The Illusion

“This episode [Ep. 8, “In Hiding”] truly felt like a warm hug. It was proof of something that has not been very apparent in medical school thus far, as I am taught by expert clinicians with 5 faculty positions, unique hobbies, and smiling family pictures included on their “About Me” slides – that doctors are like me: flawed, messy, and struggling through the trials and tribulations of adult life.

While I am grateful for the escalated attention on physician wellness and the resulting addition of sessions like “patient reflections” and “physician identity formation” to my class schedule, I wish that personal topics beyond difficult patient encounters and exam stress were similarly ripe for discussion. Group “check-ins” at the start of classes limited to “surgery or medicine?” or “favorite Thanksgiving foods” do not quite set the stage for unburdening the heart. As a hopelessly bad compartmentalizer, I struggle to meet the expectation that my personal life must disappear in the clinic and classroom, when my professional life takes over. The breast milk vignette in this episode perfectly captures the shame that arises when these two lives intersect. I felt a similar sense of shame when I said I was “sick” instead of admitting I was too heartbroken to come to class after a breakup, or suffered in the back of a classroom, hesitant to excuse myself due to excruciating period cramps. The illusion that vulnerability is at odds with professionalism keeps me, as the title of this episode articulates, “in hiding” during my work life.

In medical school, the importance of the social history is frequently emphasized; we are taught that the social, spiritual, emotional, and intellectual components of wellbeing are as important as the physical. Yet during training, we spend 10+ hours a day hiding our own fear, heartbreak, loss, and pain. I would love to experience the same inviting, nonjudgmental atmosphere I have felt doctors establish in patient exam rooms in classrooms, on-call rooms, and breakrooms.

As the vignettes shared in this episode highlight, sharing of deeply personal issues like eating disorders, physical disability, and addiction is not only shameful, but may also be dangerous professionally. I myself have chosen to see a therapist in private practice after hearing horror stories of medical students forced to abandon training after sharing sensitive information with campus health services. The response to mental and physical distress among medical professionals needs to change – it should result in rehabilitation of caregivers, rather deeming them unfit to work and making recovery all the more difficult.

I am grateful to the Nocturnists for starting conversations needed to bring about such changes and lifting the veil of shame in medicine. I feel more empowered than ever to bring my authentic and vulnerable self to the classroom and clinic, share my struggles and triumphs with my peers, and stop living “in hiding.””