“The heart must first pump blood to itself.”

                At the end of my second year of medical school, I found that I was losing myself.   I know that that is a vague concept but that is exactly what I felt.  My academic performance was adequate but I felt that I wasn’t good enough.  Coming from an undergraduate and graduate degree where I was one of the top students in the program I found myself in a room of over one hundred people who were just as high achieving as me.  I was used to defining my identity largely based on my “intelligence” and finding that I was no longer the best, I felt lost in the crowd.  I found that I was spending a lot of time dwelling on my deficiencies and feeling sorry for myself, instead of working on improving my situation, or at least, making the most of the resources and skills I do have.  In addition, I was finding that since I had to dedicate so much time to school and the new acquaintances I had made, I could no longer spend as much time with my old friends of my family.  These people used to be my anchor and I found that I was losing touch with them and myself.  This, together with some other factors, I feel caused me to have an identity crisis.  Who was “Irena” in this new and challenging environment?

                In the end, what brought me back to a level of acceptance of myself was focusing more on other skills that I have, but maybe that I have not indulged of late.  Ever since I have been young, I have loved the creative arts.  I was always sewing, drawing, but foremost painting.  I decided to dedicate a weekend to creating a work of art that would remind me that I am still myself, that I am unique and I do have a lot to offer the world.  My work of art was inspired by a quote that I found in one of my lectures.  The quote is: “The heart must first pump blood to itself”.  I found this so meaningful – the heart supplies the entire body with nourishment but, when blood leaves the left ventricle, the first place it goes is into the coronary circulation to fuel the heart muscle to do its work.  Similarly, the work of a physician is to dedicate their lives to helping others, but first and foremost, the physician must take care of him or herself.  If the physician is not of healthy body and mind, they cannot help others as effectively or efficiently.  In our generation, it’s no longer the standard to work 80 hour weeks and to ignore one’s needs and family.  There is more emphasis on a healthy and balanced lifestyle.  Knowing that this new shift of attitude is prevalent in the practice of medicine, I needed to start putting that mentality in place now.

                The painting now hangs in my apartment and it really gives me comfort, it reminds me to always take care of myself.  If I find I am struggling, I need to find help and find solutions, and not just wallow in my deficiencies.  When I feel lost or inferior, I just need to look within and remember that I am not just a medical student – that is not what defines me.  I am unique, I have many talents, and I am loved and supported by a wonderful network of family and friends.  I need to actively work to make sure I am physically and emotionally strong to face the many challenges that the medical profession presents.

Irena

Now nearing the end of my very first year in clinical medicine, it's an interesting time to reflect back on how my own attitudes have been changed through this experience.  Doing clerkship is kind of an insane experience.  It demands a kind of commitment to your work that few other training programs do.   It takes you away from the things that really connect you to who you are as a person; it asks that you spend less time with your friends and family than with the hospital wards, and it will often result in you arriving at work before the sun rises, and leaving long after it has set.  Your patients will try and make small talk about the weather, and you won't be able to participate because you won’t have had access to a window for 12 hours at a time. 

It is said that medical professionals lose some of their empathy and compassion as they proceed through their training.  Prior to starting my clinical rotations, I thought this was simply a way to cope with some of the truly sad and disturbing things physicians deal with on a regular basis.  While I still think this is true, I think there's something a little more systematic at hand.  I struggle to maintain empathy for patients and fellow health care professionals when there's a little voice in my head feeling sorry for myself for not having had the chance to eat, drink, or properly sleep in days. I also struggle to maintain a connection to people who don't work in a demanding healthcare setting.

While I am incredibly lucky to have supportive friends outside of medicine, sometimes I feel like I'm explaining the experience of being in outer space when I try to explain what life on clinical rotations is like to friends in totally different fields.  All of this serves to isolate training physicians in a way from the population we're trying to help.

I got into medicine because I like talking to people more than anything, and yet, this year of learning how to help the human body has paradoxically isolated me in some ways from non-medical humans.  One of the biggest struggles in maintaining empathy and a connection to others does come from the fact that life or death is the routine for many medical professionals.  I find myself reminding myself every day that, for some of my patients, coming to the hospital is a terrifying and unique experience for them and their loved ones.  I have to actively do this, because it matters to me that I try and understand their experiences, and yet, it's something that I forget to do all the time.

I don't know if there's a way to address this at a systemic level, or I'll just have to keep a check on myself, day by day, that it truly is important to me to be a person in and outside of my work, regardless of how strange that will sometimes feel.

On April 10th, 2013 at approximately 8PM, I shaved my head.

No, this was not a fashion statement. Nor was it in attempt to embody the great "Britney Spears" or any such thing. I did this, in fact, for my CHEO Buddy, Mitch, with whom I have come to love in but a few short months.

With Mitch's family on board and in full support, I raised approximately $4,500 dollars for Childhood Cancer research, and decided to shave my head as part of the fundraising.

I was awe-struck by the support of my classmates and the gratitude of those personally afflicted by cancer. Such a small gesture as shaving one's head, knowing the hair would grow back, seemed to really touch the hearts of those around me. I really can't describe, with words, how wonderful a feeling it was to see such a big wave develop from such a tiny ripple.

The first day bald felt like a dream. I woke up and passed by my bedroom mirror, only to let out a shriek in the realization that I had no hair. I came right up to the mirror, touching noses with my reflection, and examined the shape of my head from a variety of angles. "Thank goodness I have a round head", I thought. Not that this had concerned me before - but the fear was there. I can't deny that.

The next few days would be whirlwind of excessive chills and unbearable cold temperatures. It was shockingly frigid and no amount of scarf or sweater seemed to help

Then came the velcro stage. I literally stuck to everything. I couldn't get out of bed in the morning without taking my entire pillow case with me, or struggling to put on a shirt in the morning. I carried around balls of fluff wherever I went, and would often turn around in class to the feeling of someone pulling out some ball of fuzz.

And, of course, there were the puns. Oh, the many, many puns. I will spare you with these.

But something struck me above all else. It was the way I was treated by strangers. It took about a week for any sign of regrowth to take shape, so I was left pretty bald up until that time. During this week, I found cars stopping for me meters before I even came close to the cross-walk; pedestrians holding open doors for me, even though I was still 20 paces away; women giving me their seat on the bus, despite there being more than enough empty spaces available; and many people unable to look me in the eye or return my smile without glancing at their feet or turning the other way.

I hope, dearly, that this is the closest I ever come to feel like a cancer patient. Although this doesn't even begin to skim the surface of how one must feel in a society desperate to understand such an ailment, the mere absence of hair was enough to change the way I was treated entirely.

For one week, I was seen as helpless; as pitied; as different. Just one week.

Now, with the spikes growing in, I appear as though I am simply rocking a new hair style or following the likes of Natalie Portman. I'm wearing big earrings and flowery shirts and over compensating for my feminine appearances. And people no longer stop for me on the streets or hold open any doors.

Are we wrong to single out the 'sick'? Do we make people feel worse off by recognizing tragedy and responding to it, differently than if it were the person's 'choice'?

I have yet to conclude on this. But I will never forget this experience, as I believe it was a great lesson in the empathy I hope to never ACTUALLY understand about cancer.

The principal role that led me to study medicine is that of the person. Throughout my life, I have been exposed to sickness and health from a personal standpoint and as a witness to the experiences of others. This aspect of life has always interested me, especially the impact that health can have on an individual’s quality of life. From the many things I have learned and after much reflection on the subject, I realized my desire to act as a health advocate and help people from this perspective. I have found that many people do not understand what is happening in their bodies when an illness develops. I want to be a person’s liaison between perceptions of uncertainty and anxiety, and an adequate level of understanding to face the challenges that arise.