooyaa]

Your health comes first. Tell your clerkship director. He/she WILL understand. If not, go above their head and go to your Dean of Students and explain the situation.

A leave of absence is NOT a nail in your application. You need to talk to someone over this loss since it seems to be affecting you now.

You're concerned about your surgery clerkship grade reflecting poorly due to you taking a leave of absence. I can guarantee unless you are at a malignant hospital, no one will think less of you for this.

 

[werd]

My suggestions would be:
1.) Tell your schools clinical administration so that they are aware of this. They will be able to tell you what options you really have with taking days off. Also, they may tell your attendings about your situation so that they understand what you are dealing with.
2.) Keep yourself as busy as possible. You will have a lot of sleepless nights, and it will just take time before everything is back to normal.

#1 above. tell your school what's going on now. if you tell them they'll work with you. if you fail a clerkship or have some other negative consequence, and then come out with this story, you're more likely to be screwed.

 

[primadonna22274]

Agree with all of the above replies. Sounds like you are experiencing complicated grief which is not going to get better by pushing through it. I can only imagine the loss of a parent during such a stressful time.
Glad to hear that you've had counseling, but you're nowhere near past this. Might be time for a little psychotropic help and yes, a day off (or more) sounds like a very good idea. More counseling would be good, but by all means talk to your advisors.
Wishing you the best.

 

[ECkayak]

Thanks for the responses.

I think I'll definitely send a couple of administrators at the school an email to let them know what's going on. I've talked to several of them right around the time that it happened, and they were receptive to helping me in a lot of different ways. I've always believed in fighting through adversity, but this is one fight that, given my whole situation, I'm not sure I'll win in the long run.

 

[evilbooyaa]

The thing is, you could potentially fight and beat this grief on your own. However, at what cost would this happen? Would you hurt your grade in your surgery clerkship because you're not there 100% mentally? That's kind of a minor effect in the long run, but there's always a chance this could cause you other more serious issues.

 

[Bacchus]

Thanks for the responses.

I think I'll definitely send a couple of administrators at the school an email to let them know what's going on. I've talked to several of them right around the time that it happened, and they were receptive to helping me in a lot of different ways. I've always believed in fighting through adversity, but this is one fight that, given my whole situation, I'm not sure I'll win in the long run.

Don't forget, most insurances cover a limited number of mental health visits. Exhaust all your options.

 

[oddvacado]

As someone who was in a very similar situation, and didn't take a leave of absence...trust me, very bad idea. I accepted it, moved on, and ended up getting a horrible step 1 score. I did poorly on every single clerkship exam. I'm now in a position of having to explain that decision over and over again, and it sucks. If I had just taken a leave of absence it would have thrown off my entire medical track, sure, but it would have forced me to deal with a lot of issues in the moment that slowly leaked out in periods of stress and in times where it hurt me the most. Don't be in that situation. Make the decision early on and re-enter the track when you've gone through the stages. Losing a parent is never easy. It's...horrendous, and while there's no time period when you should be "done," just trying to get through the most important year of med school and grieving is a decision you'll regret like I do now.

 

[bashir]

Lots of good advice already in this thread. I just wanted to add that it sounds like you think taking a leave of absence is akin to giving up ("I've always believed in fighting through adversity"). I'd encourage you not to think of it that way. Allowing yourself some time and space to process the loss of your mom would not be a failure; it might well be the clearest path to success going forward in your training. You should feel no shame whatsoever about taking a LOA if that's what you decide is best. Good luck with whatever path you choose.