By Mary Crabtree

Do better. Be better. Think better. We are relentlessly slammed with this pressure to do and be and think better. It comes from inside our own heads, and from an illusion that medical students should be able to ‘handle it’. We are inflated by those fleeting moments of praise from a consultant or an inspiring patient encounter, but this feeling is too often swiftly replaced by an overwhelming sense of inadequacy.

How do we best remedy this sometimes crippling sense of pressure? To be honest, I don’t know if we can remedy it entirely. For me, it’s the desire to do better and be better that is probably what has led me to this point in my life. For so many of us the desire to succeed is inextricably linked to our choice to study medicine. So instead of allowing the pressure of our performance to dictate how we exist in medicine, maybe we should spend more time supporting students to become their best selves, rather than THE best.

Med is hard, some times are less hard than others, but there’s no denying it’s pretty hard. Sometimes it’s hard because the theory is confusing, or because you missed a tute. But sometimes it’s hard because life outside uni doesn’t care that you’re trying to study and learn and do better. Late last year, I was really struggling to be better, I was simply focussing on being. My 18-year-old cousin committed suicide and it rocked me. Life really didn’t give a shit that I was a bit stressed and tired, and I was hit seriously hard with a shaken perspective. I was already grappling with the guilt of having zero motivation to sit down at my desk and study for a degree that I so badly wanted, then the little impetus I did have absolutely vanished as I tried to put my brain’s pieces back together. The cycle would repeat itself every day: go to class and sit there distracted, feel guilty for not caring enough about uni, come home exhausted, go to bed.

I didn’t know what help I needed, but I certainly didn’t look very hard to find it. Of course I thought I was self-aware enough to just “think” myself better, back to normal. I went and saw a counsellor once, that was just exhausting. I spoke to friends, that was nice at the time but as soon as the conversations were over I went back to feeling alone and apathetic. I exercised more than usual, and in hindsight that probably did help, but at the time, no help. I did all the things that a clever, conscientious med student would recommend, but I really didn’t commit to any of them. Don’t get me wrong, life wasn’t all bad, I had some really brilliant times with some very brilliant people. It was just the overwhelming pressure to ‘make the most of it’ that came over me at the start of every week, then eventually only sometimes, and thankfully now quite rarely.

This pressure comes from everywhere. From within, from the competitive undertone that pervades the cohort, and unfortunately from those around us. I think there’s a strange precedent which dictates that med school must be difficult. Like it wouldn’t be med school if we felt well supported and safe to express our distress and disdain. Maybe feeling like absolute crap is rite of passage, so to speak. This is not healthy, not sustainable, and just not okay.

Now, the million-dollar question: how to fix this culture? My two-cent answer: I don’t know. But we can definitely make it better, and I think we should try a bit harder. Making it okay for students to take a break when they need to would be a great start. A mental health day here and there has saved my sanity in 2017. I pick and choose my timing, and sometimes there are uni commitments that can’t be ignored so my mental health takes a back seat for a week, but once things have settled down it’s so important to clock off med sometimes. Something needs to change in terms of support and connectedness, and I think that could begin with us as students, a grassroots kind of approach. Ask your friends if they’re doing okay, get a coffee and chill out, let others help you when you need a boost. And a revolutionary idea that is so incredibly difficult but really shouldn’t be, ask for help if you need it. Please please please, it sucks and it’s hard, but life is hard and we all need some help sometimes.

Feature image available from Wellcome Images.