From Nearly Dead to Medical School Graduate

Alex Lake, MD


July 12, 2018

No Time to Feel Sorry for Myself

I was diagnosed with a major neurocognitive disorder secondary to traumatic brain injury, with a contusion to the left temporal lobe region, superimposed on attention-deficit disorder and posttraumatic stress disorder. Regardless, I was ready to give this whole "becoming a doctor thing" a shot. There was no time to feel sorry for myself. I was beyond excited to start my lifelong goal of becoming a physician.

A doctor recommended that the "use of compensatory strategies or accommodations will be needed to level the playing field." Being the previous A student that I was, I surely did not think I needed any of these accommodations. Actually, I didn't even consider any of this doctor's recommendations. I wanted to go through med school just like everyone else. I'll admit that anatomy lab practicals were a pure struggle, histology images were nearly impossible to recall, and microbiology was no fun. I was definitely more fatigued than I had been previously while learning. The headaches at times were so unbearable that I couldn't get out of bed. Hell, I was already a hypochondriac before my injury, and sometimes I even freaked myself out by telling myself that my brain was re-bleeding. You can imagine how this year was for my parents, living 1000 miles away...

Then again, what med student doesn't get fatigued and have headaches? What med student, absorbing all of this new detail about diseases, doesn't think he has all of them? "My stomach hurts... Oh man, I must have appendicitis." I didn't think I was any different from my colleagues. I passed all required courses the first year. I was not an A student, but I did not fail a single course.

Second year was a little more bearable. I had slightly fewer headaches and the mental fatigue was mildly improving. The first 2 years were so densely packed with information that by April of my second year, I was mentally drained. There was still the beast at the end: Step 1. We were given April and May off, except for osteopathic classes, to study, and had to take the exam by June 10. I wasn't sure how to study for this and tried what seemed like 100 different resources. Looking back, I should have taken longer breaks, studied over a longer period of time, and overall been healthier.

Don't Lose Hope

As a third-year on my first internal medicine rotation, I stumbled upon a service called OnlineMedEd. I needed a source that was not just notecards and not just reading a book, which had, among other things, gotten me in trouble during Step 1. I watched one of their free videos, on coronary artery disease, and was immediately impressed by the presentation of the information and how they made it seem so simple. I proceeded to watch all of the cardiology videos and knew that this was the source for me.

OnlineMedEd's PACE method, along with the available content, was exactly what I needed to excel during my third year, as I learned the hard way the year before that overworking and cramming was not healthy for my bruised brain. I would read the notes, watch the videos, do associated clinical cases and questions, and use notecards to reinforce what I learned. I'm being honest in saying that the USMLE felt like an attending quizzing: "Hyperkalemic patient with EKG changes; first drug to give?" Of course, this is easy to answer after you've heard this question on every in-hospital rotation in your third and fourth year. COMLEX was only slightly different, because the questions (in my opinion) were more convoluted and I barely studied the OMM portion.

I know that this is all subjective, so here is the objective information. My results:

  • COMLEX Level 2: 622 (+176 from level 1)

  • USMLE Step 2: 258 (+48 from step 1)

  • Residency placement at my #1 choice

This story was not meant to make you think that I'm some crazy miracle. It was meant to tell you something real: I had a gun to my head, traumatic brain injury, countless sleepless nights, throbbing headaches, and debilitating neurofatigue, topped off by a dismal Step 1 score. I still made it.

If you only remember one thing from this, I'd like you to remember this: Life is going to continually test your strength and commitment to your goals, but it is solely up to you how you will react and respond. Your obstacles don't have anywhere near the strength that you do. We have the amazing inherent ability to control our thoughts and actions. You don't always get a second chance to redo the day before. But, when you wake up, it is a new day for you to win or lose. Don't lose hope!


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