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Notes -
I went blind again. Before anyone panics, it was for less than an hour, and I'm fine now.
I was previously diagnosed with a condition known as central serous chorio-retinopathy, where fluid leaks out of the vessels below the retina and makes it bulge out. It is usually due to corticosteroid consumption, which I've never done, but also due to prolonged and severe stress. Guess what I'm experiencing?
This isn't the first time. In keeping with a now-obvious pattern, it happened to me before a high-stakes exam. Once before the PLAB 1, again before the MSRA. And now, the MRCPsych Paper A looms ahead of me.
My stimulants might contribute (they're stimulating the sympathetic nervous system too), even if I take very reasonable doses. Unfortunately, my ADHD is not an affectation, I can't study without my meds, let alone pass exams. Especially exams that require months on end of grinding and memorization, when is rather be doing anything else.
So yeah, same choice as usual: lie flat, or keep fighting. I'm inclined to do the latter unless the attacks become so severe that I'm at great risk of permanent visual damage. I did see a doctor once, and it was decided that a waitful watching system was appropriate, instead of jumping to options like intravitreal injections or lasers. It's been a year and a half since then, and this attack was mild, so I suppose it wasn't the worst advice.
Anyone else have a few dangling Damocletian swords above them? Aimed at their eyeballs? Alternatively, what's the best way for me to manage my stress, when giving up or foregoing my meds isn't an option I'm willing to consider?
(I'm going to order myself some green tea. It helped in the past.)
When I was a first year in med school, staring at the sheer amount of knowledge I was supposed to cram into my brain, I would get too anxious and stressed out to even concentrate enough to study. So my girlfriend suggested I take some of her Xanax, which calmed me down enough that I could hit the books. The next day though I would have forgotten everything because as you know (and I had not yet learned at the time) benzos fuck with your hippocampus and it's harder to form memories. I did this three times before I recognized the pattern enough to bother googling it. So uh, don't do that.
What ended up working out for me was getting plenty of daily exercise. I was basically trying to study for 14 hours a day, then I'd watch a movie to unwind, then go to bed. Cutting that back to 13 hours of trying to study and one hour of exercise in the morning made me a lot less stressed out. And of course commiserating with people in the same boat as me. The worst thing you can do is not talk to your friends and colleagues about this.
Now, the thing that tends to stress me out the most is parenting. I am fully confident at times that I am fucking up my kids and they're going to need a lot of therapy in their mid-20s when they realize how much damaged my wife and I caused. But, and maybe this makes me look silly, I find the sycophantic nature of ChatGPT as well as its always available-ness is perfect for stopping me from spiraling.
Anyway: physician, heal thyself and so forth.
Another doctor here? Good, please unlurk yourself! That's a genuine request. We're up to 5 and change, depending on how you count med students who may or may not be hiking naked in Alaska.
Evidence that pharmacology should be shoved into the first year syllabus haha. You'd have been better off drinking alcohol to steady your nerves, since (paradoxically) alcohol increases reteograde memory retention, while hampering it anterograde (at reasonable doses).
https://www.nature.com/articles/s41598-017-06305-w
For anyone else reading: don't do this.
I'm in awe. I couldn't study for 12 hours a day if my life depended on it, even on medication. I feel utterly burnt out after 4-6 hours of actual study (not just sitting there with the book open, or procrastinating, as I'm doing now). This was true even before I had a job. Well, apparently that has been enough so far, and I try to keep up the habit.
I did. I still feel bad about it, my dad is always stressed when he hears of such episodes, and he's the old-fashioned type of doctor who believes I don't need stimulants because ADHD isn't a real condition. He loves me, so I look past that. They know, they care, but they're a continent away.
Friends? They get it, sometimes. I had a good buddy who was a bit older and burdened with kids, he passed the exam during the previous window, so I suppose I have no excuse.
I suppose it's my turn to reassure you, though I have no kids of my own. Donald Winnicot was on to something when he came up with the concept of the "good enough mother" (and father).
Once you're past levels of effort above outright neglect, the returns to additional parental effort decline steeply or become outright flat. Parenting is not a video game where grinding extra hours levels your kid up faster. When it comes to variance in life outcomes, heredity is king, non-parental environment is queen, and “parenting” (once you’ve cleared the bar of “not abuse or neglect”) is a minor courtier at best.
https://www.nature.com/articles/ng.3285
I have seen a full writeup somewhere, but I've lost it. I can look harder later.
In other words, you don't have to worry too hard. You've done the important things, like giving them your genes, amassing wealth, not abusing them (I hope, but feel free to disabuse me if you disagree) etc.
They're good genes! You're a doctor, hardworking, and probably more conscientious than is good for you. In all fairness, so were my parents, but you can't help some things. I turned out okay. I love my parents despite their minor failings, and I'm sure your kids will love you too. If you’re worried you’re messing up, that’s actually evidence you’re not the type who would really mess up.
Thank you, I mean it. I've been through worse, both in terms of academic load and blindness. I'll live, and if I ever become a consultant, I will dedicate my life to involuntarily commiting some of the exam-designers. Oh, and if your kids end up needing therapy, I'll offer a steep discount as a professional courtesy.
I mostly lurk because I don't feel like I have much to contribute and everyone around here seems to know what they're talking about, or at least is good enough at rhetoric to fool me. And then I have this really bad habit of needing social approval in a way that downvotes cause me mental distress, even if I am positive I'm right. I'm kind of a coward online like that in a way that I am not irl.
And my study habits were probably unhealthy. I had a few friends in med school and was generally very well liked by people who knew me, but I had more than a few people say to me at some point in our 4th year "damn wsgy why weren't we better friends? You're a great hang!". I had kind of partied way too much in university and overcorrected. My (now) wife even mentioned what it was like to date me those first two years at our wedding. The rule was she could have me for an evening and overnight either Friday or Saturday and had a blanket invitation to stay over at my place on other days but I wasn't going to talk to her until 8pm and we had to be in bed by 10:30. Like she'd be hanging out on my couch watching TV while I ignored her with earplugs in my head. It got a laugh, appropriately.
I'm not actually too worried about the kids in the grand scheme of things. But it's like having one of your vital organs removed from your body and giving it a mind of its own. You can't help but get at least a bit neurotic about it getting damaged.
Hey, having nothing useful to contribute doesn't stop some people! Don't let it dissuade you, you're probably wrong on that front.
But yes, having thick skin is a major benefit when it comes to regular participation on the Motte. I would encourage you to dip your toes in the water in the less contentious threads, like you're doing right now.
Such a shame. My parents would have loved to have you instead of me. Well, not because I partied too much (I didn't, at least in med school), but because they wished I'd studied.
A fair point. It's easy for me to talk about adopting a laissez-faire attitude towards children I don't have. The changes parenthood provoke are scary, but also strangely comforting. One's own struggle and strife seem so inconsequential when there are little people who need you. Yours will turn out great!
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