Knock on Wood
“Have you ever been sick before?”, my research supervisor asked. We were discussing patients involved in our study, and I had not anticipated a personal question.
“Um, no”, I laughed nervously, rapping my knuckles on his mahogany desk. It wasn’t the truth, or at least, not the complete truth, but it was the answer I sensed he was expecting.
Last semester was difficult, and now that I’m a week into my fourth term of medical school, I’m realizing that the winter break did not allow me to hit the ‘reset’ button. In early November, just after my first major exam of the year, I had a cancer scare. An ultrasound revealed a cystic mass on one of my organs, and there was a very small chance that it was malignant. For two weeks I drove myself insane by reading every corner of the internet, including patient forums and medical journals, and re-reading the radiologist’s report until I could recite it verbatim, Googling every term I didn’t recognize, and many that I did. I stopped sleeping, I couldn’t focus on lectures or assignments, and on more than one occasion had to leave the room during group seminars to cry in the washroom. I couldn’t bring myself to call my parents, who live very far away, with the risk of worrying them needlessly. I had already decided that if I was diagnosed with cancer, I would leave medical school and move back home for treatment. I repeatedly read over the survival statistics for the disease I “may” have had: they were extremely poor. I began to imagine that I could feel the mass in my abdomen growing and choking my other organs. Every minor cramp or twinge became evidence that I was going to die. I imagined myself thin and bald, suffering through a futile treatment for the benefit of my family, so they could say I was brave, that I fought to stay with them. I thought of how many patients I have seen perform this exact exercise out of love.
I knew the term for what I was doing: catastrophizing. I felt guilty for being so melodramatic. There’s enough real tragedy in the world, particularly in the world of medicine, that it’s senseless and self-indulgent to invent any more. My next appointment with the doctor was 5 days away: after not sleeping a wink for the first two, I decided I couldn’t wait. I have no idea how patients endure the wait time between a worrying medical report and the final clarity of diagnosis. I woke up at 5 AM and waited outside of the medical clinic. I wanted to be certain that I would get in that day. I waited for 4 hours, and when I finally saw my doctor, she was holding my radiology report and greeted me with a smile.
“This looks good.”
I began to sob. I explained how I had “worked myself up”, as I described it, trying to show some degree of self-awareness to diminish how ridiculous I must have looked to this woman in a white coat. She looked at me with kind eyes and a half smile and reassured me that cases become case reports because they are rare, and that my problem was simple and “frankly, boring”. We both laughed at that last descriptor. She referred me for additional imaging for my ‘peace of mind’ but told me that I would have to wait a while because my case was not at all concerning.
That test is now a week away, and I am trying to remain calm and focus on my studies, spend time with friends, and generally enjoy my life. Still, there are roadblocks: after calling to confirm my appointment this morning, I briefly imagined my world falling into pieces again. I still can’t bring myself to watch the 6 lectures on cancer we received before the break. I had heard of “Medical Student’s Syndrome” before I started med school, and imagined over-zealous bookworms making tuberculosis out of chest colds. Health anxiety is a very real and very common problem faced by medical learners, and I wrote this reflection because I know that I am not alone. We spend the majority of our days around illness, either in cases we discuss in class or the faces of patients we meet on the wards. We know all the worst case scenarios. Since my health scare last November, not a day has gone by where I haven’t fretted over myself or someone I love becoming sick. I know it’s going to happen, but I also know there is no preparing for it. I’ve made an appointment with a counselor at OHPSA, and I’m so grateful that resource is there for me. I wish I had reached out for help sooner. I hope I’ll be able to catch up on missed lectures before my next exam, but mostly I hope that one day I can talk about illness without the compulsion to knock on wood.
