these are my confessions

Anyone else’s mind jump straight to the Usher track whenever they hear the word confession? No, just me? That’s cool. I’ve come to terms with my embarrassing and unwavering love for Usher during my junior high years. It’s fine.

But on the real – I thought it was time for a life update since it’s been a minute. I started sharing my journey through medicine, and life in general, on here and Instagram because I wanted people to feel less alone in their struggles. In this age of social media, it’s easy to fall into the mentality that everyone has their life together except you. But that’s obviously not the case – we just choose to present our best selves to the world. And on the surface there isn’t anything wrong with that as long as we can remember that there is so much else going on that is not being shared. But in the past couple months, since finding out I failed step one again, I’ve started to feel like I’m folding into myself and only presenting the highlights of my life. And while I don’t owe anything to strangers on the internet, I feel it’s important for me that I continue to present myself honestly.

Since December I’ve hit one of the most severe bouts of depression I’ve had in my life. I’m pretty sure I’ve struggled with both depression and anxiety for most of my life but wasn’t clinically diagnosed until starting medical school. Stress has always been a huge trigger for me and obviously failure, and step one in general, is stressful. Having been through similar, but less severe, episodes in the past I tackled my depression head on with the things that have usually helped me. I continued taking my medications, working with my therapist, etc. I put away my books and I traveled. I spent time with loved ones and my kitten. And I convinced myself that I was feeling better and dove back into studying as the new year began in January.

But I wasn’t okay. I was struggling badly. I couldn’t focus. I was irritable. I had so much trouble sleeping. I was nauseous all the time. I hand anxiety attacks weekly that were almost as bad as the ones that initially drove me to seek help. So I sought council from those I trust and one of the deans at the SOM recommended that I get tested for learning disabilities in case that there was something making it harder for me to succeed and adding to my stress. I realized that it was important for me to set my ego and internalized stigma towards disabilities aside and truly find out if there were accommodations out there that would help me with both my studying and in my exam taking. It took months before I was able to find someone who accepted my insurance and saw adult patients but I finally got an appointment about a month and a half out. Those of you becoming psychologists, thank you, you are so needed.

Around this time, 45 also started his presidency in the United States. I think it’s pretty clear from my previous posts where I stand politically. The US has always had a dark history when it comes to marginalized peoples but something about the blatant disregard/outright support of the xenophobic rhetoric during the elections made the inauguration sting so much more than I had anticipated. Every executive order and tweet and confirmation has truly felt like a personal assault. It’s taken weeks for me to be okay with the fact that my resistance, at this moment in my life, is almost always in pursuit of my career. I will continue to do my best to be aware. To understand the struggles of those who look and live differently than I. To educate and have the difficult conversations. To organize. To put my body on the line as often as possible when my sisters’ and brothers’ human rights are at risk. But for the most part – my resistance is hours and hours of studying to pass an exam so that I may advocate and care for my patients. And for now, that has to be enough.

Meanwhile, I did my best to continue studying. I searched online for tutoring programs for medical students that worked through video chat. I wasn’t ready to pick my whole life up and move to another state again, as I did when attending Wolfpacc in the summer. It was clear that I had made the most progress in my studying in the months after I had returned home and worked hard on my own. I’m certain that the most helpful aspect of being at Wolfpacc was being in a supportive environment surrounded by people who truly understood the struggle but I did also miss the tutors and the structure they provided. I also missed having someone to run my study schedule by to ensure that I was as effective as I could be in my studying. I missed doing questions with a tutor and running through my thought process with them so that I could identify holes in my knowledge. And that’s when I stumbled across Med School Tutors and was immediately intrigued. I had the opportunity to do one-on-one tutoring from home with someone who would also help me create a schedule that worked for me. It sounded perfect!

Now, I don’t think that this is something that necessarily everyone studying for USMLE needs. But having been at this for so long, I knew I needed more encouragement and reassurance this time around and I’ve found exactly that in working with a tutor through MST. Their entire team has been so incredibly supportive of my goals. The thing that I love most about MST is that they share my values. When I opened up to them about how much I had been struggling, they immediately reassured me that taking care of my health, both physical and mental, is the priority. They helped me rearrange my tutoring schedule at no additional cost to work best for my needs. Having a group of people who’ve essentially been cheering me on through the struggle of doing this for a third time has been such a blessing. If you do decide to check out MST, please cite me as your referral. This post isn’t at all sponsored by Med School Tutors but I do want to disclose that I will get a free hour of tutoring if you decide to work with them.

While struggling through all this I started falling victim to some really serious negative self talk and began to struggle with so many of the things I often warn you all about: feeling shame in the face of failure, constantly comparing myself to others, etc. and it started to take a serious toll. Part of the ugliness of depression is that it’s hard to separate when your thoughts are due to the illness versus when you’re actually right in your introspection and reflection. It’s taken me some time to be able to separate those two things and journaling daily has really helped me with that. I’ve been drowning myself in self care & self love and really doing my best to replace the negative self talk with positive affirmations.

I’ve taken the last couple weeks off from studying and really focused on getting back to feeling like myself. In my appointments with the neuropsychologist, we ruled out any learning disabilities but in talking to him about everything I’ve been through and am going through the past couple years, I realized that my depression and anxiety haven’t been managed as aggressively as they should’ve been. My primary care physician had been treating me until now and she isn’t the greatest when it comes to mental illness. (Another reason why I continually come back to a career in family medicine. We so badly need primary physicians who can provide holistic care. Shout out to all my future FM docs! I’ve got so much love for y’all). While talking to a close friend about this, she asked me why I hadn’t sought care from a psychiatrist over the past couple years that I had been dealing with my undertreated depression and anxiety. And I had no real answer. I later realized that it was because I, someone who constantly advocates against mental illness not being a true disease, had been downplaying my own mental illness for years. I hadn’t sought care from a psychiatrist, knowing that my PCP wasn’t doing a great job treating me, because I didn’t think it was that bad. I expected myself to pick myself up and just brush it off. I didn’t want to be someone who had a psychiatrist, and thus, label myself crazy. Why is it so much easier to show others compassion than ourselves? If I’d sought treatment for my mental illness as I’d encourage my patients and loved ones to do, the past couple years would have been so much easier.

So in the past few weeks I’ve talked to therapists and psychologists and psychiatrists and finally feel like I’m getting the care that I need. And while I’m still not feeling 100% like myself again, I’m finally caring for myself as I’d want my patients to care for themselves. I’ve spent a lot of time protecting my heart from those who try to dismiss my experience when I share my struggles and recognizing how strong I’ve been for so many years. I’m spending the rest of this week doing things that truly bring me joy, surrounding myself with the incredible people who have held me up in these difficult times often without even knowing it and simply finding gratitude in the little things.

I found out last week that the NBME accepted my appeal to expunge my score from my second attempt – you can read about my test day experience here. That news really helped restore my faith in ‘the system’ because I’ve recently been feeling like I’ve dedicated so much of my life to a field that doesn’t truly care about its people. I also found out that I was accepted to WISE’s Muslim Women’s Summit later this year, which will help me become a more effective activist and advocate. I’m still figuring out the details of my trip to the east coast but give me a shout if you’ll also be at the conference!

I know that I have what it takes to pass this exam and have an extraordinary career in medicine. But I’m still learning and unlearning what it takes to truly care for myself and be my best self. Thank you for your company on this journey.

9 thoughts on “these are my confessions

  1. Hey Anum, thank you for sharing your story. I hope you get well soon and I can promise you you did the right think by seeking help & will be much stronger afterwards. I finished med school in December in Germany and am a doctor now 🙂 I struggled with a lot of those things too and unfortunately hadn’t much contact to other students experiencing the same which would have helped me a lot to not feel so alien. But anyway, I seeked help and am “happy” and healthy now and very confident to be a good doctor. Selfcare always comes first, especially in our field. If you want to get in contact or something, please feel free to email me. Wish you the best! Julia

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  2. First off, you are so brave to be sharing your struggle. I wish I had the courage this courage. And I’m glad the NBME voided your second score, that was not a fair testing environment. As someone who struggles with anxiety as well, I have a recommendation. Of course I don’t know you or your experience, but try everything right? You have such a presence on social media that it could be healthy to step away from it, especially if what seems like the hourly Trump reports on how he’s ruining the world is impacting your mood/focus. Of course that doesn’t make it go away but the constant bombardment that we have created for ourselves is not healthy. And I find that when I’m stressed in one area of life, it makes me so much more susceptible to letting other factors (that normally would not cause significant stress) impact me more. Either way, best of luck on your next attempt and continue to focus on not letting your past failures get into your head. You can be successful

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  3. This was an incredible read and sort of an eye-opener. I’ve always had the fear of failure and at times when I thought I was going to fail, I’d always pull through and end up doing better then I thought. Until the time when I failed a class during the semester I was supposed to graduate. I had a job lined up and everything, but life happens and when I thought I could pull through and end up doing ok, I didn’t, I failed and had to retake that class. Meaning putting off graduation for another semester, and the job I had lined up, gone. That time I felt like a complete failure, I lost hope and faith, I thought to myself, how could I let this happen to myself. I though I was going into depression because I had other things going on in life that sucked, I literally cried to sleep every night. Then when I retook the class that feeling of being a failure stopped, slowly. Because I know that I’ve been given a second chance. Also, I interviewed for a job with a major company in Silicon Valley which I thought I’d never get, but I did. I’ve always been a good student and I’ve done multiple internships and when you think you’re so good, God has a way of showing you the worst even when you’re the best. I did hit an all time low, but if it wasn’t for that all time low I wouldn’t have had this opportunity to work for the company I’m working for now. I also wouldn’t have met my better half if it wasn’t for that failure. God has a way of his timing for you, if you face failure you have to accept and and help it make you a better person., you just have to trust his plans. Because we can either use it to become the best of us or the worst.

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  4. Hey hope you see this, wanted to let you know your Instagram helped me as I was going through failing my first ever exam too.
    I just thought I’d share what I’ve learnt
    1. Everyone fails at something in life, maybe it’s not the exam but there’s something & we all go through it so it doesn’t make sense to compare because we have our strengths to offer
    2. Bad at studying does not equal bad doctor.. in the end everyone graduates with similar knowledge anyways so it’s a lot more of your personality and a lot of other things that go into being a doc
    3. Study wise clinicals are 100x better.. you remember your patients! I can’t read test papers without studying a topic and know answers now, plus you learn and apply
    4. Teach everything you learn to someone, see if you can find someone to ask you questions.. if you can do it out loud then you can do it on paper – it’s the thing tht has really helped me learn
    Also ditch fancy notes – I always had the best notes while my boyfriend never wrote any notes- he got as I got bs.. I’ve learnt notes here and there are good but no wasting time with colours etc
    5. Anxiety may just be the thing stopping us from doing our best, but just know one day there will be no anxiety and you’ll be so knowledgeable it’ll show 🙂
    I’ve become a lot more confident in clinicals and I hope the same happens for you. I hope this advice helps in some way bc it’s what worked for me and you never know it might work for you!

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  5. I too struggled around the same time in medical school with a similar problem. But eventually I got through it and made it through residency (3 months til graduation!), pregnancy, and now caring for a 14 month old— you will too. And one day you will be a doctor that not only understands how hard it is to navigate the healthcare system as a patient but also understand what it feels like to be totally vulnerable and in need of help from a physician. Just take care of yourself and everything else will fall in place.

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