mused with mary

I promise that I get inspired to write by more than what comes to me during yoga. But lately, the messages I need have come to me during this time, and I can’t help but share in case they resonate with you.

I’ve been very open about the stress that happens in medical school (surprise!). During the pandemic, my classmates and I were separated within a few hours, told to go home, and learn medicine in places we weren’t used to, in the middle of a pandemic. It was challenging, it was hard, but we made it through. Then our clinical year came (called the Principle Clinical Experience or PCE at HMS), and new challenges surfaced. Not only were we adjusting to being back in person, but the constant worry of contracting or spreading COVID-19 weighed heavy on us all. We missed the typical support and camaraderie of medical school; there were no social events, no class get-togethers, even our small group teaching was done online. We still had the same responsibilities of clinical training: reading up on our patients, studying to pass our exams, working collaboratively with our teams, adjusting to new schedules on a daily or weekly basis, navigating the professional social environment of medicine, and trying to perform to the best of our abilities. We did this while maintaining our lives outside of medicine – possibly riddled with fear, anxiety, worry, stress about what was happening in our world. Not to mention the “standard” set of troubles that come with being a young person at this stage in life – relationships, family struggles, children, financial worries. Despite the struggles that we all felt, I really did love my clinical year experience and learned so much; I learned what I loved within medicine, what sparked my interests, what kept me up thinking at night, what I was good at, and ultimately that I wanted to become an anesthesiologist (and a great one!). I won’t lie that there were times I cried at home to my husband, feeling overwhelmed by the pressure of it all. Feeling the burden of imposter syndrome. Feeling like I was incompetent for answering a question wrong or feeling like I was destined to be a bad future doctor for letting myself down in my performance in some way. Although I was clearly successful, there was a struggle of feeling like I was going to be “found out” or that my constant efforts to prove my worth and abilities would be exhausted. I’m not the only one that felt this way; many of my most competent and brightest friends and classmates shared similar feelings of being burdened by the feeling of being an imposter. But we aren’t frauds. And admitting these feelings makes us even more real and authentic than those who try to hide their feelings under the rug. There is strength in realizing that the feelings of being incompetent are false and then working hard to change that narrative. There is no doubt that medicine demands excellence, because when we make mistakes or have lapses in judgement, our patients may suffer. As a trainee, we are protected to some degree by our preceptors to oversee our decisions. Nevertheless, that pressure is real. It is what encourages me to work diligently, to learn all that I can, and to show up for my patients even when I may be limited mentally or physically. That pressure is also what drives burnout in medicine. My goal throughout medical school has been to 1) be honest about this pressure, the stress, and the imposter syndrome that some of us may feel, 2) seek answers and opportunities to address this in medical students and 3) always be honest with myself about my own wellbeing and mentality.

This brings me to the yoga I did at home today. I won’t lie to you, the past month has been challenging. I took the USMLE Step 2 exam (last board exam of medical school), and I put tremendous expectations on myself. I can typically find strength in pressure, but I also recognized during this period that this may sometimes be maladaptive. Sometimes extra pressure or unnecessary expectations can lead to sacrificing mental health or wellbeing. It was a lesson I am really thankful to have learned because I know the pressure and stress to work hard will only increase as I become a doctor (in less than a year!). I’ve also felt MAJOR imposter syndrome as I prepare for residency application. Maybe it’s just me (that is imposter syndrome convincing me at its finest), but I feel overwhelmed about applying to residency. There are some days that I am so proud, confident, and excited about what I have accomplished while in medical school, and I feel even more empowered about what I plan to accomplish as an anesthesiologist. There are other days (like today) where I wonder if anyone will think I am a worthy applicant and future doctor. I try to block these thoughts, but they linger. They steal moments of joy and happiness that I wish I could have back.

I did 30 minutes of yoga to treat these negative thoughts in the best way for me: movement. I started moving through a yoga flow, and I came to a half-moon position. This pose is where you are standing on one leg, hinged at the hips, with your opposite leg lifted and externally rotated in the air. It is a tough pose to hold. As I was doing this difficult position, my gaze shifted back and forth along the ground and I hobbled and wobbled until I fell over. Frustrated, I picked myself up and decided to stop letting my thoughts drag me in a million directions and instead fixate on a point on the ground and hold the position. I found a place in my kitchen floor where the tiles intersected and set my vision on that point. I focused, and I held my body in the air without a single wobble. I was focused on something constant, something outside of myself, and it allowed me to do something hard. This little message rang clear in my head: the past few weeks I have been shifting my gaze, letting my focus bounce around without a clear focal point. I have been wobbling and hobbling and falling around each day. When I am down, I tend to settle on something within myself that cannot pick me up. I need to fixate, focus, and set my vision on something more permanent. Something that is immovable in comparison to my shifting perspective of myself. For different people, this will be something different. For me, this immovable focus is that my purpose reaches beyond what I get on an exam, where I go for residency, even what type of doctor I become. My purpose is set by God’s plan for my life, and when I try to ride the currents of my own willpower and plan, I will certainly find it rocky and unpleasant. This analogy also reminded me to find strength in those people in our lives who are steady, constant. To lean on them when we are unsteady or wobbly. Imposter syndrome can have a toll on our confidence and self-worth, convince us that we are something we are not. Instead of falling into the same trap over and over, we need to steady our gaze, find our focus, and quiet our minds to do what we are here to do, whatever that may be for you.

With reminders like this, I need to do yoga more often!