Tuesday, January 27, 2009

Thinking outside the “Balance Box”

In med school, they spend a lot of time trying to emphasize the importance of "balance." The emphasis on balance has kept growing during second year, and here are some of my thoughts on the issue:

For most of last year and the beginning of this year, whenever I heard the word “balance,” the first word that came to me was “blah.” They were essentially paired in my mind: Balance, blah. Balance, blah. Balance, blah. At first I think my frustration surrounding the discussion of ‘balance’ stemmed from my perceived irony of it all. During orientation, they kept telling us to make sure our lives were balanced and their description of a balanced day for the typical medical student was ridiculous: attend all your classes (5 to 7 hours depending on the day), studying at least 1-2 hour outside of class for every hour in class, get enough sleep (8 hours a night), making sure that we exercised (30min-1.5 hours a day), making sure we ate healthy (at least another 1 hour a day for food preparation and acquisition), making sure we maintained relationships with significant others, friends and family (an unspecified amount of time), and making sure that you had fun sometimes (also an unspecified amount of time). If you added together all the time required to follow the med school’s instructions on how to live a balanced life you get a day that is much greater than 24 hours long! It was impossible to follow, and the instructions felt downright silly. It felt like they were just threw us an unsolvable 3D puzzle called ‘balance’ and said, “So welcome to medicine, you really need to start working on this balance puzzle thingy. There actually isn’t a complete solution to the puzzle – we just thought you should get started on it now so that you will be a little closer to the non-existent solution before you die. Here are the pieces that WE think belong in the puzzle, but we don’t know how they fit together. Good luck.”

However, I did realize the importance of trying to take care of myself and I am glad that the medical school was interested in our well-being. I did make an effort to exercise, cook good food, and sleep enough. During fall quarter of first year I got caught up in some family responsibilities, and became very stressed out trying to juggle my family and my med school course work. I ended the quarter feeling unsatisfied with medical school, and despite my attempts to stay healthy, I felt “unbalanced.” I was worried that I might not be able to make it through even the first year of medical school. However, in the winter quarter of my first year I signed up for a family medicine preceptorship at Haborview and it was amazing. I loved going to clinic and meeting patients and hearing their stories. I loved seeing what practicing real medicine was like and being reminded why I wanted to go to medical school. Although I had taken on even more things in winter quarter and was even busier with school than I had been in fall, I was much happier and had more motivation to study. The model of balance presented by the medical school during orientation might imply that winter quarter I was “less balanced,” because I spent more time with school related work. However, I think that perhaps I was more balanced in winter, because I got to see the side of medicine that I enjoyed.

Then I realized that the reason I was so frustrated with the school’s definition of balance was because I was thinking inside the “balance box.” I actually love balance. I really want balance in my life. I just don’t define balance the way perhaps some of the medical school staff here envisioning when they first presented it to us. I would say balance is “doing what you need to be fulfilled and happy with yourself and your life as a physician.” That could mean skiing on the weekends and taking a month-long vacation through Europe every summer with your family or it could mean making less money and working longer hours to serve the needs of the poorer immigrant population in your area. Different people want to get different things out of energy they are putting into their medical education.

I didn’t decide to go to medical school so that I could have a good stable income and have a comfortable family life. I decided to go to medical school because I want to change the world. I know that sounds cliché, but I really do want to do something meaningful with my medical education.


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