Last Updated on June 27, 2022 by Laura Turner
While many medical students struggle to grasp the complexity of mental illness and its management, I’ve experienced it first hand. I hardly had to study psychiatry for Step I – one of the few perks of being a medical student with mental illness.
The first time I was hospitalized for symptoms matching the DSM IV criteria for Bipolar II, a kindly gray haired psychiatrist interviewed me extensively, asking me what had brought me to the hospital, if I felt suicidal, and whether I viewed myself as sick. In the background, three medical students scribbled furiously, brows furrowed as they watched the interview unfold. I picked at the bandages on my arm, noting their short white coats.
Shortly after, the kindly gray haired psychiatrist saw fit to release me into the world. I returned to work, and my scars eventually faded. I wanted desperately to become a doctor and I’d felt envious of the white-coated students at the hospital. Sometimes I allowed myself to think about applying to medical school. I was afraid to mention the thought to my private psychiatrist, who I believed would look at me sympathetically, make notes on her pad, and gently suggest other careers.
Three years, an eight-hour bout with the MCAT, and five interviews later, I entered medical school as a first year student and launched myself into my studies. I made friends, shyly conversing about some of the stressors of first year, while carefully hiding my medications in a drawer under my sweaters. I got to practice my interview skills with a psychiatry patient, her manic words galloping over my gentle attempts at re-directing the dialogue, and I realized that empathy didn’t necessarily translate to a successful patient consultation.
I listened, feeling like a spy, to what my classmates thought of the mentally ill, noting that while most people did not want to pursue psychiatry, there was an overall kind-hearted tolerance toward psychiatric patients. Certainly there was some laughter with mixed feelings of confusion and disbelief as psychiatric patients volunteering to serve as subjects in a class dedicated to interview techniques described and exhibited bizarre thoughts and behaviors. I told myself I couldn’t identify with these behaviors, and that I had never tried to hurt myself.
I managed to convince myself that I wasn’t “one of them,” that the prescription bottles hidden in my drawers weren’t necessary, and that I was exactly like the rest of my classmates. I’d like to say I stopped seeing my psychiatrist, that I saved hundreds of dollars a month on prescriptions, and that I could finally stop hiding. However, as much as I tried to convince myself that I wasn’t ill anymore, I still was.
Once I went on a backpacking trip through the canyons of Utah. On the canyon floors, I was a captive of rocky walls that stretched upwards so that only the dusty path mattered as I plodded along in the desert heat. During the summer between my first and second years of medical school, as I descended into depression, I once again felt the sensation of being deep within a canyon, the walls too steep for escape.
I became engulfed in a gray type of depression that makes life feel like a piece of gum that’s been chewed an hour too long. One night, the depression overwhelmed me. I remember my femoral artery pulsing belligerently in the crease between my groin and thigh, exactly where I’d dissected it from my cadaver. I had noted its importance in blood supply to the leg, and the high proportion of total cardiac output. I thought about the blood coursing through my vessels now: too much Ambien, saturating my GABA receptors, too much Lexapro, too much alcohol… I called my doctor.
The human body is an amazing machine. My liver, kept in condition from a constant influx of drugs, took care of the excess, enabling me to stagger into the emergency room at one of the local hospitals. Security guards appeared and escorted me to the psychiatric section of the emergency room, like bouncers dragging me out of a bar. I stumbled into the mandatory blue hospital outfit and collapsed onto the bed, peering at the resident on call through one eye as she assessed my condition.
A nurse pulled a blanket over me, somebody stuck my arm, I took pills washed down with water from a tiny paper cup…
My sleep was eventually interrupted by a breakfast tray placed precariously on my feet at the foot of the bed. Over the next few days, I took lots of pills washed down with water from tiny paper cups. I promised my private psychiatrist, my assigned resident, and my assigned medical student that I’d take my medication, that I wouldn’t drink.
After my discharge, I spent the rest of the summer reacquainting my body with the various medications prescribed to me… quetiapine, lamotrigine, bupropion…
Although I often feel alone with my condition and the financial burden of treatment, studies show that a substantial number of medical students meet criteria for depression, while only a fraction seeks treatment. Some of the fears cited include the stigma, lack of confidentiality, and cost. Many medical students are concerned that mental illness makes them unfit to be doctors, and therefore do not want their condition known by those who might affect their careers in medicine.
Cost is one issue for which I was unprepared. Fortunately, my school provides an insurance policy that includes prescription coverage and reimburses for mental health related expenditures. However, my doctor is not covered under the school insurance plan, and the benefit I receive is minimal. Also, my monthly prescription drug costs exceed $100.
My mental health treatment is not on my academic record, and aside from an insurance trail of visits to a psychiatrist and the purchase of medications from the psychiatry section of First Aid, there is no easily accessible record of my condition. My treatment has involved a teaching hospital within the same county as my medical school, and I’ve come into contact with medical students, a humiliating, albeit inevitable, situation. If I pursue psychiatry, I wouldn’t even consider the residency program associated with that hospital as an option.
Those unfortunate realities have faded into the background as I plough ahead through third year. I’ve stopped worrying about any potential rendezvous with medical students who might recognize me. My pill bottles, once so carefully hidden, are scattered across my rug among books, flashcards, and scrubs.
Managing my illness is a full-time job. Sometimes, despite my best efforts, the medications don’t work as they should. When I think my thoughts are too fast, my ideas too expansive, I increase my dose of atypical anti-psychotics, bringing a wet curtain down on my mood, sometimes causing it to dip too low. Sometimes I want to fall asleep during rounds, other times I’m awake all night suppressing the urge to wake my roommates and tell them my great ideas.
Even when my medication does work, the side effects I experience are things most students’ eyes slide carelessly over in Epocrates: dry mouth, excessive sweating, dilated pupils. So I drink water, use deodorant, and I’m a great subject for ophthalmic exam practice. I try to look on the bright side — even when depression strikes. Attaining success in medical school while living with mental illness is possible, and I know I am not alone in that success. If you saw me walking through the halls of the hospital this year, you’d never know that deep in my pocket, under the reflex hammer and the otoscope, is a collection of pills you’d recognize from your psychiatry rotation.
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Very well written – thank you for sharing!
Thank you for sharing your story with us. I can relate to a lot of the feelings you shared with us and think it was very courageous of you to do so.
That was really touching- thank you for your beautiful and personal story it truly is encouraging to those of us who feel we can never be doctors because our mental health- this gives me hope and there isn’t any amount of words that can truly give you an idea of my gratitude- but thank you again!
Thank you for sharing.
Thank you, Emily, that was very powerful. You’re an incredibly strong woman, and an inspiration to others who suffer from mental illness and question whether or not to move forward with pursuing a medical career. I wish you the best as you continue through your studies.
thank you for writing this… I relate to the experiences you have described. best wishes Emily
Thank you for sharing this with everybody; the stigma associated with mental illness is very much alive in medical school. I have been shocked by the number of times a fellow classmate or attending physician has made comments about a patient’s “mental state” in a disparaging way. It is through articles such as yours that we may perhaps find a little more compassion and understanding. Thank you again.
Thanks so much for posting this. I can’t tell you how much your story resembles mine. And, by the way, I’m a successful 2nd year med student, but only after first being diagnosed with depression and anxiety (and subsequently treated effectively). It’s imperative to recognize a problem, and then seek the necessary help. Unfortunately, for those that do NOT have experience with a mental illness, it’s all too unrelatable. But, this stuff is very, very real.
You are what people should aspire to be. Congragulations! You will probably get further in your career than most of us will because you try with every cell in your body and you take challenges head-on. Good luck with the rest of 3rd year and in deciding which field of medicine to pursue!
WOW. I have to thank you for your inspiring story. I used to constantly doubt my abilities based upon my bipolar disorder, and wonder if it will ever keep me from my dream of becoming a Doc. To know that others have succeeded, yes though laughter and tears, is a beautiful thing. I wish you truly nothing but the best. I do hope you can maybe start a blog or something or find other outlets, including SDN to express your great thoughts. Good luck on everything you do…keep chuggin!
oh, yeah, and the above was written by me: perseveranceMD =D. ok, that’s not my real name, but I like the certain ring to it!
I love this article, good job, and keep on trucking!!!
Emily,
As an MS4 who had been diagnosed with a psychiatric condition (social anxiety d/o) during medical school, I can tell you that I know the feeling of wanting to hide my condition from the world. Congrats on having the courage to speak up about your story. Good luck and Godspeed.
Great post! Thank you for sharing your story with us. It’s so important to understand that med students can be patients too. So often we think of doctors and patients as “us” and “them”. In reality that distinction is often blurred. There are a lot of us out here who are getting threw med school with psychiatric illnesses. Articles like yours help us to realize that we are not alone in our struggles.
Thank you so much for sharing your story. I’ve suffered from bouts of depression in the past. Now, I am a 1st year medical student – what I’ve always hoped for. But once classes started, I fell into the deepest depression I’ve ever felt. I sought help early, and am fortunate enough to have a great support team. And they’ve reassured me that having a mental disorder (my official dx – generalized anxiety and severe depression) will not stop me from pursuing my dreams – I just have to continue to get treatment and work hard. I’ve been low, very low – but am fianlly feeling like my old self again.
Again, thank you for sharing your story. Hopefully, this will encourage more students with problems to not be ashamed or embarassed, so that they may seek help. It’s good to know that we’re not alone.
I didn’t know one could get a medical license with past suicide attempts or mental illness that requires medications. Could you even be a surgeon if you desired and got the residency? I know that one cannot get a pilot license, join the military, etc?
Yours is a story of courage, and it looks like you have a good handle on the illness. As a MS4 looking to match with IM/psych, I enjoyed “an Unquiet Mind” by Jamison. It’s neat to hear about your stories and struggles.
Thanks for your story. I had the sad experience of having to hospitalize my teen for depression and violence to self and others. It is all the more wrenching when you are a physician and supposed to be able to “fix” these things for others.
The exact wordings vary by state, but you can indeed be under treatment for an emotional disorder or chemical dependency as long as you certify that it is not impairing in any way–e.g. in my state “Is your cognitive, communicative, or physical capability to engage in the practice of medicine or surgery with reasonable skill and safety impaired or limited in any way?” and “Have you within the past five years been advised by your treating physician that you have a mental, physical, or emotional condition, which, if untreated, would be likely to impair your ability to practice medicine with reasonable skill and safety? If you answer this question ‘yes”, please answer the following: With regard to any condition referenced above, are you being treated so that such impairment is avoided? With regard to any condition referenced above, are you in compliance with the recommended treatment? ”
So basically, as long as you are being treated and complying with treatment in a responsible way, you can be licensed to practice medicine.
Wow i applaud you. That is wonderful and I think you will have special insight should you choose to treat the mentally ill. It brings into question what really does ‘mentally ill’ mean. Surely if you are in your third year of medical school you are not a helpless individual. You are remarkable and you prove that living with a mental illness is possible and when you succeed, won’t you be an inspiration to us all. Keep doing what you’re doing
Thank you for sharing. Wish you all the happiness and success.
great piece! Wanted to let you know that my mother is also bipolar – she’s run a successful (dental) practice for years and years and is close to retirement.
Wow. I just had to add on to the already posted comments. your story is interesting. Bravo! for the past week, stories on psychiatric conditions have been coming my way, hmmm…maybe I should consider it as an option during medical school. All the best Emily!
After spending weeks on a psych rotation where I’ve felt we have very little to offer our patients, I’m thrilled to read about your successes. It gives me hope that what may sometimes seem like futile effort is, in fact, so very important and life-changing. Best wishes in your career!
very well written…i entered medical school with undiagnosed ADHD and had a horrible time initially. now i’m on meds and med school is a lot better! however…i also feel the stigma and isolation of wondering why i’m not “normal” like everyone else and i want to go off my medicine ALL the time!!!!!! i think this article is just a step to sharing the burden of our secrets and knowing that you’re not the only one…
Thank you for inspiring me.
Great article. I am also bipolar II and a medical student. No one at school knows. I have only been able to stay off medications by restricting my life in a way that most people would not be willing to do: no alcohol, no sexual relationships, regular exercise, extensive counseling, and constantly monitoring my moods so that I can get help before things get out of hand. It’s not an easy way to live, but so far it’s working.
thank you for sharing your story with us. it was very courageous of you. i wish you the best for the future.
Your awesome for posting this article up Emily. I am a premed who has recently been diagnosed with Schizotypal Personality Disorder. I don’t plan on going on any medication to treat any of the symptoms it has been causing but its great to see that there is hope to live a manageable life in the career of your dreams. Good luck in your third year.
I was diagnosed with treatment resistant depression with manic tendencies, ADD, and a generalized anxiety disorder during my 20’s and I thought I had it under control with medication before I started medical school. When I started my first year the extensive pressure of being in medical school later in life (30’s) I started having some serious problems. Lucky for me I was never suicidal (I am too chicken) but it did make me question whether I was capable of completing my dream. I was introduced to someone just like you who spent time with me and explained how she was able to finish and thrive in the medical field with the help of medication and awareness of her condition.
I am happy to say after I took some time off between 2nd year and 3rd year to get my medication right I am now doing my clinical rotations and hoping to go into Emergency Medicine (good for those of us who are ADD).
I wish you the best of luck and just want to say you are not alone out there.
Emily, you’re a brave gal to “come out”! I would highly suggest reading Kay Redfied Jamison’s books for further inspiration. She’s a psychiatrist afflicted with bipolar.
I am a dentist but I’ve dealt with very ugly situations as a result of my condition as well. I was an honour roll student throughout my life and completed my undergrad education in a reknown university. A little after graduation, I had my breakdown and had to deal with a lot of people in academia (and fellow students) who completely crushed any hopes I had in achieving in my career. I had nearly no moral support whatsover in the academic environment. I only survived as a result of the support of friends (outside my program) and family members.
I was completely taken by surprise by the lack of knowledge of mental disorders by those who supposedly had a medical education. It’s taken me a good decade to recover my self-esteem. I was robbed of a lot of happiness and relationships in my 20s because of my struggles. I am faring well now and you will too if you don’t ever give up!
“Run when you can, walk when you have to,crawl if you must, just never give up.”- Dean Karnazes (runner)
Emily, what an inspiring piece! Very thoughtful and beautifully written. Having people in your life close by who understand, accept, empathize and admire you must be a great boon. Hang in there and you will be a FABULOUS doctor!!!
thanks for the inspirational article. sometimes i wonder if im suited for the medical field, considering my past history with depression. reading your article made me feel pursuing medical school is possible.
definitely takes courage. thanks for sharing.
Thank you for sharing, Emily. Good luck in medical school!
Emily, I thank you for posting this. I’m a 4th year med student, and I’ve struggled with depression, ADHD, and anxiety for years. I was pretty open with my friends about my medications when I was on them, only to have some of them suggest it was “all in my head” and that I didn’t really need medication after all. At the moment I’m unmedicated, but I do wonder how long it will last, and where I will turn the next time I need help.
It’s interesting, having been on so many of the psych meds – I have a knowledge of those drugs that, like you mention, is way more extensive than that of our colleagues who have merely read about them. My knowledge occasionally gets me into sticky situations, when I seem to know a little too much about a particular drug, but hey, everyone has their quirky things they know really well… right?
One of my goals, in the long run, is to raise awareness about mental illness in medical students. It’s a long-neglected topic which needs some attention so that people will realize that stories like yours are not isolated incidents. There are many medical students with mental illnesses who can and will become successful doctors, both despite and because of their illnesses.
Good luck to you, and thanks again for writing.
Thank you for writing this. I had been carrying around a prescription for Lexapro (for depression and generalized anxiety disorder) for one week. I even had some free samples from my psychiatrist but several things prevented me from taking the medication. First thought was: future doctors are NOT patients. So I procrastinated and might have not taken meds at all if it were not for me reading this article tonight. I’ve decided to take the plunge. So, thank you so much!
~Jan
I know the feelings you went through – rest assured you are not alone. Residency may be a bit more difficult to cope with our disorder, but with great support from family and friends, you’ll pull through.
Thanks Emily…courageously disclosed your struggles and strengths in an excellent manner! I am an aspiring med student, do you think I should mention my illness in my application essay/ elsewhere?
Thanks for bringing a ton of hope to many of us like you! Good luck with med school, your career and life:)
AG – a friendly word of advice – don’t disclose your illness unless you REALLY are obliged to.
You would think the medical community would be understanding but take my word for it- I’ve learned the hard way (especially when I had to take a sick leave as a student and when I was a resident) – expect no understanding or compassion. Expect a lot of prejudice and judgement. When it comes to psychiatric disorders, doctors (and even some psychiatists) are still in the Dark Ages of knowledge/understanding.
You can disclose just about any illness known to mankind- (ie.alcoholism, drug abuse, cancer or even HIV etc.) and people will be understanding but when it comes to mental afflictions, there remains to be A LOT of progress! People will say it is not a REAL disease and that it is because you aren’t religious enough or grew up in a bad home or have a weakness of caracter or are just plain making it up (I’ve heard this from health professionals).
Just make sure your condition is stabilized with either cognitive therapy, physical exercise or the proper medications (or all three) before you enter medical school because the stress of the curriculum will probably be harder on you than the average person. Good luck! Stay strong!
Well written, but sadly it is true. There are times I do wonder of my time through medical school and thereafter in residency with a stigma of a psychiatric diagnosis. Despite all of my health ordeals however, I am passionate about applying to medical school and a career thereafter. After my episode of a psychotic episode followed by hospitalization last year, I think I have come a long way, from taking 3 pre med courses while working full time, getting a GPA of 3.7, to getting a couple of research publications. However, when I took my MCAT exam, I got a pathetic 18 on it. This has blown away all my chances of a secondary application except a couple of schools that recommend writing a letter explaining the reason for low scores that “because of wh/ I was unable to exhibit to the fullest of my academic potential”. With all my meds the night before my exam, and surely a bout of anxiety, I was hung over the following morning, and could not focus on my test at all. I am otherwise stable with psychotherapy, meds and meditation. I am preparing to take the Jan MCAT again and do well this time; my psychiatrist says I am doing great and is very encouraging of my decision to pursue medicine. even though I refrained from mentioning anything about my illness anywhere on my application, and would like to be considered purely on the basis of my credentials; I felt like may be writing a letter might explain to the committee where I come from and why I couldnt do well and potentially getting me a chance for an interview, event though I would take my MCAT.
But thanks for all the good words, it is amazing and without no doubt a great accomplishment that you all have successfully made it through med school and residency…I look forward to life, career and my ambition and thanks for being good examples!!
Stick to your guns,AG! Nothing ever came easy for the things which are worth it in life! You’ll be a better doctor because of what you have experienced. Your condition will humble you and teach you that the greatest thing to overcome in life is one’s mind. If you can master your own mind, everything else will be much easier in comparison.
It’s very inspiring to hear what everyone has to say. I can relate to a lot of these comments. Mental illness needs to be better understood by medical students and professionals.
There needs to be more support frameworks avilable to medical students. The road is tough already, without the extra burden of fighting yourself all the time.
Courage to all, and thanks for sharing!
I just wanted to let you know that there is a light at the end of the tunnel. Managed to get my BSN even though I was suffering with BPD for most of my life – and most of it undiagnosed & then medicated incorrectly (tx for severe depression only). Took 11 yrs to get my 4 yr degree – had to take a 5 yr break in between as I wasn’t very functional. I’ve been an RN for over 2 years now, and an Peds ICU nurse for over a year. My coworkers would probably say I’m a “kick a–” nurse. I’d say I’m a success story. Looking at me one would probably never know I suffer from such a debilitating disorder. Hang in there! You CAN do it.
Dear Emily,
Thank you for sharing your story. I see myself reflected and am comforted by kindred spirits. I’d like to tell my own.
I was depressed during the first year of medical school, but isn’t everyone. A month into my second year I cried so much I could no longer attend class. I didn’t understand the source of my depression and was reluctant to admit my anxiety. While on Prozac I continued to get worse and my subtle ADHD characteristics became not so subtle.
After my first clerkship of 3rd year medical school I couldn’t take it anymore. I took a leave of absence and contemplated whether or not I should go back. After having four psychiatrist suggest that I have bipolar disorder I am coming to grips with reality and possibility. I switched doctors and am now seeing a psychoanalyst twice a week who manages medicine and does therapy. I thankfully have a wonderful husband who provides emotional support and insurance, but since my psychoanalyst is out of network we have a $3000 deductible, not to mention the drugs. One month we spent more than a thousand dollars on healthcare related expenses and I haven’t even been hospitalized for mental illness.
We weren’t meant to hurt this much and it’s not our fault that we do. My family is in denial. My friends struggle to survive medical school and life. Sometimes I feel so alone, but one of them sent me a link to this article and now I’m a little more hopeful.
Your article was well written and incredibly heart felt. I understand your pain and admire your measurable strides. People like you are needed in medicine to understand what patients are going through. You offer hope to those of us who have struggled with mental illness and the stigma surrounding it. Thank you very much for sharing.
Thank you so much for your article, Emily. I also struggle with Bipolar Disorder, and I’m just beginning the application process for entry in 2009. I deal with doubt about my ability to get into and get through med school all the time, but becoming a doctor is my dream. Your article gave me so much hope. Thank you.
Never ever ever ever ever ever ever ever ever ever ever ever ever ever Ever give up. EVER.
Yeah- NEVER EVER GIVE UP! And if you’re like me, when the head of your residency program or the dean of your school tell you that you aren’t cut out to make it (when you inform them about a sick leave about your illness for instance), smile and as you talk to them think to yourself “I CAN and I WILL SUCCEED! You just wait and see!” After being humiliated , failing some courses because of my illness, sick leaves, recuperating and dealing with constant opposition, I graduated and I have succeeded.
I have been having a difficult time this semester, trying to still manage and control my bipolar disorder and psychotic/paranoid thoughts. My room is a total mess, and I constantly worry about my looks, and how I think people perceive me and how I perceive myself. I haven’t been sleeping, eating, or working-out right, which makes my psych soo much worse. I have wasted more than 4+ hours a day this semester worrying if I’m good enough/smart enough for med school and my classes in undergrad..worrying about my looks, and looking in the mirror every .23 seconds for way too long wondering how I look at the moment and if I’ll ever be beautiful. worrying about fitting in. worrying about worrying. worrying about where I’ll be at the end of the semester. worrying about suicide (no, I’ll never do it). worrying about if I’ll get my gpa above average by the time I apply. worrying about not being able to accomplish my goals/dreams. worrying about not making my parents proud/happy. worrying about not making myself happy. worrying about giving up. hating that I can’t concentrate/focus as well as I’d like to because my mind is consumed with petty problems and thoughts. hoping I can somehow magically become a genius. dreaming of things that don’t make any sense. wasting life. WASTING LIFE…worrying. that is what I’ve been doing. and you know what? I’m done. cold turkey, with all this worrying crap. from here on out, I am never going to put limits on myself or worry about petty things or worry about what/how others perceive me…
Because I have a dream…and with all the baggage above..it’s only going to weigh me down..and hurt me. I’m done hurting. I want to start living. Living life. experiencing life. From here on out ITS A FRESH START, A NEW BEGINNING. because I owe it to myself. EVERYONE deserves to have their dreams come true..and mine is to be called “Doc” in a few years. Yup, I like the sound of that. Doctor candlelightlove.
its 12:51am October 25, 2007 (well, 12:54 now, haha)
don’t ever quit.
“THERE’S TOO MUCH BEAUTY TO QUIT…TOO MUCH GODDAMN BEAUTY”
candlelightlove, you should go to your student health clinic and tell the doctor everything you just wrote here. Please, don’t wait until the pain becomes so bad that you do something desperate.
This story took brass ones.
On my application (to pharmacy school) there’s a part where they ask if you have any special circumstances that you think may have negatively impacted your academic ability.
My first time around, I was too scared to write anything. The second time, I wrote about my severe depression and panic disorder. I even prefaced it explaining how I feared this revelation would have a negative impact. Apparently, it didn’t, and I got in.
The pressure, though, is one hell of a trigger.
My grades have sucked when I’ve been too lethargic or apathetic to study, or when I start to panic during a test. I’m scared of attempting to make friends, I’m scared I’ve lost my passion for pharmacy, I’m scared I’ll end up just scraping through on academic probation. I miss out on things I like to do anyways because I’m constantly in class or at conferences, etc.
In fact, I have to end this now to get to class…
Yes, I have been seeing someone for it…have been for the past 4 years. But, I’m feeling a heck of a lot better now that I have gotten my meds changed.
=)
point as someone said before..never give up, EVER.
A few things:
Anyone feeling suicidal should try to get help immediately! If you don’t have a regular doctor for medication management and/or therapy, try to find one.
Be careful when disclosing information. Sometimes it’s necessary; the Student Health center knows of my illness because I disclosed my medication list to the clinicians there. The Dean of Students knows because I took some time off. Be careful when it comes to confiding in superiors, co-workers, clerkship directors, interns, residents… etc. I’m not ashamed of my illness but a stigma exists. (and this is not my real name)
Good luck to all those in similar situations and thanks for the supportive comments!
you are an inspiration and you will make a great doctor.You have the will, the strength and determination to succeed in medicine. I have a sister that was diagnosed with bipolar. I have seen first hand the roller coaster of emotion associated with this disorder. I admire your courage. God bless!
For another inspirational story of an individual with a psychiatric disorder who has become a successful professional, I suggest the book “The Center Cannot Hold,” by Elyn Saks. Saks has schizophrenia, paranoid type–but she also has a JD degree and is a professor of law at a top university. She is an amazing woman and she tells of her journey to understand and accept her illness, and ultimately achieve stability in her life through medications, psychotherapy, and good self-care.
Thank you so much for writing this article – and for having such incredible patience with the people around you who can not understand mental illness as intimately as you do.
Emily,
Do you plant on disclosing your illness on medical license applications?
it’s tough living with this illness. but it’s not the end of the world, even when it might reallyreallyREALLY feel like. KEEP THE DREAM ALIVE, KIDS.
“there can be miracles when you believe, though hope is frail, its hard to kill. who knows what miracles you can achieve, when you believe, somehow you will. YOU WILL WHEN YOU BELIEVE”.
Emily…Thanks for your advice abt careful disclosure to folks in the medical setting abt illness. One very specific question….what do you think about mentioning illness as a real life obastacle one has faced and successfully accomplished many things personally and professionally despite it, and talking about it in one’s application for admissions? I am really struck at this stage, and am afraid of the consequence of it. Any advice from anyone is appreciated!!
Thank you, and yes we’ve all come long ways, but are not too long away from acheiving our dream:)
this is true.
Thank you for this article. I am premed and was just diagnosed with bi-polar disorder. I am worried about how to go about presenting my illness at application/interview time. I was sent to rescue crisis for acute pyscosis as I was also diagnosed with PTSD. I am afraid this will show up on my background check. My dream is to be an Orthopod. I am not going to let this stand in my way. Any advice on disclosing my disorder at time of application/interview would be greatly appreciated.
Thanks for the bout of perseverence.
There’s an old saying that fits:
“If you can get up in the morning and do your job, you’re a doctor. If you can’t, you’re a patient.”
Keep getting up. You’re doing a great job.
People with BP have to be stronger than the “average” person especially if you work in the health care field. You can’t let on to your co-workers or your patients that you have any problems.
The isolation can be very very challenging even if your condition is stabilized by medications. The most important thing I have found is you should be very selective about who your friends are because they will be your lifeline in difficult times. Without any form of support, no medication in the world will be suffice to help you deal through the difficult times.
wow-you should publish this in NEJM or JAMA, it is so important that doctors and medical students talk about our own experiences as patients and break down some of these cultural barriers-great piece and thank you so much for sharing!
Yeah, it’s about time the medical world stop being so judgemental and prejudiced towards people (especially those in the same profession) who are afflicted with BP and other psychiatric disorders. Is the medical world ready to embrace them though? Sometimes, I wonder…
Hi I just wanted to let you know I am also a 3rd year medical student with Bipolar II. I have had great success taking fish oil for this condition. In fact I only take fish oil (7200 mg daily). There was a Harvard study that researched this. I would recommend looking into it. P.S. I totally understand your part about wanting to wake up your roomates to tell them your great ideas.
I think someone should create an online support network for medical/dental/pharmacy students with BP and other psych problems. I find it hard to find others who can sympathize/empathize with my condition. I want to make some online friends who are going through similar experiences.
I’m facing a very challenging time now. I haven’t told anyone how I’ve been doing lately – neither my family, friends or psychiatrist are aware of my condition. I was stable in the last few years but lately, it’s been very difficult. I’m trying to “tough it up” by keeping to myself even when in the presence of friends or family members. I’ve pretty much cut myself off from anyone who has tried to get closer to me because I was very badly hurt by some individuals that called themselves my friends in the past few years.
I am conflicted in many aspects. If I tell my family, they are going to go balistic, constantly check up on me, call me at work and panic when they don’t know where I am or what I am doing. If I tell those people I presently call my friends, they will tell me I have to spend more time volunteering, meditating and finding “self-love”. If I tell my psychiatrist, he will write a report which has a high chance of being read by the medical licensing body of the region I live in.
Perhaps I did the stupid thing of being honest and declared my psych disorder (in the medical history part of the application) when I applied for my license. As a result of this, I have to give the license bureau a yearly report from my psych so I have to be careful what I tell my psych. I trust my doc but a little bit too much information may do me more harm than good. It’s an awful situation to be in but that’s how it is. Those with a history of a psychiatric illness are treated like criminals by the licensing bureaus.
To be honest, I think if most people would know what I think and feel these days, they would say I should be on a “suicide watch”. I had crazy ideas of killing myself (overdosing on a lethal combination of sleeping pills,antidepressants and alcohol) during the upcoming Christmas holidays if I don’t feel any better. I wish I had someone I could talk to in order to share some very painful memories which constantly haunt me and have pretty much destroyed any self esteem I had.
Believe it or not, I am excelling in my job. Actually, I love working and my co-workers as well as my patients like me. Working temporarliy distracts me from my feelings and self destructive thoughts.
I don’t know how, maybe with some form of faith (whatever I have left in me), I’ll overcome this and be the happy person I used to be. I have to somehow find the strength to face this alone. I have to learn to survive because I won’t always have someone to morally support me – people come and go- it’s just the way life is.
Em,
Too much medicine is bad also . Of course you know yuour condition better . I do recommend Mind-Body Medicine for you .
Lift yourself up and fly high in the blue sky , like Jonathan Livingston Seagull …
Good luck babe .
Em,
I don’t have such an inspiring story.I’m a final year medical student (and very functional still) who voluntarily left medschool a few months ago in the uk due to a diagnosis of Bipolar Disorder.
I very much enjoy medicine and would have liked to have continued but the profession is one that is highly regulated. Bipolar disorder (by defintion) has multiple recurrences. I could not possibly take the risk of further manic episodes, for potential problems that i could face having had the grandiose delusion before that I could read people’s minds (happened in 2 separate episodes and though fun at the time, deeply embaressing later).
I’m very poor at recognising relapse signs which has resulted in three psych hospital admissions in the last 6 years.
The current meds I’m on Lithium and Lamotrigine.I have been before on Olanzapine (20mg), Sertraline.
The question with me has, therefore, always been whether I should do medicine, rather than whether I could. I hope the best to you and hope you remember that there are many Bipolar Doctors out there, even Bipolar psychiatrists that I am aware of practicing in the uk….It’s not impossible and even if you can’t see the light at the end of the tunnel, there’s always hope.
to all those who have Bipolar and are in Med school, how did you deal with/manage the disorder in undergrad.
I know there’s the meds, and the therapy, but what else has there been that has kept you “sane” and healthy, and happy and good enough to get into Med school?
how do you control your obsessive thoughts? ( yes, i know meds and therapy, but what else…shear willpower?
I was just diagnosed with Bipolar I in August after a severe psychotic bout of depression, mania, and hospitalization. It was my first ever episode and it came as a complete shock. However, I decided 2 weeks after leaving the hospital to continue into my second year at dental school. Last year I coasted fairly easily through school, but I’m finding it difficult now because I can’t concentrate. I don’t know if it’s me or the meds. I am filled with self-doubt. However, I’m hanging in there and stories like yours give me hope. THANK YOU!
wow… very touching and heart rending. It was truly inspiring. Thanks so much for sharing such a personal and heroic story.
In response to candlelightlove. My BP 2 symptoms didn’t really become bad enough to interfere with my life on a regular basis until the fall semester of my second year. I think it was a combination of SAD (seasonal affective disorder and BP ) because I was used to living in the tropics and moved to a temperate climate. In addition, I went out a lot with friends on the weekends and took part in regular exericise prior to med school. Once medical school started I wasn’t able to do as many social activities and was not able to exercise outside as much which I think made my symptoms get much worse. In order to control my symptoms, once I was diagnosed, I quit drinking coffee and drinks with a lot of caffeine like Redbull, realizing that caffeine exacerbated my sx. Now I drink tea only. I also don’t drink as much alcohol as before. Now I only will drink on weekends and limit myself to 2 drinks per night out. Having a regular sleep schedule is very important to managing sx. I also got rid of any bad relationships that I had with other people that could influence me in a negative way. I feel very lucky because I have a supportive family and one or 2 close friends that know about my condition whom I feel entirely comfortable calling if I don’t feel mentally ok. I find that living with BP 2 is all about balancing different aspects in your life. However, none of this would have been possible if it weren’t for Fish Oil which I take daily.
Thank you for sharing your story and I believe that everything happens for a reason
Accolades for sharing your career path with us. Indeed that you have made all the way i trust you will get through all hardships in future.
Dear Emily and all,
I am a “super” second year student. I was just diagnosed with BPII two months ago, and it has been terrifying. During my first year of med. school, I lost 2 loved ones within a 2 week span. I was diagnosed with anxiety disorder, had panic attacks every other day. Then depression. Then I had my “best” friend at school turn on me and tell people that I just wasn’t “studying hard enough.” A couple of months later I was diagnosed with ADHD. I was on medication for ADHD and was able to do okay in the spring, then lost another loved one and lost it again. Lost yet another loved one at the end of the summer. Had my psychologist turn on me because I had trouble coming up with enough money to pay off the huge debt… her office continually called harassing me. The depression/anxiety got worse. I realized I’d gained 25 lbs on my depression meds. I failed second year. I started seeing a psychiatrist last summer, as well as a psychologist who specializes in Cognitive Behavioral Therapy. We started working on the ADHD/depression, when two months ago my psychiatrist told me she thinks I have bipolar II. I have cried so, so much. My “highs” and “lows” have gotten really bad, but with CBT I’ve been able to pull through. Now, all the meds that I was on for ADHD/depression have to switch over to BPII and it’s taking a long time. I studied my ass off for my exams this fall. I thought I was going to do so great… and then I panicked, and crashed during the exams. Now I’m so depressed that I don’t even know if it’s worth it anymore. It feels like it keeps getting harder and harder, and I just don’t know if it’s worth trying to keep pulling through to become a doc. I just don’t know what to do anymore. Was anyone else recently diagnosed with BPII while in medical school? It was relatively manageable when it was just ADHD/depression. There are a handful of other med. students who also have that in my class. It seemed so much easier to deal with, ADHD and depression. Such a large percentage of any med. school class is depressed (I’ve heard that 1/3 of the 4th years are on antidepressants). But BPII??? It’s not something you can ever, ever talk about. The stigma is so huge!!! My CBT psychologist keeps gently hinting that perhaps med. school is too hard, that I should choose another career. But I’ve put so much of my life into medicine! I want to help others, and I think I’d make a kick a$$ psychiatrist or whatever I decide. I want to believe that I can do it, but I am so depressed at my recent test scores… I keep falling down, over and over. It’s been one thing after another these past 2 1/2 years. I’ve had to leave my class behind. I’ve had TWO close friends turn on me and start gossip (thankfully it was before the BPII diagnosis), but it’s still been so incredibly painful. I’ve been trying to read, and to find other medical students/physicians to talk to, but I feel so alone. You can’t talk to anyone when you have BPII. It’s so much worse than when I was just ADHD/depression. When you hear “BPD”, I feel like people automatically think your nuts, delusional, suicidal, etc. I think I hide it at really well, but when I’m by myself, it is so hard. And I don’t feel comfortable getting close to classmates anymore. I just don’t know what to do. I don’t know if this is worth it anymore. I’ve tried so hard, and it is so difficult to keep failing, and to keep getting back up, and keep trying over and over and over and over and over again.
Please help. I need some advice.
to the person above, DON’T EVER GIVE UP. it’s that simple. make sure you take care of your self, and are stable enough and feel more functional..and the rest will follow. you must be in the right state of mind, so I would suggest taking care of yourself FIRST.
but don’t give up, ever. you can do it!!!
=]
As everyone else has said, thanks so much for this article!! It is so inspiring. To the person 2 above, i believe if it is what you want to do, you will make it, just believe and again as everyone else has said, never ever give up! Just try think positive and if u make it, you can look back and say, “wow, i did this, look what i achieved!”
Keep on trucking!
Dear Emily,
Thank you for your brilliant article! You provide lots of hope to those of us who have similar conditions.
Dear Scared&Confused,
I’ve been diagnosed with BPII while in 2nd year med school too. Please don’t lose hope. Keep at it. You will be an AMAZING doctor because you know exactly what a BP patient is going through..it won’t be just words on a page. He/she won’t be just another patient. Your health comes first – you need to take care of yourself and get stable. You have been through SO MUCH and the fact that you’re still here, writing about it is testimony to your strength.
But should you find yourself in a situation where Medicine is too stressful to continue – that is OK too. It doesn’t make you a failure. Circumstances change, and perhaps your calling lies elsewhere.
I tell this to myself. But I’m not gonna quit anything without a fight.
I’m a med student who’s also failed her exams despite studying really hard. I’ve been diagnosed with BPII after lots of stresses and years of crazy mood swings…i can relate to the HUGE stigma associated with BPII. I’ve never been hospitalised but have seriously harmed myself through the reckless shopping sprees and sexual indiscretions which I really, really regret. I’m still in the process of adjusting to the meds and forgiving myself. This loss of confidence that comes with swinging up and crashing down is just so painful.
I just hope that I’ll stabilise on the meds and get on with life and succeed in my studies and be that doctor who really understands how much BPII can mess up your life. Until then, I’m just taking one day a time.
This was a beautiful article, and I am so glad that I stumbled upon it. I just submitted my app. to med school, and in my personal statement I discussed my self-diagnosis and behavioral therapy for OCD, something that I struggled with from 10 years of age until 26 (I am now 31 and still need to work to keep things under control, but the meds have been a life-saver.)I am hoping I will get in, and like you, think the psych classes will be a bit of a breeze. Thank you for sharing.
This writing has made me feel like a burden has been lifted off my shoulders. I have denied my bipolar diagnosis for years and after a tearful visit with my Dr. in which he got very stern with me I promised to take my meds “all the time”. Although I’m not pursuing a doctrate in medicine I still questioned my abilities to care for my patients. Thank you for sharing and wish me luck because I’m going back next semester. God bless you!
Do you have any idea how hard it is to find ANY website that addresses this? There is no support group, no website, nothing.
I just finished medical school, and thank you so much for writing this. Almost worse than the illness is the isolation, the stigma, the having to hide.
All I learned about stigma about mental illness, I learned in medical school. Unfortunately, doctors are some of the worst about these kinds of things. I am afraid to tell anyone, scared every time I have to refill a prescription, lie to my GP so it won’t be on the EMRs that we have here, and pay for a psychiatrist and all labs out of pocket just so no one will no, so my license will be safe.
Thank you so much for writing this. I wish this page had some links about opening a site for people like us.
Thank you so much for all the supportive responses! I agree; it would be wonderful to have a way for people in medicine who deal with these issues to connect with one another.
Self doubt and the loss of confidence is the worst part of it all. In my first two weeks of medical school, I could not concentrate, took a million years to read one page, could not even understand what DNA was after having studied it all throughout pre-med. After quitting medical school after those two weeks, believing that it was because I wanted to be in the business world (and having dreams of starting my own business), I was diagnosed with BP 2, began medication, and realized how much I had lost. I am able to come back again to medical school, but I have lost all my confidence in my study habits and in who I am in general. I had completely changed and did not even see it. I am so scared that I will not succeed academically, that I will again be unable to concentrate or understand very simple concepts because of my fear. What if I constantly think about my inability and that in itself results in my failure to understand simple concepts? Can someone please advise me on how to clear my mind of this phobia.
Oh, and also, what happens if someone in medical school knows your diagnosis? I know people can view you differently, etc. But, how can it actually negatively affect your career?
Thank you, as I’m sure everyone else has said. I’m looking at trying to get into med school, with bipolar. I haven’t dared tell my psychiatrist, not wanting to get that sympathetic look and brush off. I am terrified of making it into med school and failing miserably. I’m scared of people’s bias, if it came up on the app or in an interview since my condition screwed up my undergraduate grades a lot.
Thank you. I can imagine that you understand how helpful this article is.
I think that if a health care professional or pre-med student tells you your mental illness is all in your head, you should ask them why they’re a doctor or aspiring to be one. I know it won’t have the desired effect on everyone, but it’s likely to at least shut them up.
Hi Emily,
Thank you so much for your post! I found it really inspiring. I have a question for you… I have BP II and I am really interested in pursuing a career in medicine. However, I am very concerned about the amount of sleep deprivation that occurs during residency and the affect this will have me as an individual with BP. I was wondering if you’ve had any experience/problems with sleep deprivation and if so, how you plan on managing this during residency.
Thanks again!
I find the sleep deprivation to be very difficult. I managed the first two years by pacing myself well and not procrastinating. As for third year, I have to be very careful and things aren’t easy. My need of a more regular schedule will influence the specialty I choose, as well as where I do my residency.
Emily,
This was exactly what I needed to read tonight. I was diagnosed with GAD/MDD 7 years ago and have been on/off different SSRIs, benzos, and SNRIs. I received metiocre grades at best in my undergrad and am just now completing a post-bacc pre-med program. (grades are stellar this year) I am 28, on a stable medication/therapy regimen, and sill submit apps to medical schools this summer. I feel that I need to provide some sort of explanation for my undergrad grades, but I am reluctant to mention my diagnoses because of the stigma. Does anyone have any thoughts on this matter?
above post should read *will* submit apps this summer
I started a blog- http://bipolarinmedschool.blogspot.com/
I googled bipolar depression and medical school, and I found your article. I was just diagnosed with bipolar II. I have been wondering if bipolar people should even consider pursuing medical school. Your story is inspirational to me and renewed my hope to be a doctor. Thank you!
This hits so close to home. Just yesterday I got into a bitter arguement with my mom about trying to go to medical school. She shot my idea down, saying that it was too stressful, I would get sued, and I would never be able to handle it. The problem I had with her comment was that 2 days before she had told my brother that he should go for it and that it was a truly rewarding career. I know that my mom still sees me as a little girl with a lot of problems, even though I am now finishing my second year of nursing school. I hope that one day my mom can finally realize that just because I have a mental illness, I can still be a successful women. Thank you for this truly inspiring article! I can’t tell you how much it means to me.
My 23 year old son is entering med school this summer and he is bipolar. I’ve decided to live with him for the first year to help him maintain stability by cooking, cleaning, doing his laundry, etc. so all he’ll have to do is go to school and study. He was going to get a roommate but we were concerned that he’d be forced to hide it and it would leave him vulnerable to having his illness revealed. He’s worried the other students will think he’s weird for living with his mother the first year. What do you all think?
Thank you Emily for writing this article, it gives many people a chance to see what a lot of people with bipolar disorder go through.
I discovered that I had bipolar disorder when I was in 11th grade. It was a very confusing time for me, and it took a lot for me and my family to adjust to. I never liked taking my medications because I felt like it was making me an invalid and I had two or there relapse during the time of the discovery of my bipolar disorder. Presently, I am a B.S. in Chemistry and I am working hard to get into medical school. At times I would feel a little discouraged and unconfident, but I do my best and work hard at brushing those thoughts away.
I wanted to send a message out to Anonymous on April 6th, 2008 at 5:54 pm. This person majorly droughts themselves and I know it is hard to believe in yourself when there are so many obstacles in the way. But please don’t give up. God never puts us in a place that he felt would be too much of a load. If you got into med school you’ve got to fight your way to stay in. There are many times in my life where I could have just quit, BUT I DECIEDE NOT TO. And because we all decided not to quit we all have made this world a different and better place for us and other people.
Keep doing your best, because it is worth it.
Thank you again Emily for making a difference.
WOW!!! I have been looking for an article like this! Im on my way to Medical School and have dealt with bi polar disorder for several years now!! Thank you so much for the publishing this article! I’ve needed inspiration for some time especially with pre med advisors telling me it would be a bad idea to go to med school w/ this disorder! Thank you for the enthusiasm!!!
Kudos to you ! You are an inspiration to many
thank you. MD & Psychs alike like to discourage us from medical school or any type of medicine. Like it’s a club that we’re not good enough to be apart of. Finally someone speaks out. Congrats!! I learned its better not to tell people of my ideas of attending medical school i don’t need their comments.
You are a very strong person Emily and I can personally sympathize with you situation: I am a pre-pharmacy student and I have a sister (that I live with) that suffers from Bipolar Disorder. I know that there is no cure and that its a daily battle to be fought, but it definitely can be managed through the right meds and a caring support system. You are not only going to be a great physician, but you are going to be the BEST one! You have a unique story and can symphathize with patients more than the typical MD or med student. God bless you.
Thanks for sharing your story and showing that mental illness does not make medical school an impossible task. Thanks for being you.
Thank you! I’m in my 3rd year of a PhD program and will be applying to medical school in a year. I was just diagnosed and its comforting to know that they are people like me who have achieved their dreams in a medical career even with BP. Not very eloquent sentiments, but true.
Thank you for this article. After many good and bad years and a recent suicide attempt, I’ve been diagnosed with a condition somewhere between rapid cycle manic depression type 1 and schizoaffective disorder. I was informed that my symptoms address both. I’m in my final year of college and considering medical school. The mental problems have been dissuading me for some time.
Again, thank you.
So encouraging to read. I was diagnosed 3 years ago. I am an undergraduate student; the diagnosis delayed my studies and I decided to do an Bachelor of Education degree in order to become an elementary school teacher. I figured it would be a fun routine job where I could be creative.
I am a strong student and have always wanted to apply to medical school. How does the diagnosis factor in with the interview process for medical school?
Thank you so much! I am on some of the same meds you are on, recently recovered from a suicide attempt. My family practice doctor, after seeing my prescribed depression meds told me all I needed was to “stop stressing”. I went off the meds, joined a yoga class, ate more healthy foods, and started exercising again. Three weeks after I got of the meds, I tried killing myself. Fast forward eight months, I am stable and proud to have an acceptance to med school. I have so many fears of being found out, of having to many bad days to handle–but I’ve learned to trust in my psych (and got a new family practice doc!!) and trust in taking the medications.
Thanks for the article. I started applying to med school in recovery from a bipolar depression. Next year I’ll join the ranks of bipolar med students. I don’t plan to hide it. Openness is the only was to fight stigma.
As a professor of clinical medicine and a nurse/physician teaching in an off shore university of health sciences (both BSN nursing and medicine) I am thrilled to see your profoundly inspiring article. Thank you for the courage to act and speak and I am grateful you have the gift for journalism that has led to such a great article! I am also grateful to your publishers. I wish you well and plan to use your words to guide, educate and inspire my own students! Mary Jo Cannon
You’re a very talented writer – I hope you keep writing. I’ll be entering med school next year, like you, with bipolar disorder. I worry about the stress of the profession, but I guess I’ll see what happens. Glad you made it through, and good luck to you!
thank you for hope, it saved my life
HI I am an M.D. 29 years old, always knew something was weird about me just got diagnosed with bipolar 1, its good to find possitive stories about bipolar most of the things you find in personal experiences arent that great. This is fantastic. I am scared of doing a residency because of my medical condition but we never know where life leads. Nice article.
Thank you for the story you shared. I lost my kids to the state of Texas, then I pushed to find out what was wrong with me, come to find out, I had the signs of bipolar all my life and it runs in my family. I hate having bipolar 1 because it’s ruined my life put my husband is trying to help me. He encourages me to start Pre-Med and that justice will be served when it comes to the kids. I tried to explain to my husband how my brain works and i’m not quite sure he understands. When I look at people I look at their facial features instead of looking at the person, so I get people mixed up a lot because of that.
Emily, thank you so much for posting your experience. I am entering medical school this fall and have a history of depression (3 months free) and bulimia (3 years free) which I am successfully managing right now through weekly therapy and anti-depressants. I have a lot of fear that the depression will take over during medical school in response to the stress and pressure and that I will fail to complete the program due to it. I have a belief that my mental illness makes me weak and possibly unfit to be a doctor but I continue to be drawn to medicine for the right reasons (i believe). You give me hope that it is possible to do this and that it could possibly make me an even better doctor someday because of my first hand experience. I also know that my mental health will have to be a priority, just as much so as school. I have already talked to the counseling center at the school I am attending and made sure that I can get the support from them that I need. I would love to talk to you more about your experience.
Dear author and readers,
I just finished reading this piece and some of the comments, and I think this topic is a big issue that does not get enough attention, or perhaps the wrong type of attention. I am currently working on a research project investigating medical students with mental illnesses: what resources are available to them? what can medical schools do to identify and help these students? What implications does this have on the students’ lives, on their professional performance, ethical considerations? et cetera.
I wondered if any of you would be willing to help me with my research. Perhaps you or someone you know has had a mental illness while in medical school and would be open to an anonymous interview? If so, or if you have anything else to share, please contact me. Any help would be greatly appreciated, and of course, everything would be kept completely anonymous.
Thanks,
Eric
Thank you very much for this article. It gives hope to people like me who want to pursue medicine as a career but are afraid of not being able to make it. You’re an inspiration.