The AAS Ethics Committee continues our 2023 blog series, presenting member’s submissions from this year’s essay contest. We are also delighted to promote theĀ 2024 Art and Essay Festival. Click HERE to learn more about this year’s event and submit your work.\
The first time I tried to outrun it was in the Badlands the summer before medical school. I found a musty, iron-frame backpack, stuffed it with a peanut butter and honey sandwich on whole wheat bread and then drove an hour at dusk. It was a new moon that night and zero humidity. I hiked two miles then set up camp under starlight in the middle of a prairie. If there was a black beyond pitch, this sky was it. The stars stretched from horizon to horizon. Billions of glittering pinpricks. Just up there, existing. Usually, this feeling of insignificance and overwhelming awe helps to recenter me and creates a peaceful gratitude. That night, however, nothing helped the unsettling feeling I had yet to name.
The second time I tried to outrun it was in anatomy lab the first month of med school. Itās easier to forget the world while tangled amongst new classmates and a cadaver. Following arteries to their source, twanging on nerves, I remember being surprised at how strong our bodies were even after death. It was hard not to picture my insides open on the table. Novice pathologists deducing my cause of death. Hypoxia, exsanguination. I didnāt mind the thought. In death I could be more useful.
The disappointment of waking became a constant. No one knew me here. No one knew how I had changed or who I was before. Iām not the picture of suicidality. Hair in a ponytail and mascara on, I could masquerade my way through lectures and small groups. I still have no idea what force of nature guided me to a psychiatristās office for the first time. It was probably my ego and failed exams. Not even depression can beat out two decades of tying your self-worth to grades.
The drugs and weekly therapy helped. My therapist admitted that I scared her the most of her patients. There would be no warning signs, things would seem better even. āHigh functioning depressives are dangerous.ā Iām good at completing tasks. Through the fog of first year, I managed to make friends who saw through the faƧade. Who told me I was worth it and loved. They kept me alive the next four years. Making sure I was never alone at the apartment, knowing my appointment times, a heroic task unbeknownst to me until later.
My surgery rotation was another opportunity for running. Waking up at 03:45, pre-rounding, rounding, operating, sticking to the chief like their shadow, there was too much to do and see and learn to want to die. Plus, I was too tired by the end of the day to go through with it. My profound apathy began to dissolve. I started to feel excited and capable again. Suturing was mutually therapeutic. It was a testament to the mentors, both residents and attending surgeons, who saw that spark and fanned it even in the unknown context of wet kindling.
Itās better now, my first reaction to life or hardship isnāt wanting to kill myself. It feels worth it to keep living. Iām negative on the PHQ-9 metrics and the patient surveys. My overwhelming sadness now is the idea that I would have missed this. The present moment. Residency. Operating. Finally feeling like a doctor. Every wonderful moment is a bittersweet gift and reminder of how I almost didnāt experience it. In the trauma bay, I hear the authenticity in those who donāt want us to save them after a suicide attempt. It hurts how deeply I can connect to that. It hurts how much I want to impart that it does get better. Please stay. Joy returns. And it is so worth running towards.