Healing the Healers: Breaking the Silence of Mental Health in Medicine

Akshara Ramasamy

The application to medical school shines brightly on my computer, each line a shimmering promise but also a shadow of hesitation. My desire of becoming a physician – a beacon of hope in the sterile white of a hospital room – collides with a dark truth gleaned from my psychology courses. I have studied firsthand how mental illness distorts one’s self-perception, turning the inner voice, once our most ardent advocate, into a relentless critic. The question arises – can I become a physician who provides care not only to my patients but also to myself?

As a pre-med student at the University of Texas at Austin, I have witnessed my peers put their mental well-being as collateral for the sake of productivity. Studies confirm this bleak reality: pre-med students shoulder a burden of depression nearly double that of their peers. Driven by an insatiable hunger for a medical school acceptance, we transform into multi-hyphenates serving others – medical scribe, research assistant, or hospice volunteer – all while overlooking our own needs. A relentless barrage of “weed-out” courses, the dreaded MCAT, and the cutthroat competition for limited spots create a self-feeding cycle of anxiety.

The marathon of application season descends upon pre-med students once the MCAT, grueling coursework, and extracurricular activities are conquered. However, this exhausted victory march is often overshadowed by a familiar foe – imposter syndrome. Four years of relentless hard work are distilled to mere numbers: a score, a GPA, quantified hours, and a $220 fee. The pressure to impress intensifies, bringing with it self-doubt. What if my MCAT score is too low? Are my extracurricular activities impactful enough? Will medical schools accept me?

These anxieties become relentless companions as we spend hours meticulously crafting narratives within the confines of 3500 characters, including the notorious “adversity” essay. We dissect past challenges, comparing and ranking our hardships to choose one that best demonstrates resilience. Yet, the most valiant battle for many – the one waged within our own minds – remains unseen and unwritten. We’re discouraged from sharing stories of overcoming mental illness, for fear of being deemed unfit for the very profession that demands unwavering empathy. The stigma prevails: mental illness is not a real struggle, but a potential liability.

Once the acceptance letter arrives, the imposter returns. How did I even get in? What if people think I am not smart enough? How will I last four years here? Gradually, the student takes on the role society expects, a tireless and “invincible” automaton fueled by sheer grit and passion. But the image of the physician as an all-knowing, unflappable hero imparts a dangerous illusion. What happens when the physician becomes the patient? More than 1 in every 4 medical student struggles with depressive symptoms, with 11% engaging in suicidal ideation. Despite this, talking openly about struggles still feels like a betrayal, a scarlet letter in the eyes of an unforgiving admissions committee. Instead, long hours are seen as a badge of honor. This pressure to be invincible takes a toll. With constructive coping mechanisms like SSRIs and therapy ostracized, students turn to destructive ‘medications‘ for coping – illicit drugs, alcohol, and tobacco – creating a normalcy out of self-sabotaging behavior.

The habit of silent suffering continues to be reinforced, where ambition comes at the cost of mental health. Ultimately, we have a system breeding physicians destined for burnout, which can erode empathy, transforming a compassionate provider into someone emotionally unavailable to their patients. The irony of it all – a profession devoted to healing has among the highest suicide rates with an estimated 300-400 medical professionals dying annually in the US. We become hypocrites under the Hippocratic Oath, sworn to “do no harm” while neglecting the harm inflicted on ourselves.

Healthcare demands resilience, but not invincibility. Psychotherapy is effective not only because it’s a professional service but also because it provides a safe space with a non-judgmental listener. But, we can offer this service ourselves. When students come together to form peer support at their institutions, mental illness no longer becomes a solitary struggle. The versatility of these groups makes it an even more transformative tool as solace can be found virtually or over the phone. This is why the words, “me too,” are so powerful. The struggling individual (“me”) sees there are others “too” confronting similar hardships. Silence kills, but the shared experience found in solidarity saves lives.

The current system thrives on deadly silence, directly contradicting the open communication essential for true healing. Medical school professors have a unique opportunity to pave the way forward by leading these support groups and sharing their own experiences with mental health challenges. This wouldn’t be a betrayal of strength, but its embodiment – the “See one, Do one, Teach one” philosophy finally practiced, not just preached. When faculty actively cultivates a culture free of stigma, students are empowered to shed the burden of silent suffering and seek the help they deserve.

Examples like the Lifestyle Medical Education program at the University of South Carolina School of Medicine in Greenville, which teaches healthy habits for mental well-being all four years, demonstrate the positive impact of such initiatives. By prioritizing mental health, we don’t create just competent doctors, but healers who can care for themselves and their patients. Studies paint a clear picture: well-rested and emotionally healthy doctors form stronger relationships with patients, deliver care imbued with empathy, and make fewer mistakes.

In a field rife with uncertainty such as healthcare, setbacks are inevitable. We will face challenging cases, lack answers to our patients’ questions, and continuously face the doubt of “Did I make the right choice?” However, healthcare is a team-based endeavor. A patient is not healed by one person alone. It is this common humanity shared by all caregivers that makes each other our best resource in combating mental health struggles. By acknowledging this mindfulness, we become better equipped to navigate the emotional complexities of caring for others. After all, how can we truly empathize with a patient’s struggles if we can’t offer ourselves the same understanding?