We all hear the phrase tossed around. Self-care. For many years, I discarded the ideas surrounding the concept of self-care as being phony or a scam. I remember wondering to myself why all of these people thought that a candle or a bubble bath would solve their problems.
It would not. Sure, I enjoyed the stereotypical things that others labeled as self-care, but I did not hold the belief that they were changing my life in any positive way. These thoughts were based on my own limited belief in what self-care was. In this article, I will discuss my own evolving relationship with self-care, and how it has influenced my mindset as a medical student.
Table of Contents
Introduction
It is a well-known reality that medical school is one of the most demanding academic pursuits. A study of 4287 medical students spanning seven U.S. medical schools revealed that 49.6% of students reported feelings of burnout at some point since beginning medical school with 11.2% of participants reporting suicidal thoughts at some point since beginning medical school.
Another 2020 study aimed to assess burnout symptoms in medical students preparing for the USMLE Step 1 exam. The study reported that among the second-year U.S. medical students surveyed, 43% experienced moderate burnout and 16% experienced significant burnout. Only 3% of participants reported no feelings of burnout.
While these statistics are alarming, there has been more awareness brought to the issue in recent years as medical students and medical school systems work together to provide a more enriching approach to medical education. Many professionals have been realizing that to better care for patients, we must first care for ourselves.
Hustle Culture
As I began studying for the MCAT in the fall of my senior year of college, I had a gradual realization that I believe most of my peers will agree with. The medical school application cycle is toxic. From forum after forum I saw people comparing how much they studied, how many practice tests they took, and how many nights they did not sleep… all to prepare themselves for this defining exam.
This so-called hustle culture was the notion that those who were most passionate about medicine, or getting into medical school, would spend the highest number of hours working towards this goal. I was overwhelmed, had no intention of taking 16 practice exams and staying up all night reading about glycolysis.
I am confident about my mindset now, but at the time I had a nagging thought that if I did not want to grind and work throughout the day and night studying for this exam, it must mean that I did not want to go to medical school all that bad.
Dr. Ginsburg, an emergency medicine physician, states that taking frequent breaks is essential in preventing burnout and can even improve results. As he puts it, “Falling asleep while reading the same paragraph over and over is not an effective study strategy, and drinking another cup of coffee in the evening when you are already tired is sure to make the following day worse and accelerate burnout”. This statement in its nature is the opposite of what hustle culture promotes.
My distaste towards hustle culture stems from the fact that it eliminates the person and focuses on reward and praise based on the results when oftentimes these results are based on external circumstances.
Placing one’s self-worth on external circumstances creates an environment where self-worth is in danger of fluctuating. Adapting the mindset that you are intrinsically worthy simply by being human and having a goal fosters the act of valuing effort as opposed to outcome.
Looking back at my pre-MCAT self I wish I could tell her that her method would be successful and to stop comparing herself to others. This overall experience led to an addition to my personal definition of self-care: I will listen to my own intuition and body while working towards a goal rather than comparing myself to others.
As you can see, not only does hustle culture promote placing self-worth on results, but it is counterproductive in pursuit of these results. Studies consistently show that taking breaks and working shorter hours improve productivity.
Taking short breaks helps maintain focus for a longer period of time, versus working until you are exhausted. Ideally, the break should be something that gets you moving and takes you away from the screen. Taking a short walk or standing up to stretch for a few minutes prevents eye strain and fatigue.
So go ahead, take that break!
Taking care of yourself and valuing your mental health is the best thing you can do for your future patients. By working during your most efficient hours, and taking a break when you feel your focus and attention declining, you can listen to your body while also using your time wisely.
Mental Fatigue, and How to Avoid It
Steve Jobs wears the same outfit every day to reduce the number of decisions he has to make. He is not an indecisive man, but he does this to reduce decision fatigue. This is based on the idea that our brains are only capable of making so many decisions in one day. After this limit is reached, our capacity to think clearly and critically takes a steep dive.
I remember my dad always advising me to make important decisions in the morning because it is when the best thinking happens. Similarly, we have all heard the saying “Sleep on it, and decide in the morning”.
Decision fatigue is an intriguing notion because it leads to the concept of a more broad mental fatigue. I began to think about ways I could prevent mental fatigue in my own life. While wearing the same outfit every day is a good idea to reduce the choices you need to make every day, I do not see it working for myself.
Mental fatigue can be caused by a number of cognitive processes that we do without realizing it, such as procrastination and catastrophic thinking. Procrastination can lead to spending more emotional energy avoiding a task than the energy it would take to complete the task itself. I am guilty of this myself.
Spending all day thinking about that email you have to write uses up mental energy that you could use more effectively elsewhere. Similarly, catastrophic thinking can not only cause mental fatigue but can actually prevent us from taking actionable steps towards a goal. Catastrophic thinking is the act of thinking about the worst-case scenario again and again.
Shockingly, our mind convinces us that we are doing this to protect ourselves by thinking of everything that could go wrong and making backup plans. However, this type of thinking can actually use up the brain juice, so to speak, that you could be using to work towards something positive or beneficial.
Ruminating all day about the possibility of failing your exam could lead you to become too emotionally exhausted to actually study for the said exam. Learning this, I have expanded my personal definition of self-care even further: I will preserve my mental capacity for things that I can control, and not overthink things that are out of my control.
Conclusion
My own experiences have led me to the working definition of self-care that I hold today. In order to best care for myself, I will listen to my own intuition and body while working towards a goal rather than comparing myself to others and I will preserve my mental capacity for things that I can control, rather than overthinking things that are out of my control.
I am sure that this definition will change as I continue through medical school and have more experience. Self-care is not something that can be defined for you, but you must define it for yourself though realizing what helps you love yourself more.
When do you feel that you are taking care of yourself the most?
What are things that you do, consciously or unconsciously, that end up feeling like a betrayal of who you are?
These are some guiding questions that I hope will lead you to define the term for yourself. It is not all candles and bubble baths, but they definitely can help you on your way to discovering what self-care means to you.
By Maria Sandhu