There may be an outdated parable a few farmer whose horse runs away.
The neighbors cry, “Such dangerous luck!”
The farmer solely replies, “Perhaps so, possibly not. We’ll see.”
The following day, the horse returns with two wild horses. “Such luck!” they cheer.
Once more, the farmer solutions, “Perhaps so, possibly not. We’ll see.”
Quickly after, the farmer’s son breaks his leg taming one of many horses. “Such misfortune!”
The farmer solutions, “Perhaps so, possibly not. We’ll see.”
Weeks later, the military arrives to conscript all ready younger males. The son is spared.
The lesson is straightforward: in actual time, we can not know whether or not any occasion is inherently good or dangerous. Solely in hindsight do we start to search out that means. That parable turned my grounding device.
On paper, I used to be doing effectively in medical college. Earlier than I ever sat for Step 1, I survived a motorcar accident that shattered my dominant hand. Whereas learning and spending hours in hand remedy, I tied my footwear with my enamel. I fainted making an attempt to choose up a Styrofoam dice. I lived with everlasting lack of sensation and suppleness. Nonetheless, I took Step 1 (in ache, on medicine, unable to make use of my proper hand) and I handed.
I returned to clerkships decided to show myself, and I did. I earned honors on my first, a excessive go on my second, and powerful evaluations all through. Attendings known as me proactive, attentive, and a valued member of the workforce. My lodging: prolonged time, personal testing rooms, telemedicine flexibility, had been accredited on paper below ADA regulation, however by no means applied.
As an alternative, I used to be reminded of a bylaw: college students with out “full motor capability” might not belong in this system. And once I struggled, professionalism entered the image. Not as steerage. Not as remediation. However as a hammer. Once I tried to return, obscure professionalism citations changed due course of. I used to be dismissed, not for failing Step 1 or clerkships, however for “professionalism,” although each analysis affirmed I had met professionalism standards throughout domains.
That dismissal was not simply tutorial. Like my hand, it fractured my sense of self. Across the similar time, my companion of six years ended our relationship. He had envisioned a dual-income, steady family. With my uncertainty, debt, grief, and dismissal, I had turn out to be extra of a legal responsibility than an asset. It was an excessive amount of for him, and it was an excessive amount of for me, too.
I don’t blame him, however it deepened the grief. Grieving somebody who remains to be alive is its personal type of torture. In some methods, it’s more durable than grieving these I’ve liked who’ve died. Not less than dying provides finality. Ambiguous loss doesn’t. It lingers. It reshapes you in silence.
I used to be not simply dropping my hand. I used to be not simply dropping my profession. I used to be dropping the model of myself I assumed I used to be constructing, and the longer term I assumed I might share.
Psychiatry gave me language for this.
Grief will not be a five-stage course of. It’s cyclical, intrusive, nonlinear. It strips away certainty and id. It leaves you asking: Am I damaged? Am I resilient? Am I rising? Or am I merely in denial?
But psychiatry additionally taught me about post-traumatic development, the paradox that loss, whereas devastating, may generate that means.
In hand remedy, I discovered group. We joked about Velcro footwear, cursed our splints, and cried about futures we weren’t positive we nonetheless had. That room, uncooked, unpolished, human, felt extra actual than any “resilience curriculum.” I discovered that resilience will not be about avoiding loss. It’s about weaving it into who you’re turning into.
Psychiatry lives in that gray house. It asks us to carry paradox: fragility and energy, despair and hope, id misplaced and id remade.
Trying again, my accident felt just like the worst factor that ever occurred to me. My dismissal did too. And my breakup, that was the worst of all. Perhaps all of them had been. Or possibly not. Perhaps, just like the farmer says, “Perhaps so, possibly not. We’ll see.”
As a result of none of them broke me fully. Or possibly all of them did, and possibly that’s the level. They compelled me to grieve an outdated id and start forming a more true one. They taught me to reside in uncertainty, the place that means is created slowly. They usually jogged my memory that grief, although merciless, may be psychiatry’s biggest instructor.
Professionalism ought to nurture development. However when left obscure, it turns into a projection, a Rorschach check of institutional bias. For me, it turned a weapon. And we can not afford to maintain dropping shiny, devoted college students this manner. Not as a result of they may not turn out to be good physicians, however as a result of the system selected to not help them.
So, I preserve the parable shut. Perhaps my accident was the worst factor. Perhaps my dismissal was. Perhaps my heartbreak was.
Perhaps so.
Perhaps not.
We’ll see.
As a result of ultimately, grief isn’t just about medication, or professionalism, and even loss. It’s about what it means to be human: fragile and resilient, damaged and remade, unsure and nonetheless shifting ahead. And possibly that’s the lesson psychiatry has to supply all of us, that our value will not be in being flawless, whilst “docs,” however in being totally human. That, maybe, is the truest professionalism of all.
Hannah Wulk is a medical scholar.
