How Can I Counteract the Depressing Hospital Setting?

Daniel Egan, MD

Disclosures

April 27, 2009

Question
The hospital environment is so drab and depressing. How can I stay motivated when I have to spend so much time there?

Response from Daniel Egan, MD
Attending Physician, Department of Emergency Medicine, St. Luke's-Roosevelt Hospital Center, New York, NY


Ahh... We have all been there. My guess is that you are in the midst of your clinical rotations and you feel like all you do is wake up in the morning, go to the hospital, leave, sleep, and start the cycle again the next morning. Well, my friend, we have all had those feelings and wondered how to keep on going. There is no magic answer, but there are a couple of key elements to maintaining your sanity throughout medical school.

The most important thing that I kept telling myself during my clinical rotations was that everyone in the class ahead of me got through it. Additionally, many of your classmates who have already completed the rotation that you are on have survived it. To me, that was motivating: They had endured, and so could I. It is a little reality check as you try to keep your eyes open during hour 24 in your surgical clerkship.

I also kept telling myself throughout my medical school clerkships -- and especially residency -- that I could do anything for a fixed period of time. In residency, we changed rotations every month, so I would repeatedly say, "I can do anything for 4 weeks."

But you are correct: The hospital environment can seem drab and can be depressing. Therefore, it is critical for you to maintain a life outside of the hospital. We all know that it is possible to eat, sleep, and dream medical school. There is so much to learn and there are not enough hours in the day. However, you need to remember that you are a person who had a life and interests before you got there.

I have written about this before, but I often remember something that a dean told us students early in our education: Even if you spend 24 hours a day studying and trying to learn, you will still never know everything. So make a schedule. Make an agreement with yourself. Fit outside activities into your day (even if that means just an hour at the gym each evening). Consider it as mandatory as prerounding on your patients. Consider it essential to your health and well-being.

There is a certain time of year (coincidentally about the same time as when you submitted your question) that seems to predispose students and also residents to feelings of "drabness" and depression. You wake up in the morning and it is dark outside. You leave the hospital to go home and it is dark outside. The rest of the world has enjoyed a full day of sunlight while you roamed the halls of the hospital and only caught a glimpse of the sun if you went into a patient's room. One of the coping mechanisms for this is to talk about it. Go out to dinner with your classmates and share your feelings. Of course, try not to talk only about work. Sometimes a nice, long venting session can do a lot of good; things are put in perspective and you recognize that you are not alone.

This pattern will continue for the next several years as you go through residency, so developing distractions and coping mechanisms now will only help later. Perhaps the most important step that you can take is devoting at least part of your day to a nonmedical activity that you enjoy. This can provide the motivation for getting through the day. For me, that activity was participating in a music group. Although we didn't rehearse every day, that 1 night a week of doing something that I love helped me to get through those very long other 6 days.

Keep a novel at your bedside. Spend even just 20 minutes before going to sleep reading something completely unrelated to a medical journal or textbook. Make a few phone calls to friends who are in other fields. Read the newspaper. And remind yourself regularly that there is a whole world out there that you will soon be able to embrace.

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