Testing, Testing, 1-2-3
Last week, I had a meeting with the director of my program to discuss my status. I wasn't sure what to expect, but I was prepared for the various possible outcomes. I had plans for each path; I just had to know which fork I was going to take.
Since I disclosed my illness, he has shown that he understands that my situation is different from that of most other MD/PhD students, that I have unique challenges to my education, to my abilities. He has appeared reluctant to just remove me based on grades alone, which I have really appreciated.
But, he admits, that of some concern to him [and to me too, honestly] is my seeming inability to perform to the standards of the program. Some of his points seem valid, and are the same concerns I have: that I was admitted to the program based on a high level of academic performance that I haven't been able to achieve--or come close to achieving--in medical school.
Of course, the reasons for this seemings academic floundering can be any number of things. I am especially susceptible to my environment, and for the past year, my home learning space [ie, the desk jammed into my room] was less than desirable. I always felt like I needed to leave home to study well, and a lot of nights, by the time I had gotten home and eaten dinner, it was 7 or 8 and a struggle to get my ass out the door ensued.
But it's more than that, I think--I did leave the house most nights, and I did study hard. Very hard. I found that I often felt like the things I had supposedly committed to memory were there, but just barely. Or else somehow inaccessible. Even now, sitting here, I wonder what I've learned. I know that I've passed, and that I ended up doing better than I expected, but is it there permanently? I still read things about the brain or about anatomy and feel lost.
It's a terrible feeling.
I think that the biggest problem I have is an inability to judge what is normal. I don't want to over-pathologize, and I don't know if the tendency is to do so. I don't want to make symptoms out of nothing, out of normal human experiences that everyone around me is having. But I have no benchmarks, no setpoints. All I have to compare is the achievements of a girl with a fucked-up mind that revved at convenient times, a mind that ran on fumes until it completely ran amok, fell to pieces, gave out.
So, I have this mind, the pieces put back together, held in place by Crazy Glue and Duct Tape, a mind that must be beautiful because it's saving itself, saving me, day by day. But it's a mind that doesn't work like it used to because it can't, because that way was destructive and wrong.
The upshot of all of this is that I am going for testing on Friday, that my director asked for a panel of tests from various centers to assess my memory and attention, the cognitive functions I need most to succeed. Hopefully if I test deficient in any area, we'll have somewhere to proceed. But most of the time, these days, I can't decide if what I want is the normalcy we are all programmed to crave, or if it's the deficiency, some evidence that I don't just suck
Since I disclosed my illness, he has shown that he understands that my situation is different from that of most other MD/PhD students, that I have unique challenges to my education, to my abilities. He has appeared reluctant to just remove me based on grades alone, which I have really appreciated.
But, he admits, that of some concern to him [and to me too, honestly] is my seeming inability to perform to the standards of the program. Some of his points seem valid, and are the same concerns I have: that I was admitted to the program based on a high level of academic performance that I haven't been able to achieve--or come close to achieving--in medical school.
Of course, the reasons for this seemings academic floundering can be any number of things. I am especially susceptible to my environment, and for the past year, my home learning space [ie, the desk jammed into my room] was less than desirable. I always felt like I needed to leave home to study well, and a lot of nights, by the time I had gotten home and eaten dinner, it was 7 or 8 and a struggle to get my ass out the door ensued.
But it's more than that, I think--I did leave the house most nights, and I did study hard. Very hard. I found that I often felt like the things I had supposedly committed to memory were there, but just barely. Or else somehow inaccessible. Even now, sitting here, I wonder what I've learned. I know that I've passed, and that I ended up doing better than I expected, but is it there permanently? I still read things about the brain or about anatomy and feel lost.
It's a terrible feeling.
I think that the biggest problem I have is an inability to judge what is normal. I don't want to over-pathologize, and I don't know if the tendency is to do so. I don't want to make symptoms out of nothing, out of normal human experiences that everyone around me is having. But I have no benchmarks, no setpoints. All I have to compare is the achievements of a girl with a fucked-up mind that revved at convenient times, a mind that ran on fumes until it completely ran amok, fell to pieces, gave out.
So, I have this mind, the pieces put back together, held in place by Crazy Glue and Duct Tape, a mind that must be beautiful because it's saving itself, saving me, day by day. But it's a mind that doesn't work like it used to because it can't, because that way was destructive and wrong.
The upshot of all of this is that I am going for testing on Friday, that my director asked for a panel of tests from various centers to assess my memory and attention, the cognitive functions I need most to succeed. Hopefully if I test deficient in any area, we'll have somewhere to proceed. But most of the time, these days, I can't decide if what I want is the normalcy we are all programmed to crave, or if it's the deficiency, some evidence that I don't just suck
posted by Another Chance to Get It Right at
11:10 PM
2 Comments:
This entry made me think about how interestingly and profoundly ingrained stigma is within common thought.
I was diagnosed with clinical depression, severe, at age 14; diagnosis changed to clinical depression, severe and recurrent following a second major depressive episode at age 16 (though my psychiatrist is fairly certain that it was actually bipolar II, presenting for so many years as unipolar depression, and keeping an almost paranoid eye out for any hint of full-fledged mania). I did both my undergrad and grad degrees (completed just last month!) at ivy league universities; both were degrees requiring both research and clinical work. I am literally an epitome of successful concealment of mental illness!
Disclosure has been a constant back-and-forth discussion across the last 10 years, waxing and waning with the onset and resolution of depressive episodes that increased in both intensity and duration with every one. I almost never regretted disclosing my illness, and looking back, I regret not disclosing it at other times. Pride and fear kept me from asking for the help and support I needed in my academic and professional career, and that is something I regret. At the very least, my academic transcripts would certainly have been more uniform! By the end, I did - more or less ;) - learn that incredibly difficult lesson, and thankfully: I simply couldn't have made it through the last year of my degree (which included my first ever psychiatric hospitalization) without the minor accommodations for which I was finally able to bring myself to ask.
And yet, at the same time, I ask myself if I would want to put my future child in the hands of a clinical professional with a similar illness. And the most awful part is that if I had a choice, I don't think that I would. What happens if my child saw this clinician on a day when s/he was struggling? Or, what if this future child of mine needed to see the clinician in a phase of his/her illness? What if his/her judgment WAS impaired...and by something that wouldn't have been present had I sent this imaginary child to someone without the disorder....
These thoughts plague me, because what, then, do they mean about me, my definition of myself as a person - as a person apart from my illness, as a person in sync with a mental illness, as a person for whom performance, personality, existence are often so dependent on synthetic neurochemistry...?
I don't know. I just don't know.
If there's any confusion, that sara isn't me.
I know this is probably terrible advice, but all through medical school, I used to stop meds during exam time, fly through them, then bite the bullet of the depression after them until the meds kicked in again. I remember one semester being so horrible, at the end of the exam period, I took pills with me to the last exam so I could immediately take the first dose right at the end. Came home and collapsed on the sofa suicidal, but then the drugs were back and all was ok.
I just did it again for Step Two. Got a perfect score. And it was just a one day exam, so not that bad.
Before that, I didn't do it this time for the final university exams - stayed on the meds, and I barely passed. I have made my peace with the fact that my brain works in a strange way that will involve a willingness to sometimes tolerate a large amount of suffering in exchange for its abilities.
You can always go back on the meds...I know this is advice that doctors hate and so on...but I do need my periods when my brain is on fire. And a lot of the time, they come even in a horrible mood...not only pure mania. I felt horrible - horribly clear - the day I took Step Two.
It's just a balance. I wouldn't want to live like that all the time, probably would be dead without the meds. But sometimes, I'm willing to suffer pretty badly to be able to do the things I can do.
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