Balancing Medical School and Chronic Illness
I knew I wanted to be a doctor when I was 13 years old. However, when I pictured my journey to medical school and onwards to become a physician, I never imagined that I would go through it with multiple chronic illnesses. When I developed fibromyalgia and POTS, I was terrified at this whole new level of barriers I would have to face to achieve my biggest dream of becoming a doctor. I had to adjust to living with constant widespread pain, stiffness, fatigue, dizziness, weakness, (pre-)syncope, & more. As you might know, this can be distracting, exhausting, and mentally challenging, which can make studying & procedural skills difficult. I knew that the physical aspects of medicine would be a struggle for me, and I was right. However, like most people I know with chronic illnesses, we don’t give up easily.
I’m now in my second year of medical school. It’s been an incredible experience, and nearly every aspect of studying medicine is made harder by my disabilities. There are times when ableism in medicine is so palpable that I could cry with frustration. For example, accommodations are not allowed for our lab exams so I see stars throughout the entire thing and have to will myself not to faint.
There are other challenges I had never even considered – what do I do when my preceptor doesn’t have a stool for me to sit on during patient encounters? What do I do when my preceptor assumes I can take the stairs to the unit on a bad pain day? What do I do when I can’t get the ultrasound picture to focus because of my hand tremors & pain? You might think there is one answer to all of these challenges – to advocate for myself. However, this is not always that straightforward. I don’t always feel comfortable sharing my personal medical history with people, especially if those people have the power to negatively impact my success and reputation as a medical student. Especially when I live with diagnoses which have histories of negative stigma and disbelief in their reality.
So, what do I do when I can’t personally advocate? Adapt, and advocate at higher (non-individual) levels. Compression socks, choosing to do my electives in non-surgical specialties, hydration, prophylactic Tylenol, mobility aids on stand-by, pencil grips, always scanning for places to sit, physio exercises, resting more than my peers; prioritizing my well-being. I share my lived experiences in safe environments such as the Student Diversity and Inclusion Committee, the Disability in Medicine Society, and here. Gaining allies and diverse voices. My goal is to bring issues of ableism in medicine to the minds of those in health care. In order to make change, we need to vocalize the injustices that exist – in varied environments, wherever we feel safe to do so.
Of course, it’s not all barriers and challenges. Because of the myriad of interactions that I’ve had with the medical system in the last 10 years I very firmly believe that I can better relate to and empathize with patients. There is something about living with pain that makes it even more impactful to see other patients find relief, hope, and answers. I often receive feedback that my ability to establish a good rapport with patients is impressive. What can I say, when you’re a young teenager bouncing around to a bunch of different doctors who don’t know what’s wrong with you, you develop a knack for knowing what to say to others who might be feeling similar doom and gloom.
I’m also fortunate to have a great deal of background knowledge on certain (often seemingly random) topics because of my own health. Sometimes preceptors will start explaining something to me and I will pretend I wasn’t extensively educated on that very thing as a patient. You want to teach me about medications used for neuropathic pain? I’ve got them all at home. If they ask how I know so much about this topic, sometimes I’ll disclose my conditions, but other times I’ll just say I have an interest in the area and they’ll think I’m smart– when positives come from being chronically ill you gotta take ‘em.
The medical system as it exists now was not built around helping disabled doctors succeed, but that doesn’t mean they don’t succeed, and that the system can’t change. In fact, it is changing. There are now some schools with special pathways to apply to medical school through if you have medical issues (shoutout Western! Many schools, including Dalhousie, are now offering hybrid learning options. There is a Canadian Association of Physicians with Disabilities that offers a mentorship program, equity and inclusion in medicine is beginning to earn the attention it deserves, many classmates and preceptors support and elevate me and seek to learn more about ableism. And it is incredible to be a part of these positive changes that are happening.
I once read a quote that said that “Disabled doctors exist in small, but impactful numbers.”. (I don’t remember where this came from – please share if you do!). Disabled doctors are immensely powerful. To be a patient with a chronic condition is often to have a complex relationship with health care. For a doctor to personally understand such complexities is invaluable to patients and to the entire institution of medicine. The world needs more of these remarkable doctors. The world needs more disabled & chronically ill doctors.