Wednesday, November 11, 2015

Who Turned Out The Lights?

by Sameera Mokkarala

Ive been a bit of an early bird ever since high school. My dad, whose business associates lived on the East Coast, would rouse at 5:30AM to begin the daily onslaught of conference calls, and since my bedroom shared a wall with his office, I usually wound up joining him in being awake at ungodly hours. It became a habit that stuck with me through college, grad school, and now into medical school. And so, when Daylight Savings Time rolls around every November, I am typically the only person in my social circle whos been counting down the days, since I also tend to be the only weirdo whos consistently up before the sun.

Its disorienting to spend the first several hours of your morning in the dark, which is why I prefer the earlier sunrises that come along with rolling the clocks back. Even so, walking out of MedEd after class to find that its pitch black outside is its own type of unsettling. It becomes easy to ignore, for example, the many productive hours you ought to have left in your day when a 4:45PM sunset leaves you second-guessing the time display on your phone. Are you sure its 8PM? Because it definitely looks like midnight...

Its gotten darker out there.


During my first year of medical school, I heard an older student comment that if you arent having breakdowns a couple times per block, you probably arent doing med school right, and at the time this unsolicited advice made me laugh. I know this because I recently had occasion to flip through my intermittently-kept journal and found a set of entries from around this time last year which, while tinged with the usual exam stress, were fairly chipper. Maybe other people had to go through breakdowns and crying jags to get through, but not me. After all, as much as med school may be challenging at times, didnt I ask and even fight to be here? Isnt this me finally (after years of study and CV-plumping) living the dream?

A year and a few meltdowns later, Im not as sold on this logic as I was. Much of the time, it doesnt feel like the dream so much as it feels like a slog. Uphill, both ways, through the snow. Or through the allergen-laden breeze, as the case may be in Sacramento. Comparing my journal entries over the last couple months with those I made towards the end of 2014, its clear that something has changed, and that its changed in a way that I cant see when examining myself directly. When I think about myself and who I am, I dont feel that Ive changed overly much in the last year and a half; I still have love for what Im doing, and the goal that brought me to UC Davis--to promote care for underserved communities--burns as brightly as it ever has. I like to think Ive maintained my sense of humor, and that Im still managing to fulfill my roles in other peopleslives. I am who I was. But the consistent shift in the tone of my writings, from upbeat and somewhat glib daily updates to more measured weekly or monthly entries, betrays something else. Something is different.

It has, as I said, gotten darker out there.


This week, the medical education admin folk lured our class with free burritos to an introductory talk about third year Clerkships. Two weeks ago, they brought us together to talk about Boards. Cue 106 MS2s breaking out in nervous sweat at precisely the same moment.

While they might not always know exactly what these keywords mean, the non-medical people in my life have quickly come to understand them and their related terms as imbued with both great importance and an impending sense of Armageddon. This is USMLE. This is a Shelf Exam. This is Sameeras spiking blood pressure and sense of constant existential dread. Tread lightly.

These specters have been floating over our heads since the day we got to MedEd, but their insistence on now materializing and becoming real is, quite honestly, scary. I have found that its really easy to get overwhelmed and decide to solve the problem by ignoring it and re-watching Amelie instead. (I have also found that, in spite of my fondest hopes, this is not a viable problem-solving method.) While I wish I were the kind of person who felt invigorated by this sort of challenge, I am embarrassed to admit that I am more frightened than anything else--frightened of failure, of not being smart or personable or xyz enough, of somehow compromising my chances of being the doctor Ive always dreamed of being. Even more than that, Im afraid of not being able to be the person that the people I love need me to be, of disappointing them with my inability to be present and attentive. At the Clerkship meeting, they told us that one of the most difficult adjustments for third-year students is the fact that their time is no longer their own. But if Im already having problems with time, and if Im already having to miss things I care about--birthdays, holidays, Skype dates--, what does that say about the next two years? What does that say about me?

The people I love all assure me that it will be fine. That well figure out, well handle these things as they come, that were a team. I, for my part, remind myself and others that bigger fools have made it through with their MD and most of their sanity, so why not me? Why not us? I am trying, per my mothers very good advice, to cut this thing into sensibly-sized pieces, to take reasonable bites, and to chew the appropriate number of times before swallowing so as not to choke.

Ive thought about changing the way I write--about being more determinedly upbeat, deliberately infusing my entries with the positive, recording less of my doubt and anxiety--but I want whatever records I keep of this time to be true to the experience. Its why I do the time-consuming thing of actually writing by hand rather than typing my thoughts down, and why I use pen instead of pencil: if left to more impermanent formats, I would likely wind up with airbrushed gloss rather than faithful portrayals. I want to be able to look back in five or fifteen years and remember things as they were, whatever that winds up looking like.

What I can do is try to reach for my pen in times of happiness as often as I do in times of stress, to remind myself that there is a moment of magic--cheek kisses from a grateful patient, an impromptu visit from my younger brother, successfully out-punning my boyfriend--for every moment of frustration, sadness, or difficulty.

As I write this, light is beginning to creep its way across my kitchen floor. The sun is rising from over the hospital complex, casting the world in pink and orange. Its quiet, and its beautiful.

This is definitely worth the dusk.

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