It’s 4:17 a.m. as I begin this entry. I’m scheduled to be at the hospital in 43 minutes for one of my last days on surgical rotation, and I’ve been working on the following text message since 3 a.m.:

“Hi, team. Im afraid that im burned out and anxious. I will be taking today off. Sorry to be blunt but i felt it better than to make up an excuse. Thanks for all your kindness and education this rotation.”

Last week, our class got a surprise email from a physician-leader who’s taken it upon himself to visit our school and discuss medical student wellness and burnout. Though I have been contemplating the topic for some time, I finally accepted the fact that “burnout” is the word I would use to best describe my medical school experience.

I have a strong family history of anxiety disorders and was first diagnosed with depression and anxiety at the outset of my career change towards medicine. Despite the fact that the profession self-selects for those predisposed towards anxiety and perfectionism, I heeded my mentor’s warning to, during the application process, avoid discussing my perseverance through health issues.

The pinnacle of my life thus far has been achieving matriculation to my top choice medical school; I have worked exceedingly hard for years in order to attain this, but without medical management of my health issues I never would have been so empowered as to actualize this dream. I was firing on all cylinders through the day medical school began … things have changed over the past two-and-a-half years.

I worked as a program supervisor from 7 a.m. to 6:30 p.m. five-and-a-half days a week; I went to Krav Maga classes from 7 to 8:30 p.m. four times a week and once on Saturday mornings. I cooked all my own meals.  I was 163 pounds, and I could, for an hour without tiring, throw punches, kicks, knees and elbows while defending against chokes, knife and gun attacks. I spoke to universities, colleges and community groups about humanitarian emergencies and the aid I’ve committed myself to since 2007. Then medical school started.

I moved out of state, and within the first couple months of school, I gained 25 pounds. In order to maximize my study time, I stopped taking a weekly day off. I stopped exercising and engaging my passion for self-defense training. I stopped preparing my own food and eating healthfully. I stopped cleaning my apartment. I stopped dating. I stopped my volunteer work, I stopped my leadership work, I stopped my speaking engagements. I continued my medications but have had no time for doctors’ appointments. I started binge drinking biweekly. I continue binge drinking.

Based on hours-per-week, I have not been any busier than I was in the past but the type of work, the levels of stress and demand are far higher in medical school than ever before. My inclination is to blame myself for my current state, but I’ve taken all the ownership that I can, and the problems remain. I am not happy, and I’m tired of being blamed by my peers, my school and my mentors for my current state. Folks, I’m burned out; I’m depressed.

When I feel burned out, I revisit the personal statement I submitted that helped me succeed as one of the 1-in-60 applicants accepted to my medical school; I do my best to live out the core commitments central to this statement; as such, I was recently nominated by my peers for our university’s “Student of the Year Award.”  I remind myself that, despite what I feel, I am not sh*t. I have friends and strangers alike read my essay to show them, “Hey, what you see now and who you know now … well … it’s not really me. I’d like to get back to me sometime soon.”

On that note, it’s 5:08 a.m.; I think I’ll send that text to my surgical team now. Here goes nothin’.

The author is an anonymous medical student.

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